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Does anyone have siblings that don't help their parents adhere to doctor's instructions because they feel their parents are "just going to die anyway' and should do what they want?
Sandwich a stroke may or may not make Mom a vegetable as you know but she would not enjoy the build up of fluid in her body. Can't eat because of a belly full of fluid, can't breath because the waves are lapping in her lungs and legs so swollen the skin pops and she has weeping ulcers. Not a pretty sight.
My mom complains and says that if she has another stroke she doesn't care because she'll be dead. Well, that's not guaranteed. You can end up a vegetable from a stroke.
It is very difficult to win this battle doing care at home. Thank heavens my mom is in a facility where she gets her meals prepared by the kitchen. She gets a diabetic/kidney/High BP diet and that's that. She thinks that's the same thing everybody else gets, and even though she doesn't like it, it's what there is. There's no access to snacks in a cupboard, and complaining does nothing.
If mom were on hospice, then I say let 'er rip. Cake, burgers, pizza, and all the pepsi she can guzzle.
Yay Vikki, I am with you and am stunned too that people do not feel they should have to modify their lifestyle to stay healthy. Your cousin certainly is an example. In my experience, you are an unusual for a medically trained person.
Diet and exercise can prevent or treat adult onset diabetes. Metabolic syndrome is primarily caused by obesity and inactivity (quote from Mayo Clinic). Cardiovascular disease is linked to diet and lack of exercise and other lifestyle factors. I have to continually adjust my diet and activity as I age I order to not gain weight, and to keep my blood sugar, blood fats and blood pressure in a good range. In doing so, I concentrate on getting the biggest nutritional bang for the buck, so to speak. Untypically as I age, I have found I have less desire for sweet things. Fruits are fine for that and them in moderation. I agree that you can adjust your tastes for salt and , I have found, also for sugar. I eat a little whole grains, some legumes, coloured veggies, lean meats or fish, eggs in moderation, nuts, coconut milk yogurt a little dark chocolate and some fruit - mainly berries. I largely avoid processed foods. Cakes, pie etc. are a very rare treat. A common one is a single brown rice cookie. I make muffins from ground flax sometimes - low carb. I know my calorie needs are lower than they used to be and will continue to drop. I don't need much more that about 1600 calories.
It isn't rocket science. If we want to stay healthy, we have to adjust what we eat and how much we exercise accordingly. I find there is plenty of good tasty healthy food, even with my gluten and dairy allergies. My afternoon snack was a plate of mushrooms sautéed in a little coconut oil.
Off my soap box.
I gather part of the issue is that the sib brings high sodium meals over for her parents and they eat them.
If siblings feel your food is not tasty enough, sibling should be cooking for parents. I can see why this would bother you. I am sure your meals are fine.
OMG, yes, yes, YES! My sibling is a NURSE also; helps the bare minimal amount but has no shortage of stupid, snotty, uppity ("I'm THE top medical professional in the entire world") advice.
It has pretty much destroyed our relationship.
I truly feel for you; I understand how antagonistic this can become.
Some things you compromise on, some things you don't. I say if two pickles and a bag of chips will push you over the edge into the hospital, stick with one pickle slice on the low-sodium turkey sandwich. You can get your taste buds used to lower salt, it is not that hard. Eat just the things that taste good without salt for a while and it will come naturally.
I remain stunned at the number of people who find it unimaginable that they should have to modify lifestyle or diet in order to preserve health and mobility. I don't know whether to blame that on advertising and constant jokes and funnies about how it is too hard to get off the couch or stop stuffing yourself full of high fat, high sugar treats and desserts as a steady diet. I think about all the outrageous commericals of slender, healthy, active people eating various candy bars and presenting a picture of who absolutely blissful it is to do this. (Some people can just have those things occasionally; I'm someone who truly has to avoid them altogether if I want to stay un-diabetic...and I won't even get into the rampant denial of the seriousness of long term consequences of that...OK I'll get into it - I have a cousin who brags on FB about eating waffles with syrup and cinnamon buns and weighs 300 lbs, needs u100 insulin, and has now developed fatty liver, but is pleased that it has made her blood sugar lower so she thinks she can eat even more carbs - in other areas of her life she is absolutely brilliant.) Morbid obesity is not a benign condition; even without diabetes in the picture there is high inflammation in the body, wear and tear on the joints, risk of sleep apnea, and even some evidence that poor sleep the inflammation affects brain function, hence the endorsement of Pam's comment above.
Now, that said, I have to admit that yes, you make some allowances and don't go overboard on optimal diet when quality of life is paramount and nothing much you do or don't do will add many years of health; sometimes whatever brings on a good mood and certainly when the first goal is just to get adequate calories into someone with a poor appetite, an ADA 1200 or 1400 calorie plan makes no sense. But that's for when the horse is already out of the barn, IMHO.
The problem is not the diet, but that the sib is interfering. The sib is angry and it makes WOD angry. WOD ought to just smile and say I'll take that into consideration, like the other poster said. The sib will just have to be angry. WOD is not responsible for sib's anger.
Ha - We're ALL going to die someday, but I can't run around eating cake and ice cream all day long, every day. What kind of logic is that?
Until a doctor and hospice tell me mom is really, really, really near the end, she is going to be on her meds and restricted diet. The end, no discussion.
It helps A LOT that my mom is in a memory care facility where the meals are prepared by the kitchen to the diet orders for each person. Mom gets low sodium, kidney disease, diabetic meals and snacks every day.
If I let her have the McDonalds and pizza and dark pop like she wants, she'd be dead from a stroke or kidney failure in short order. She's not on hospice, so there's no point aggravating her conditions.
To WornOutDaughter, Yes. We do have siblings that think they know better than we do. Not so much that our parent is going to die anyway, but that they just know more about everything. Medicine, nutrition, clothing, anything and everything. I used to try to defend my actions, but realize that's useless so now I just do like I did when my kids were babies. I smile, say thank you, I'll take that into consideration and then do what I want to do.
Veronica and others: Try the Morton's No Salt. I keep in a salt shaker on the table and Mom doesn't seem to notice the difference. I cook with very little salt and try to buy low sodium food when possible. It has made a difference with her legs swelling. Also, she has developed an intolerance to lactose as she has aged. We buy Lactaid milk (or the generic equivalent) and it is wonderful. The added bonus is that it has a longer shelf life. We have cut out ice cream for now, except for the occasional treat. She doesn't need the fat and calories either, and we don't eat it anyway (doctors suggestion from years ago). Anyway, that way she can enjoy her morning cereal and I also cook with it.
Well as an elder I can attest to the fact that our tastes do change. I am able to limit the salt but do ocassionally treat myselt to a jar of pickled herring. I still like chocolate but in very small amounts and a bar may last me a week. Potato chips are another luxury and there is usually a bag close by but that bag may last me almost a month. Deserts, cookies and cake have almost disappeared. I have not specifically been prescribed a low salt diet but when I have overdone it I know to stop because my legs start to swell a little and I realize the warning signs. I still take sugar in my tea and coffee but no longer eat cereal because I am lactose intolerant. I am my own food police and would be very resentful and devious if some one else tried to control what I eat.
Everyone said what I am thinking very well. My mother loves salt. I tried to put her on a low-salt diet in the past, but she fought it. She doesn't understand that the leg swelling, 3 different blood pressure medications, plus Lasix might be able to cut back if she would quit craving salt. I keep the salt as low as possible, but decided the battle was not one I would win.
My mother talked about not taking the medications, because they probably didn't do anything. Of course, I know they do, because we've had problems keeping her bp down at a safe level. I know she won't live forever, but I don't want her to have a stroke. Chances are great that she would continue to live, but be unable to do much. What kind of life would that be?
So I would say that IF someone can get a parent to cut back on the salt, it is a very good thing. It is better to cut back on salt than to add medications to keep bp and swelling down. And we certainly don't want to increase the risk of damage from a stroke or heart attack. Wouldn't it be nice if our elders wanted less salt and sugar when they aged, instead of more?
I can understand the frustration. Our parents (if capable) can decide what medical advice they want to adhere to. We & the doctor can tell them something is not good for them and why, but ultimately it's up to them. Each situation is unique. For some people who may not eat well, I say let them eat what ever it is they want. For others moderation is the key. We know sodium isn't good for a variety of reasons. Try using different spices to make foods taste better. Maybe they want regular mashed potatoes with salt but can use other spices on vegetables or meats. Some foods are just not good without salt while others I can do without the salt; garlic, lemon pepper, cumin, turmeric, curry, onion are all good spices to use to flavor foods. Mrs. Dash makes a variety of spice combinations that can be used. My dad is the same way so I compromise, I cook with salt (for some foods) but don't allow it on the table, or I may not cook with salt, use spices and he doesn't miss the salt. Either way it's a battle to find a compromise that works. Good luck.
So what your sibling is angry? Keep trying to follow the diet the doctor has ordered and tell the sibling if they have a problem to speak to the doctor directly, and then stop trying to please this sibling. You are wasting your valuable time you could be spending with your parents.
I'm with the common sense approach. That never in our life leads to "do just anything you want and ignore the consequences and maybe just let yourself or someone else die." Yes, everyone does die, but I don't agree that it's common sense to hasten it along.
My mother is in mild dementia so she is still able to make a lot of decisions, herself. She does tend to stray off her low sodium diet if I don't remind her. She and I had a talk about what she wants. Here are some things she is definite about: She doesn't want to die. She doesn't want to end up back in the hospital. Like most of us, she does want to eat whatever she wants, but she does realize she can't do that and does want to stick to her diet.
So, it is kind of part of the human condition that, if asked, we all would like to eat whatever we want without consequences. To say that a person should be eating just anything and just let them die, when they don't really know any better and we're supposed to be their caretaker - that wouldn't be right, either.
With that said, I agree that we shouldn't be the food police and make things too strict, either. I try to keep all the worst snacks out of the house. Mom does forget what she eats. So, as an example, she might herself say she wants to limit her snacks to two cookies. She'll do that but then forget she had her two cookies and eat two more.
There are certain snacks that I keep available all the time, other snacks that sit on the counter for a limited time, other snacks that don't come into the house. Of course, if a person really desperately wanted something that is highly salty, I can see that a snack-sized bag once in a while might be a way to address that urge. Fortunately for me, my mother is a candy/cookie hound and doesn't that much about chips.
My mother admits she has a hard time remembering what she is and isn't supposed to eat. One day, she ate the deli-sliced cheese as a snack. In the previous part of her life, she never would have eaten that as a snack. These days, it's hard for her to know if I don't hide things a little - she really just forgets and does need my help. During her reasonable times, she also wants my help.
WOD - how often does your sib bring over fast food? Can you leave lower sodium meals in the freezer for your parents? Are your parents "with it" enough to politely decline the fast food, at least sometimes, and eat their own food while visiting with the sib? Does your dad suffer enough after eating one of these meals to be a deterrent for him? A lot of questions, I know. Sounds like the sib has serious food issues, possible addiction and wants a "partner in crime". People feel better about overeating if they are in the company of others who do the same, and will encourage others to eat the wrong things. I have experienced that with overweight people who can get quite huffy if you refuse a muffin. "Here, one muffin won't hurt you". Well, for me, the pounds go on one muffin at a time. There are other foods I would rather spend my calories on. I think you are coming from a place of caring for your parents and wanting the best for them. Can you find a middle ground? Good luck! Your parents are fortunate to have you.
I think this is an issue on which reasonable and well-intentioned people can differ. Both my husband's geriatrician and his neurologist said, "Let him eat what he wants and can swallow." The nurse who monitored his weight daily (electronically) for CHF wanted, of course, a low-salt diet for him. Since he'd been doing that, more or less (more than the average person and less than ideal) for years it wasn't a big deal most of the time. But when we'd go out to eat, his weight would be up a bit. No swelling and no symptoms, but slightly higher weight.
Once we had this conversation over the phone: Nurse: Coy's weight is up quite suddenly, quite a bit. Me: Oh. That was probably because he had a big pickle with his Ruben sandwich at the deli yesterday. Nurse (sounding scandalized): Don't you realize that that is a very high-salt meal and not advised for people with CHF? It will cause swelling and is hard on his heart. Me: I do realize that and we were much more careful before his dementia diagnosis. He has a terminal disease. I am not going to deprive him of a beloved deli meal once in a while. I know he will retain water for a few days. So be it. I do want to monitor his weight and keep the increases within bounds and not lasting long, and the electronic scale is helping us do that. But I am not on board with a total low-salt diet for him all day every day.
It doesn't sound like your sister has much influence over what your parents actually eat, at least not very often. Do you think her attitude really makes much difference in your parents' lives? If not, why don't you just agree to disagree and go on controlling their diets as you see fit?
I agree with everyone that while the parents continue to enjoy some quality of life they should continue to follow dietery recommendations. If Mom no longer continues to not be able to cook could you make up some things that can be warmed up. Failing that if you are too busy get some microwaveable meals that are low sodium. Sounds as though the parents could afford to buy ready made meals. Do the best you can that's all you can do.
My battle was with cigarettes. The smokers feel we should allow occasional cigarette. Mom has hypertension and COPD, among many other problems. No inheritance issues, they just feel she should have quality of life over quantity. Ok, so are they available 24/7 to sleep at hospital and handle the after care? They used to sneak cigarettes to her. Since my brother passed and I fired the previous caregivers, it hasn't been an issue. I don't claim to be perfect but I'm the only one here. Me and the dogs and the crickets.
WOD, Education should never be confused with Common Sense. Ron White said "You can't fix stupid. There's not a pill you can take; there's not a class you can go to. Stupid is forever."
Thank you for all the advice and comments. My sibling and in-law are morbidly obese and don't take care of their own health. I would be surprised if they live past 65. That is another issue - since it's not a big deal to them, they don't think it's a big deal for my parents. Wrong. Even sadder, they are not uneducated people. They know better but are too unmotivated to help themselves let alone anyone else. Maybe I expect too much.
Hi, Windyridge - I believe they should be able to eat what they want in moderation. My concern is quality of life prior to passing. Everyone does die eventually, but I would rather my father be as comfortable as possible. My parents do understand the point of eating low sodium - they have always been health/weight-conscious. It's just the hidden sodium that causes problems, and the fast food my sibling brings them is part of the problem. It's just so easy since my mother doesn't like to cook anymore and it stresses her sometimes.
Tell her to walk a mile in their shoes with swollen ankles and pain on every step ...failing that why dont you butt out might be a little strong but hell if they arent doing the work they shouldnt be a jerk
For those who think low sodium doesn't make a difference: when mom stopped going out for lunch and stayed with the ALF low sodium fare, she lost ten pounds, the leg swelling went down and the shortness of breath improved, all within a month. BP lowered and so did heart rate. So if you want to kill them off, pass the salt. It won't be pretty.
Thank you! I know I'm not the only one with these issues, and I sympathize with others that do. I told my sibling that I know I don't know everything, but I do know quite a bit (I've been an RN for 12 years now) and I'm only trying to keep my father from suffering the side effects of too much sodium in his system. I don't want to see him suffer with shortness of breath and swelling in his legs due to decreased circulation. And he hates to be in the hospital, so my goal is to avoid it at all costs. I'm not bossy or nasty or think I'm God's answer to nursing - I am just trying to help. I am at my parent's house every day except when I work on the weekends doing 12 hour shifts, and a lot of the time, my husband is over there, too. My father and my sibling have not been close, and any involvement is limited to taking my father for a haircut, or out to eat (if my parents are paying), and grudgingly checking on them maybe once a weekend. I have POA for both financial and medical, and my parents live in their own home, but I am within walking and seeing distance. My sibling lives even closer, but is more concerned with going out and having a good time and not letting anyone interfere with that. I'm just tired of walking on eggshells because even though the help is limited and infrequent, I can't make my sibling and in-law mad because then my mother, who has moderate dementia, will be upset. I don't want to make her more anxious. I have not talked to my sibling for a week, and am in no hurry to do so. And the inheritance will be substantial; we're not talking a million dollars, but enough to pay off a mortgage on an average single family home and buy a condo, if you get my drift.
I think it always a balancing act with nutrition and hygiene with elders. It's not realistic to expect old folks to maintain our levels of diet and grooming. You do the best given the circumstances you have. A low sodium diet is fine if your parents don't fight it. If they don't want it, so what. Will they only live to 100 instead of 102? As for the sibs, tell em go............yourself.
My sister was supportive of my mother not taking her antipsychotic meds. Mother ended up suicidal and spent a year in a geriatric psychiatric hospital till they got her back on them. She might have done it on her own anyway, but my sister did not help and was critical of me for wanting mother to continue on them. It makes the caregiver's job that much more difficult and I sympathize with you. There are many stories on here about uncooperative and obstructive siblings who don't help but criticize.
Is your sibling close enough to go to the doctor or dietician who prescribed this diet with you to get the story from them?
Everyone is just "going to die anyway." That does not mean we should not do what is right for our health.
Is your sib waiting for their inheritance and wanting your parents to die sooner? Many have that agenda.
I cut contact with my sister after years of verbal abuse and share information as needed with her daughter, my niece. I don't need any more of it.
BTW who has POA financial and medical? Are your parents living with you or in their own home. You have a huge load with two parents to care for.
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It is very difficult to win this battle doing care at home. Thank heavens my mom is in a facility where she gets her meals prepared by the kitchen. She gets a diabetic/kidney/High BP diet and that's that. She thinks that's the same thing everybody else gets, and even though she doesn't like it, it's what there is. There's no access to snacks in a cupboard, and complaining does nothing.
If mom were on hospice, then I say let 'er rip. Cake, burgers, pizza, and all the pepsi she can guzzle.
Diet and exercise can prevent or treat adult onset diabetes. Metabolic syndrome is primarily caused by obesity and inactivity (quote from Mayo Clinic). Cardiovascular disease is linked to diet and lack of exercise and other lifestyle factors. I have to continually adjust my diet and activity as I age I order to not gain weight, and to keep my blood sugar, blood fats and blood pressure in a good range. In doing so, I concentrate on getting the biggest nutritional bang for the buck, so to speak. Untypically as I age, I have found I have less desire for sweet things. Fruits are fine for that and them in moderation. I agree that you can adjust your tastes for salt and , I have found, also for sugar. I eat a little whole grains, some legumes, coloured veggies, lean meats or fish, eggs in moderation, nuts, coconut milk yogurt a little dark chocolate and some fruit - mainly berries. I largely avoid processed foods. Cakes, pie etc. are a very rare treat. A common one is a single brown rice cookie. I make muffins from ground flax sometimes - low carb. I know my calorie needs are lower than they used to be and will continue to drop. I don't need much more that about 1600 calories.
It isn't rocket science. If we want to stay healthy, we have to adjust what we eat and how much we exercise accordingly. I find there is plenty of good tasty healthy food, even with my gluten and dairy allergies. My afternoon snack was a plate of mushrooms sautéed in a little coconut oil.
Off my soap box.
I gather part of the issue is that the sib brings high sodium meals over for her parents and they eat them.
It has pretty much destroyed our relationship.
I truly feel for you; I understand how antagonistic this can become.
I remain stunned at the number of people who find it unimaginable that they should have to modify lifestyle or diet in order to preserve health and mobility. I don't know whether to blame that on advertising and constant jokes and funnies about how it is too hard to get off the couch or stop stuffing yourself full of high fat, high sugar treats and desserts as a steady diet. I think about all the outrageous commericals of slender, healthy, active people eating various candy bars and presenting a picture of who absolutely blissful it is to do this. (Some people can just have those things occasionally; I'm someone who truly has to avoid them altogether if I want to stay un-diabetic...and I won't even get into the rampant denial of the seriousness of long term consequences of that...OK I'll get into it - I have a cousin who brags on FB about eating waffles with syrup and cinnamon buns and weighs 300 lbs, needs u100 insulin, and has now developed fatty liver, but is pleased that it has made her blood sugar lower so she thinks she can eat even more carbs - in other areas of her life she is absolutely brilliant.) Morbid obesity is not a benign condition; even without diabetes in the picture there is high inflammation in the body, wear and tear on the joints, risk of sleep apnea, and even some evidence that poor sleep the inflammation affects brain function, hence the endorsement of Pam's comment above.
Now, that said, I have to admit that yes, you make some allowances and don't go overboard on optimal diet when quality of life is paramount and nothing much you do or don't do will add many years of health; sometimes whatever brings on a good mood and certainly when the first goal is just to get adequate calories into someone with a poor appetite, an ADA 1200 or 1400 calorie plan makes no sense. But that's for when the horse is already out of the barn, IMHO.
Does she want to eat low sodium, or does she really enjoy other (higher sodium) foods?
Until a doctor and hospice tell me mom is really, really, really near the end, she is going to be on her meds and restricted diet. The end, no discussion.
It helps A LOT that my mom is in a memory care facility where the meals are prepared by the kitchen to the diet orders for each person. Mom gets low sodium, kidney disease, diabetic meals and snacks every day.
If I let her have the McDonalds and pizza and dark pop like she wants, she'd be dead from a stroke or kidney failure in short order. She's not on hospice, so there's no point aggravating her conditions.
I have not specifically been prescribed a low salt diet but when I have overdone it I know to stop because my legs start to swell a little and I realize the warning signs. I still take sugar in my tea and coffee but no longer eat cereal because I am lactose intolerant. I am my own food police and would be very resentful and devious if some one else tried to control what I eat.
My mother talked about not taking the medications, because they probably didn't do anything. Of course, I know they do, because we've had problems keeping her bp down at a safe level. I know she won't live forever, but I don't want her to have a stroke. Chances are great that she would continue to live, but be unable to do much. What kind of life would that be?
So I would say that IF someone can get a parent to cut back on the salt, it is a very good thing. It is better to cut back on salt than to add medications to keep bp and swelling down. And we certainly don't want to increase the risk of damage from a stroke or heart attack. Wouldn't it be nice if our elders wanted less salt and sugar when they aged, instead of more?
My mother is in mild dementia so she is still able to make a lot of decisions, herself. She does tend to stray off her low sodium diet if I don't remind her. She and I had a talk about what she wants. Here are some things she is definite about: She doesn't want to die. She doesn't want to end up back in the hospital. Like most of us, she does want to eat whatever she wants, but she does realize she can't do that and does want to stick to her diet.
So, it is kind of part of the human condition that, if asked, we all would like to eat whatever we want without consequences. To say that a person should be eating just anything and just let them die, when they don't really know any better and we're supposed to be their caretaker - that wouldn't be right, either.
With that said, I agree that we shouldn't be the food police and make things too strict, either. I try to keep all the worst snacks out of the house. Mom does forget what she eats. So, as an example, she might herself say she wants to limit her snacks to two cookies. She'll do that but then forget she had her two cookies and eat two more.
There are certain snacks that I keep available all the time, other snacks that sit on the counter for a limited time, other snacks that don't come into the house. Of course, if a person really desperately wanted something that is highly salty, I can see that a snack-sized bag once in a while might be a way to address that urge. Fortunately for me, my mother is a candy/cookie hound and doesn't that much about chips.
My mother admits she has a hard time remembering what she is and isn't supposed to eat. One day, she ate the deli-sliced cheese as a snack. In the previous part of her life, she never would have eaten that as a snack. These days, it's hard for her to know if I don't hide things a little - she really just forgets and does need my help. During her reasonable times, she also wants my help.
Sounds like the sib has serious food issues, possible addiction and wants a "partner in crime". People feel better about overeating if they are in the company of others who do the same, and will encourage others to eat the wrong things. I have experienced that with overweight people who can get quite huffy if you refuse a muffin. "Here, one muffin won't hurt you". Well, for me, the pounds go on one muffin at a time. There are other foods I would rather spend my calories on.
I think you are coming from a place of caring for your parents and wanting the best for them. Can you find a middle ground? Good luck! Your parents are fortunate to have you.
Once we had this conversation over the phone:
Nurse: Coy's weight is up quite suddenly, quite a bit.
Me: Oh. That was probably because he had a big pickle with his Ruben sandwich at the deli yesterday.
Nurse (sounding scandalized): Don't you realize that that is a very high-salt meal and not advised for people with CHF? It will cause swelling and is hard on his heart.
Me: I do realize that and we were much more careful before his dementia diagnosis. He has a terminal disease. I am not going to deprive him of a beloved deli meal once in a while. I know he will retain water for a few days. So be it. I do want to monitor his weight and keep the increases within bounds and not lasting long, and the electronic scale is helping us do that. But I am not on board with a total low-salt diet for him all day every day.
It doesn't sound like your sister has much influence over what your parents actually eat, at least not very often. Do you think her attitude really makes much difference in your parents' lives? If not, why don't you just agree to disagree and go on controlling their diets as you see fit?
Is your sibling close enough to go to the doctor or dietician who prescribed this diet with you to get the story from them?
Everyone is just "going to die anyway." That does not mean we should not do what is right for our health.
Is your sib waiting for their inheritance and wanting your parents to die sooner? Many have that agenda.
I cut contact with my sister after years of verbal abuse and share information as needed with her daughter, my niece. I don't need any more of it.
BTW who has POA financial and medical? Are your parents living with you or in their own home. You have a huge load with two parents to care for.
Take care of you!