Taking Care of Our Parents: Our Next Baby Steps

          It can be downright embarrassing. You are helping your parents in their golden years. Sometimes the help is deciding where the investments should be kept. For most of us, it is more down-to-earth decisions, like where will Mom & Dad stay if one of them needs physical or mental assistance.

Most recently, I was sitting with my mother while a nurse came in to visit with her. After remarking on how well she keeps her house (it is immaculate. . .I think dust stopped trying  to collect at her house. It just moved on.), she began with the medical questions...you know, the ones that you were embarrassed by when your mother sat with you at the doctor’s office when you were too young to be in there alone. Now its my turn.

The days leading up to the visit were tense, as I have shared before. But the day of the visit, everything went just as planned. We met in the evening. Most long term care providers, including nursing homes, continuing care communities, and in-home care providers will work with your schedule. They understand that the senior for whom they may be offering care may be accompanied by someone with a nine-to-five job. My mother was as gracious as if the nurse was a long-time friend. She was a thorough professional with a very friendly demeanor. This is also something that I have seen is generally the rule, not the exception.

A two-hour visit passed without incident. Mom asked the questions she wanted to ask, and the nurse (who was dressed in plain clothes, not  the starched-white “I’m coming to get you” outfit that you see in the movies) answered them to her satisfaction.

“I’m not signing anything or committing to anything tonight,” was mom’s strongest objection. It was met with “of course not,” from our nurse.  

The evening concluded with more paperwork for mom and I to fill out. We needed to give her financial information before proceeding to any ‘next step.’ That was fine. Mom was in control of the process. And that is the point I hope to make with this blog entry.

Taking Care of Our Parents: My “Baby Steps

        Many of us are thrown into making long-term care or health care decisions by an emergency. Your Mom falls and breaks her hip, or you get a call that Dad is wandering, sometimes aimlessly, and the neighbors are afraid that he’ll wander off. These events are heartbreaking and, often, budget-busting. When your parents’ doctor tells you “we need to know where you want your mother to be transferred to for her long-term rehabilitation” and gives you four hours to decide, you have a problem. And this scenario plays out everyday.

         Instead of being thrown into the fire, you can do what we did. Or, at least, what we’re trying to do. Look ahead, to a time when your mother might need to have some assistance or, gasp, to be in a nursing home. So we told Mom that we were going to have someone come to the house to “visit” with us and talk about what we needed to know. 

         “What for? I’m not going to sign anything.”  Strike One. Mom was more than a little defensive. I had to talk to her and reassure her, more than once, that no one was trying to take her house, or send her to a nursing home.

         We anticipated this answer from her. “No mom, we don’t have to sign anything.”  We wanted her to know that we were trying to help, not trying to control. About a week before this time, my aunt was rushed to the hospital. It seems that she fell. She lives alone, uses a walker , and is in her eighties. Strikingly similar to Mom. It seems her niece, who frequently came by to visit her, found her one morning sitting on the floor of her kitchen.

         “What are you doing?”

         “Resting” responded a clearly incoherent Aunt Julie.

It turns out she landed there about twelve hours earlier, broke several ribs, contracted pneumonia from sitting on the cold floor, and on and on. It was really heart-breaking to hear.

So I said to my mom, “It’s too bad about Julie.” And I let it go right there. Silence can be deafening. She said “Oh, I know,” and she let it drop. Strike Two. I wondered whether or not I should keep pushing. I mean, I already had two strikes.

“Well Mom, we’re having someone here to visit. You don’t have to sign anything, and we’re not going to make you do anything. We just want to see what’s available for you. We care about you.”

“Well. . .Okay” she said.

We were glad to have things moving in the right direction. We don’t have all the answers, but by being just a little bit insistent, we’ve got things going.

Keep taking those steps with your parents. Nudge them when they need it. Keep them moving in the right direction, but be sure they know that you are walking right there with them.

Thank you to all who have shared your stories with us. Let us hear your comments.

                                                  Originally posted 5-11-11

Dealing With The Stress (or. . .Why Are We Such Babies?)

           When we have to care for our parents a change happens. A change which involves switching roles with our parents, and for many of us it is uncomfortable. Nothing in our education prepared us for this. We don’t know how to ease into this change.

With me, it’s caring for my mom. I always took direction from my mom. I looked up to her and asked her for advice. She had the place of authority in our relationship. So now that I am beginning to care for her, do our positions really change? Does this mean that I no longer look up to her? Now that I have the ability to care for her and can take on some of that responsibility, do I respect her less?  

           For many of us the answer to that question never comes. . .because we never have the nerve to ask the question. We cannot fathom Mom needing us in the way we once needed her. She made the bed, cleaned the house, walked us to the bus, and made sure we had enough money for lunch before we left for school. We try to act like it isn’t happening, or we wait for the other sibling to step in, because we don’t want to face it.  And what is the “it” that we don’t want to face?  Mom’s mortality? Perhaps. Our own mortality?

           Mom didn’t like it when I asked her if she had protection documents such as a living will or  power of attorney, in place. Neither did she like it when my brothers and I suggested that we have a person come in to help her with chores around the house. “I don’t want some stranger coming in my house” was the response. Then my brother Tom (God bless him) went ahead and arranged for Meals on Wheels to begin bringing in hot meals three days a week. “We can always cancel it Mom” was the way he got past her first line of defense.  And Mom didn’t like that.  At least not at first. Now, a few years later, Mom looks forward to the delivery of her meals. The delivery is a welcome part of her new routine.

           It was stressful forcing the Meals on Wheels into Mom’s routine. But it was for her own good. And today she accepts it. I dare say she even likes it. So on to the next step, caring for Mom…and the hope is, that this gets easier. It does, but only by small degrees. Mom is still living at home, and she still needs help, but we’re getting her the help she needs, one little step at a time.

           I welcome your responses or your stories. There are lots of us out here caring for our parents. . .

      

When Mom Needs Help, But Won’t Accept Help.

 So what do you when you don’t know how to move Mom forward ‘for her own good?’ I know that my family is not unique in our present situation. My brothers and I have taken all the steps that conscientious, well-informed, adult children are supposed to take. Mom reluctantly agreed to meet with the proper medical professionals, and the meeting went very well.

Now, when we could move forward, we’re once again treading water. Mom is happy where she is. She is healthy, if not active. She is in a clean environment, and its her own home. It is familiar and its safe, mostly...except for the steps that she has to climb.  So why would she want to move to assisted living? Or why would she want to have a stranger in to her home to assist her?

“I didn’t ask for help.”

“I’m fine. I’ll manage.”

Its us, her sons who want to give her the help. It is the three of us boys who don’t want her to have to ‘manage’ on her own. We’re understandably concerned about Mom’s health and safety. We would love to have piece of mind that Mom is safe and cared for. But is it our call to make?  Where do Mom’s wishes come in? When do we hear from her?

We now have to carefully balance the need to help our aging parents with the need to calm our own fears, or to salve our own consciences for any past issues we may have with them. As long as a senior is safe and is able to remain in his or her own home, they should be allowed to do so.

The competing interests are real, if not completely well-defined. We want our parents to be happy. We also want them to be safe. By insisting on a move out of the family home, we may be creating “safety” without a shred of the happiness they seek. Sometimes the medical needs dictate such a move, which makes the decision easier, if not more pleasant. But these two competing interests remain.

In our case, Tim, Tom and I continue to struggle to offer mom all the help we can, which includes keeping the doors open to outside help. And Mom continues. In the home she loves.

Originally posted posted 4-27-11

So What's Next?

           You may recall that I explained that my brothers and I are dealing with our widowed mother who has become more frail in recent years, and has just celebrated her 85th birthday. We talked again about how we could do this or that, but created no specific steps. With mom in a seemingly more precarious position than ever before, what are we to do?

We all wanted to be sure that we were treating Mom fairly, but that she was safe. So do you make ‘safe’ decisions, even if it drives the person you are caring for crazy?

Like walking. You and I take walking for granted. Mom needs help to walk, heavily leaning on my arm each time we go for dinner or simply to the store. Do I mind? Not at all. Its sweet for me to have Mom on my arm when we walk into a favorite restaurant of hers. I think she likes it, too. But don’t tell her that she needs assistance to walk, and heaven forbid you would bring a walker to her with the suggestion that it will help her get around the house.

“Walkers are for old people” she once said to me. Even I was speechless, as the obvious reply  would not have been the kindest of answers. If mom embraces the use of a walker, she is embracing her old age and, by extension, her mortality. She doesn’t want to do it. My brothers’ instincts are just like mine…she has to use it to be safe. “Tell her that” is our response to each other, with bewildered looks to each other.

So, in order to take care of her we strongly suggest she use a walker, but we won’t make her use one. Do we risk jeopardizing her safety? Yes, but we dare not insist lest. . .lest. . .what? And therein is the problem. None of us wants to offend our parents. But neither do we want to put them in harm’s way. So we struggle to find the right balance (and we happily let mom hang on to our arms every chance we get.

Tim, Tom and I are struggling with other, similar safety issues. Using the stairs of her split level house. Do we simply install the chair glides? Will she use it? And cooking? Will she remember that she left the stove on? Her bedroom is on the top floor, the kitchen the middle, and laundry on the lower floor of the split level house. Do we suggest that we combine these on one floor?  I can just imagine her response…”And wreck this house? Forget it.”  

So we struggle with safety and familiarity and hope to find a way to gently bring her to the next steps in life, whatever they may be. In our case, the next steps are not any easier than when we had mom sign her living will and power of attorney documents, but that somewhat humorous story is for another blog entry. . .

origingally posted  3-16-11

What Will Mom Think?

           What will Mom think when we broach this subject? That’s the question my brothers and I had when we discussed having ‘the talk’ with her. The talk is, of course about having someone assist her at home. About having her spend time at the senior center. (What? Mom? A senior? Oh wait. . .she is eighty-five years old). The talk that implicitly acknowledges that she is mortal. That we cannot pretend any longer. We can’t pretend that mom will always be there to make us peanut butter sandwiches when we come in from the cold, from playing football. Those years are long gone. But if you don’t address it directly, you hold on to a thread of that life, of that time. But that time is gone.

           So what were we afraid of? What would Mom think of us? What would Mom think of her own life? What would Mom think we were trying to do?

           In our extended family, we have seen the best and worst of dealing with seniors in their golden years. We have seen people with Florence Nightingale-esque, selfless giving and sharing, doing everything possible to make the final years of their loved ones as comfortable and happy as possible. We have also seen those that resembled vultures.

           Would Mom think we were vultures, trying to ‘get at’ the inheritance early? Would she see us as Florence Nightingales? With three boys, that one is unlikely. . .but what would she think?

           Facing this question, we were naive. We thought, since we knew our motives were pure and driven only by the need for Mom to be safe and healthy, she would surely see it that way. I’m not sure we were correct.  “Why are you doing this to me?” was the delayed reaction. She is holding on to the “I-can-take-care-of-everything-myself” stance. Bravo for her and her independence. But she can’t walk on her own. She needs help. But is that my decision to make?

           When we were young boys, if we were at the neighborhood store and Mom saw someone who was struggling with bags, she would say “go help that poor woman.” When a neighbor lost a loved-one, she would have us help the family any way we could. Mow the lawn. Walk the dog. Whatever. Now that she was the ‘older woman struggling with her bags,’ surely she would understand that her well-raised boys were there to help her. Right?

           Not exactly.

           We needed to allow her the full authority to make the final decisions to move forward. Even though it scared us, we would not force the issue (at least not yet). We were sure she would see the wisdom of putting things in place for her to be able to move or to receive services, should the need arise.  At the present, we’re S L O W L Y walking through the process of having her enrolled in a program that will help her, monthly, with basics. She is a strong-willed woman who is proud of her home. She needs to see all the options.

           We’ll keep things moving. Hopefully.

When Mom and Dad are Now in Your Care. . .My Own Story

I’ve helped hundreds of families make those tough decisions. My law office has a good reputation as caring professionals. We have a heart, and we are there to help.

We have worked with the family members, their financial planners, their priests and pastors. We’ve worked with accountants and even other attorneys. These decisions are tough. How do we best help Mom and Dad, and how do we gently tell them when it might not be safe to stay in their own home?

I have been very pleased with myself. I have a good handle on this ‘senior care’ thing.  Then it was my turn. With my own mother.

My brothers called an ‘emergency meeting’ on how to care for Mom. It seems Mom had fallen and, while there was no immediate crisis, it brought home the need to deal with this issue proactively. As the attorney who deals with these issues every day, I helped lay out a plan of action. I would do A, my brother Tim would do B, and Tom would do C. That was at Mom’s 80th birthday party.

I did A. And that’s where it stopped. I didn’t raise the issue again. My brothers had good reasons to not do B and C. And I had good reason to let things sit. These were uncomfortable discussions. “We’ll get to it later,” I thought.

Mom turned 85 a few months ago. And we’re only now getting to it.
There are so many considerations.  Should a person live alone at 85? Why not?  I am accustomed to the legal considerations, but the personal considerations. . .they are the difficult ones to deal with.

Should we let Mom stay at home? In a split level house that is fraught with potential falls on steps?  Never mind that she is healthy, albeit more frail than she was at 75 or 80. And what business do I have in telling Mom what to do and when to do it? Dave Ramsey jokingly calls it the “powdered butt” syndrome. “When someone has powdered your butt, it’s hard to take advice from them about anything.” Mom was there when I broke my arm as a six year old. Who am I to tell her it’s time to make some changes?

In this blog, I hope to explore my own adventure, not as much as an estate planning attorney, but more as a professional who is dealing with these considerations on a personal level.  Please add your comments or questions. I hope that by sharing my story, someone else, and maybe even someone else’s mother, will be helped.