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My mom lives in the mountains. Generally she does well but she lives alone in a big house. She's showing signs of lowered mobility and maybe a little cognitive decline. She loves gardening in her green house and going on small walks around the house.


I am terrified that one day she'll be bed ridden or fall on her walk or in her green house and she won't be able to get to her phone. She won't carry her cell anywhere.


I want to give her space and independence but I call her everyday to check-in which she hates. She doesn't want the call to be a healthcare check-in.


She refuses to have wearables like an apple watch or life alert and there's no way to sneak a camera in.


Any thoughts? Has anyone had a similar experience?

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My mother had a fall alert device, but didn't wear it when she showered. She hadn't yet put it back on when she had a dizzy spell and couldn't get up from the floor (she didn't fall on the floor, but must have been bending over and had to sit down on the floor). It took her a half hour to manage to crawl over to the phone to call me. After that, she always wore the fall alert device.

My mil (age 89) refuses to wear one. She lives by herself in a 2-story house on 40 acres, miles from town, with steep, not-to-current-code stairs. The stairs have things on them. There is only a half-bath downstairs. She has mobility problems and has fallen twice in the past, not knowing what happened.

Her two local daughters keep in contact with her. Still, though, she could fall and lie for hours if she wasn't conscious and didn't have her cell phone on her or couldn't use it. She has said she will have to be carried out of the house someday, and will not live elsewhere. (When she fell and hurt her shoulder a few years ago, she did go to live with one of her daughters for 7 weeks because she needed so much help.)
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What will happen will happen. That appears to be her mindset. You’ve warned her and expressed concern, but she doesn’t seem to care. So maybe just give up. As an ER doctor told me in the ER when I was there with a family member, “Older people sometimes get so strange, don’t they?” Yup.
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Tell her "if you wear this apple watch, I will stop calling you so much. I just need to know that you're okay because if you fall, it could be a long time, maybe even days, before somebody finds you. If you fall and get hurt, you likely will never get to live in this house again. If you want Independence, that's great, but just wear the alert device."
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At age 95 My mother was living by herself in her own townhome. She had lived by herself since she was 68. Although she was very independent, it was a worry of mine. Although I gave her an alert device to wear, she didn't always do so. I had the two neighbors on either side of her, keep an eye out - did she pick up her paper? Her mail? We also set it up so that she would call me every day in the morning to at least say or leave me a message that she was o.k. We didn't have to chat - she could just leave a message.

At 95, the ultimate happened. She called that morning and left message. Around lunch time She was getting out of her recliner, got her feet twisted up in the blanket she was using to keep warm, and fell, breaking her femur at the hip replacement site. Fortunately, she had the alert device on her that day and was able to activate it to get help. Otherwise, she would have laid there on the floor for who knows how long.
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It really depends on the person.

I had a 93 year old patient who was in the hospital. He and his wife live on 5 acres of woodland that he cares for himself. He fell while lifting 50 pound bags of mulch and didn't stop working on his landscape project. That evening he had really bad back pain and learned he had a small fracture.

I also had a 55 year old patient with diabetes. She doesn't take good care of herself and ended up in SNF after she needed her foot amputated and to be put on dialysis.

All this to say... if mom takes good care of herself, relax a bit. Find ways to chat and catch up during the week that seem less like "are you still alive and ok" and more like "I love you".
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You can read Atul Gawande's books and videos.

Similar ideas were expressed by a doctor I had worked for. One of his patients had died, alone, in a little trashy trailer, and no one found him for months. I was upset. He said: "Understand, we need to allow people to die the way they had lived."

If it benefits your Mom, ask her and then help her to move closer to available help.

You could find a helper to move in or onto her property?
How close is her nearest neighbor?
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You could have a very frank conversation with her. You can keep doing things how you do them, fall, and lay there (possibly) a very long time before help comes. Or you can do something simple like wear an alert at all times and just push a button to get help. It 's all a matter of taking a huge risk or being just a tad more careful.

My grandmother wanted to 'wear out, not rust out'. Meaning she wanted to keep moving and doing her thing until she died. When neighbors called to say she was on the roof sweeping pine needles, we had a little talk where I began with her wish to wear out/not rust out. I then told her if she fell from the ladder or the roof she could end up rusting out while being immobile in a bed, She was angry at first and before I left, said if it will make you feel better just take the ladder with you. I did. She could blame it on me to others - no longer being able to do what she used to do because I 'took' the ladder away from her. She saved face and the long gone ladder saved her for another day.

If she leaves you no choice, do a little covert work. Take one of your tech-smart kids or relatives with you and have them install a camera (or several) while you take her away from the house for a while. Maybe one or two around the property outside so you can see what's going on.
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VigilanteSon: My late mother was adamant about living alone seven states away from me. She said "You just expect me to keep going on" - as if I was naive. I was not. Perhaps more information is needed such as how does your mother accomplish ADLs and other things like grocery shopping, operating a motor vehicle, et al.
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Had the same problem with my Dad, he lived along in the woods.

I made it a point to get to know my Dad's friends and ask them how he was doing. I also got phone numbers and ask them to check in on him from time to time and to report back. later I found a handy man who I'd send up to help him out with some repair work. Little by little I built a network of "spies" to keep track of my Dad.

Dad never knew.
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Maybe alert system if she is totally isolated. If you are visiting and getting more concerned about decline then it is different matter.
I understand your concerns, but if she wants to stay independent she will stay independent. Yes, things can happen, friends Mom walked with attendant in NH and fell and broke her hip. Some things we will not prevent.
As caregivers, we quickly learn accept it and let go.We let people be and keep our sanity.
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This situation is a lot like my 86 year old mom's was, before I moved her in with me. We had so many close calls that could've had disastrous endings but for sheer luck of good neighbors being in the right place at the right time. For example mom fell in her front yard and laid there for several hours yelling but no one could hear or see her behind her tree. Another time she locked herself out and didn't know who to ask for help so she went across the street knocking on doors until someone was home. Another time her dog ran out and down the street and she went after it. Only by chance good neighbors just happened to be home and realized what was happening and helped her out. These are things I know of. There were many more I probably don't know of. Please think twice before relying on neighbors, especially if/ when it gets to this point. It puts such a heavy burden on them. In our case they had good hearts and were always willing to help but it was too much to expect such help every day. They have enough of their own family/job/business responsibilities to have this burden. Mom certainly had an angel watching over her.
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My dad always made fun of the commercials on tv where they said “help I’ve fallen and I can’t get up”! He was very stubborn about staying in his home and wouldn’t go to the doctor even though he was in full dementia and practically deaf. He fell down his stairs and laid at the bottom for at least 3 days before his neighbors became worried and entered and found him near death. Is there anyone your mom respects who will be frank with her about the real danger of living alone? It’s no joke, it really does happen. In my dads case it seemed like poetic justice after the way he mocked those commercials.
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Geaton777 May 2022
Before my MIL went into AL both she and her 6'4" husband with Parkinsons were taking turns falling in their home almost daily (none resulted in injury thankfully -- just bruised egos). We'd be called over to set them upright. In an effort to sooth my MIL's embarrassment about it, my husband began proclaiming that his Mom is a gold medalist in Olympic Carpet Diving. I'm wondering if I'll get to use that on my husband first or if he'll have the pleasure.
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My Mum is 88 and lives fully independently. I have no need to check in with her on a daily basis. My step sister who lives many hours away goes into full panic mode if she cannot catch Mum on the phone. Eventually she calls me, freaking out, demanding I drive over to Mum's house etc. I remind her that Mum is out of town, busy etc and will call her back later.

Mum has belonged to a social group for over 60 years. They have created their own phone tree and friendly visitors, plus regular lunches etc. One of the ladies and I report what we hear our Mum's saying about the group and keep each other in the loop about concerns. An example, Mum mentioned that she could not get my friend's Mum on the phone, the group thought the husband was screening calls. Turns out the other lady could not hear well on the phone any more and stopped using it. Another case they were having a pot luck. My friend warned that her Mum's food handling skills were not great and passed the message on to me to get it to Mum that she should not be asked to prepare the sandwiches.

Dad was more challenging. In 2017 I mentioned that I was concerned that he was a fall risk when at the cabin for the summer. Plus the place is hoarded. He said he took his car keys with him into the garden and would set off his car alarm if he fell. He said he had talked with the neighbour about this. Problem was the neighbour worked full time.

Since 2018, my son spent the summers at the cabin with Dad and although my son works, he was around to mind Dad.

I suggested an Alert device, but Dad and my brother said it was too expensive. I asked how much, was told $50 per month. I asked my brother how much a days lost wages cost him? It took a few years, but one is in place now.

I think it is important to include the elder in planning for safely living at home. Dad did not want a device, until it was pointed out to him and brother that the monthly fee was minimal compared to my brother losing wages.

An Aunt lived in her home until her death at 96. She had not children and had been a widow for decades. She set up her own system and it worked. Her postie rang her bell and handed her her mail Monday through Friday. She has the same cabbie drive her to go shopping every Saturday. Both men knew where to find a key to her front door. She had an Alert device.

Her postie found her on the Tuesday after a long weekend. She did not answer the door, so he went in. She had fallen at night, probably getting up to use the toilet. Her alert device was on the bedside table. She died shortly after getting to the hospital.
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How old is she?
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Circling back to the alert pendant for a moment.... My LO was concerned about appearances and what would others think if they knew she had an alert pendant. I knew she would not wear the doggone thing - even though she had MANY falls both inside and outside. She was always able to get up or enlist someone's help to get her up. I never bothered to get her a pendant because it does little good sitting in a dresser drawer - unless she happened to fall right next to the dresser perhaps.

Anyway, when the time came for at-home therapy and other help to start coming in, we were advised to get the life alert and why was I such an incompetent caregiver that LO didn't have one? I explained she would not wear it, so why get it? Well, these helpers started asking LO directly why she did not have one and suddenly she WANTED one. Apparently, if it's someone else's idea besides MINE.... she will go along with it. Interesting.

I did get one for her . She did wear it 24/7. But it was someone else's idea - not me telling her to wear it. Is there someone else who can suggest some of these things your mother? Sometimes they don't want to hear it from the person who's truly responsible for them. They'd rather hear it from someone outside the circle - someone who "knows more" about such things.

I was glad she finally got it because we bought the one with falls detection (highly recommend getting falls detection) and the pendant called the paramedics when LO had an unwitnessed fall with likely loss of consciousness. Serious enough that she was never able to return home after that. Good thing she had it.

Years ago my grandmother laid on the floor with a broken hip for days - there were no alert pendants at that time. It does still happen.
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When my Grandma was in her late 80's, still spry and active--and VERY independent, my mom would fuss at her for 'going places and not telling anyone'. Well, I could see both mom and gma's POV. Gma felt completely independent and only asked for 'help' on the rarest occasions.

Finally, as a family we worked out a 'plan'. She spent every Sunday with the family. Every other day of the week, one of us had 'gma duty' which simply meant a phone call on that day. If we didn't actually speak to her, we passed that on to mother. Oftentimes, on my day, I'd grab whatever kiddoes were home and we'd go get gma for lunch or a drive. So no one's commitment was onerous--just a call.

She did get a fall pendant when she hit 94, and it was what alerted us to the 'final fall', but until that point, we were simply checking up on her. She was extremely social and had many friends. We enlisted them in the most simply way. IF they saw something out of the ordinary, or didn't see her for a couple days, they'd call mom or one of us kids.

This worked really well for a long time. I think she personally would have LOVED a RING or some kind of tele-visits. They just weren't around in the late 90's.

She enjoyed the calls and we all felt better about being able to touch base with her. All the worry didn't fall to mother.
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LoveLea May 2022
When I was stationed overseas, I called my mom every morning (bedtime overseas) to check if she was alive and well. If she didn’t answer the phone, I’d keep calling. If no response, I’d text my sister who lived out of state. She’d take over the phone calls to mom. If still no response from mom, my sister would start the grandkids’ phone tree. One by one, she’d send out an SOS to all the grandkids living in the city where my mom lived. One by one, they would franticly drive over to bang on her door until she answered. If one of neighbors saw them banging on the door they would report that she had left out earlier in the morning. Then the grandkids would report back to my sister and my sister would report back to me. We did this for many years.
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Our mother, with dementia, was still driving at 82. She only went on a particular route, almost daily. Our fear was that she would eventually not remember the route and drive off somewhere. We installed a tracker on her car called "Bouncie". It was fabulous. We could see when she left the house and everywhere she was, in real time. She had no idea it was on her car. Took less than 10 seconds to plug in. It gave us all such comfort to be able to see her path so we knew where she was if help was needed. The house is a whole different challenge. There are many options that are discreet if she wont wear a fall device.
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AlvaDeer May 2022
Yes, so was my brother driving with Lewy's (undiagnosed and hidden very well by him) a regular rou. Until he was flat on his back bleeding in the arms of his neighbor after hitting the refuse dumpster, backing to a palm, driving forward into the dumpster, and back once again into the palm. Luckily no one other than my brother was hurt, and after a week in hospital getting diagnosed and treated, and a month in rehab he/and we at least knew what we were dealing with. Seniors with dementia on the roads is a danger to the public imho.
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Your question implies that checking on your Mom is requiring too much effort and that is what is frustrating.

You also suggest that she is still capable of living on her own and she wants privacy.

It sounds like you would both get what you want if you give her the privacy she has requested.

Take comfort in the fact that she is living life according to her wishes.
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So Mom is all alone in the mountains with cognitive decline?
How does she get groceries? Who are her neighbors? Is she driving?
Dependent on the level of cognitive decline, the word pretty much says it all.
This really is a very dangerous placement for an elder.
It is terribly sad, and understandable that she loves her home, but without 24/7 care, which is enormously expensive, I cannot imagine how she can stay in this situation. You say that she refuses to wear any helpful device, but the sad truth is that even her willingness and her determination to "do the right thing" and wear one, isn't assurance at this point that she WILL.
Much depends now in so far as what happens ongoing are such questions as diagnosis of dementia, POA issues, and Mom's wishes.
If you know your Mom to be willing to risk her very life and a painful drawnout life ebbing away over days, that is something valuable to know. If you are making a.m. and p.m. calls and there is a neighbor willing to check any unanswered calls, that is another.
But, as I said, living ALONE in the MOUNTAINS there are MANY issues here. And "I-have-fallen-and-can't-get-up" is but one.
Who shops? Does Mom drive? Is that safe for Mom and for others?
You are the one most familiar with all this situation in the whole of it.
You are the one who will have to consider things now ongoing and it sounds as though you ARE.
Yours and Mom's decisions now determine the future.
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Myownlife May 2022
You know, people who have lived in the mountains for a long time are usually pretty well self-sufficient. You're making an awful lot of assumptions.
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Could you tell her that you just feel better checking on her, that you are sorry if it is annoying. You worry about her now; she must have done the same thing to you when you were a kid, annoying you at the time. Just loving someone and wanting to make sure they are ok is no crime. Perhaps if you treat it as your idiosyncrasy and ask her to tolerate it, she will. As an older, I understand that stopping doing the things one loves to remain "safer" is not a no brainer trade off for the older person. Some would rather take the risk and enjoy life as they always have. Would something like an Apple watch rather than a safety necklace be acceptable to her?
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Good Morning Folks,

Just for a laugh--when I used to call my mother from work for a wellness check, she would answer "Hello, I'm still alive!"
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Odaat59 May 2022
I love your mom’s sense of humor, and exactly how I hope to be at her age!

I just shared this thread with our only daughter, and asked which one of you kids is gonna do the daily “check on mom” call. She suggested I stay “sharp”, and we can continue our awesome texting relationship! Said her brother would prefer that too! My parents refused to even attempt to learn how to do email or turn on the computer! Me, I’m all over technology that can keep me/us in touch with our kids.

Lol, I am doing my best to be that mom that can be ok on her own, if my sweetie goes first, and they know I am mentally and physically preparing myself, for my old age. I hope I embrace them checking on me, feeling grateful, they see in me a mom, that “just needs a check in” call”!
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Thank you all for the incredible feedback. The best solutions I'm hearing are:

- using calling in a loving way (I like this but my mom will definitely know that I'm using it to keep tabs on her and that alone might annoy her)

- considering a ring doorbell (I like this for security outside the house but she would never let me put one in the house and wouldn't catch if she's sick in bed or something)

- carepenguin activity sensor (I am seriously considering this. I'd love some more information on it if anyone has some. I've read through the website but haven't seen many testimonials. For the price though I think I'll just give it a shot.)

- getting access to her phone account (This could be helpful too. I think I'll reach out to verizon.)

I'm going to install a ring doorbell at her front door and buy a CarePenguin sensor (links to an App and alerts me when my mom has no activity). I think this combination will keep my mom and me happy. I'll follow-up in a few weeks to let you all know how it's going.

Thanks again for all the feedback and if anyone else has more info let me know. I didn't think I'd get this much help this fast!
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Libbby May 2022
Maybe ask her if she would check-in with you once a day (call/text/email), that might feel less “nannied”. I have a older friend who lives alone, we send each other funny gifs once a day.
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I actually had to get access to my elderly aunt's phone account to monitor and control literally 100+ spam calls per day. I can see her incoming (mostly now blocked!) and outgoing calls in close to real time. I just check on it a few times a day. One of the unexpected benefits of this is that I can see when she is behaving normally (making/getting a call or two each day) or if there is no activity, I or another family member give her a quick call to "chat". It works for us.

She gave me permission to be authorized on her account, and knows I'm monitoring for the spam, but she doesn't realize I'm using it to "check in on her".
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VigilanteSon May 2022
This is awesome.
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Compromise.

Calls somewhere between what you want (for welfare checks) & she wants (for social).

Farmers are the same here. Won't move off their land & into town until they have to.

Knowing Mother's wishes & values may help aa time goes on. If she has strong views - eg always said no to all invasive treatment... Would she want CPR now? Treatment for cancer etc?

It is hard one. As she 'ages in place' her risk of injury/accident will keep increasing.

But if forced her down the mountain, her spirit may decrease.

Maybe see if there are any social services, council, charities who do friendly visiting/welfare checks. These quick but friendly visits can be a good support. Chat & cuppa but can also raise the alarm when needed.

Good luck finding the right support level.
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My (100) yr. old mother is similar in not having any kind of devices -- no WIFI in the house -- no cell phone -- no fall indicator, etc., etc., I got tired of arguing with her about her in-home safety. I have managed to get her to call my cell phone when she gets us -- two rings only -- then she hangs up. This way I know she made in through the night and she doesn't have to talk to me. If she doesn't call by a certain time, I call her -- just to "chit chat" and somewhere in the call I'll mention that she forgot to call me but I don't make an issue of it. (That has only happened once). I live close enough that I can check on her if I need to. Irish stubborness is going to be the death of her (or me)!
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Install RING devices ... let her know these devices are necessary to 'age in place'.

Especially the 'door bell' What a relief to know my mom is okay at all time. She also lives in the mountains and can answer the door from 2 hours away just to be safe.
I have also installed 'Medical Guardian'. She was not happy but after dad died it was the only way to keep her on the ranch, mom and dad's home for 25 years.

So happy to know where she is ... she doesn't know they are cameras. She would not like that at all but they are motion devices to help her stay in her home.

karen ...
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Your concerns sound like how my kids will be feeling about me, especially if their dad dies first! I plan to be on the go, still doing my chores, taking walks, living hopefully independently, going on road trips!

Does your mom text? That’s how I talk day to day with our son and daughter, 32 & 34, and phone calls are for long chats. I guess if she doesn’t carry her phone much she is that generation ahead of me, that isn’t as dialed into their cell phones.

I’m thrilled your mom isn’t clingy, needy, demanding like so many I read about on here, and similar to our mom. She is usually happy, but is waited on hand and foot, expected to do basically nothing, and needs dad and our caregiving sister with her, to feel most comfy. To have an elder that is independent, doing their own thing and ok solo, well, that was my mom’s dad, and she worried about him all the time. Too bad he was in Seattle, and she was in Alaska! Grandpa loved it, until he was 89! Two years in assisted living, mind still sharp. He was a stubborn Swede, disciplined as all get out!

Finding a happy medium, where the old folks will answer a phone, assure us they’re good, and we can breathe, perfect! I’ll probably be ornery, too.

I’m thrilled cause I get an outside visit, on Sunday, and bought two very stable wicker chairs, with nice cushions, for mom and dad. Our new gate allows easy access for mom’s walker and being outside means no masks! Finally!! Feels good to have plans with them, cause talking on the phone isn’t a visit. It’s just me talking to mom. Good luck with your mom, wish I was more help, than just a different perspective.
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We had an elderly member of our synagogue who lived alone in an apartment building here in Brooklyn.

One of her neighbors noticed that her papers were piling up outside her door. The doorman said " oh, she's on a trip with her step-daughter". Everyone knew she hated the step-daughter.

The neighbor called 911, the cops broke down the door. She'd been there for 3 days. She'd had a heart attack and broken her hip. Probably HA first, then the fall.

She rehabbed well and went back to her apartment with 24/7 aides.

Can you compromise with her on 2x a week (and have a neighbor call 1x?).

Many of us here end up waiting for the "event" that takes their elder's independence from them. Make sure you know where you want mom to go to rehab and to AL when the inevitable happens.
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Artgirl11 May 2022
RING
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We have one poster whose Mom won't leave her alone and now a son whose Mom thinks him calling everyday is intrusive.

We have a WaWa right next to an appt complex. At one time the employees had worked there for a while so the customers knew them pretty much by name. One went to school with my brother and she was telling me about a older senior lady that came in every day and bought something. She would tell the staff when she was going away and coming back. This one day she didn't show up. Everyone was asked if she had mentioned going away. All said no. So the police were called to do a "well check". She had passed away.

My MIL lived in Fla by choice. She had the option to live closer to her sons. But no, she expected us to move closer to her. We were 15 hrs away, another son 8 and another 12. Thank God she had neighbors. One noticed her newspaper had not been taken in for 2 days. He had a key to her home and let himself in. MIL was laying on the floor. She had a bad UTI. So, asking neighbors to call you if something doesn't seem just right should not put them out. I am not close to my neighbors but everyone has a routine. How far is Moms greenhouse from her house? If not far, maybe putting a walkway with a railing in case she does start to fall.

Tell your Mom she is lucky you care. My brothers rarely called my Mom. She may not feel old and she is lucky she has her health but it does not take much to have a fall. My Mom just had to pivot and it threw her balance off.
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If she won't carry a cell phone, she probably won't wear an alert pendent, either. My own mom was resistant to the questions and attention, too. I took her out to lunch (and had written out my thoughts in advance) and calmly made the case that the "protections" were as much -- or more -- for me as they were for her. To tell me I shouldn't worry about her is to be in denial of my love and concern for her, and it felt dismissive and disrespectful. I was not going to be able to stop having concerns because of just basic realities, like the fact that no one escapes their mortality and that usually it is preceded by decline, which is natural and normal, and preparing for it is what makes a mom a wise and loving person. Especially since I am my mom's DPoA, anything that happens to her is my responsibility no matter what.

FYI unreasonable or uncharacteristic "stubbornness" is often an early sign of dementia and/or memory impairment. Getting your mom to adapt to some least-intrusive protections while she has good cognition would be a good goal.

With my MIL (who lived in a townhome complex) I enlisted the help of 2 closest neighbors to do wellness checks if I asked them to. I left a key hidden outside that I'd tell them the location if they needed to let themselves in (my MIL didn't know about the hidden key) and also for emergency responders if they needed to get into the house. Your mom's neighbors can call her on other pretenses and report to you. I thanked my MIL's neighbors by getting them GCs and subscriptions, not a lot but enough to feel appreciated (they wouldn't accept cash plus that would make them feel more responsible).

Of course, indoor and outdoor cameras would be very helpful.

In addition to this you can visit her to make sure her home is "seniorized" to reduce falls (you can find what this entails online). Make sure the path to her greenhouse is flat and level, and her supplies are close at hand. Explain to her that the goal is to keep her in her home for as long as possible (do NOT promise to never move her out!)

Finally, make sure she has all her legal documents in place and updated, including an Advance Healthcare Directive (Living Will) that her physician helps her to fill out. I wish you success in helping her stay safe!
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VigilanteSon May 2022
This was super helpful from a communication standpoint. Thank you for sharing.
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