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My parents are headstrong and difficult. In their early 80's they yet play at length in their state-of-the-art Polaris Razor/Dune-Buggy, traveling for extended periods between the Montana Rocky Mountains, and the Arizona desert from their home in southern Colorado. That said, as Mom's dementia worsens, Dad's failing health (read hip replacements and mental decline of his own) makes it seemingly inevitable that we (my sisters and I ) will eventually be forced to impose some kind of assistance upon them both. Obviously we would prefer not to wait for some kind of crises moment in which to undertake such decisions. We are looking for insight and guidance. Eager to hire someone we can pay enough to be both competent and dependable long term while suffering the inevitable abuses of two grumpy old white people, we have serious doubt that this is something low wage "care providers" under the umbrella of a corporate conglomerate can provide. Thoughts?

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tj,
Thanks so much for this update. It is all so much more clear. We have gone from running around happily in the Rockies to Mom and Dad actually needing a whole lot more care. Dementia is mentioned. And that shoulder is going really to be problematic. You actually are one armed and one handed for quite a while, and rehab can be pretty tough. It looks like it is Mom that may have some dementia? Or at the least is quite difficult.

I honestly think that right now your Mom and Dad are on borrowed time with staying in their home, and I am wondering if that's kind of what you were thinking when you said "when should be impose upon them more care...............".

Wow. I think it isn't more care, but how long can they sustain living where they are now. You Dad is in care of Mom and doing it one armed. I don't know what housekeeping help they have but this won't be possible. I don't know what family support is in the area for them?

In general I think that a move to an independent living facility at the LEAST is not nearing, but is here. How you do that one armed with a wife who is difficult? I can't imagine.
The family needs now to get together. Check on ALF in the area. Speak honestly to Mom and Dad FACE TO FACE. This may mean a family trip.

I don't think hired help is the answer over time. Emergency wise it's here and you need it and you are correct that if Mom is difficult this is going to be tough.

I have honestly not a lot of good news here. The time to address safer living conditions is kind of past and you are now up against it. Or they are. Which means you ALL are. I think a family meeting on this, and an honest talk face to face is starting point. Things are downhill from here. Somewhere within themselves, to the extent they are competent, your parents understand this. I am 81. We all understand this. So I would start with family meeting where they live, exploration of options, being certain all the paperwork of POA, wills, advance directives are in order. Honest assessment of assets and where they can safely live with some modicum of care.

You are quite bright. I think you may already know all of this. I wish your family the very best.
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Thanks all for the feedback!
Of course it is difficult -- in an introductory paragraph -- to provide sufficient context. Yes, the POA's are all in place and end-of-life ducks are generally well ordered. Yes, Dad is taking care of Mom, which -- being a full time job these days -- is hastening his decline. Yes, Dad is still inclined to "climb trees" but more importantly, he is increasingly inclined to "fall" out of them. It is such a fall that has recently brought the nature of their predicament into sharp focus. At 82, a recent fall (one of several in the last 6-9 months) has resulted in the need for a difficult "Reverse Shoulder Replacement" surgery which promises a lengthy recovery period during which time he will no doubt be physically and emotionally unable to continue in his capacity as full time care-giver. Where he previously balked angrily at any suggestion that he might need help, he now only grumbles that he wouldn't know how/were to go about getting any. They live outside the small town of Pueblo, CO which means a rather shallow pool of healthcare resources to draw upon. We are keenly interested in any outside-the-box solutions/means of helping him find help, both short and long term. As I'm sure you are all quite aware, change and deviation from routine are particularly problematic with dementia. As such, we are painfully aware that a long stream new faces resulting from high turnover corporate providers will only exacerbate their struggle. Someone to just to keep Mom occupied 3 or 4 days/week would be a great boon for him, but as Mom is a dyed-in-the-wool misanthropic curmudgeon that someone would either have to be well compensated, or a saint. Something on the order of adult day care would be welcome, but we (my sisters and I ) fear the alternative may be placing her in assisted living which would only further hasten our fathers decline. Unsure what to look for, or where to look. Had hoped this would be a good place to start.
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I hate to burst your bubble but there is no way you can "force" your time line on your parents.
So as much as you don't want to do this you are going to have to WAIT.
You wait until something happens to m om or dad or both.
What you can do is talk to them NOW and ask the following questions.
1) Dad, if something happens to you what are your choices for CPR, IV's, Tube Feeding.
2) Mom if something happens to you what are your choices for CPR, IV's, Tube Feeding. (if she has diagnosed dementia I would argue that none of these options are good ones)
3) Mom, Dad what are your wishes for Funeral? Can we get that arranged and prepaid?
Do they have POA's in place for Medical and Financial decisions?
Once you get the answers to these questions their life choices are pretty much out of your hands.
You can chose to be as involved as you want to be once they need help. Let them know NOW how much you are going to be able to handle.
Now all you can do is Back off and let them live the lives they want to live.

**all that said, if you think your dad's mental decline is adversely effecting his decision making capabilities and is putting your mom or himself in danger then you can step in and either have the POA that I hope you have effective or you try to obtain Guardianship.
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Hip replacements do not indicate "failing health", however dementia and cognitive decline DO, depending on severity. It seems like dad is taking care of mom and not looking for a family intervention at the moment.

If your parents are able to "play at length in their state-of-the-art Polaris Razor/Dune-Buggy, traveling for extended periods between the Montana Rocky Mountains, and the Arizona desert from their home in southern Colorado" then it sounds like they're well enough to be enjoying life to the fullest right now, God bless them. Unless they are posing a risk to others, posing a risk to themselves is irrelevant because if they die playing, they'll have died on THEIR terms instead of on yours. I'd rather go out laughing than crying, truthfully.

You can't force two grumpy old white people to accept low wage "care providers" to come into THEIR home if they're against it, so I'd mind my own business if I were you and wait to be asked before going out of your way to help your parents.

From your profile:
About Me
I would like very much to speak with someone knowledgeable as to the ins and outs of senior care, ON MY SCHEDULE, not the other way around. I am annoyed by the prospect that this is just a clearing house for senior care services in much the same way Kayac.com is a clearing house for travel. I tried this once after which I was inundated by UNTIMELY calls from organization I had never heard of wanting to talk to me about difficult life decisions about family members in the middle of my work day. Can't we do better? Please advise. 

You are on a forum of caregivers to elderly loved ones, OP. If you'd like help from A Place For Mom, click above where it says Find Care.
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AlvaDeer Dec 18, 2023
OMG I have the serious giggles now, and fear I cannot be cured.
Thank goodness for AC. It always makes my day.
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........................."impose some kind of assistance?" you say.

Golly. I think I might begin by working on the wording a bit.
Elders just HATE to have things "imposed upon them".
Especially when they're out there playing in the Rocky mountains.

I think I would first work on kinder/gentler approach.
I'm 81: often things like "help you" and "assistance" and "do you have plans" and "can we go over your assets" and such like come to sound a bit like "Things change one coffin at a time, and yours is just around the corner in case you didn't notice".
It sounds like--you know--loss. Or even a take-over. And more losses coming.

We old folk recognize that we aren't going to get younger. I bet that holds true for both me AND your folks. But we are proud (my mom used to say "ALL pride is FALSE pride"; one of the few things I disagree with her on) of how well we are doing.

When the help is needed I suspect there will be a whole different industry out there waiting. So I wouldn't waste time worrying about it as it exists this month.

I am just now at the point where I am thinking, at 81, "You know, maybe not wise to be climbing up in that fig tree to trim. Already fell out of an oak. Something could just bust next time. Why not look in the next door ads"........
But so far I haven't.

So, trust me. Your parents, being of sound mind, are likely already thinking.
As long as their minds STAY sound they'll handle this in their own time and way.
As you recognize it's getting closer.

Just be open to them.
And if a good way into such subjects as "end of life wishes" come up (Like Uncle James on the ventilator) then ask if they have considered and written out and discussed such things with all of you, or if they would. Unless they already did. I have discussed things lifelong, being an old retired RN.

When you bring up things to them, preface them with YOUR OWN aches and pains.
I guarantee that method.
We 80s year old parents just LOVE to hear about our kids in their 60s crumping. I still remember my own mom happily saying "You know, I think the gene pool is getting shallow. You kids get atrial fib earlier than I did!").
And when my daughter, 62, tells me about her problems with nerve pain and bladder, what have you, it is oddly comforting.
So you can kind of try this one:
"Gee, Mom, I got AWFUL nerve pain in my neck. I was thinking. I don't know how you maneuver that vacuum under the sofa. Ever think of just hiring it out once a week, because I sure am!"

Your Mom will just love that one. She will say "Well, I guess I feel pretty good because poor tj's neck's a mess. And it will open the door. Tell her "Gads, I want a housekeeper, but I keep thinking here YOU are with no help at all! I feel a mess!" That will work.

I am trying to give you just a little humor on this.
I honestly recognize you are loving, well-meaning, and want to help.
But it's an odd time when the tables turn. Because for years your Mom looked at you as just a kid. Even when you had wrinkles and crow's feet she felt that way. And it's hard to know that you are growing into someone who might "impose something" on her.

For now, I would say, just love the folks being on the trails, admire their fortitude and compliment them on it, and wait until they ask you for help.
You sound like a loving family (to say nothing of great genes). Please continue to love one another and take care. I have every confidence that you will all do great. And wish you all the very best and continuing health.
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AlvaDeer Dec 18, 2023
PS, tj. I just read your profile info which was kindly reposted for us.
It appears that you have a much better sense of humor than I do, and I bow to it. I haven't stopped giggling since reading it. Just a little advice if you apply to any caregiving agencies and then are in future bothered with them bothering YOU: tell them that your parents are on Medicaid. This often has a magical effect on them that causes them never to contact you again. That's honestly the truth.
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First to clarify: no one is forcing you to provide or manage their care. It feels that way emotionally because they are your parents, but this is not the case. It's voluntary. So, you decide. And even if you decide to plunge headlong into it, any other siblings are not obligated so don't get mad at them if they opt out.

Next: unless you are their DPoA (or someone is) then you won't be able to impose any sort of help or solution without their cooperation. You will have no power. You need the legal authority to do this (PoA or guardianship).

Maybe you are getting the cart before the horse: you need to have the conversation about whether they have all their legal ducks in a row: PoA and back-ups assigned for each of them (and hopefully a Advance Healthcare Directive created, Medical Representative, pre-need guardian, etc).

Start with this. You may be shocked that they haven't done any of this or are in denial or get angry. If so, then don't make any plans in advance about their care because you'll have no idea how things will go down.

I commend you for trying to think ahead (this is me, too) but from personal experience you will waste a lot of energy if you don't have the conversation with them first.
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lealonnie1 Dec 18, 2023
Even with POA, the folks can keep their door locked and refuse entry to these "low wage "care providers" under the umbrella of a corporate conglomerate" anyway! I sure would.
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