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Need some advice re: elderly parents - When they become uncooperative

2,653 Views | 34 Replies | Last: 1 yr ago by Texas Ag Mom
Ryan the Temp
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AG
This is probably not the right place for this, but there isn't an "adulting" board for life's more serious conundrums.

My MIL is unable to care for herself. She is wheelchair-bound and has Lewy body dementia. My FIL is her sole caregiver, except when we visit or my BIL visits. They are both in their mid-70s.

We have reached the point where we have to consider making decisions for them against their will. Earlier this week my FIL had to be transported via EMS to the hospital for pneumonia and fluid buildup around his heart. Us kids had to stop everything and step in to care for her while he was in the hospital for 2.5 days. It clearly demonstrated how quickly the wheels can fall off the bus if something happens to my FIL.

The solution us kids agree on is the best option for getting them both the care and assistance they need, when they need it, is to move them into an assisted living facility and sell their house to pay for it. The proceeds from the sale would pay for a facility for more years than they have left.

They are absolutely opposed to this and their response was a very aggressive, "We'll let the place fall down around us and die here before we sell it."

Their current living conditions are not sustainable and not acceptable for us to hire a live-in caregiver. We've put a lot of money into the house and tried to do what we can to improve their overall quality of life, but my FIL is the brick wall we are up against.

(Side note: My husband and BIL have individual power of attorney for my MIL and joint power of attorney for my FIL)

Getting to the point - If the only solution is to involuntarily relocate them for their own safety, we're at a loss for how to approach that situation. We are hopeful that if we can present a clear and thorough plan for their future that leaves nothing left to question that we can sell them on it, but we're admittedly pessimistic about that.

Any advice from folks who have been through this type of situation or can help us navigate it would be greatly appreciated.

TIA
TXTransplant
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I don't have any advice for you, just empathy as I have a parent who has become increasingly difficult over the last few years. Thankfully, my other parent is in good enough health to provide care, but to say it stresses the entire family is an understatement.

I had an aunt who refused to leave her house in another state after her husband died. Both kids lived here in the Houston area. From what I understand, both of them gave her an ultimatum: move to TX to be near us or stay where you are and none of us will come help you when there is a problem. They stuck to their guns and eventually she agreed to sell the house and move.
Ryan the Temp
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My FIL dug his heels in on getting rid of his truck when told him we would buy a wheelchair van for them. We were eventually able to convince him how much it would improve their lives. It also helped that one day he couldn't get my MIL out of his truck and I had to drive 30 miles to go help him.

With that situation in mind, we might be able to put all the details together and sell him on how much it will improve his life - because he's a selfish SOB.
Vernada
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I think you might have to go the 'soft' sell route like you are thinking. At least until you've completely exhausted that option.

It will probably take you touring some suitable facilities and then selling him/them on how great it is and how much it will benefit them.
bam02
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Good luck. That is a tough situation.
Max Power
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Really sorry to hear about this situation, you're in a tough spot. Both my parents are in their 70's and fortunately are in ok health but I do worry about them. Both of my grandfathers and grandmothers died in nursing homes, I can remember going to visit each of them. None were great facilities, there are likely much better available now. I felt uneasy at all those places, not where I'd want to end up or my parents.

Both of my parents have long-term care policies so I know there's a chance they'd go if and when necessary. I do think my dad would be the one of the two who would fight it. Having been to nursing homes and him having been to them enough I could see him taking the same stance and your FIL.

If my parents are at the point where the only thing keeping them alive is a nursing home and can't they take care of themselves and they didn't want to go, I don't know that I could bring myself to force it upon them. A big part of me believes it's their right to live out their days as they seem fit. It would break my heart to force them out of their home.

I do hope that your in-laws are able to accept that they're in an untenable situation and what is being told to them is coming from a place of love.

If you are looking into doing this by force I'm not sure what the next step would be. If it hasn't happened yet I would assume talking to a family-law or senior care attorney would be a good place to start.
htxag09
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You could have a different relationship with most. But seeing as their your in laws I'd personally take a step back and let their children decide what's best. Be there for your husband and his siblings/parents if they need anything, but I wouldn't interject my opinion too much......my .02 at least

Either way, sorry to hear about it. Good news is they made it to this point, I lost my mom to breast cancer a couple years ago, she was in her late 50's....But terrified of how anything like this will be handled with my dad who's hard headed as hell.
TXTransplant
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Question about the POAs - are they medical or financial? Because typically those are separate.

I ask because, if someone has medical POA for your MIL, they should be able to make decisions in her best interest, regardless of what's done for your FIL.

Meaning, if your MIL is in poor enough health that she needs to be in a care facility (and staying with your FIL is or could be dangerous to her health/safety), then someone should be able to make that decision.

FIL may still be healthy enough to live at home. If she is moved and he isn't, maybe he would come around faster.

I realize you want to sell the house to pay for a better facility, but if your FIL is as difficult as you say, he may only be motivated by negative consequences.
Ryan the Temp
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TXTransplant said:

Question about the POAs - are they medical or financial? Because typically those are separate.
We executed both before her dementia diagnosis. We lost my dad to Alzheimer's three years ago and I saw the writing on the wall with her. I had to really press the issue because my husband and BIL were both in denial and refused to see what was going on.
JeepWaveEarl
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I was going to ask about the medical POA for either of them. I worked at a private in-home care company for years and am familiar with many of these things. There are many options that may not require them to leave their home, BUT they have to be able to afford them.

EDIT: now that I see you guys DO have medical POA, there are for sure options.. depends on how much you want to stronghold them into something.

Ryan the Temp
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Got it. About to send you an email.
Quad Dog
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htxag09 said:

You could have a different relationship with most. But seeing as their your in laws I'd personally take a step back and let their children decide what's best. Be there for your husband and his siblings/parents if they need anything, but I wouldn't interject my opinion too much......my .02 at least

Either way, sorry to hear about it. Good news is they made it to this point, I lost my mom to breast cancer a couple years ago, she was in her late 50's....But terrified of how anything like this will be handled with my dad who's hard headed as hell.
This is good advice. When this happened to my wife's grandmother i saw myself as helping the direct family, and not helping the grandmother. I supported and helped with every decision they made even if I didn't totally agree.
Ryan the Temp
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I view my job as being supportive and helping them think about things they may not have considered or know anything about. For example, they had no clue about how POAs work, so I navigated that process for them and facilitated it.
NoahAg
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Sorry, Ryan. That's tough.
Not looking forward to dealing with my parents.
Let's go, Brandon!
ABATTBQ87
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My sisters and I went through this issue with our parents 3 years ago. My dad has lost his vision and my mother has Parkinson's but they felt they could stay in the family house alone.

We made the decision to move them to assisted living because of their failing health, and my dad fully accepted the decision but mama hated to leave and let us know verbally.

Daddy has adapted well to the apartment life and not having to worry about taking care of the property, but mama still wants to move home, but that is not an option due to her Parkinsons' and heart issues.
91AggieLawyer
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I went through many of these same issues until I lost both of my parents late last decade. There are no easy answers.

If you push the issue and your mom doesn't like it, she could do (mental) harm to herself and not be around for very much longer. I've seen that happen. My sister was able at the time to move in with my parents about 2.5 years before my dad passed, however, looking back, I'm not sure that was a good thing (although I don't want to get into the details). Obviously, if you leave things the way they are now, you don't seem to think it will work.

My only advice is to get with your siblings (or spouses siblings), identify the problem as best you can, and make the best decision that is in the best interests of your parents -- not in the best interests of the kids. Then present that to your mom. Try to avoid ultimatums at all cost. Be prepared if she resists.

Just because there is a POA doesn't mean it is automatic. One has to be legally incapacitated or the terms of the POA have to be met for it to be in force. Keep in mind that if they start insisting that your spouse and his siblings start coming down to help far more often than they are willing to, that, to them, is a viable option over moving into a care facility of some kind. The siblings may not like it, but you may have to do that.

This is a problem that no one has adequately prepared for.
Ghost of Andrew Eaton
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I feel for everyone that is dealing with this because it just plain sucks.

As my Dad said, "There are worse things than dying."
If you say you hate the state of politics in this nation and you don't get involved in it, you obviously don't hate the state of politics in this nation.
Ryan the Temp
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The dementia diagnosis triggered the medical POA, and all of her providers have recognized it at this point. That's been very beneficial for us to be more involved in her care and it has also allowed us to push her providers a bit and make changes where necessary. Sadly, the life expectancy of someone with Lewy body dementia is 5-7 years, but based on her behavior and overall health, I think her remaining life expectancy is much lower than that.

The real challenge, aside from the physical assistance she needs to do basic things, is the irrationality of the dementia. She wants what she wants, when she wants it, and turns into a raging ***** if she doesn't get it (severe aggression is a symptom of Lewy body dementia). My FIL makes it much, much worse by being mean to her in response - just screaming and yelling at each other all day, nothing physical. She has also tried multiple times to call 911 to have the fire department come out for menial things like adjusting the position of her chair.
EMY92
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I didn't have to deal with this with my parents, but there is an elderly couple that I've helped for many years. Both have health issues and I had to go over and call for an ambulance more than a few times for them.

They finally moved into an assisted living facility. It was a tough transition initially, but now they are happy.

The other option is to get in home care. It's not cheap, but it is cheaper than the assisted living facility. I think they're paying about $8000/month now. There are services that will provide people around the clock if needed. In most cases they are not nurses, but helpers that will be there and do things around the house.
wbt5845
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What I finally had to do with my parents was tell them they were on their own when Dad fell down or Mom slipped or whatever the latest emergency was that I had to drop everything and come rescue them.

It only took a half dozen 9-11 calls before the fire chief in their town told them to get help.

They then agreed to sell the house and move into an assisted living center. And they are now 10X happier and wish they would have done it years ago. I just grind my teeth and nod.
Vernada
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EMY92 said:

I didn't have to deal with this with my parents, but there is an elderly couple that I've helped for many years. Both have health issues and I had to go over and call for an ambulance more than a few times for them.

They finally moved into an assisted living facility. It was a tough transition initially, but now they are happy.

The other option is to get in home care. It's not cheap, but it is cheaper than the assisted living facility. I think they're paying about $8000/month now. There are services that will provide people around the clock if needed. In most cases they are not nurses, but helpers that will be there and do things around the house.


And how many people can afford that? I feel like it's to a point where some folks probably think dying is better than any other alternative.
billyjack2009
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I'm hoping it's a typo with one too many zeros.
wbt5845
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My parents assisted living center is a brand new, nice place in the D/FW suburbs. Two bedroom, two bath apartment - all meals for both of them - it's about $4000 a month.
Ryan the Temp
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billyjack2009 said:

I'm hoping it's a typo with one too many zeros.
I doubt it. One place I called was $11,000 a month. If we can convince them to sell the house to fund it, our budget will be $4,000-$5,000 a month.
billyjack2009
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Wow
Ryan the Temp
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billyjack2009 said:

Wow
This place:
http://crimsonheights.com/index.html
Iowaggie
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I hate reading about your situation and the stress it puts on all involved, partly because I know this is a road I'll soon be traveling down. My in-laws ultimately convinced my wife's grandma to go in to a care facility as they told her it was the only way she would be able to see them and the grandkids, but that would not have worked had she not fallen and gotten injured.

I think of it from the parents perspective too. I'm sure someday it will be my time to take that final walk out of the house, but it will be very hard to leave the place I saw my kids learn to walk, celebrate birthdays, and tuck in at night. That will be tough to do...unless my wife turns into her grandma, then I might be running out.
BigOil
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A flip side is everyone should be laser focused on their health in their 30s and 40s to hopefully avoid your own decline and impact on your own children or other younger loved ones.
TXTransplant
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My goal now is to just not be a PITA to my kid when I get old. If that means I have to move out of my house, so be it. He deserves to live his life without having to argue with or worry about me.

The hardest thing for me is seeing people become irrational and unwilling to listen to logic. I think it happens more than we realize and we aren't prepared. Sometimes it's due to Alzheimer's, but it can also be caused by mental health issues (these can get worse with age) and even substance abuse.

In my case I have a parent who is simply not capable of making logical decisions anymore, but they aren't completely incapacitated. They are just miserable, uncooperative, and verbally and emotionally abusive. Their world has shrunk so small that the expectation is that everything revolves around them, and if they don't get their way, it's a meltdown/tantrum. Watching that kind of mental decline is excruciating, especially because there is absolutely no trust extended to the rest of the family. You become the enemy and every decision, sometimes something as simple as what to eat for dinner, becomes a combative confrontation.
AndesAg92
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Ryan the Temp said:

This is probably not the right place for this, but there isn't an "adulting" board for life's more serious conundrums.

My MIL is unable to care for herself. She is wheelchair-bound and has Lewy body dementia. My FIL is her sole caregiver, except when we visit or my BIL visits. They are both in their mid-70s.

We have reached the point where we have to consider making decisions for them against their will. Earlier this week my FIL had to be transported via EMS to the hospital for pneumonia and fluid buildup around his heart. Us kids had to stop everything and step in to care for her while he was in the hospital for 2.5 days. It clearly demonstrated how quickly the wheels can fall off the bus if something happens to my FIL.

The solution us kids agree on is the best option for getting them both the care and assistance they need, when they need it, is to move them into an assisted living facility and sell their house to pay for it. The proceeds from the sale would pay for a facility for more years than they have left.

They are absolutely opposed to this and their response was a very aggressive, "We'll let the place fall down around us and die here before we sell it."

Their current living conditions are not sustainable and not acceptable for us to hire a live-in caregiver. We've put a lot of money into the house and tried to do what we can to improve their overall quality of life, but my FIL is the brick wall we are up against.

(Side note: My husband and BIL have individual power of attorney for my MIL and joint power of attorney for my FIL)

Getting to the point - If the only solution is to involuntarily relocate them for their own safety, we're at a loss for how to approach that situation. We are hopeful that if we can present a clear and thorough plan for their future that leaves nothing left to question that we can sell them on it, but we're admittedly pessimistic about that.

Any advice from folks who have been through this type of situation or can help us navigate it would be greatly appreciated.

TIA



Tried to PM you. My mom runs a private home healthcare in Houston that has clients make the move into facilities weekly. I realize you said no I'm home care but I think she could be a resource to you regardless of best practices on the move and legality of it etc.

Shoot me your email and I will send info over if you want to contact her.

ETA: her husband (my father) passed from early onset Alz back in 2016 so she has been around the block with dementia/Alz and could be a resource.
Howdy Dammit
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My Mom and her siblings are dealing with this right now. My grandma has early dementia and poor mobility. She has gotten very mean and threatening about home care/moving. At some point, you have to treat them like a child. Love isn't making them happy… it's making sure they don't die an agonizing death bleeding out with a cracked skull in their shower. Good luck
Caliber
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This suggestion comes from knowing nothing past the concept... You said in the OP that it wasn't acceptable for you to pay for home care but that selling the house is already on the table to pay for their care in a facility.

Have you considered a reverse mortgage or anything else to assist with end of life care if you can't get them out?
Ryan the Temp
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Caliber said:

This suggestion comes from knowing nothing past the concept... You said in the OP that it wasn't acceptable for you to pay for home care but that selling the house is already on the table to pay for their care in a facility.

Have you considered a reverse mortgage or anything else to assist with end of life care if you can't get them out?
There are some complicated issues involved I'd rather not get into in a public forum that affect any consideration of in-home care. We are trying to find some options, but live-in care is a non-starter.
Texas Ag Mom
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I feel for you. We went thru this w/my MIL. It was easier because she was a widow so we were not fighting both of them. We kept her at home as long as we could. She was in a daycare facility for Alz & she hated it. Then we had someone coming into her home. We set forth a plan & we picked her up & took her to a facility one day. She kept asking about going home. We told her we were having some work done on her house & she had to stay in her new home for now. It is a difficult process.
Texas Ag Mom
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"My parents assisted living center is a brand new, nice place in the D/FW suburbs. Two bedroom, two bath apartment - all meals for both of them - it's about $4000 a month."

Which facility? I am headed down a rough road w/my mom & her husband.
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