*I want to stay home*. I get that.. but what does the *as long as I can* actually look like?
Not being able to shower or dress? Collect shopping? Prepare meals? Can get Aides to visit for that.
Not able to change soiled continance aides? Put rubbish out, clean up? Yuk but not life threatening. Can wait for next Aide visit.
Not being able to get out of bed to let the Aide in the door to do these things?
I think we've crossed that line of *as long as I can* now. She just doesn't get it.
So my question is: is there a list from APS (or Human Services or wherever) of minimum standards to stay living alone? I found a hospital discharge questionaire but have lost it - inc ADLs, falls risk, poly meds.
I have advised her Doctor, had an OT assessment done. Both recommend assisted living (ignored). Suggested a key box (refused). Calls ambulance when fallen but keeps refusing to be taken to hospital.
Getting back to your question of what it looks like. If there's lots of money, it looks just fine and dandy, and Adult Protective Services never gets called because the person who doesn't wear shoes is considered "eccentric". If there's no money, it looks and smells horrible. If there's some money, it's just plain hard because they are squeezed of every last cent before qualifying for assistance.
You will run out of spots to put grab bars - trust me when I say that we did.
Falls will happen more frequently. Nutrition will decline; personal hygiene will too. Their brain will turn to mush as they withdraw from engaging with their community and people their own age. Depression, anxiety, and mental illness may set in. They may become reckless, and drive or take risks to assert themselves and their self determination. They may get scammed out of money.
USA is no place for old people who never prepared themselves for being old.
"run out of spots to put grab bars" Dad is arranging another one in the shower next week!
The trifecta of depression, anxiety & mental illness already live there... I think it may be MY mind that goes to mush very soon :)
I am breathing easier already :)
Even though I love my MIL & late FIL, if my Hub was living that life he would be Ex status instantly. I would not be his No 2 staff member.
I suppose it creeps up slowly though: help with shopping here, drive to the Doctor there. I wonder if he knew at the start where he'd be in 6 years time if he'd chosen the same path - some do.
I do hope they have a plan if Ex breaks a leg/gets ill/burns out & runs off on a road trip.
No plan = nursing home or ward of the state as mentioned below by Geaton777
My inlaws tried to pull the same baloney with us, MIL gave her son/my DH DPoA but her turd of a husband wouldn't. And they were not only broke but in debt. They had never given a thought to their "sunset years" except to assume we'd take care of them hand and foot (without our permission).
Since I did the bulk of the care and management, (he had Parkinsons and Lewy Body at 6'5") I told him we're not running 2 people over there in the middle of the night every time he keeled over or couldn't get out of his recliner. His wife would call 911 every time we refused to go help. This meant they'd take him to the hospital, then to rehab, then came the medical bills they couldn't pay. Over and over. Finally I informed him of his choices: either give someone PoA, apply for Medicaid and get yourself into AL or be prepared to become a ward of the state. He didn't believe me. He died as a ward of the state. But there was nothing we could do so I don't feel guilty about it. The lived in a house with stairs to get to the main floor. My MIL had profound short-term memory decline and wasn't remembering to eat. We got my MIL onto Medicaid and into a very nice facility and doing well. even though she didn't want to leave her home. It took her almost 2 years to adjust. Now her mental state is the best its been in years.
The only thing you can do is lay out the realistic options and even then they may not believe you, or they may have enough dementia that "reasoning" is a waste of time. For your own peace of mind you may wind up calling social services on them so they are on their radar as vulnerable adults. Not sure about your sister...she's on her own. Or should be.
What is an OT assessment? Is that for cognitive decline? Goo luck!
OT is Occupational Therapist. Family agreed to a *falls risk assesment* of home to hopefully reduce the falls - more grab rails, remove rugs etc. I had pre-worded up the OT that a *full functional assessment* was required - included many questions about ADLs but sadly no, not inc a cog eval. (Doc says need a specialist for that - NO hope of permission for that!).
OT asked why so many falls in bare feet. Why aren't the shoes being worn? Do they fit well? Show me. A-ha moment! Can't actually reach the feet properly to put them on. I see.
Have considered calling social services but while Dad is at her beck & call (even though he lives elsewhere) she does have access to 24/7 support. As soon as he is ill (he's 76) - I will make that call & start the ball rolling. It will include pushing for a cog eval, & possible guardianship or ward of the state.
If her doctor and OT recommended assisted living and she refuses then that is tough. Sometimes they listen to others better than family members.
I would say to her that she is out of options since she isn’t cooperating. I have the lockbox and I love having it.
I am here with mom so I let emergency workers in and I still put a lock box with key out front.
Your mom should have a lock box. I’m curious as to why she wouldn’t. Seems like it would give her peace of mind.
If she is not able to do the basic things like food prep can she at least get meals on wheels delivered? Have you contacted your local Council on Aging for assistance?
Go and check out suitable assisted living facilities by yourself, then tell her what is available. It really does sound like it’s at that point to me.
Best wishes to you and your family.