I am concerned that I could be held accountable if she becomes malnourished or dehydrated but I can't be expected to force food and water down her throat, right? What can I do to protect myself legally? Should I give her everything she asks for to eat or drink even if it's not good for her? Should I withhold things she likes and risk conflict? Please help!
And why in the world ask US and not those people you fear are concerned with your client's nutritional intake?
Given that said, on we go to the problem.
How old is your client?
What does your client's family and medical team think about an elder's right to eat what he or she wishes in his or her last years?
Does your elder client have dementia so that they have no say or no control over food served to them? If so this is an easy fix; serve nutritious meals that are also yummy. If they DO have say over their intake then it is the business of no one on this earth what they eat.
Dehydration is common and almost all us elders enter the hospital with blood work that indicates dehydration. We lose the drive to take in fluids and we often have the fluid to bladder direct connect that makes us purposely not have intake before appointments and etc. We often go down with dehydration and consequence low blood pressure and such. So this is not only common, it's almost the norm, and most medical personnel are aware of it.
Forcing fluid and food on an elder is nothing short of abuse to my mind.
So all of this said, time to talk with that family now, isn't it? Tell them your concern that their loved one isn't taking in enough nourishment. Be aware also that as we age we both NEED and WANT less food. I am 81 and eat pretty much one meal a day at about 3 pm. A yogurt snack with muesli on top later, perhaps a half english muffin in a.m. and I am good to go. God forbid the day I have people forcing food at me.
The OP isn't going to call it quits because she wants to inherit the woman's property when she dies.
I don't like caregiving situations like this. I've seen too many of them.
Where some vulnerable elderly person's care needs aren't being met at home but placing them in managed care is out of the question.
The reason is always to keep assets away from being spent down by a care facility.
So, who would come after you for not 'feeding her' correctly?
Are YOU buying all the food? Does she live with you?
You're not legally bound to do ANYTHING for her. You're probably doing way too much as it is.
You have POA, but you can reject that. And I suggest you do so.
AS far as the eating, my MIL eats >300 calories a day and she's done so for 9 months and she's still here, so evidently you can last a long time on a 'starvation' diet.
Please dump the POA and move on. Report her as an endangered elder and let the authorities take over.
Your decision “to fulfill my promise to her to keep her here at home til the end, comply with her DNR, honor her final wishes, and spread her ashes where she has directed” assumes that one person can provide all the care, whatever the circumstances. If your son values his own future, he will eventually move out and you will indeed be ONE PERSON taking on 24 hour care. Are you joining so many of us in hoping that she will die peacefully in her sleep, without extra needs at the end?
You say she “adamantly wants me to inherit her home”. She also ‘adamantly’ insists that you continue to do everything without payment (in fact with you paying some of her own bills). And that you are really a tenant receiving free accommodation and she doesn’t require a carer. She is perfectly able to think that you have had a good deal, change her mind, and decide to leave her assets to a charity for a building with her name on it. Her diet seems like the least of your concerns.
As I already said, I won't give up. Knowing that, the only helpful advice you could give would be regarding her care, or my financial/legal questions. Anything else is just a scolding which is not helpful.
Do you think I didn't also have these thoughts? I spent the 1st year of living here without any kind of agreement, document or anything. It was a kind of trial period for us both. It went well, she improved, she wasn't lonely anymore, her house got clean, her diet got better, etc and we agreed that it was time to make it formal because I was not about to put my entire life on hold without some kind of assurance. So she had her attorney do the things and life went on much as usual. I had no reason to intervene yet so I let her control her own affairs and only helped when asked.
Early on she didn't need alot of Healthcare type help and I was not privy to her financial situation. I managed her house, property, shopping, errands, meals and helped with her dog. Fine. That was worth the cheap rent and I continued to work full time and could even leave for a few days if I prepped meals.
Then she fell down a couple times. And then a couple more times. She always assured me she was fine, didn't need to be seen, would be fine again in a day or 2.
But I could see the decline.
She would write checks that weren't legible. She would pay a bill twice but forget a different one. Then the next month she was fine, then not.
We had a talk and she got frustrated, then mad, then silent treatment for a few days, then cried in my arms about how terrified she was about losing control. I began by writing the checks as instructed so all she had to do was sign. Then I saw a bill that seemed odd and asked about it. She said it was a collection agency for her late husband (15+ years ago) who didn't finish paying Sears for something. It was a scam so I put a stop to it and began monitoring her credit and bank account for other fraud. She only has 1 credit card through her bank with no balance.
With her permission I started autopay for the rest of her bills so she rarely has to write a check. Basically,
I am preparing to take over her finances and want to do it legally as is my duty.
My questions were: When is it time, how do I do it legally, what pitfalls to avoid, etc but I got alot of "how dare you" and/or "are you stupid?" non-advice.
Please don't treat me like I'm an idiot or like I'm doing something morally wrong. If anything, all you naysayers are the bad ones for telling me to dump this poor old woman and never look back.
Is it because I'm not her blood relative that you assume I'm preying on her? As if family members don't do it to "loved ones" all the time, but ok, since I'm nothing but a neighbor, it's not possible that I have her best interest in mind. Doing right by her is not negated by the fact that will benefit in the end. It's just a reality of the matter.
This situation makes perfect sense if you think about it.... Younger people need a leg up to home ownership, old folks with no family have a home but no one to leave it to. Old person gets to stay, have care and companionship, young family gets a home.
This is a dynamic that should be celebrated and implemented, not thought of as strange or shady.
Just trying to point out that you are laying a lot of your life on the line, and there is no guarantee that it will work out the way you expect and hope. If you are willing to take the risk, good luck for it all working out well the way you expect.
After reading so many posts from unhappy people expecting to be rewarded for years of unpaid service, and being seriously disappointed, can you blame us for being a bit negative? It's warning, NOT scolding!
I'll tell you who will question her diet and many other things along with it.
The state. Homecare agencies and visiting nurse agencies who have lists of seniors living in an area. Then they move in and start soliciting the household.
My mother gets all kinds of calls and advertisements in the mail and even online for homecare services and free this-and-that and how wonderful. She was getting a near daily call from her insurance for a free consultation with a nurse and social worker for services.
I had to talk to these people ten different times to tell them no one is interested and to stop calling.
When any entity involving social work, nursing, or homecare find a senior not receiving services they move on that senior. If the senior has assets like real estate, investments, and bank accounts that's blood in the water and the sharks come.
I've seen it many times as an in-homecaregiver. All homecare agencies canvass areas to find these seniors myself included.
Only I have a conscience and will not be as intrusive as most are.
Some elderly person with no family but owns a house, a bank account, and has good insurance.
The OP's has a doctor's appointment and the OP (the live-in caregiver) takes her. The doctor suggests they go to a nutritonist because the senior isn't eating, then makes the appointment.
This is how the ball gets rolling.
The visiting nurses start showing up. Then social workers who will claim to be "there" for the caregiver (the OP) just as much as to benefit the elder.
Then before you know it that elder who was maybe a little fussy about eating is now a ward of the state and in a nursing home.
Their house and assets get liquidated to pay for it. The visiting nurses and social workers who got the ball rolling are patting each other on the back and enjoying their bonuses.
It's not unusual in the U.S. for doctors, nurses, and social workers to receive "incentives" for getting elders with assets placed in care facilities.
I know this because I've seen it happen too many times and even to seniors who did have family and were being adequately cared for.
Such a power imbalance.
Does it ever work out?
"If you move in, help me around the house, the house can be yours".
It's a contract. Not a *legal* contract, but still a contract.
But sketchy.. Will the 'work' be 7 days a week, or a reasonable 5? How long to work before 'payday'?
Will it be for 2 years? Or 15..?
Even with a legal binding will, as others have pointed out, this can change.
At the start the house owner holds all the power, but later, when frail or ill, the caregiver has potential for tremendous power - this trust must not be abused. As Burnt says, sometimes awful things such as abuse & neglect do happen.
My workplace had to report a seemingly very loving & attentive daughter to protective services. Frail aged Mother had many bedsores yet daughter claimed she was walking well. Daughter broke down & revealed she entered a house-for-care deal with Mother after her divorce, loss of job & lost her own home. Was now stuck, couldn't look after her all all day & night too, was overwhelmed but had nowhere to go (& no money) if Mother moved to a NH.
What started out a good deal was now a living nightmare for both of them.
Like a daughter, she has written you into her will. Like a daughter you feel obligated to provide care.
So, what would a daughter (or son) do?
I can tell you what I do.
I provide SOME care tasks. At a reasonable level. Yet as family needs are MORE than I can give, OTHER help is also needed. Home help like house cleaning, bathing assist, transport, deliveries etc.
That's the big picture view. Daughter or not - I am but ONE person. I know I am not a super-powered robot or super-human hero. I believe that's why so many replies are similar. They also are looking at your big picture.
But to answer this specific smaller question on food & drink.
Your lady has the RIGHT to decide for herself. To make good or poor choices. You have responsibility to perform your agreed role. Which is what? Buy the groceries? Serve meals?
Many older people can have diminished taste & so want SWEET as they can taste that better. This can be sugar-free alternatives if she wants. Suggest them.
Water is avoided for many reasons, some reasons are;
- Loss of thirst sensation
- Lack of sweet taste
- Swallowing difficulty.
Ideas include:
- Soups & sauces - adding water into meals.
- Drops of unsweetened cordial to add a nice flavour.
- Thickened drinks like milk, juice, or thickend water should be tolerated better if swallowing issues.
So as a daughter, volunteer or paid caregiver, I would say the same thing.
* OFFER the lady choices.
(Water, low sugar, sugary drinks, healthy snacks, less healthy)
* SHE chooses.
I am in the process of straightening out the financial stuff.
Thank you for the advice on getting fluids in her, Beatty.
You are correct that I will need to hire out some of the care. I will need to enforce my POAMC to get that ball rolling.
CWillie, wanting a smooth legal transition and worrying about her health are not mutually exclusive. Sorry to be long winded with the the "hyperbole", but I find the best advice is given when the advisor has all the details. Even still I had to elaborate so people can wrap their head around an admittedly odd situation.
I really appreciate your willingness to respond and participate and that response has made me understand your situation so much better.
I agree with the responder here who said you are basically now her daughter and are functioning as that. All that said, do be certain there are no "hidden" relatives out there. The recent passing of a dear friend with "no one" who left things to her friend and neighbor who was the only one who did anything for her in life and progressing toward her death proves that these folks are suddenly pouring out the woodwork.
That said, I think you are clearly BRIGHT and CAPABLE and it sounds as tho you are POA and doing the job well. Get it all sealed up now with an attorney. Once that is done proceed as you have been.
You have been honest to say that this woman, who basically is like a Mom to you and you functioning as daughter, is leaving you her home; But that is not a certainty when you cannot in any way predict if you CAN care for her inhome until the end. I know that's your good intention, but as someone who had a nasty little cancer enter a settled picture and cause a bit of disruption 35 plus years ago, I can tell you thinks can go wonky. So keep working. You need to and you must. You cannot squander a job and job history and your own savings, because this home you SHOULD get and MAY get is no certainty. We on Forum see so many end up homeless, jobless and without a job history and have been forced to tell them to "get thee to a shelter" until you can work and save enough for a room somewhere.
I surely do wish you luck. She's lucky to have you and your support. This is all about a good deal more than what she eats. As an 81 year old living with an 83 year old with SEVERE GERD I can tell you he eats almost nothing and he "persists". Elders don't need much food to live. Sneak in an occ. supplemental drink disquised as a milkshake. Do the best you can.
Best of luck to you, again, and again thanks for giving us more information, and I think it provides us all with so much more complete a picture.
See All Answers