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Labs4me Asked March 2014

Mom has COPD and insists on living independently. Any advice?

My mother is adament about staying in her own home to the end. She has chronic COPD using oxygen constantly at the 2 liter level. She has been recently been diagnosed with a heart irregularity due to her disease. She does not drive and walking any distant leaves her out of breath. Her immobility is causing edema in her lower legs for which she takes lasix. She is pretty much homebound and only goes out for doctors appointments. She has six hours a week of in home help with bathing and light housekeeping. She is lonely and depressed. My sister and I do what we can, but we both live an hours distance and work which leaves us little time to help in her increasing needs. As her DPOA, I try to honor her wishes, but I am not so sure her living independently is realistic. She is not incompetent so I cannot force her into assisted living or move closer to my sister or I. I finally convinced her to look into alternate transportation for her medical appointments. My mother will not increase the hours of in home care. She doesn't want to spend the money, even though the cost is subsidized based on her income. Any advice or someone in the same situation that give me some insight about managing living independent in my mother's situation?

akdaughter Apr 2014
We had the same issue about 14 years ago with my MIL, who also had COPD. She was living in her own home and kept firing the home health aides that we found to help her. After repeated 911 calls, ER visits and hospitalizations, the hospital social worker got involved and said that she could no longer live at home alone. We moved her to an AL facility the next day. She lived there the last 17 months of her life. I have often thought that she may have had a longer, more comfortable life if she had moved sooner to AL where she had help with her meds, good food and some socialization.

agrace Apr 2014
I know of a similar situation.

Perhaps you could research some solutions, like one or two trustworthy caregivers, or several assisted living facilities and let her situation evolve so that she makes the decision herself, when she's ready.

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JessieBelle Mar 2014
It does sound like AL with the sale of the house would be best. The main problem is getting your mother on board with the idea. From the bit I know about your mother, it seems that she is going to do what she wants. I don't blame her. I don't think anyone wants to lose the things that they have in their life. What would be great is if she were to realize that her life would be better and happier if she was living in a place where care would be available when needed.

Labs4me Mar 2014
Thanks JessieBelle. COPD at her stage is scary. She manages, but I do not think she follows her Pulmonolgists recommendations of Abuterol 3x daily inhalation therapy. She has a Spiriva inhalant, but I have never seen her use it when short of breath. Her biggest concern is just getting oxygen by use of a home unit. Her recent heart diagnosis concerns me. I am not sure she should be living on her own without more hours of care. Her primary physician felt she shouldn't live alone a year ago. Her finances for in home care 24/7 would deplete within a year. Assisted living with her income and sale of home could last her at least ten years, she is 82. Inheritence is more of a concern for her than my sisters and I. As long she is competent to make decisions I cannot and will not override her decisions. Not an easy situation to live with.

JessieBelle Mar 2014
A paid caregiver does sound like a good solution for her. I know it is hard for her to get out much. The Lasix can keep them going to the bathroom every few minutes. I wish there was a way to help shed the fluids without disrupting life so much. But I guess the water has to go somewhere.

Does your mother do her breathing exercises? Do they help at all? I don't know a lot about COPD, only that it can drain the energy from people. She and you have my sympathy. Does she sleep well through the night?

I was thinking yesterday about how easy it is to write on here what seems to be a good idea, but how hard it is to do it. If it were just us, we could do everything ideal. However, we can only do what they will let us do. It sounds like hiring a caregiver to help during the daytime would allow her to age in place. That can be very expensive. I don't know how much care she qualifies for with her subsidizing.

Now, that sounds all good, but then we run into the problem that our parents don't want someone else in their home, or doesn't like the person hired. Sometimes there seems no good solution unless everyone is in agreement with things going on. I guess the best thing is to work on getting everyone in agreement.

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