Caring for elderly parents

I mentioned a while back that my mother-in-law is moving here to SC from Idaho. Well, the time has come: she arrived Monday night. My husband flew up to travel back with her. His other brothers, a new sister-in-law, and two nieces also traveled up from other states, so, with the sister who already lived there, they had a bit of a mini-reunion.

Jim was concerned about the logistics of getting her to the airport, handling his luggage and hers, and getting the rental car back without having to leave her somewhere while he took care of things — she doesn’t have Alzheimer’s, but she can get confused in unfamiliar situations or when she is nervous. (The other relatives didn’t come with them to the airport because we fly in and out of an airport about two hours away and rent a car to drive home. Her little town does have an airport, but it’s exorbitantly expensive to fly to it.) Jeremy and I prayed specifically about that at lunch time, and Jim called me later and let me know that someone from Hertz offered to take care of the car for him and bring him the receipt; an airline employee took the luggage on an elevator for them and told them the wheelchairs were at the top of the escalator (she doesn’t usually use a wheelchair, but would have had a hard time walking the distances you have to in airports); a skycap wheeled her straight to the front of the line. Jim had allowed about an hour to take care of all of that and get through security, but it only took half an hour. We were so thankful that that all went smoothly!

She seems to be doing ok — she got a little teary saying good-bye, understandably. I just can’t imagine this week for her: saying good-bye to the area she has lived for 35 years, to the family on that side of the country (we’re the only ones on this side), to her dog, traveling across the country, and now facing a new living situation. I’ve been praying for God’s grace for her during this whole transition process. If you think of it, I’d appreciate your prayers for her and for us. As I mentioned in that earlier post, this is going to be a new situation for all of us.

I have found that when I tell people my mother-in-law is moving here, they smile and say something like, “Oh, that’s nice!” But when I say she will be living in an assisted living facility, their smile drops somewhat and they look a little uncertain.

I know some folks have the mindset that they’ll never put a loved one in a home. I probably felt that way myself at one time. But two things changed my thinking. One was the assisted living facility my grandmother was in. It was more like an apartment complex for older people with medical staff on the premises. She enjoyed living there and having a certain amount of independence while still having care close by when needed. It was hardly being “put away in a home” at all. Then, my grandfather had been living with his daughter, my mother’s sister. She worked full time, so he was home alone in the day time. He didn’t eat right, didn’t take his medications regularly, didn’t do a lot. After he had a series of small strokes, he went into the hospital. Some specification with his insurance or Medicare would only allow him to remain in the hospital a certain number of days: after that he had to go into a nursing home. My mom and her siblings stood around his bed and cried. But none of them was in a position to give him the care he needed. As it turned out, when the time came that he could have gone home, he decided to stay. He found eating three regular meals did help, and he enjoyed someone else providing them (many older people don’t like to cook for just themselves.) His medications were dispensed; he met people and had activities that were stimulating. He loved it and lived there several years until he passed away.

Though family members do have responsibility to see that their loved ones are cared for, there is no one right way to go about it. When a family has to make these kinds of decisions, there are several factors that come into play:

1. Housing situation. Not everyone has the space to include a new adult addition, or the house might not be conducive to someone with physical problems. Though Mom is only staying with us a few days until she moves into her new home, we’re concerned about her dealing with the steps. But this was one factor in deciding on assisted living care. We could move to a house that is all on one level if need be, but that takes time.

2. Availability of other family members. This is one of the reasons she moved here: much of the rest of the family was moving away from her area. I’m the only daughter-in-law who isn’t working outside the home.

3. Finances.

4. Mental ability. If the elderly parent has Alzheimer’s or mental confusion, someone would need to stay with them all the time, and even a family with a stay-at-home member might not be able to manage that between errands, school obligations if there are school-aged children in the house, etc. I know some handle this by hiring someone to stay with the elderly parent a certain amount of time each week.

5. Level of care needed. There might be some situations in which the older person needs physical or medical care that can’t be given at home.

6. Relationships. Some older people will always see their adult child as a child, and won’t follow instructions about medical care (e.g., medicines), food, etc., but they would take such instruction from medical personnel in an assisted living situation.

7. Personalities. We might be loathe to admit this and we might think that every family relationship should amicable, but in real life that is just not the case. Some relationships prosper with a little bit of space for each party. Privacy doesn’t allow me to disclose anything about situations I know of personally, but it is definitely a factor (by the way, this isn’t a factor with my mother-in-law. She is pretty easy to get along with).

8. Safety. Particularly Alzheimer’s or some forms of dementia in advanced stages may cause some patients to physically strike their caregivers when frustrated even if the patient would never have done that in ealrier years.

9. Socialization. I almost hate to even use that word because I know it is leveled as an unfair charge against home-schoolers has been a lack of socialization, and most of them get plenty of social interaction and don’t really need to be put into a classroom of people the same age to get it. But this is one of our concerns with my mother-in-law. If she lived with us, we would be her whole world — she wouldn’t feel the need to or have the desire to interact with others besides surface greetings at church. As we have talked with the staff at the assisted living facility, we feel this is an area in which she could benefit. Not only would she have the mental stimulation of interacting with others and participating in the activities there, but it might encourage her to know there are others who are going through the same things she is.

10. Independence. It might seem odd to list this as a factor when a person going into assisted living seems to be giving up their independence. But in such a facility they actually do get to make their own decisions and schedules and have their own living space. Some would feel that if they lived with their children they would be an imposition (even if the family is glad to have them), and they are more comfortable being on their own as much as they can be.

Not all of these reasons are factors for my mother-in-law, but they have been with friends dealing with elderly relatives. As we prayed and discussed the situation with the rest of the family over the past several years, we felt this was the best solution. We know to expect an adjustment period, but if she truly hates it or has a terrible experience, we’ll have to seek the Lord about what else to do. But for now we feel sure this is the right path.

My husband did all the initial legwork in researching the different facilities in out area. The one he chose is only about five minutes away from us, and it has a small, homey feel rather than a big institutional feel. Every time I have talked with any of the staff I have been reassured by their knowledge and attitude. As we have gone over several times in the last week to set up the room, hang curtains, etc., we’ve enjoyed saying hello to the other residents and look forward to getting to know them better. We do plan to visit often as well as bring Mom over to our house and take her to church with us.

I know there may be some bumps along the road for all of us as we figure things out, but ultimately I have every hope that this next stage in her life and ours will be a blessing to her.

21 thoughts on “Caring for elderly parents

  1. Hello from northern BC, Canada! I was writing on my blog tonight and thought I’d do some blog searching about caring for elderly parents and came across your blog. I was soon absorbed in reading about your mother in law and then started reading about you and thought, gosh I wish this gal lived next door so we could have coffee together and chat! I hope you don’t mind me adding your blog to my blog links! I am an almost 50 ( cringe!) year old wife , mom and grandma and most importantly, child of God. My mom came to live with us in February. Some days it feels like an adventure. Some days I want to run away. ( with hubby and pets of course) LOL I have a started a separate blog about my experiences with my mom. It’s turning out to be a great outlet ( and my kids and their spouses and friends are my best cheering section!)

    Bless you and thanks for sharing!

  2. I’m praying for your family and especially your mother in law. It’s not an easy decision to put a loved one in assisted living but sometimes it’s the best decision for all involved. Sometimes we have the best intentions of personally taking care of an aging parent, but since we are not health care providers the situation may warrant that a medical facility be involved. This was the case with my husbands grandmother and some of his family had a very time coming to terms with it. In the end it was the best thing for his grandmother and the best thing for the family in general. She was well taken care of and major medical attention was eventually needed and she was already familiar with her surroundings so it made things much easier on her.

  3. You’ll be in my thoughts and prayers as you enter this new situation.

    Assisted living homes can be wonderful places. It sounds like it will be a wonderful place for your MIL!

    I think sometimes we as Christians can do a wonderful job of making other Christians feel guilty about their decisions, and this is one of the areas; so don’t let anyone do that to you! There is not “one size only” for caring for elderly parents. You and Jim are doing a wonderful job of honoring his mother.

  4. Barbara, we haven’t had to face how to care for our parents yet, but if and when we do, I want to keep your list in mind. It would be easy to make an emotional decision and say we would never do one thing or another, but I know from other life situations that you can’t say what you will do until you get to that point. Thanks for a well-done list, and I pray that this time of transition will go well for your family and your mother-in-law.

  5. God is good
    bless those helpers

    praying for her
    hope it is indeed a nice peaceful happy time in her life

    Mr Wonderfuls mum has gone into respite care for a couple of weeks while dad gets better i havent been to see her yet but it does sound like another wonderful elderly rest home

    thanks for this post I found it interesting

  6. You are soooooo right! And ya know… no matter what decision you make, it’s a HARD one! We know that eventually Mom will have to go into a nursing home. It’s the nature of the disease that we will NOT be able to care for her here forever. IF she would be okay in an assisted living situation we WOULD have chosen that… but for her, she needs more than just an assist! She takes care of her “personal” needs — as far as restrooms are concerned — but when it comes to baths or showers, she needs someone to remind her to wash ALL her parts – and see that she does! She’ll wash her legs 12 times but won’t get her arms or her neck even once! Things like that! Most of the time she can dress herself just fine. She does need help often with her bra. (and she’s okay with that) But she would NEVER remember to eat. She would never remember her medicine… OR she would take 6 doses in 20 minutes! Even the day dividers don’t work for her – because she can never remember what day it is! Or what time. She has a watch and asks us 20 times a day what time is it? We say what time does your watch say? Well… sometimes she can’t even read her watch. And when she CAN, she doesn’t trust that it’s telling her the correct time.

    Sooooooo…. we just keep her around and keep her as entertained as we can. But we do know that eventually she’s going to get to the point that I can’t handle on my own anymore. We’ll cross that bridge when we get there. I’m hoping that by the time she can’t control bodily functions, that her mind will be SO FAR gone that she won’t know she’s in a home. We don’t have many “good” homes around here… as a matter of fact, the only REALLY good one I know of is FULL UP and has about a 3 year waiting list to get in. (give or take… ) So I really DON’T look forward to that time.

  7. Pingback: Moved in! « Stray Thoughts

  8. I pray that this circumstance is still years from us, but even so, there are times when I have thought about what could happen. This list of reasons and your thinking process of it all is very encouraging. I will continue to trust that if/when God brings this to our lives that we will be able to reasonably consider each of these items as well.

  9. Hi, Was so happy to find this site as I was beginnig to think there was no-one to talk to. Mum is 91 and mentally very active. Unfortunately, physically she’s got several problems, including not being able to use her left arm and requiring a walker to get about. Her right arm is also not fully functional so she can’t open and close doors easily. She also has problems with our steps (they’re not suitable for a ramp). She’s lived with my husband & I (it’s our home as she came from overseas with no money) for all of our married life (30 years). How do I approach her regarding going into an aged care facility? We both work full time and she obviously needs extra care although she’s clever enough to hide this when questioned by health care workers. Also, I think my husband feels we need to spend more time alone together in a normal married relationship!! I’d appreciate any help with this as I feel caught up in the middle of both of them.

  10. Thanks, everyone, for your prayers and words of encouragement!

    Pauline, that would be a very tough situation, especially after 30 years. In my mil’s case, we first began to talk about this possibility several years ago after her husband died. It was becoming obvious to everyone else that she couldn’t live alone in longer, but not to her, and when we talked with her about moving, she was polite but firm that she was fine. Her daughter was able to come and live with her for several years, and that helped immensely. But she also became more and more dependent on her daughter — she gradually took over all the housework and cooking, then eventually Mom couldn’t get completely dressed or out of the tub by herself. She had several falls — after one of them she couldn’t get herself up until her daughter came home from work. Then her daughter was petrified that would happen again every time she went to work. I think all of those things contributed to helping her realize she couldn’t live on her own any more. Then her daughter began having back problems and ended up having surgery, and then she couldn’t lift Mom out of the bathtub any more, so the thought that she needed to do something different gradually took hold. There is very little family left there, so we didn’t want to put her in a place there where there would be no one to visit and and we’d have no way of knowing if she was properly cared for, and since I am the only one of the kids and in-laws not working outside the home, it was felt that our area would be best (cost of living is a factor as well. My bil lives in CA where such things are significantly more expensive).

    She stayed with us for a few days before going in, and I mentioned in another post that I wondered if she had harbored some thought of seeing if she could stay here rather than going into the facility. She never said as much — I just wondered. But if she did, I think she was convinced by the few days here that the stairs and the tub situation just wouldn’t work.

    Really, a lot of it was just the grace of God. I had been praying for her during this transition, and I have just been amazed at how well she’s done.

    One of the things she has appreciated most at this facility is the safety features — handrails in the bathroom, etc. There are not only the physical features but the fact that people there are trained in how to safely lift and help. My mil’s shoulder started hurting the day after we tried to help her up from the tub, and I am afraid that in her efforts to push up and ours to help lift that she may have wrenched it in some way. If she were to stay here, I think I would have asked if someone could come out and train us in things like that. But knowing that people there are trained for such things is a big relief. That might be one way of approaching things with your mother — that a place like this is more equipped for meeting her unique needs, and that especially as you and your husband are both working, you’d feel much more at ease if she were in a safe place.

    Perhaps you could visit some of the facilities in the area and either decide on one or, if you think she would want a hand in the decision, ask her to look over the brochures and visit them with you. If you have several in your area I think I’d visit and look them over and narrow it down to a couple to recommend to her.

    I don’t know if this has been much help! I wish you well — let me know what happens.

  11. I just finished reading a new book “MEMORY LESSONS” – by Jerald Winakur, a geriatrician. He eloquently and poetically describes the challenges faced not only taking care of the elderly, but also in taking care of his own seriously failing parents. As a psychologist who deals with the elderly and their families, I found this beautiful and very helpful.
    Dr. Charles Merrill

  12. my mother is 88. We lost my father 5 years ago. We live in a two apatment house. My husband and I leave in one side and my mom in the other. Mom has what the drs. call the beginning of dementia. She could not live alone. My husband and I recently opened a sandwich shop on the property so we could be near her. We have help 3 days a wwek in the morning for my mom. She is vvery demanding and very forgetful. I tend to lose my patience alot with her. THen I feel guilty afterwars. She never remembers it 10 minutes after if happens. SHe calls about 20 a day and will not stay up if I go to bed so I stay up until she is ready.I need help on keeping my cool and help on dealing with it. I feel trapped.

  13. Charles — somehow I didn’t see your comment earlier. I will look into that book, thank you.

    Doris, I can understand your feelings. It’s hard to be patient with a lot of what goes on with dementia. For me, as a Christian, I pray a lot the part of Paul’s prayer in Colossians 1:11: “Strengthened with all might, according to his glorious power, unto all patience and longsuffering with joyfulness.”

    It’s good that you have help coming in some times.

    I found a couple of good sites that may be of help to you:

    Encouraging Caregivers
    http://encouragingcaregivers.blogspot.com/

    KnowItAlz.
    http://www.knowitalz.com/

  14. I was skimming my spam folder and clicked “delete” and only then noticed what appeared to be a legitimate comment on this post just before it disappeared — something about nearing the one year mark with my mother-in-law here. I’m sorry, there is no way to get it back. I apologize to whoever left that comment, and I hope you see this and leave it again. I’ll be more careful next time, I promise! I usually only skim the spam folder rather than looking at it closely because there is some vile stuff in there, but every now and then a legitimate comment gets stuck in there.

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  16. Fortunately, I had saved my post to a word document, so here it is again.

    Barbara, now that you’re nearing the first anniversary of having your mother-in-law live in town near you, I hope and pray that the experience has been a good one for your family and for her.

    Similar, but different, experience for me. In April 2003, we moved my 83 year old mother from eastern Oregon where she had lived for 50 years to Texas to live with me and my family. My mom was mentally and physically strong and capable. Our reasons for moving her were financial.

    Like your husband’s family, my siblings had all moved from the area. Since my father had passed away in 1991, my mother had lived in an assisted living home. It was very nice, but we could no longer afford it. Since my wife was a stay at home mom and we had room in our house, my siblings and I agreed that the best choice was for Mother to move in with us. By the way, my wife was very supportive of this decision. Her Grandmother had lived with them as she was growing up so she was very open to having a multigenerational household.

    At the time, our three kids were ages 10, 8 and 5. While I’d like to say that the experience was always pleasant and rosy, there were bumps in the road along the way. (But isn’t that the case in all of life’s circumstances?) For the most part, having my mother live with my family was a blessing to all of us and an experience I would not trade.

    Perhaps, I have better perspective now that it’s been a little over a year since we buried my mom, but even while living through the experience, I never regretted the choice we made.

    For others faced with making elder care decisions about their parents, I’d strongly encourage you to consider hiring a Geriatric Care Manager (GCM). There is a national website http://www.caremanager.org/. A couple of great articles about the use and benefits of GCMs are “Worry-Free Care for Faraway Parents” http://www.bottomlinesecrets.com/article.html?article_id=47887 and “Why Hire a Geriatric Care Manager?” http://newoldage.blogs.nytimes.com/2008/10/06/why-hire-a-geriatric-care-manager/

    A good GCM is an excellent resource and can provide perspective and objectivity that is needed when making such emotional decisions.

    I’ve recently started my own Blog where I’m trying to journalize my experiences of being a caregiver to my mom, including a full time caregiver the last 4 months of her life with the support of Hospice. Feel free to check it out and share your stories or questions. Perhaps the experience and perspective I now have can be of help to those still living through the experience. http://ed-adams.blogspot.com/

    My prayer is for God’s blessings on all caregivers of the elderly.

  17. I’m so glad you resubmitted it! I felt so horrible about accidentally deleting it. I just read it, and I think what got it diverted into the spam folder was that WP is automatically set to put comments with two links or more in there. But I am glad you shared the links — I will check them out — and your experiences as well.

    Overall the experience has been a positive one, though, as you mentioned, not with a few bumps in the road. But that’s life. 🙂

  18. My wife’s mother is in great health and is a very intergral and active part of my wifes life, and as a result mine and our son’s. She is also quite elderly.

    Although my B and her mother have on the surface a close relationship, my wife has made it clear that as soon as her mother becomes a burden, through illness or age, she will send her back to China, either to her sister or to a nursing home.

    This is a very pragmatic approach, and oddly, her mother is in complete agreement with this.

    Now my wife claims to have been raised in a very close family, and this is borne out of the ongoing contact she maintains with the rest of her family, but something about the pragmatism of these relationships doesn’t sit well with me.

    They tend to represent relationships of convenience, which in my ‘Western’ world is the anti-thesis of the foundation for family. In any case, it has worked well for their whole family so far, and given that there has never been any family inheritence to fight over, the relationships have remained symbiotic and mutually beneficial.

    Of course, this is the easy part. If or when her mother ages to a point where she herself needs ongoing help, the pressures on the whole family will be compounded. Although I have some work colleagues who have easily transitioned their parent’s into a nursing home facility, the emphasis on family within the Chinese culture, I expect, would make this a more difficult proposition.

    Only time will tell, and although my mother-in-law is in great shape for her age, both mentaly and physically, she does have a worriesome tremor and increasing rigidity in her body, which is looking more and more like Parkinson’s disease.

    For those who know about this disease, it is progressive and insidious, and takes a terrible toll on the whole family in terms of the level of care that is required. For my mother-in-law’s sake, I hope that this care, no matter how difficult, is provided by us, and not a nursing home. It just wouldn’t be right.

  19. It’s an article about Dementia that is really good!! Thanks!
    I also have a blog about Dementia too. Come visit me sometimes^_^

    [url=http://www.agedementiasymptoms.net/]Dementia Symptoms[/url]

  20. Pingback: Bringing Grandma Home | Stray Thoughts

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