What are our options?

[JM1975]

What is the name of your state? I’m in Indiana. Parents are in Colorado
Mom (86) is very frail and just returned from rehab after a fall with a broken rib and pelvis. Dad (91) is diagnosed with moderate to severe dementia. Dad needs to be in memory care and mom needs to be in assisted living. We (me and 5 siblings) are unable to do anything because mom has medical POA and has not been diagnosed as incapable. She’s physically frail and unable to care for herself, but mentally okay. Mom and dad want to live in their house and be left alone but they cannot adequately take care of each other. I see 2 options: 1) We continue to press mom’s drs to declare her incapable and literally FORCE them out of the house into assisted living /memory care or 2), Leave them alone, check on them when we can and wait for the inevitable catastrophe when one of them is severely injured or dies and can’t get immediate help. They both have long term health insurance and have the means to afford any kind of long term care necessary. Any recommendations would be appreciated.

 

[quincy]

What is the name of your state? I’m in Indiana. Parents are in Colorado
Mom (86) is very frail and just returned from rehab after a fall with a broken rib and pelvis. Dad (91) is diagnosed with moderate to severe dementia. Dad needs to be in memory care and mom needs to be in assisted living. We (me and 5 siblings) are unable to do anything because mom has medical POA and has not been diagnosed as incapable. She’s physically frail and unable to care for herself, but mentally okay. Mom and dad want to live in their house and be left alone but they cannot adequately take care of each other. I see 2 options: 1) We continue to press mom’s drs to declare her incapable and literally FORCE them out of the house into assisted living /memory care or 2), Leave them alone, check on them when we can and wait for the inevitable catastrophe when one of them is severely injured or dies and can’t get immediate help. They both have long term health insurance and have the means to afford any kind of long term care necessary. Any recommendations would be appreciated.

Do your parents have the ability to pay for in-home care?

My family discovered it was cheaper than paying an assisted living facility to have, at the start, visiting care nurses and then, later, live-in care for my grandparents. My grandparents really wanted to remain in their home.

Would this be a workable solution for your parents?

 

[JM1975]

Do your parents have the ability to pay for in-home care?

My family discovered it was cheaper than paying an assisted living facility to have, at the start, visiting care nurses and then, later, live-in care for my grandparents. My grandparents really wanted to remain in their home.

Would this be a workable solution for your parents?

Yes. They can afford in-home care, and that may be the solution. We’ve tried that in the past and my parents think of it as maid service and have not wanted the intrusion. Things are different now and home care may be worth another try.

 

[Taxing Matters]

What is the name of your state? I’m in Indiana. Parents are in Colorado
I see 2 options: 1) We continue to press mom’s drs to declare her incapable and literally FORCE them out of the house into assisted living /memory care

I think that most doctors will not cave to that kind of pressure — at least they shouldn't. A doctor needs to make his/her own professional assessment of a patient and not be pressured into a diagnosis that is really not supported by the evidence. Doctors can lose their license for doing that kind of thing. Your second problem is that even if the doctor were to say she's not mentally competent, that's only part of the battle. You or one of your siblings would need to go to court to seek guardianship over your parents. That would have to be done in Colorado courts. Only then would you and your siblings have the power to force them to do anything. So if you want to go that route, see a Colorado elder law attorney. Bear in mind that if this is the way you go, your mother may well resent you for it.

or 2), Leave them alone, check on them when we can and wait for the inevitable catastrophe when one of them is severely injured or dies and can’t get immediate help.

If your mother meets the criteria for being mentally competent under the law that may be all you can do, other than try to persuade your mother that they need that kind of care, with in home care or moving to assisted living or whatever level of care is appropriate. That kind of persuasion is not easy to do. I had to do that with my grandmother, and it was hard because she really didn't want to give up the home she'd been living in for so many years, nor did she want to give up many of the things she and my grandfather accumulated over the years. Those things had sentimental value; she had significant memories attached to them. So my sister and I took care to reassure her that we would take those things and care for them so she'd not have the fear that they'd just be tossed or just sold off to someone who wouldn't appreciate them. But if you take care to approach the problem looking at it from her point of view and try offering solutions that would address her concerns you may be able to get her to agree.

 

[JM1975]

I think that most doctors will not cave to that kind of pressure — at least they shouldn't. A doctor needs to make his/her own professional assessment of a patient and not be pressured into a diagnosis that is really not supported by the evidence. Doctors can lose their license for doing that kind of thing. Your second problem is that even if the doctor were to say she's not mentally competent, that's only part of the battle. You or one of your siblings would need to go to court to seek guardianship over your parents. That would have to be done in Colorado courts. Only then would you and your siblings have the power to force them to do anything. So if you want to go that route, see a Colorado elder law attorney. Bear in mind that if this is the way you go, your mother may well resent you for it.



If your mother is meets the criteria for being mentally competent under the law that may be all you can do, other than try to persuade your mother that they need that kind of care, with in home care or moving to assisted living or whatever level of care is appropriate. That kind of persuasion is not easy to do. I had to do that with my grandmother, and it was hard because she really didn't want to give up the home she'd been living in for so many years, nor did she want to give up many of the things she and my grandfather accumulated over the years. Those things had sentimental value; she had significant memories attached to them. So my sister and I took care to reassure her that we would take those things and care for them so she'd not have the fear that they'd just be tossed or just sold off to someone who wouldn't appreciate them. But if you take care to approach the problem looking at it from her point of view and try offering solutions that would address her concerns you may be able to get her to agree.

Thank you for this thoughtful advice.

 

[stealth2]

Yes. They can afford in-home care, and that may be the solution. We’ve tried that in the past and my parents think of it as maid service and have not wanted the intrusion. Things are different now and home care may be worth another try.

There are different levels of help that can be used. Perhaps look into what is available and what can be cobbled together to meet their needs. Do they *need* actual health care all day, every day or would a weekly visit by a nurse take care of those issues? For personal care - look into an aide. For other care - cleaning, laundry, meal prep - look into those sorts of services. Check with their doctor wrt what each actually need in terms of nursing/personal care, and speak with their insurance (don't forget their supplemental provider) to see what may be covered - they may also have a social worker who can steer you to possible services. Their community/county likely has a Senior Services department that can guide you. If your Dad (or Mom) is a vet, the VA can offer assistance.

Would your parents (Mom, really - Dad is likely past the point of being able to use it himself) accept some type of "monitoring" device, be it Life Alert, a monitored video system, etc.? Alarms on the outer doors (my Mom - also w/dementia - has taken it into her head to just (try) to walk out)? If you present it properly, Mom might be amenable.

Good luck - it isn't easy.

 

[JM1975]

There are different levels of help that can be used. Perhaps look into what is available and what can be cobbled together to meet their needs. Do they *need* actual health care all day, every day or would a weekly visit by a nurse take care of those issues? For personal care - look into an aide. For other care - cleaning, laundry, meal prep - look into those sorts of services. Check with their doctor wrt what each actually need in terms of nursing/personal care, and speak with their insurance (don't forget their supplemental provider) to see what may be covered - they may also have a social worker who can steer you to possible services. Their community/county likely has a Senior Services department that can guide you. If your Dad (or Mom) is a vet, the VA can offer assistance.

Would your parents (Mom, really - Dad is likely past the point of being able to use it himself) accept some type of "monitoring" device, be it Life Alert, a monitored video system, etc.? Alarms on the outer doors (my Mom - also w/dementia - has taken it into her head to just (try) to walk out)? If you present it properly, Mom might be amenable.

Good luck - it isn't easy.

Thank you for this good advise. We are working closely with the doctors and looking into all levels of in-home care. And we’re setting up a life alert system.

 

[stealth2]

Thank you for this good advise. We are working closely with the doctors and looking into all levels of in-home care. And we’re setting up a life alert system.

Something which just occurred to me.... I had a period of time when both Mom and Dad needed PT/OT, a (weekly) nurse visit, and an aide for personal care (not really, as they lived w/me, but insurance provided it, so I accepted the help). To *me* it made sense to have one nurse to do the medical stuff for both in one visit, one aide for the personal care in one visit, same w/PT/OT. Insurance insisted on separate nurses, aides, PT/OT for each on separate days. A waste of resources, IMO. But... in your situation? The extra regular pairs of eyes may serve well.

ETA: The aides that came were also willing to help each do their daily exercises (if there was time), so I tried to alternate those days w/the PT/OT visits. I could also do the exercises for one while the PT/was here for the other (LOL same exercises!). See how that can be arranged. My folks were much more amenable to doing the exercises under those conditions than on their own/with just me. Especially important for your Mom - emphasize how vital getting her abilities/strength back are so she can continue helping Dad as much as possible.

 

[quincy]

In addition to all that stealth has suggested, we lined up “Meals on Wheels” for lunches for my grandparents. This not only ensured they got at least one hot meal a day, this also was (as stealth put it) “another pair of eyes” that checked on them on a regular basis.

 

[stealth2]

In addition to all that stealth has suggested, we lined up “Meals on Wheels” for lunches for my grandparents. This not only ensured they got at least one hot meal a day, this also was (as stealth put it) “another pair of eyes” that checked on them on a regular basis.

Does Meals On Wheels have an income threshold? @JM1975 's parents may not qualify if they can afford in-home care... But worth looking into. I stopped looking when I realized that Mom wouldn't qualify due to my presence.

 

[quincy]

Does Meals On Wheels have an income threshold? @JM1975 's parents may not qualify if they can afford in-home care... But worth looking into. I stopped looking when I realized that Mom wouldn't qualify due to my presence.

Home bound seniors over 60 are eligible. I believe my grandparents paid for the service but payment is not, to my knowledge, necessary for anyone.

Here is a link to Meals on Wheels that covers counties in the metro-Denver area of Colorado:

https://www.voacolorado.org/gethelp-denvermetro-foodnutrition-mow