Any tips on having conversation about moving to ALF?
Mom lives alone in home and says nighttime care is too expensive. Mom wants to stay in her home with her dog and has been unwilling to have "the conversation" about considering moving to ALF and selling her house. Siblings feel she can make decisions for herself. She has dementia but is not declared of incapacity. She is depressed and lonely most of the time, and says she is ready to die. She allowed me to set up hired care givers to come to fix simple meals or take her to the doctor. I live 8 hours away, visit every month and am POA. She DOES have the money but does not want to spend it on her own care. She thinks it would be hiring someone to sleep in her house and is not rationale about safety concerns. Siblings feel that ALF is out of the question because Mom doesn't want that.
We did just that. One sibling says his kids are on their own and he can't control if his daughters take Grandma shopping for groceries for her and new boots for themselves ($150/pair). And he at first denied taking any money, then said exactly as you say "Mom likes to give more money to one of her children/grandchildren and you are just jealous." Now that sibling is in denial again and acting like other problems are of more concern; that I didn't thank him for arranging the pool service to clean mom's pool when it is so he can have mom pay for his pool cleaning service!
How miserable can you be to pray upon your mother to pay for cleaning your crap!
I'll tell you what though. What you can do is add up, and keep records, and perhaps - using neutral terms and keeping your face as calm as possible - get them together and confront them with the accumulated sums they've taken from her.
Again, though: if their comeback is that she wanted to give them the money, and doing so makes her happy, and who are they to refuse? - then I don't know the answer.
I have financial POA. My brother who lives very close has medical POA but is afraid to execute any authority. My mother was determined by psychiatrist within 6 months to still have the capacity to make her own decisions with assistance. Like, what the h*ll does that mean? They don't want to make waves is my best guess!
So, little happens without me other than my mother giving money to my siblings and their children. I cannot stop it because there is no evidence. If I install cameras the money gifting would happen under a table in another room. I am not confident that I could watch 24/7 in order to catch a thief. I have limited resources and time; I am primary care giver for my adult son with disability. I think you are right that it is a waiting game and maybe I am impatient with all the needs from others.On the other hand, I am really ready to slam the phone down and just move her myself and take over her finances. But, I do not have medical POA so how would that play out?
This is really helpful to hear others with similar and different situations. There is no right answer without a crystal ball. Keep your thoughts coming friends; I appreciate it all.
That might be something else to consider, but until it has been Rhonda's mother calls the shots.
"any emergency situation such as fire or theft she would not be able to manage due to dementia and physical frailty, as well she has had a couple of hallucinations (sun downing) and opened the front door for strangers she imagined."
I think a nicely-turned handrail can lend a certain chic to a hallway, myself...
The ladies that do the shopping for her are paid employees...they do what they are paid to do or you fire them and hire people that will.
Either your mother is stashing the cash or giving it to someone.
Cameras are around $1625 for the entire system and you can easily install them in the home.
I would immediately if we had outside caregivers.
As far as adult siblings...same thing. Either they do what you want or they don't come around. Simple.
My eldest son was living with my mother at one time and I had him legally evicted because he was using her money and food my brother was buying for her...for himself.
If she refuses the safety issues...then you implement them anyway.
If you've actually tried to offer her choices and you hit a brick wall..then you make the decisions.
Ask yourself this...what can you live with...your mother being mad because you implemented safety procedures or her falling down the stairs, breaking her neck, and either being in a wheelchair or dying?
My brother and I take care of my mom. I go every morning and Saturday evenings...my brother on Wednesday afternoon and Sunday. Our sister (older than me)...came down 3 years ago for 2 weeks...that was the first time in about 10 years. haven't seen her since. And we don't dwell on it. Life is too short and i prefer enjoying it.
My sister is missing out...I love taking care of my mom...even as crazy as it gets at times...and it does get crazy...she used to be quite hateful and physically abusive...I just practiced love & patience and prayed it would end and it did...like all the phases she goes through...it's a chess game...mom makes a move...we make a move.
But she took care and raised me...how could I not do the same for her?
Awesome thoughts and focus. And yeah Martha627 I really love your story; right on!
The bank has contacted APS months ago due to large sums of money being taken from ATM when Mom uses credit card and checks almost exclusively. Not sure why she has to have around $1200 a month in cash...
My mother owns a car for other people to drive her places, she does not drive.
I like all the healthy food choices, but I can't from my home manage such details with the ladies who mostly do the shopping for her.
She has refused anything that would improve safety or mobility near the stairwell, the toilet, the front door, etc These were all offered as ideas and she chose to decline them all. I want her to have options but it is such a weight for me.
Maybe the better question is how to get along with adult siblings who do not see the degree of disability or have secondary gains ($$$) and would rather let it go than invest the time.
Go back and re-read what I wrote. I'm talking about visiting...staying with her for short periods of time...this type of interaction helps an elderly person realize that change can be a positive experience...similar to what a parent does with a child experiencing separation anxiety.
Then the conversation can go like this:
"Mom...I love you so much...and I thank you for everything you've taught me and showed me how to do...I want you to know that I worry about you. I am so far away and wish that you were closer to me so that we could see each other more often. Wouldn't it be great if we could see each other every day? I sure would love that."
And tell her all the reasons you would love her to be closer...and all the things she could help you with. "Mom...you were always such a great cook...it would be so wonderful to have you near me and you could teach me all your recipes."
Use anything positive to build her self esteem and let her see what a great value she still is to you.
"Mom...I'm such a lousy house keeper...you were always so great at it...would you come and stay with me and show me how to get organized and how to clean my house?"
These are just examples...you can use your own. Maybe she was a great artist..."Mom can you come and help me decorate or pick out art?"
Once she sees that you value her and don't want to just shove her away somewhere...she will be more receptive to your conversation...
There comes a time when an elderly person such as your Mom cannot refuse options... especially when those options are safe alternatives for her to stay in her home or move to an ALF. Is there a senior center that she could attend during the day? My Mom attends one...I drive down every morning and fix her breakfast...her shower...her hair...and off she goes. Before having the conversation with her...do this.
First...make a list of your concerns and safety issues. Then jot down any solutions you may think of. Right off (for me)...I would place a door on the open stairwell...if your Mom's bedroom is on the second floor and this stairwell leads to her room...move her bedroom downstairs and get a secure safety gate for this stairwell.
For the toilet...you can get a raised seat with armrests that slides over the toilet...non-slip and it helps Mom so that she doesn't have to sit so low.
Falling out of bed...there are side rails that they make for toddler beds...Google them...not too expensive.
The monitor is there for fire and break-ins...not sure what you mean about theft...caregivers?...a break-in?? Why would she still be driving if she has dementia? If you know she has dementia and allow her to drive...you will be responsible for lawsuits. Disconnect the battery...try as she may...the car won't start.
Second...clear out the cabinets and place items that Mom likes to have...such a cereals...snacks...whatever it may be...on the shelves closest to her reach. Do this with the refrigerator as well. And place those items in containers that are easy for your Mom to use.
Third...there are several gadgets that help people with arthritis to open cans and jars.
Fourth...jot down the days and times the caregivers are at your Mom's home and the responsibilities of each caregiver.
Fifth...take your Mom shopping and allow her to choose items that would be easy for her to handle. Take her food shopping as well for the same reason.
Once you have done all these things with love and patience...and your Mom sees that you care deeply for her well-being...it will be easier to have the conversation.
Always...I cannot stress this enough...always give your Mom choices. I can just tell you from experience that the reason your Mom is so depressed is because she knows she is losing her independence and she feels worthless. Imagine how you would feel. What if you said "Hey Mom...how would you like to come and spend a few days with me? It would give you a break from here and I sure would love the company." I don't know your living situation...but giver her your bed...make it like a resort for her.
What types of things did your Mom like to do? Bowling...sewing?...Knitting?...Reading?...It's easier to have a conversation when someone is engaged in an activity.
I would get the monitor anyway... the police and firefighters can get there way faster than you can...if need be. We have a camera aimed at the front door and the back door...we know who comes and goes and for how long.
Get an account with PublicData.om and you can do your own background checks on anyone at any time. Run license plates...arrest records...anything...and you can check all states.
I'll share a funny story with you. I went to research ALF's...and one of the workers decided that my Mom was not in a safe environment being at home and called Adult Protective Services on me.
When I met with the case worker...she thought she was catching me off guard by telling me she had already visited with my Mom. I kind of chuckled o myself and pulled out my phone...scrolled to the video clip of her coming to the house...and showed her where I had checked her license plate on PD and knew where she lived and how long she had her car...and that she had had no arrest records. Her visit with my Mom took place while I was running my own errands. After she saw everything that we had in place for Mom...she started taking notes to give to other clients when she visited them.
Concern about being alone: falling down the open stairwell, not being able to get up off toilet (happens occassionally), falling out of bed (happens regularly), any emergency situation such as fire or theft she would not be able to manage due to dementia and physical frailty, as well she has had a couple of hallucinations (sun downing) and opened the front door for strangers she imagined. As well when left alone for long periods of time she reports that she gets so depressed she just sits and cries and thinks about death and her desire to die.
Her arthritis makes it difficult for her to reach into cabinets or the back of the fridge and pick up items, she cannot open containers because of the deformity in her hands. She is often found eating saltines and drinking instant coffee until someone comes and fixes any food. She gives them money for fast food for the care givers and herself when they are there.
Good suggestion about the monitor. I have had several clients who have used those very successfully. However, my mother refuses.
I agree stay in her home as long as possible and I think I am about at my maximum length. I manage getting her car maintenance, in home care, lawn and pool care, clothing, and the like from eight hours away. Maybe you have some help in defining when "long as possible" is no longer feasible for the caregiver? I am asking how to have a conversation with her as stubborn as she is on how to plan the future. I am all ears since she is my only parent.
First...what are your concerns about her being alone at night?
You state that she has hired caregivers six days a week... but has nothing to eat and cannot reach food in the cabinets??? What exactly are these caregivers doing there?
Alarm can help you set up cameras around the house and inside the house...you are able to view live-streaming video right from your phone...computer...or tablet. They also provide sensors for each door and window and you can set up an alarm to 'ding' your phone depending on which sensor you
want to know has been opened or closed and it is immediate. My brother and I set this up for my Mom's house and it is one of the best things we ever did and provides a huge piece of mind.
Let us know how it goes with mum!! and my prayers are with you!
It does always surprise me that different parts of the world have different kinds of care for various populations. My son has mild autism and we are also lucky with him being a member of society here in the US.
I have thought about asking my Mom to try a week of respite. That would be one way maybe she would realize how much of a burden her management of her house is. I did also have a conversation on the phone with her about the problems with her house being overwhelming and expensive while her care is relatively easy to manage. At least my siblings are now allowing me to talk about ALF and I know what you mean about it becoming too late and needing NH if we wait. Baby steps, baby steps!
Like ive said before here you ARE lucky in US that you have some very nice ALs here in Ireland we are so behind in elder care and elders end up in NH when all they need is an AL? there are a few but only for the well off which is so wrong hopefully this changes soon! AL would be perfect for mum she laughs in my face when i mention it?
Good luck and let us know what happens!
You always have wisdom in your responses.
I really like that idea of leaving it as a seed to plant. It could back fire on me that she thinks I have made plans because she is a bit paranoid. But I think with that post-it note idea, it is more likely to be something that helps care givers have a reason to talk with her about the idea. The more other people talk, perhaps the idea will trickle in to positive conversations. I have requested the brochures and will be making appointments for my visits in the next few weeks.
It goes against all our generations instincts to allow there to be risk for our frail aged parents and yet we have promised to do as they wish. So goes the conflict the autonomy-safety conflict deep in our hearts.
Tips on starting the conversation - I'm not sure I'd even try right now. I think what I'd probably do is earmark some likely-looking ALFs, get their brochures, and leave them somewhere discreet with a post-it note saying - oo I don't know - 'worth looking at for future reference :)' or something that wouldn't put her back up; and hope she found them more attractive as time went on and getting about got harder.
I feel perplexed, sometimes, about this autonomy-safety conflict we have to try to resolve. If I hadn't uprooted my mother and transplanted her to this house with us, it's a racing certainty she'd have broken her hip, if not her neck, by now. Or died when she had her strokes. But, you see, then I think "...and?" It's the not being sure she would be worse off if I'd just left her to it that can get a bit depressing. I try to cheer myself up by reminding myself that sometimes there aren't any right answers.
Yes, talking to siblings is like talking to her dog; I get the same inquisitive look without it sinking in. I have at least just started doing things myself and not expecting much else to get done.
Yes, it does feel like I am waiting for the phone call. And you're right that planning ahead is the best thing to do.
Disagreeing siblings are a huge problem people write about on the site. All it takes is one foot-dragger living in fairy-tale land to botch up desperately needed care & changes.
I like your style! Unfortunately sibs are not okay with that style. I do have DPOA for financial issues, but other sib does for medical issues since they are in same city. I would be fine with doing that since I manage her finances 90%; but, sibs will not go for it and she is still declared capable of making her own decisions by her doctors. Doctors see her at her best and know there is more to it, but, full battery of psych testing declared her capable with occasional assistance. She does get overwhelmed and then balks at ANY more discussion. So I do not have full authority.
I am really glad you took charge and made it happen. More dementia is a certainty once it starts. You were smart to select a facility with full continuum of care too; very important point.
This has to be a guided tour ending up in a move to a safer, more purpose built/equipped location.
Dementia gets worse, and can spring surprise crisis on you at the WORST most inconvenient times.
One thing I did with my mom that I do not regret is just handling it for her. She couldn't make decisions anymore, and would just get mean & angry when a decision came up. She wasn't aware her reasoning was going, going gone.
I was able to get DPOA, so I could write checks out her account. My husband & I found a place for her nearby that was a continuum care campus. They also take medicaid. We toured, we reserved her spot.
Then we took her over for lunch & a tour. She LOVED the model apartment. We finalized the paperwork right there. They had to remodel the unit reserved for her, so for the next three weeks, we prepared her for the move. Then move day happened, and I did all the unpacking without her, so everything was in place when she was brought over for supper, to stay.
Yes, there were some transitional behaviors, but staff is used to it, and it's normal. It's a darn good thing she was there when she fell & hit her head in May. As an existing resident, she had preference for rehab after a hospital stay. Then with more dementia decline, she has been shifted down into the nursing home wing. Recently, she had another episode in the hospital, and was immediately put into a memory-care ward after. I did not have to do any work to find a spot for her when her needs changed.
If I had let her be at home, she'd be gone by now without a doubt.
Talking about getting a hospital bed in her home might be a point of discussion since that was the last place she could not get up from. Brilliant! Yes, I am open to keeping care givers in a smaller situation such as apartment. You have helped one small step of cost/benefit analysis.
I upgraded her shower chair months ago since safety and comfort are key. She used LifeAlert to call neighbors to help again recently.
Fortunately she can afford what she needs but does not want to spend it. I understand being frugal; I am getting there myself being a good steward of her finances!
I am grateful for this forum to have other care givers with pearls of wisdom. Thank you all for your kind and ingenious thoughts.
Keep em coming!
If your mom is having trouble getting up from the toilet, have safety rails installed. We had them installed in the shower and toilet area to assist. Get her a seat for the toilet that has the handles so she sits higher and gets a better balance when sitting down and getting back up. Get her a hospital bed in the house which will help her get in and out of bed- I am renting theirs. The life alert has been a God send and they wear theirs 24x7. Life alert will call the neighbors, family, MedAct , etc... We got Dad a recliner lift chair so it stands him up and helps him balance. All of these things are minimum costs and possibly could help make your Mom safer at home if the decision is to keep her at her house for at least the next 6 months.
Parents don't want to lose what they "feel" they can control and the money is huge for them. I get it. If she suffers depression and is totally against AL, than perhaps putting her into Independent Living that is more like a small home would be the option to consider. She gets hot meals cooked for her 2x's a day, transportation to shop or go to the doctors and still has independence. You may still need to keep the caregiver but perhaps could decrease the hours? It might be a good transition to AL since they generally are in the same community. Perhaps after a few months you could convince her to get rid of the caregiver for the same price and move her to AL. Wish you best...it's been an exhausting experience.
I already do have the care givers with her six days a week. I am not sure what you're saying about double locks. Explain? My mom isn't worried about people getting into things that are not their business; she doesn't want to spend "so much money". Actually she has trouble getting up from the toilet/chair/bed and has to call the neighbor to come help her up about once a month.
You are exactly right, I cannot control her life as she is not determined incapacitated, nor will likely qualify in the near future. Thanks for offering comfort; it is terribly hard to sit by when she calls and is crying, needing help but is alone, has nothing to eat or cannot reach the food in the cabinets. It is the house and it's ongoing needs that is so draining.
Maybe to just tell her that I think the house is the problem and talk about an apartment with the hired caregivers?
In the end, you do what you can and accept that you can't control her life. I know you know that . . . but don't feel guilty. Some people can't get past their own desires, even when it's in their very best interest. And there's nothing the rest of us can do.
She will not be moving near me, nor would I take her dog. She has visited many friends who live at different places and tried one for 6 months when she could live in independent facility; this isn't our first rodeo. Have her for an overnight? She won't even talk about it; that is the problem! The places I have visited all take pets; not even considering one that won't. You are right that she would not have to go out for most of her doctor's appointments; good pro.
Thank you jeannegibbs-
One other sib lives in same town I think this would make things easier on them too, but he does not have confidence to talk to mom (long story). Yes, maybe just taking her to lunch as Maggie described would be good before the conversation. Yes, in person and she knows I want to talk about "the future". She is being treated for depression, but, self medicates and does not follow doctors orders due to confusion of what meds are for. A nurse manages her pill dispensary each week.
I know I cannot force her; she can be stubborn. She has a friend who was "hijacked" by her kids; took her "out to lunch" and checked her in at place they chose. So this is very scary for my mom. Right now I want to just start having some adult conversation about the future.
Maybe that is the thing to say to her!?
I like Maggie's idea of taking her to lunch at an ALF BEFORE you have the conversation, but is that feasible? Were you thinking of bringing her close to you, eight hours away from where she is now? Or finding a place in her current town? Do other family members live close to that?
Anyway, having a specific place to talk about (even if it isn't the one she'd be moving to) would be good background for the conversation. (You are going to do this face-to-face, right? Not on the phone.) You can matter-of-factly show her the cost of an ALF, and compare it to the cost of staying home with the help she has now plus a night aide. Then you can talk about what she sees as the benefits of each. This is, of course, assuming she is willing to talk about it at all. One conversation is not going to settle this, but at least you are planting the seed.
Is your mom being treated for depression?
When you talk to Admissions Coordinators, they will have VERY helpful information for you. They've been to your rodeo and back many times. When you find one you're satisfied with, ask the AC if you can bring mom for a tour at lunch time so she can sample the food.
All this without even discussing it with your mom. When everything's in place to spring the news, make an appointment with the AC, and have mom for an overnight with her puppy. Tell her that a friend of yours talked up the one you've chosen, and you JUST WANT HER TO HAVE A LOOK. She has no IDEA, after all, what AL is really all about.
Then sell her the sizzle. Forget the steak. That's for later. The activities; the gardens; the free transportation; the wonderful food, the pretty rooms. Maybe even see if your appointment can coincide with one of their entertainment programs...they have lots. Take her to that. Make a half-day out of it.
Go home and let it all sink in. Answer her questions . . . still talk about the sizzle. Let her steep on the busy day she's had.
Then tomorrow, talk about the steak. The STEAK is that she'd be close to you. She'd have no responsibilities other than taking puppy out and choosing from the meal menus. No fussing about doctor appointments. (They usually come to ALs.) She'd see you more often...your kids, if you have them...assure her she can easily afford it.
She'll be thinking about how much trouble it'll be. "No trouble at all!" I'll come for a few days to pack up your best clothing...photographs...some personal things you'd like in your room...and one morning? We'll go there for lunch...and you'll check in to your new suite!! "I'll handle every single little thing!!"
"I'd be sooo THRILLED to have you close by? You can't even imagine!"
(If you can't find a facility that takes pups, then tell her you're fencing your yard for her puppy; she'll have a wonderful life with you; and you'll bring her to visit every time you come. (Almost every ALF allows that . . . people love them.)
Good luck!!