<p>Chuckle- We use Boost and Ensure type drinks for our elderly gals when they aren’t interested in eating. We also get milkshakes for them.</p>
<p>We have noticed the same thing with mom’s appetite. Each time we visit we bring a case of Ensure, since it is very expensive and we suspect mom is not drinking it regularly as she should. She has lost 20 pounds in two years, but when I brought this up at the last doctor’s visit he said her weight is fine. One thing I have noticed is that she tends to eat a bit more when we go out to a restaurant. Either the food tastes better, or the social aspect helps with the appetite. Otherwise, it is another thing we would like the care manager to address by perhaps having someone come cook several times per week.</p>
<p>^^ we’ve tried both Ensure, Boost, and the non milkshake drink and mom doesn’t like any of them. She says they’re ‘too sweet’. She has diabetes, can’t tolerate spicy food, or acidic foods and to make things worse is very picky. Although she does like to eat out, so I’ll make an effort once or twice a week to stop at ihop or the Mexican food place for a chimichanga.</p>
<p>She’s on the waiting list for the local ‘meals on wheels’ type thing, but it’ll take 6 months to move up on the list to see if she even qualifies for food delivery. </p>
<p>This is the only thing that really drives me and my hubby crazy.</p>
<p>While it may not be exactly on point for this dicussion, a book that helped us dealing with a lot of issues with aging parents was:
<a href=“http://www.amazon.com/Coping-With-Difficult-Older-Parent/dp/038079750X/ref=sr_1_1?ie=UTF8&qid=1343057457&sr=8-1&keywords=dealing+difficult+aging[/url]”>http://www.amazon.com/Coping-With-Difficult-Older-Parent/dp/038079750X/ref=sr_1_1?ie=UTF8&qid=1343057457&sr=8-1&keywords=dealing+difficult+aging</a></p>
<p>ChuckleDoodle, is your mom on insulin or any kind of diabetes medication? While I realize that getting some calories into her may be your over-riding concern right now, a diabetic–even one who can “cover” it with insulin–should not be eating the very carby foods mentioned so far. Are there any types of foods that you know she definitely likes? I’d be happy to share some diabetic-friendly dishes based on them. Establishing good blood glucose control usually makes diabetics feel and function much better.</p>
<p>Maybe we need an aging-=parent-exchange-network. I would be happy to look in on someone’s aging parents in my town periodically if they would do the same for mine (5 hours away)!</p>
<p>It might help to meet with a dietician. I’ve read that B vitamin supplements can help to increase appetite. I have to take a lot of supplements and have trained myself to have them with some yogurt. It makes a big difference in absorption.</p>
<p>ATINTM- and if we visit each other’s parents none of us will be so annoyed by the things that have annoyed us since childhood, could be a win-win</p>
<p>I don’t want to start sounding like a broken record on this forum, but helping families in your situation is what I do for a living when I am not taking a break and reading CC threads. Remember that planning for our aging parents and other relatives is not only about the immediate needs, but playing out the “what if’s” as the person continues to age. As an elder law attorney, it is my job to help educate families about the many care options available, to help them identify which option best meets their loved ones’ needs now, what kinds of care might be needed in the future, and equally important: how to pay for it all. It is critically important to remember that things done now with an elder’s funds can significantly impact their ability to access benefit programs now and down the line. We have many tools and resources available but the more in advance you begin to plan, the more options there will be (and the less likely it is that something will get badly messed up). I encourage you – and everyone else beginning the long term care journey – to reach out to a local elder law attorney to help guide you and your loved ones on the journey. We all have large networks of health care and financial professionals (including care managers), and working together we can help maximize the quality of your loved ones’ lives (and yours as caregivers). You can find an elder law attorney by referrals through your loved ones local senior center, or by searching on the website of NAELA (National Academy of Elder Law Attorneys) naela.org. Good luck on your journey.</p>
<p>My mom was in her own home being cared for by my dad until she died unexpectedly. She had Parkinsons and my dad was just starting to have some serious difficulties caring for her. He also had a home aid who did some cleaning and errands for him. But after my mother died, my brother moved in with my dad. My dad then had a stroke and broke his hip and has been in declining health since. My brother still lives with him and and now is ripping him off financially. I tried to intervene but have been disowned by the family - especially by my dad who loves being “needed” and aparently I am the only one who doesn’t need him. So he has cut off all contact with me and more. It’s really a lose-lose situation. I just hope his money lasts long enough to get him to the end of his life and then my brother and my two sisters who live off of him can finally find out what it means to be a real adult. </p>
<p>MJS - I am hoping to go to law school soon and was thinking about going into estate planning - it sounds like what you do is even more than that. I was inspired to read your post, thank you!</p>
<p>PhotoOp</p>
<p>We just had this exact conversation in our family last week. I"m always the go to person in our family for caregiving since I have chosen to forego a paycheck and career to be at home for my family instead of working outside the home. I cannot tell you how many times I’ve heard a relative say they’ll just call me since I don’t have anything to do during the day. Uh, wow…Really? Have you noticed the three children I’m trying to raise? </p>
<p>Unfortunately, I think many families have these types within them who are constantly waiting with their hands out, but never their hands up to volunteer for the caregiving, errands, or any of the often unpleasant tasks that must be handled by someone. While I don’t mind doing my share, I do begrudge the idea of others resting upon their laurels on the other end of a phone and making excuses as to why they can’t help…all the while taking financial and emotional advantage of an elderly relative. </p>
<p>I’ve been spending time in the ICU with my mom while her husband is critically ill. The doctor came in after midnight to discuss signing a DNR. Since my parents are divorced and remarried I wouldn’t think of advising her on what to do because this is not my father. I nearly choked when I heard one of her step children and a son they have together give her permission to spend what they consider “their inheritance” to hire help to care for him if he survives. Really? I was appalled since there is already the distinct possibility my mom will outlive the financial means they currently have. </p>
<p>Caregiving can be a thankless job. I just have to hope I’m teaching my children what it means to be a responsible adult and a good person by example and realize that I cannot change the actions or outcomes of others…Lord knows I’ve tried.:)</p>
<p>^^ consolation and ek4^^
Mom eats veggies and protein mostly fish, geen beans, chicken, zuchini, squash. But its hard to make sure she eats enough when she’ll eat 2-3 bites of each and then declare she’s ’ full’. She has a Dr appt Friday so I’ll have my hubby ask about the dietician and b supplement. Consolation-- if you have some recipe ideas I’d be willing to give it a shot, just pm me. Mom is only on metformin for diabetes, but also takes meds for hypothyroidism, lupus, rosacea, high blood pressure, and calcium for bones. Oh- and dilaudid for the constant back, hip pain. To top it off, she has a narrow passageway and has an extremely hard time swallowing pills.</p>
<p>Hi there~Well, that’s definitely a hard decision to have to make when it’s your parents. And, as has been mentioned, it’s difficult to say for sure what the right choice is here, since everyone’s different and has their own set of needs and preferences. But, have you thought of talking to your mom’s doctor and getting some suggestions from him/her? I’m sure they’ve advised other adult children in your shoes and might have some counsel or referrals to offer you. </p>
<p>Well, I hope you’re able to find the best solution for your mom. Praying for you!</p>
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<p>Just watch out in advance for that transition, as their needs will (by definition) change a lot. Our contract did not tie our Mom to the campus she picked out for herself. We were able to find a different kind of Assisted Living – one we never could have imagined when she first entered the CCRC as an Independent resident.</p>
<p>As it turned out there were two levels within Assisted Living. By the time she needed to leave Independent, she had leapfrogged over their main floor Level One Assisted (charming single or double rooms surrounding a green courtyard) to their upstairs Level Two Assisted (a clinical Memory Care wing with only tiny doubles looking exactly like any hospital ward). </p>
<p>The staff/patient ratio at Level One Assisted was insufficient to keep her safe, so she had to be assigned to Level Two Assisted. While technically she could take an elevator downstairs, in actual fact - due to the dementia-- she couldn’t learn to navigate between the two floors, even after some weeks of trying. She felt really trapped upstairs.</p>
<p>At that point, we were able to disengage from the entire CCRC campus. We found a different Assisted Living facility in town that serves 35 not 200 people, specializes in memory care only, and designs every meal, social activity and staff training around that one issue. Although she must share a room, it is twice as big as the previous Level Two Assisted Care, and there’s a divider between the two residents such that it feels like a single. </p>
<p>Had she been able to go into Level One at the first place for a while, that would have been fine. Since she couldn’t, it was a relief to be able to exit the CCRC for a different kind of place.</p>
<p>Note: She spent most of her adult working life telling us she NEVER wanted to live with any of her children. So she made that part easy on us.</p>
<p>There are varying levels of options in different areas of the country. I have had friends who had long-term assistance. One had live-in and the other had many hours/day. I have also had a relative & also a friend who has had someone go to adult day care. If you choose the services, providers and/or facility carefully, it can be a great match and can be quite affordable.</p>
<p>As was said, be sure to ask A LOT of questions, so you know what IS and IS NOT provided and what would happens if/when funds are fully depleted. These are important things to figure out as you travel down this road that many are also traversing. The local state Executive Office on Aging in your mom’s area may have additional resources available to your mom. Good luck–you’re not alone. Those of us with parents who are still alive are on this journey or will be at some point in the near future.</p>
<p>So true, HImom. These periodic CC threads really help me, just knowing that I’m not alone.</p>
<p>OP, there’s so much wisdom here; I’ll just toss in a few thoughts.</p>
<p>Someone said upthread that changes can happen suddenly, and that’s really true. I’d always assumed that there would be a gradual decline, and we’d know ahead of time when it was time to start planning for the next stage. Not true! Their lives are more like plateaus – they go along at a certain level for a while – and cliffs – there’s a crisis. So far, mine have always been hoisted out of the gorge, but the next plateau is always lower than the previous one. And the stretches between cliffs get shorter. </p>
<p>There’s a level of care that I just recently found out about, called Board and Care. This is Assisted Living, but instead of a large facility, it’s provided in a private-home-sized house. Much less expensive than Assisted Living, but also far fewer staff and residents to interact with. For my introverted father, it might work, but my gregarious mother would die of boredom.</p>
<p>My parents’ Assisted Living has a Memory Care wing, should they ever get so far into dementia that they can no longer stay in their apartment. It would obviously be easier on them to move downstairs than to a brand new place. Something to think about.</p>
<p>If you’re looking around for an Independent Living or Assisted Living facility, go yourself to look at a whole bunch of them (I think we looked at 9). You begin to get a feel for what to look for. Then you can take your mom to see the finalists. I wouldn’t take her to more than two; it will only confuse the issue.</p>
<p>My parents’ AL has a guest apartment, often used for visiting relatives, but also available to a prospective resident who wants to “test drive” the place. Ask each of your finalists if they have this.</p>
<p>It’s pricey, but I am a HUGE fan of Assisted Living, assuming you find a good place. In addition to all the help they give on a daily basis, it’s a wonderful lively, life-filled place for seniors to be. I think that many seniors get isolated; I know mine were, and isolation can lead to depression. It’s impossible to be isolated at AL. They see their peers at least three times a day at meals, and there are activities all day every day (I think their motto is “Any excuse for a party”). The residents also see the fresh young faces of the staff all day long – the servers in the dining room, the receptionist in the lobby, the aides who bring them their meds or help them get dressed. All that human contact is like a tonic for them.</p>
<p>I cannot tell you what peace of mind it gives me, knowing that they are being looked after, and help is immediately available for any kind of trouble they may get into.</p>
<p>(Too late to edit the above.) </p>
<p>Skilled nursing is a whole different beast than the other options. For starters, I believe it requires a referral by a doctor (someone correct me if I’m wrong). But also, the ones I’ve been in are really depressing. Not their fault – they’re basically medical facilities, one level below hospitals, and they’re filled with the sickest and oldest people. Personally, I would not want to put my seniors in skilled nursing unless there were no other choice.</p>
<p>LasMa - I highly recommend that anyone who is considering a CCRC check out ALL levels of care on a campus. Marketing will show you the apartments, the amenities, the social opportunities - but they may not suggest you tour AL or skilled nursing. </p>
<p>Brethren Village in Lancaster County has a beautiful skilled nursing facility. It is not depressing. They have gone to great lengths to make it appealing. I have had my issues with BV, but their skilled nursing is outstanding.</p>
<p>I wasn’t clear – my recommendations are based someone already having decided on a free-standing AL, which is the type of facility my parents are in. I have no experience with CCRCs. And I’m glad to hear that there are cheerful skilled nursing facilities.</p>
<p>Lasma: I work on a skilled nursing floor. It is always short term as medicare/medicaid will only pay for 100 skilled days per year (rolling). You are right in that it is “1 step” down from the hospital when you are talking about patients admitted from the hospital.</p>
<p>To qualify for skilled nursing care you must have a 3 day hospital stay. Pts. receiving skilled nursing will also be receiving physical/occupational/speech therapy - at least one but many times all those therapies. They must be assessed frequently for appropriateness to stay on the unit. Again, it is short term only. On my unit I would say the average stay is around 4 -6 weeks. I do not take care of long term residents. Occasionally, on my unit, we take care of hospice patients but they are not receiving any therapies and sometimes are just respite to allow their families to have a break. </p>
<p>The average age of skilled pts is younger than long term care residents as many skilled patients just need a little therapy to get stronger before they can return home. I frequently work with people that have had knee/hip replacements or a major surgery of some kind that requires further care-IV therapy, wound care etc… Skilled residents receive the highest reimbursement rates because they are receiving more intensive therapies and treatments.</p>
<p>The unit I work on is very pretty, all private rooms and we never take care of more than 14 residents at a time. You will find this to be the case in many places. Our residents receive a lot more individual attention than long term care residents and most of the time direct care from a Registered Nurse or a Licensed Practical Nurse closely supervised by the RN. Long term care residents are most frequently cared for by LPN’s.</p>
<p>Skilled nursing isn’t “depressing” nor is it long term. I love my floor because I get to see people progress and go home. The OP’s aging parent is not a candidate for skilled nursin services. (unless she developed an acute illness/condition that required at least a 3 day hospital stay) Depending upon her level of need may be appropriate for long term (not skilled) care in a nursing facility.</p>
<p>Just wanted to clarify. :)</p>