Re: resistance to bringing the appropriate of caretaking help in
Given how hard changes can be, I found it best to focus on the most immediate/impactful way to address needs. With hiring caregivers, I told my folks that since it’s a new scenario and it is easier to reduce hours if excessive than add more, it makes sense to start with more time and assess how it’s going together. Another plus: you may meet more ‘helpers’ allowing you see who clicks best with your parents. I found that while full time care was a hard sell initially, the caregivers themselves were usually very good at building connections, making the more abstract concerns moot.
Best to everyone who’s supporting family members through these challenges.
It’s all in how it’s presented sometimes. My mother didn’t want a caregiver. At all. But we lived a distance away. We hired a fabulous Russian woman who we told my mom was there to take her to lunch, and do things like the laundry, and take mom grocery shopping. They became fast friends quickly, and mom let the woman do more and more. She never did personal care thibgs like bathing, but my mom really didn’t need that anyway.
It gave us great peace of mind to know someone was with my mom three days a week.
Thank you for this. I actually signed up for a free account so I could read the linked article about a woman who planned an elaborate ruse to get her elderly parents out of their home - worth the read!
My own father (77) wants to move closer to civilization. My mom(77) won’t even have a discussion. He is lonely, eating poorly because she refuses to cook and he is doing all of the household chores. She has serious short term memory issues ( was in Florida January and February of this year and remembers nothing) not related to dementia, but there is no diagnosis. I’ve tried to talk with her but she gets angry and says she’s not moving - doesn’t care what he wants to do. I will say that my dad has always let her have her way so her response in unsurprising.
He has toured a few retirement communities alone. Loves them. This is going to be a long journey.
Talked to a neighbor today who is 92. She is doing great for that age, still lives independently in her own apartment (not in any kind of CCR community). She recently went to the motor vehicle agency to renew her license. The woman at the counter told her, I was ready to pull your license, but talking to you I decided you are fine. The 92 year old told her she only drives locally during the day to places she has been before (which is true).
This does not make me happy. The motor vehicle agency needed to see her behind the wheel. I have, they should have taken away her license.
Some states require more testing with license renewal - both vision and driving with an examiner. My 89 YO BIL hasn’t driven for almost 4 years and is now getting a picture ID in replacement of a DL - my sister has done all the driving.
My MIL needed to give up driving in her upper 80’s.
It does depend on the individual, but reaction time, even with driving close to home distances at non-busy times is a concern. What can be problematic are other drivers who don’t want to be behind someone driving slow (well below the speed limit). Sometimes I think there are some senior drivers who are extra-nervous because they know their abilities are slipping - and those individuals do need to recognize that they should not be renewing their DL.
My 94 year old cousin lives independently. However she has bad macular degeneration. She was required to pass a vision test at the dmv before renewing her license. The test was just to read a vision chart. She couldn’t. So she winged it, and made up the letters. The clerk passed her.
FWIW, my H’s aunt received a letter that she was randomly selected to retake her driving test and vision screen next month to renew her license (she’s almost 89). Now she’s telling us that the letter was sent in error and there is no record of that at the DMV. We called BS on that as we saw the letter from her state and looked up the rules. Unless we see the renewed license with our own eyes, we are operating under the assumption that she is making stuff up so she can continue driving.
As I’ve been navigating this, and been following this and the romance thread lately, I keep focusing on the same common theme/question:
Why are we/families enabling elders who are suffering from some form of dementia (or brain impairment), to stay in situations or make decisions that endanger themselves and/or their spouses? Where is the dementia line, where there is an obligation to make every effort to stop the car crash? And what is the best way to do it?
Obviously, everyone has a different answer. I’m definitely in the ‘we don’t let toddlers do dangerous things, why are we looking the other way when our elders do?’ camp. My toddlers were definitely easier to deal with than my parent, so not sure why I think they are so similar. (Oh yeah, it is the frequent lack of rationality and inability to understand consequences.)
My father renewed his license at age 90. I think it required eye test but not driving test. His driving seemed fine around town when I was with him, but for trips he deferred to his much youngr wife. A few years later he stopped driving but change is hard… he kept the beloved convertible a few years more. A sweet neighbor sometimes took him out in that car for errands or ice cream run.
Not doubting that she renewed the license. Wondering about the conversation with the clerk. Trying to convince others that the clerk thought she is fine driving. Just feels like a reoccurring story I keep hearing in my real life.
For me personally, my mom had ALZ but my dad was cognitively fine. And he was the decision maker. Took us a long time to get him to agree to extra help and eventually memory care. But I will say, what put him over the edge and finally made the decision is when my H made a job change and we moved. I don’t think he appreciated how much extra work I was doing and how much of a safety net I was for them, even with their caregivers. Once he was on his own with her, he made the decision quickly that she needed MC.
So, I agree that I definitely enabled and should have pulled back much sooner. It was hard though when we were in the same town to not help.
We are in a harder situation right now with H’s elderly aunt who lives alone, never married, never had children and lives out of state from any of us. She’s not in a safe living environment but she’s alert and oriented x3, fully able to do her ADLs, and there isn’t a court anywhere that would say she doesn’t have capacity to make her own decisions. And she’s not a parent so we don’t really have any legal sway either. Family are doing their best to try to get her to agree to moving to a CCRC. H is visiting sites and is hoping to bring her for tours the week after next. At this point, we need her buy in and are praying she likes one of the places. But, bad decision making isn’t the same as not having capacity to make those decisions.
My dad is an enabler - he’s the first to own it. I’ve told him that he has to be firm and make decisions - it isn’t up to me. He keeps thinking he has time - he doesn’t. I can be very direct and blunt - my mom cries every time I bring up these difficult subjects. It may sound harsh, but at this point I am unmoved by her tears. I explain that right now she has a lot of great choices and that these choices can and eventually will disappear.
Because I was a parent legally responsible for my minor child. I have no legal authority or agency over my elderly parents unless they are legally declared incompetent. They have not been, so they are free to make their own decisions. I can advise if asked, but that’s it, and I don’t give another thought to any of their behavior or decisions, unwise as they may be.
I think if people are cognitively sound/fully oriented they have to be allowed to make their own decisions, even bad ones (driving being the one exception as they can hurt others, not just themselves). For me the difficult area is when they are cognitively slipping but still alert and aware in many ways. My mom is there - desperately wants to come home, doesn’t like assisted living. If she were cognitively all there and we could have a rational discussion about money (she can live in assisted living virtually forever as she has long term care insurance and her social security check covers her 20%; if she came home the cost of caregivers would put her out of money in 5-7 years even if insurance agreed to keep paying 80% which I’m not sure they would as it more than doubles their cost each month - at 89 she’s unlikely to outlive her money but does she want to take the chance) and other considerations - assisted living would never take her back if she left so if something happens she is looking at nursing home - but the nuances of those conversations are a bit beyond her right now. She’ll tell me she can’t come home because she doesn’t have enough money, but the nuance of that is way beyond her. I want her to buy into the decision but the reality is I have to make it for her. And I have my own biases which are really hard to separate out - it’s way easier for me if she’s in assisted living (I’m the local child so coordinating care would fall on me if she came home) and even ickier it’s financially beneficial for me if she stays in AL (not only might I inherit a little bit, which I can use, but I happen to own her home and what I charged her in rent is way less than I can get on the open market - and the rental decision has to be made soon). I really hate making these decisions! My sibling will back me fortunately but isn’t willing to help.
Why doesn’t she like assisted living? Are there ways to help her integrate? Is there a different facility she’d like better/would better meet her needs? Remind yourself of the benefits and services she is getting there. Any socialization? Improved nutrition? At least she understands at some level that she can’t come home. I don’t think you need to have second thoughts about having her in the ‘easier’ option, I’m sure it’s hard enough itself with visits, any coordinating/taking appointments, getting supplies, etc. If she were in her rational mind, don’t you think she would want the option that preserved her assets, and was less of a daily burden to you?
@Leigh22 It sounds like your dad is overwhelmed by the process, bucking a lifetime of acquiescence, and your mom’s emotions/objections. Can you help him re-visit and evaluate his top choices and come to a decision? Time to break out the college choice spreadsheets senior living edition?
@ChoatieMom I absolutely don’t have your ability to disengage. I love my parent, want her to be safe and as healthy as possible, and eke out some level of social engagement for quality of life. She’s a lonely widow, having some cognitive decline, and while I have no legal authority, I certainly feel a moral and emotional obligation.
Driving or not, AL or not, these are the most difficult intersections of responsibility, agency, compassion, love and cognition. Everyone’s cocktail of issues will be different so these articles that seem to encourage a magic conversation make my particular head ache. If talking with my FIL would make him see reason, wouldn’t that be nice? Ain’t happening.
Without legal ability and geographic proximity, it is impossible to force change that an elder refuses. This thread is entirely full of every possible situation where a caregiver knows what would be best, and cannot get the elder to agree. It’s awful.
Because what I have learned here is that when we are cognitively able, we don’t want to borrow trouble or guess at a bad future. When we are completely unable, somebody else gets to decide. But in between? Impossible days one after another.
Sending support to all who labor in the field of caregiving. Not for the faint of heart, at all.