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How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
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Could you tell us a little bit more? What about all of the activities of daily living like cooking, cleaning, dressing, bathing, eating etc. Can she do all of those things herself without help? There are so many conditions and diseases that create cognitive and physical problems but at the end of the day it boils down to the person's ability to take care of herself doing day-to-day activities. That would be a big part of any assessment so please tell us more so we can better help, aside from advising on the obvious ambulatory and safety issues.
Well she was told last March that she was in stage 3 and very close to stage 4 for her kidney function. She does not cook for herself ( we bring her meals up the stairs)otherwise she won't eat. Prior to going down south (July to October) visiting in laws she was able to get up and down stairs. Some days she is able to make it to the bathroom, others not so much. She wears Depends and cleans herself as best she can. She needs cataract surgery in both eyes but she is afraid to undergo surgery. Hence,she is terribly unsure of herself, so she won't use the shower chair to bathe or come down stairs with my husband's assistance. She has memory loss, and cries out the names of her sons at night. Of course she is unaware of this.90% of the time she sleeps, sits in her room looking at the walls or her TV.She cannot go to any other places of the house because she does not do the steps and can barely walk. I believe she is depressed and has given up on living. She will talk on the phone and tell everyone how she's been out to see her doctors. This isn't true at all because she hasn't seen a physician since we took her to the hospital in November. The hospital strongly suggested that she see her primary physician. She has canceled the appointments when the doctor's office called to confirm. My husband has power of attorney but does not feel that she is ready for additional outside help.
How terribly sad. I'm sure your husband cares deeply for his Mom, maybe he is not able to accept her deteriorating condition or perhaps he believes he is honoring her wishes. Have you talked to your state Elder Services? Perhaps they can guide you.
No one with mobility issues should be on the third floor. The first thing you need to do is rearrange the first floor living space so she can be on the first floor.
Then get a medic alert so any change of posture will trigger a response from the monitoring company. If she falls and the first alert people (such as the family) aren't available, they can call the police or EMS to respond.
Get a lockbox for the exterior of the house; mount it directly into the studs and put a house key in. This will allow EMS or the police to get inside in an emergency.
I would also get internal sensors and cameras to help with the indoor monitoring.
Put grab bars along the routes she'll need to travel on the first floor; get some kind of portable bed if you can't bring down on of the regular beds.
If you don't have a bathroom on the first floor, then get a commode.
To get her to a doctor, SAFELY, contact the local transit agency and ask if they have paratransit, door to door or point to point services. It's described differently in different areas but these vehicles are typically equipped with wheelchair lifts so people with compromised mobility can just sit in their wheelchair and be hydraulically lifted into the vehicle.
When you do get her to a doctor's office, ask for a script for home care. She can have PT at home. She really needs to get therapy for her mobility or she'll be worse, very quickly.
If she doesn't have a walker or rollator, get her one, as soon as you can get her to a doctor, including an orthopedic one.
Your husband is in denial. She needs help and she needs it NOW.
If I had mobility issues and was confined to one floor, I'd be more than depressed.
TMB makes a good point that I didn't think of, i.e., that your husband is in denial. If he could accompany her to a doctor's visit, he could get a better idea of what she's facing.
It may also be that he doesn't really know what to do or where to start. You might have to be the guide on this.
First issue though is to get her down to the first floor. Being trapped on a third floor is a definite safety hazard. If you need support, ask the police or fire department to opinion on this issue.
Thank you all so much! I know this is a terrible position to be in. We live in a row home so there is no place for a commode or bed on the first floor. I have been in so many arguments with my husband over this that I'm ready to leave. But before I do I want to get her into a safe place. This house is NOT it. ( Incidentally she does have a walker)
CK, I can't emphasize how dangerous this is, even if your husband is taking a head in the sand approach. How would he feel if she fell down the stairs, or if a fire broke out as Pam suggested? He could possibly be criminally charged since he failed to provide a safe environment.
Even if there is no space, something has to give and this poor lonely woman needs to be safer.
What you could also do is anonymously contact APS and advise that she's living in an unsafe environment. I'd hate to do that to a husband, but the bigger picture here is your MIL's safety.
And even though that's the priority, the secondary issue is whether he's going to take an intransigent attitude on other issues relating to her care. If so, I foresee a lot of battles ahead.
Is there anyone to whom your husband listens? Family member? Good friend?
CK1964, my elderly parents had a similar situation in their house, it was extremely difficult for them to go from the 1st floor to the 2nd floor, and Dad could barely make it to the basement to get to his workshop. They had fallen on the stairs numerous times according to my Dad. Plus getting in and out of the house because of that one step from the house to the outside level. My gosh, what were they thinking trying to continue to live in that house.
A major crises happened to change my Dad's mind about leaving the house for something safer, in fact we move Dad into Independent Living today, he's happy as a clam now.... sadly my Mom's mind couldn't be changed because she died a month ago due to a serious fall. If only she would have accepted a move to something safer :(
Yep, your hubby is in deep denial. Feel free to tell him about my Mom [98], and ask him would he want that to happen to his Mom. I bet his Mom has fallen numerous times but has been afraid to tell anyone.
If the first floor isn't going to work out, then she'll need to be placed in a group home or nursing home - ASAP - where there's usually a nurse practitioner or doctor seeing patients regularly. If this is too expensive, another option is to get her into a groundfloor apartment and hire round-the-clock caregiving or to stretch the dollars, either you or your husband or some family member can be with her part of the day. Depending on where you live, there can be non-emergency transport for wheelchair-bound or people suffering from other mobility challenges. Where we live, it's a little pricey but is affordable occasionally. Arrangements about your MIL's situation needs to be made ASAP because if there was an emergency and access to her is a problem, her doctor may want to why is it his patient with serious mobility challenges is not in an environment suited for her irreversible condition. Is your husband ready to give an answer to Adult Protection Services if the doctor or someone else calls them to report his mother is not in a safe environment? This can get ugly very fast.
I know it may sound daft but have you considered a stairlift? They have arms and you can also have a safety belt to hold them in place as long as they can sit upright (my mum can't). They aren't cheap but you might be able to get a second hand one and you can sell them later then move her down one floor and put a commode in her room and a wash stand for hygiene or a bowl on a tb le or wet wipes or even hand gel although that last is not so good for extended use - YOU MUST wash your hands after the third use or bacteria starts to grow on the gel which rather defeats the point of its use.
Could an Occupational therapist (or whatever you call this particular OT in the USA) come and visit the home WHILE HUBBY IS THERE and advocate what a) Must be there b) should be there c) what would be useful d) what else you could consider
For then and only then can you plan for her safety and possibly your husband will learn that she is not immortal. I am not being flippant here but a lot of people stay in denial not recognising that the final stages of life can come quickly
OhJude, glad you brought that up; have a friend who has one, but do you really think that's the solution in this situation because even if she could then get down, then what? or maybe can you move them in and out, though I know that still leaves her up there, or maybe she could at least be down in the daytime while they're gone?
That why I suggested the OT Debs - mum isn't suitable for a stairlift - she WAS....when the OT came but when she did an assessment she said it wasn't suitable because of mums declining posture. While it would have been great for a year (actually slightly more but who's counting) in the long term it would become unsuitable hence us moving not adapting.
IF we had had one Mum could have retained the use of her bedroom upstairs and had a commode and washstand downstairs.
My real concern is with that level of lack of mobility is this woman safe to be left alone and only an OT can tell you that for sure. The one thing that they will be interested in apart from everyday stuff is .... in the event of an incident can she get out of the house to safety. Mum can't now if she were alone in the house and to that end if I DO have to go out and there was an incident alert then the response services know there is a vulnerable person in need at this address
I guess one thought is if she is in later stage kidney failure is she actually Hospice? The one reservation I would have about an institution is that sometimes the care is so negligent at nursing homes that she might be better off where she is. We love to imagine that residents of skilled nursing are lovingly watched, constantly tended to, and that every danger is removed, but staffing is frequently 12/1. At home she is at least free to get up and use the restroom rather than being parked in a wheelchair at the nursing station and forbidden from standing ("SIT DOWN Mrs. Smith -- you might fall") while being forced to wait 45+ min or soil herself when she has to go to the bathroom. Maybe you could hire someone (neighbor?) to come around mid-day to check up on her, eat lunch with her, etc. Also, there are Dr.s & Nurse practitioners who will visit patients who are housebound (which she is. really). Local Hospice providers may have a list of Drs. who do house calls.
Confined to the third floor: 1) Is not safe 2) Is not emotionally satisfying or intellectually stimulating. It is depressing, in the clinical sense 3) Is probably illegal
Good luck in breaking through hubby's denial.
(Would reading these posts be educational for him?)
wonder who was seeing her in the hospital that they didn't do any more then than just say she needed to see her primary and wonder if they let him know she was in there, if he didn't see her there?
My Mom had what I thought was excellent care in her nursing home. My Mom [98] would try to get up to go to the bathroom but she kept forgetting she could no longer walk, thus would be falling constantly.... one reason she was kept in her Geri recliner by the nursing station, as she was a major risk to herself.
Being that she is late stage kidney failure, perhaps turning your dining room or a section of your living room into a bed/sitting area for her might be a solution for her. The isolation alone is a bad place to be for her depression. If he Loves her that much, it's the least thing you could do for her. It doesn't sound like she has that much time left on earth, and if you can get Hospice in, all the better! If there is no possible way you can get her to the ground floor, then other suitable living arrangements need to be looked into! I can't imagine being stuck up on the third floor for the rest of my life, it must be terribly lonely for her!
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Then get a medic alert so any change of posture will trigger a response from the monitoring company. If she falls and the first alert people (such as the family) aren't available, they can call the police or EMS to respond.
Get a lockbox for the exterior of the house; mount it directly into the studs and put a house key in. This will allow EMS or the police to get inside in an emergency.
I would also get internal sensors and cameras to help with the indoor monitoring.
Put grab bars along the routes she'll need to travel on the first floor; get some kind of portable bed if you can't bring down on of the regular beds.
If you don't have a bathroom on the first floor, then get a commode.
To get her to a doctor, SAFELY, contact the local transit agency and ask if they have paratransit, door to door or point to point services. It's described differently in different areas but these vehicles are typically equipped with wheelchair lifts so people with compromised mobility can just sit in their wheelchair and be hydraulically lifted into the vehicle.
When you do get her to a doctor's office, ask for a script for home care. She can have PT at home. She really needs to get therapy for her mobility or she'll be worse, very quickly.
If she doesn't have a walker or rollator, get her one, as soon as you can get her to a doctor, including an orthopedic one.
Your husband is in denial. She needs help and she needs it NOW.
If I had mobility issues and was confined to one floor, I'd be more than depressed.
It may also be that he doesn't really know what to do or where to start. You might have to be the guide on this.
First issue though is to get her down to the first floor. Being trapped on a third floor is a definite safety hazard. If you need support, ask the police or fire department to opinion on this issue.
Even if there is no space, something has to give and this poor lonely woman needs to be safer.
What you could also do is anonymously contact APS and advise that she's living in an unsafe environment. I'd hate to do that to a husband, but the bigger picture here is your MIL's safety.
And even though that's the priority, the secondary issue is whether he's going to take an intransigent attitude on other issues relating to her care. If so, I foresee a lot of battles ahead.
Is there anyone to whom your husband listens? Family member? Good friend?
A major crises happened to change my Dad's mind about leaving the house for something safer, in fact we move Dad into Independent Living today, he's happy as a clam now.... sadly my Mom's mind couldn't be changed because she died a month ago due to a serious fall. If only she would have accepted a move to something safer :(
Yep, your hubby is in deep denial. Feel free to tell him about my Mom [98], and ask him would he want that to happen to his Mom. I bet his Mom has fallen numerous times but has been afraid to tell anyone.
Could an Occupational therapist (or whatever you call this particular OT in the USA) come and visit the home WHILE HUBBY IS THERE and advocate what
a) Must be there
b) should be there
c) what would be useful
d) what else you could consider
For then and only then can you plan for her safety and possibly your husband will learn that she is not immortal. I am not being flippant here but a lot of people stay in denial not recognising that the final stages of life can come quickly
https://www.agingcare.com/questions/I-have-an-important-share-Not-a-question-May-I-share-193873.htm
And in a situation like this I would not be at all surprised if someone were to report this to Adult Protective Services.
IF we had had one Mum could have retained the use of her bedroom upstairs and had a commode and washstand downstairs.
My real concern is with that level of lack of mobility is this woman safe to be left alone and only an OT can tell you that for sure. The one thing that they will be interested in apart from everyday stuff is .... in the event of an incident can she get out of the house to safety. Mum can't now if she were alone in the house and to that end if I DO have to go out and there was an incident alert then the response services know there is a vulnerable person in need at this address
The one reservation I would have about an institution is that sometimes the care is so negligent at nursing homes that she might be better off where she is. We love to imagine that residents of skilled nursing are lovingly watched, constantly tended to, and that every danger is removed, but staffing is frequently 12/1. At home she is at least free to get up and use the restroom rather than being parked in a wheelchair at the nursing station and forbidden from standing ("SIT DOWN Mrs. Smith -- you might fall") while being forced to wait 45+ min or soil herself when she has to go to the bathroom.
Maybe you could hire someone (neighbor?) to come around mid-day to check up on her, eat lunch with her, etc. Also, there are Dr.s & Nurse practitioners who will visit patients who are housebound (which she is. really). Local Hospice providers may have a list of Drs. who do house calls.
1) Is not safe
2) Is not emotionally satisfying or intellectually stimulating. It is depressing, in the clinical sense
3) Is probably illegal
Good luck in breaking through hubby's denial.
(Would reading these posts be educational for him?)