NotMyFamily Asked September 2021

When aging in-laws live out of state, how do adult children provide care?

In-laws live in another state away from adult children in other states. Recently there were some medical emergencies and there was no plan in place. How and what can we do to make them realize they need help even though one of them stubbornly thinks they can do it all themselves. None of the adult children feel confident in their parents abilities to be by themselves. What and where to start?

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You can only do the best you can. If they are still able to make decisions on there own there is not much you can do. They make decisions until they can't & they live with the consequences of their decisions. Going thru this now with in law parents 96 & 86 yrs. Tried many times to get different things set up, house cleaning, in home care, meals, POA's you name it. They are both one fall away. Yes it happened wife now in a care home & not doing good. Husband scrambling to try to get things done now. He doesn't drive. Siblings all live out of state. What a mess, but they created this. It's so sad & hard it didn't have to be this way. Good luck & hope your journey is better.

Helpful Answer (7)

We are in a similar situation with my 91-year-old MIL. She lives in a huge house by herself and refuses to move. She doesn't have a cell phone nor a life alert type item. She keeps saying she has one and just needs to ask her neighbor to set it up for her. That is a lie. She lies to us constantly and keeps information from us. My husband is an only child, and we are her only close relatives. We live 4 hours away.

She used to be an immaculate housekeeper, but I have noticed a lot of things that are no longer as clean as they were. She told us she was down to 89 pounds at her doctor's visit (she is 5'6"), and her doctor about had a fit and told her to gain weight. She claims she is over 90 pounds now, and says she eats well, although there never appears to be a lot of food in the house. She still drives a 21-year-old vehicle.

She keeps all her financial info private, including not wanting my husband to see her will. We think she probably cut us out of a lot. It's her money to do with as she wishes, but we think maybe the mega-church she attends talked her into giving them a bundle when she passes.

If she has any dementia, she hides it well, because she still seems very "with it". Her memory is probably better than mine. :-) Right now she has neighbors who keep tabs on her, and they have our phone numbers. So, there isn't anything we can do until a crisis occurs. The idea of dealing with all that fills me with dread. I wish she would deal with her big house and the stuff in it while she still can.

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Any type of family discussion is the first step. So they don’t want help. OK. Ask for a talk about what they do want now and about their future plans. Talk about an additional emergency “just in case”. Get in some more together time to get started and don’t push for resolution. Just get “your foot in the door”. Meanwhile, on your own, check out what is available (for every scenario.

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Sometimes you have to wait for that trip to the ER then tell the powers three that the parent is unsafe living alone and that you live several states away and need the parent needs to consider assisted living.

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My next-door neighbor is 92 and lives alone in a 2-story house (no full bathroom downstairs). Her children live hours away. She still drives, but not that much. She had hip surgery a year ago, and she would have gone to rehab afterwards, but her dr. didn't want that because of covid-19. There was no plan, so of course the sole D became the plan. She had to come down to be w/her mother for about 5 weeks. Sometimes one of her 2 brothers came down on the weekends. And then the mother went to stay with the D in her home, and maybe in one of the son's homes, too.

The mother is back now. She did have a helper come in the afternoons most days, but that has ended. So she's all alone now. I guess her children are waiting for the "event" to happen to force a permanent change. Their mother is very stubborn. This is a common tale.

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I have worked in home healthcare for almost 30 years as a caregiver, as a home health aide or nurse. You have asked how to make the realize they need help even though one of them stubbornly thinks they can do it all themselves? You can't. NO one can. This is one of the hallmarks of dementia. They cannot be reasoned with. It is NOT that they see what their problems are and just will not admit those problems, They CANNOT see them. Again, you cannot reason with a dementia patient and why you try to, you will only become frustrated and angry. So.. what to do? Agree with them and then go do what you HAVE to do to keep them safe and out of harms way which means, keeping them from harming themselves. Please get rid of any guns out of the house. Call Adult Protective Services, Talk to their primary doctor about what is going on. They can advise you. When it gets to the point that you describe, they need someone to be their advocate, to make the decisions that need to be made on their behalf. Leaving them home alone puts them in danger of not only maybe cooking and leaving a burner on and burning the house down with them inside, but setting fires to others homes nearby. They won't like what you do "for them" but you must. You have no choice. Again, someone has to make decisions for them because they no longer know what is right, what they are capable of.

Helpful Answer (5)

Some of the best information, support and advice. This is what I would say although I read your response first. THANK YOU.

It sounds like a change of location - for family or aging parents is necessary. Or find a good person (care manager, as I am) to be the family's 'eyes and ears' as needed. Many people cannot afford a case or care manager. And, I believe case mgrs are licensed (social workers or medical social workers). I am not licensed so I call myself a care manager - I manage all kinds of care (hire and supervise caregivers, work with attorneys, empty out entire large homes, pick up rush prescriptions . . . ) and work with out-of-state (or local busy professional family members, or those who travel for work.

People / family 'try to reason' (as you know) because they do not understand dementia and they 'think' / 'react' as if they are talking to the parent they knew before dementia. It is a very difficult, challenging situation - even for the best or more experienced of us. I always say DO NOT ARGUE. Argue, change the subject and do what needs to be done.

I appreciate your response.
Gena / Touch Matters

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You do not move and you do not take them into your home. You work with an eldercare attorney to make sure you have the Power of Attorney, they have a will and do whatever else is needed to make sure their affairs are in current perfect order. If they refuse then back off and simply tell them they are on their own unless they cooperate. If possible, hire someone to look after them and their affairs and be up to date with you. If all else fails, face the fact they will do what they want and will have to lie in the beds they make. But you must protect yourself in advance to the maximum possible because it will eventually hit you in the nose. You get very tough and make them know there are now rules to be followed - or else.

Helpful Answer (5)

My parents have had their ducks in a row for 20 years or so! Now that they are 94 living alone with minimal support the issue is getting them to commit to increased help and/or AL. My mom who is now showing dementia has every reason why any suggestion won’t work and my dad goes along to keep the peace. My dad always wants a family meeting but they turn into hours of mom rehashing everything that hasn’t gone right. We have put our foot down to only meeting for the purpose of planning or moving forward. It’s very hard, sad and frustrating to sit back and now wait for an event or for the two of them to reach out to us. Even with financial and health ducks in a row doesn’t mean the end is smooth sailing. Glad we’re all here fir each other!

Helpful Answer (4)

Mom showing signs of dementia -and- you put your foot down to only a meeting with purpose. Those don't really go together. If dad indicates he needs more help, get the help and one of the children plan to be in the home with them for a week or so to make the transition to adding the help.
Maybe mom feels railroaded in the group meeting. Get her alone and ask her what kind of things might help HER take care of dad - even though that might not be the case. Perhaps she would admit a little house cleaning or laundry help would be nice. It might get your foot in the door with her.
If mom gets argumentative, the child calms her. Stay in the home with them long enough to get the ball rolling. In the future, just add another hour or so that mom won't notice much and will be more helpful to dad.

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Someone in the family needs to visit them for at least a week to learn exactly how they are managing. Some people at their age can manage fine on their own; others are good at hiding their deficiencies. Being in the home for at least a week will help you know whether they are current on meds, eating well, keeping house clean, keeping themselves clean, etc. Of course, at that age, the situation can go downhill very quickly.

Helpful Answer (4)

NotMyFamily: I hear you; I truly do. In my case, my late mother was adamant about living alone in her own home seven states from mine. I had to move there and in with her. I do NOT advocate this.

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In whatever plans your family makes for your in-laws remember that the said in-laws are the responsibility of all of their children not just the female children.

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AMEN

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When aging in-laws live out of state, how do adult children provide care?

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