Here are some details about my grandparents:
Grandfather:
Incontinent, forgetful, everything is done slowly, extremely stubborn. Almost fully deaf yet refuses to use hearing aid. When talking to him, we have to shout in his ear. He shouts at us as well because he can't hear himself and has a bad temper. Wants things done his way or else he throws a tantrum. Refuses to use wheelchair, walker, or wear diapers or even have a bed pad. Wets his underwear (27 pairs) every day and asks us to do laundry. Tries to get up to use the restroom but by the time it takes him to walk across the hall, he's wet his underwear. No energy. Sleeps for about 20 hours a day. Room smells of stale urine. Did I mention stubborn?
Grandmother:
Diabetic, dementia, basically no short-term memory, sleeps for about 20 hours a day. Requires insulin shots four times a day.
My mother is a widow and has been caring for them for a while now. I work and live several states away and don't get much vacation time to come home. When I am gone, my mother thinks she cannot handle caring for them all the time. Luckily, grandparents live in the same apartment building as mom and she has to visit them several hours a day and finds it hard to find time to do her own work (she works from home).
Grandparents have no insurance (as they did not work in the US long enough) but are both US citizens. They only have Medicare B and D (no A, and no long-term care insurance).
How do we take care of my grandparents and especially deal with my stubborn grandfather?
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And then what about grandfather's incontinence? Who will manage that? And now his health has taken a turn for the worse. Who is nursing him?
Keep checking your options. I'm sure you will feel better if you can know in your heart that you did your best to find a way to keep them safely at home (while safeguarding your mother's health). But be prepared for the possibility that even with your best effort there may not be an affordable way to keep them home.
My grandfather, up until now, has been able to get up to prepare and eat breakfast and eat lunch and dinner (pre-prepared by mother). Today and yesterday, the most he's been able to do is sit up from his bed. He has no energy and needs help getting to a sitting position (and when he does decide to stand up, he needs help too). He lies down in bed and refuses to sit up and asks that we feed him meals. We bought diapers for him and he needs coaxing to wear them. After soiling them, he takes them off and just sleeps butt-naked which means his blankets and bedsheets are all soiled soon afterward.
He hasn't been able to talk much and speaks in a raspy, hoarse, and breath-y voice when he does. Yesterday, he woke up and started putting on his clothes saying that it's time to go to church. He wakes my grandmother up at 3am and says it's time to eat breakfast.
His room smells of stale urine.
As for sleeping, both my parents, who still live on their own, do a lot of napping... of course, they are in their 90's and that's a lot of years to live, they are tired. Plus they are no longer active. Even I would doze off if sitting all day in one place.
As for your Mom trying to care for her parents.... my gosh, it is exhausting helping just one parent, cannot imagine trying to help TWO parents each with memory issues and other medical issues. Please note that 1 out of 3 caregiver dies leaving behind their parent(s).... so please fast forward trying to find help for your Mom or to place your grandparents into a continuing care facility.
It doesn't sound like the current option, them staying in their apartment with only your mother for help, is a viable one. Where to look for options? Call the area agency on aging in THEIR state. Explain the situation and ask for suggestions. As Pam suggests, look into exactly what insurance they have and what it covers. If they belong to a religious community, call the clergy there and ask for suggestions. You could also ask for a needs assessment from their county's Social Services department.
Perhaps your mother could handle this is she weren't the only one responsible -- if they had in-home care, if someone "official" came in and said he has to wear disposable underwear, if someone could help her with showering, etc. Doing all the care for two adults is simply beyond what should be expected of your mother.
And in-home care might not be enough. Even if it is now, Grandmother's dementia will progress and maybe the only safe option for her is a care center with around the clock staff.
You can help by doing all the research. Most of it can be done by phone and internet. If you get an appointment set up, for example with Social Services, you may want to arrange it when you can be there -- for sure when your mother can be there.
Good luck ... and post again as you find options. We learn from each other!