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Old 11-15-2008, 05:34 AM   #1
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New Here .... Where do you start?

Hi There,

I'm new to this board and was hoping to get some guidance for my parents. They are in their mid 80s. My mother has Alzheimer's and my father is definitely showing signs of dimentia - but seems to think he is sharp as a tack.

My mother is now at the point where she can't remember if she has eaten or not, has difficulty remembering to take her medications, etc. My father has not been very helpful in taking care of her and just seems to get angry because she can't remember things. Luckily my mother gave up driving in the past year or two, but my father still drives - but probably needs to give that up soon too.

We really feel it's time for them to be in assisted living - but they have both stated that they do not want to move out of their house. (We had a home health care worker come for a visit to talk about having someone come in several hours a day to help out, and they also expressed concern about their living conditions.) We also think my parents would both be much happier and better taken care of in Assisted Living. Any advice on how to even begin the process of getting them to consider assisted living?

 
Old 11-15-2008, 09:11 AM   #2
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Re: New Here .... Where do you start?

I have some advice, that comes from experience, move them to Assisted Living ASAP!!!

Two years ago I found myself exactly where you are now. My Dad has Vascular Dementia and Mom was his care giver.. until she developed ALZ. She spent a lot of time angry at him for what he could not do and was unable to properly care for herself let alone him. A medication mistake landed Dad in the hospital for 5 days. That was when Mom was finally officially diagnosed.

It was not that my Mom and Dad didn't want to move, they flatly refused to move. My dad built their house 55 years ago. Dispite the fact that life had gone crazy around her Mom swore she was just fine. She had her excuses for everything that happened and none of it was her fault.

So for a year we tried keeping them at home. The daughter split up the weekend and there was somebody there from Friday to Sunday night. A niece stayed with them on Tuesday night. We hired a care giver to stay with them during the day. She was an angel who cooked, cleaned, did laundry, gave them their medication, and anything else they needed.

Dad was supposed to give up driving years ago, but we found out Mom was making him drive because she was uncomfortable driving. The neighbors started telling me horror tales about her driving. Mom broke her arm one evening and we still don't know how. A door window was shattered because they couldn't figure out how to use the key. A battery back up was overloaded when Dad plugged the vacume into it and burned the wall and floor. They just flipped the breakers and never called the fire department. Shall I go on? They were only alone three nights a week.

Mom hated the caregiver... she didn't need that kind of help. Then Mom's driving priviledges were taken away. She went off the deep end and ended up hitting the caregiver and having a full emotional melt down. Ten days later they were moved into AL.... despite their objection. My only regret is that we didn't move them sooner!!

What you have to realize is that they are not capable of making this decision. If a toddler tells you that they want to stay at home alone, do you let them? Or do you do what you know is the best for them. That is exactly what you are dealing with.

Start by visiting AL facilities. We took Mom to let her see what it was like. We only talked about the positive. She wouldn't need to cook any more. There would be no house repairs to deal with. They have happy hour in the afternoon. They have outtings to the beach. They go out to eat several times a week. Blah Blah Blah....nothing negative. We made it sound like a spa. Then we emphazied that they would be closer to two of the daughters. Mom finally agreed to "try" it. It was only temporary. Uh huh... yeah right!!!!! Beyond that we didn't give them a choice. Mom, you have no help now, so find somebody or we have to come up with other alternatives. You can't care for Dad alone. We are doing it for Dad. Of course she couldn't find suitable help in 2 days (their lack of time frame played to our advantage there). So Mom agreed "for Dad's sake".... and she actually liked the benefits of the facility. It's all about how your frame it. If you tell them they are incapable of living alone and have to move they will resist. If you make them believe that it is for the best and for the best of the worst of the two of them... you can sway them your way

Once there..... there will be an adjustment period. Mom went through a rough period when she wanted to go home and made life miserable for everybody. But a year later, Mom and Dad are both relatively happy and much better cared for than they were at home.

I am going to be honest. That was one of the hardest decisions I have ever made. The great ladies here knocked me in the head more time than one to get me moving forward. Finally I hit a wall where I didn't have a choice. Mom's adjustment period was long and frustrating, and even warrented some medication intervention, but not that it is over.... it was all worth it.

So I go back to my advice..... move them NOW!!!

I hate you have to be here but glad you found us. I am sure others will chime in as well. Little deb has just gone though with her dad what you are dealing with. Several have loved ones n AL and NH and others are still trying to maintain at home. A few are through their journey but have been caring enough to stay and help guide us that are on the path behind them. They are phantastic and a wealth of information and understanding. So hang around, drag up a glass of wine, and type often

I will keep you and your parents in my thoughts and prayers.....

Love, deb

 
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Old 11-15-2008, 09:38 AM   #3
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Re: New Here .... Where do you start?

ssdizzy....Sorry your having these problems with your parents. I only have Mom so I cannot relate to having double the problems. I can't imagine.
But deb, the lady who gave such wonderful advice knows exactly what she is talking about. My advice to you is listen to her........NOW.
Moving my Mom to Assisted Living was one of the hardest things I ever did. I cannot tell you what it has meant to our family to have Mom cared for 24 hrs a day. The sooner you start the better. Mom should have been there at least a year before we made the move. It was a very very long year.
Again, Welcome.
Chris

 
Old 11-15-2008, 11:22 AM   #4
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Re: New Here .... Where do you start?

Dizzy..... I forgot to mention. If somebody does not have durable Power of Attorneys and Medical Power of Attorneys/Medical Directives/Living Wills, do it NOW!! Also have somebody else's name put on their checking and savings accounts. Those legal tidbits are absolutely necessary to take care of their financial and medical affairs. Don't wait until they are unable to do it or make a major mistake. It saves going to court and declaring them incompetent or losing their savings.

Even though my Mom hid her inabilities for a long time she did take care of the legal process for us when she first realized something was wrong. She had been through this with her Mom and knew the importance. The day she realized that she had amost turned over $250,000 to a fly by night third rate insurance guy she met at a restaurant... and I had managed to get her money back so it only cost us the capital gains and penalties on her IRA and long term investments.... she turned all of her financial dealings over to me.

If they are paying their own bills or keeping track of their check book please check behind them. Mom, who was an amazing bookkeeper/accountant all of her life couldn't balance her check book, bills were unpaid, items ordered that she refused to pay for because she forgot she ordered them, money was lost, and so much more. Be vigilent and snoopy!!!

But most of all get the legal process in place for somebody to take care of their financial and medical affairs.

Love, deb

 
Old 11-15-2008, 11:50 AM   #5
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Re: New Here .... Where do you start?

I'll chime in with everyone else, it's better to make decisions now, rather than when there is an emergency and you have to make decisions in a crisis. Sooner or later there is going to be a crisis. You could wind up with one of them in the hospital and the staff there telling you they have to go to a nursing home. Then you have to figure this out in about 15 minutes. Not good - a lot of us have been there, done that and can't believe we let the situation go on as long as it did.

They will be incapable of making this decision. Even without ALZ, it's really hard to contemplate moving away from a place you have lived for years. I'd bum out if I had to move now.

You are going to have to lie like a rug, but to them it will look like small baby steps. If you live in a place where the weather is on your side - you can say "We need to move you into this senior center - just for the winter." Their house can need a new heater installed, it has to be painted, there might be something that needs to be renovated. You might be going on a lot of trips for business or something that would keep you from being able to help them as much as they need. Be creative, and since it doesn't have to be true you can really make it good.

Depending on where they live, this might not realistically work but the idea is they are reassured their house will still be right where they left it.

Anyway - talk to them like this is a done deal that they have already accepted. "Remember, you were so worried about who would shovel snow? Well, it's great that now you won't have to worry, I'm so glad you made this decision." You can also build up your Dad that it's the best thing for Mom. She might need to stay in the AF to get her meds adjusted, Dr's orders.

You set up moving day so that they wake up in their house one morning - have everything necessary moved (bedroom set, small amount of kitchen and living room furniture -- enough to make it look like home) and sleep in their bed in the AF that night. Don't give them any time to dwell on this, "We move in the morning, isn't that great! I'm so excited!"

So - once they are in, you remove anything valuable or important to the family from the house and put it in storage. If they are pretty far gone with ALZ and you have a great power of attorney, you might be able to sell the house outright and not even need to mention it again.

If not, you start on - it really isn't safe to leave the house unoccupied, let's rent it to some nice person they know from church, synagogue, neighborhood, whatever. Once they get used to that idea you can move on to the tax advantages of selling the house rather than renting it.

When they are in the AF, they will see someone else preparing their meals, fixing everything and there will be a lot more going on. At their house they may be pretty isolated. There is a good chance they wouldn't want to go back to their house, they just don't want to admit it.

Sooner is better than later. Some of the nicer places have waiting lists, or you might want a specific floor plan for them that might not be available right away. You will also have to take good look at their finances - this isn't going to be cheap.

Good luck - come back often and keep us posted.

 
Old 11-15-2008, 12:51 PM   #6
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Re: New Here .... Where do you start?

Thanks to everyone for your replies. You have confirmed what the little voice in the back of my head has been saying for the past year or so. It really helps to hear it from people who have been through it.

Luckily, we have some of that stuff handled - my brother and sister have been helping my parents pay their bills and balancing their checkbook, and my brother is on the checking account - so I think that's a good thing. They have a living will and power of attorney already established - so we think the legal stuff is basically in place and are trying to make sure.

I have called several Assisted Living facilities in the past week and my sister and I are planning to go check them out next week. I truly believe in my heart that they will be happier and better off in Assisted Living - but when they fight the idea - it makes me question and wonder if it's the right thing. So thanks for the reassurance!

 
Old 11-15-2008, 01:35 PM   #7
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Re: New Here .... Where do you start?

Great advice teapot... I have used so many of those same lines myself. Dizzy, I wore out the "we need to do this for Dad" excuse. He was worse than Mom and, though she didn't want to admit it, she was having difficulty dealing with him. We were doing her a favor!!! In AL there will be people there all day and night to help you with him. Won't that be great. And besides that you won't have to worry about cooking or cleaning or.... She was our resistent one. Dad is just happy where ever he is as long as Mom is with him and he can see his girls. We did assure Mom that the house was still there (for now) and this "temporary" situation has lasted for 14 months now... and is only getting better. She did go through a bad period and wanted to go home but that seems to be over. We actually moved them 2.5 hours from home, to the city where two of my sister's live, so going home is not a quick trip. We have taken Mom back a few times but not Dad since he is happy. Recently I took Mom to her Aunt's birthday party.... and she never ask to go by the house. We were just 2 blocks away, I ask her if there was anything else she wanted to do while she was there, and she said "No, it's time to go home." So we drove back to the AL facility and she was happy to be "home".

Yes, their resistence does make you question what you know. The more they resist the more you question but you have to keep that positive upbeat attitude and throw all the benefits and none of the drawbacks at them. It's a done deal.... "aren't we glad WE made that decision!!"

I don't call it lying to them.... I regard it as going into their reality and doing what is necessary to make them safe, happy, and well cared for. So steel your will, know you are headed in the right direction, and full steam ahead. If they resist to loudly then drop it for that hour and go back to it with more positives. Eventually they will get the hang of it. It is a new concept and we all know that new concepts are slow to register in their foggy brains. The more you talk positively about it, the more receptive they will become.

As teapot said don't wait until it's too late. We had that crisis and only a week to do something. We were so very lucky to find what we did as quickly as we did. It was the LAST unit available at the facility we wanted.... and we had to wait a day before it was available. The previous resident was moved to a nursing home and her belongings cleared out the day before we moved in.

Mom and Dad (to a lesser degree) were able to pick out what they wanted to take with them. Mom had a panel truck load and Dad had a box and his chair. Then we sent them off to sister 4's house for a 48 hours. It was not unusual for them to be at my sister's house and it was "just another visit". Sister 2 and I packed up what they needed and took it to their new home where we were met by the rest of the family. In a few hours they were set up. We delivered them to their new home completely set up with their furniture and belongings. They were off to supper, an activity, and then to bed. I have not looked back!!!

It is good that you have all the legal matters taken care of and are looking to their future by finding a safe happy place for them before it is a crisis. Know we are here on those days that are difficult.

Love, deb

 
Old 11-15-2008, 01:51 PM   #8
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Re: New Here .... Where do you start?

It seems like you you have most of the important things taken care the financial and medical POA. The move to the Assisted Living Facility will prove to be the most challenging and difficult one.
My mom has Dementia/Alz. My Dad is overwhelmed with years of being the caretaker to all my mom's medical conditions. When I saw how overwhelmed and angry my Dad was becoming I decided I would move back into their home to help out. That was four years ago. In the four years I have been there things with mom have continued down the slippery slope. Dad continues to try his hardest to do what he thinks is best, but continues to get angry and overwhelmed by it all. I unfortunately have become just a second person brought into the picture. I have days when I am angry and overwhelmed but I try like hell to not let it get to me. I feel I am there to lighten the load for Dad. I do work full time so I have my OUT I call it. Plus I am avid runner. So those are my OUTS.
My brother and I talked with dad twice on the ALF. Once, for both of them to move into together. DAD would NOT budge on that. I tend to agree he still works and does all kinds of things to the house he practically built so I can't imagining him surviving in an ALF. He would die. He needs to keep active. Working on the house is his OUT!! When mom began to decline this past summer with the dementia we approached the subject a second time with dad. This time for just mom to move into a Nursing Home he said a flat out NO. He would not do that. If it was going to happen then it would happen over his dead body. Unfortunately, some days that is how I see it happening. He will die from taking care of her. Then she will have to go into a nursing home. I truely understand the road you are at. It is going to be one of the hardest things you have ever done. Just read and take all the advice from all the ladies on this board that have been there and done it!!! There advice is worth gold.
I wish you all the best.

Love Pauline

 
Old 11-15-2008, 06:14 PM   #9
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Re: New Here .... Where do you start?

I had 80 year old Mom, with health problems, trying to care for 80 year old dad with ALZ. Obviously not working, but she was resisting any change.

What got through was an intervention by her Dr. I hate to look back and see it had to go that far, but her Dr called me at home to set up a plan for me to bring her to her next appointment. There, the Dr. laid it on the line to her. You can make decisions now, they might not be decisions that you want to make, but you can make them. In a crisis, other people will make decisions for you. He told her there was going to be a crisis - he was 100% sure.

His examples were good - if something happens to her, will my Dad react correctly? Dial 911, call me, get the neighbors? If she goes in the hospital, and the 911 crew doesn't figure out he shouldn't be alone, what happens? If they do figure out he shouldn't be alone - they will call social services and put him somewhere. Either way I'd be relying on the neighbors to track all of this and call me.

If something happens to my Dad, she's going to need to put him in a NH at the end of a hospital stay anyway. Better get organized now, rather than take whatever bed is available from social services when he's ready to leave the hospital.

It seemed more official coming from the Dr., my opinion was easier to brush off with everything is fine, nothing is going to happen.

 
Old 11-15-2008, 06:50 PM   #10
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Re: New Here .... Where do you start?

I agree - better sooner than later. Better now than when one of them burns the house down or neglects their medicine or gives the other an overdose. Better while they are still together than when one of them is alone.

Yes, you have to be the parent as this disease progresses, and you have to make decisions for them, even over their protests.

Glad your siblings are cooperative and not combative!

Good luck

Love,

Martha

 
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