My brother and sister and I are going to have a phone meeting to share the latest conversations we've had with our parents so that we all have the same information from which to make any decisions related to them. Lately, we've each had or own conversations with my parents that make us think it's time we up our involvement. Our quandary is, how does one decide what extra involvement we need to have if my father doesn't share what's really at the heart of his worries and my mother doesn't want to burden us with anything? How do we analyze all the tasks they still do and prioritize and decide which ones we offer to take over? How do we know when it's time to tell them we are going to help them with things even if they don't agree? And what things do we continue to let them do on their own even though it seems they have a lot of anxiety over them. If they don't relinquish duties that they are capable of but that give them so much anxiety, how and when do we decide to do things for them? Now that they are 90 they don't think as quickly, don't understand things as easily and they spend inordinate amounts of time figuring out new technologies (don't we all sometimes?). It keeps their minds active but takes away from time spent on other priorities and everything worries them now. Anyone have experience with this?
I'd recommend what we did - get a timed/locked dispenser (2, one for each.) Depending on how many meds they take/times of day, these can be filled and last 2 weeks or 1 month. Audible alarm and flashing light for reminders. Depending on where/how they get the medications, can they be set up to automatically be renewed/sent? Typically a doc would need to see them at least 1/year to renew the Rxes, but mom gets her regular BP meds through CareMark and since taking over, I get text messages when they're up for renewal to confirm, then they're sent to me. They'll even contact doc if no refills remain. Another item we get at CVS, the doc put in for the whole year, so I get text from them as well, each month, to confirm refill. With POA in place, this should be doable. We never got the "definitive" doc confirmation of dementia, but I've had little trouble getting the POA active into all the necessary places (med ins plus CVS & CareMark, bank, bills - none needed for just changing the billing address, signed up for SS rep payee which took care of SS and Medicare. The worst one was mom's federal pension. No federal entity accepts ANY kind of POA - they each have their own.)
"taking care of the house"
Depends on what is needed. Talk about getting bi-weekly cleaning service? Yard maint? Painting? Window cleaning? Trash? He would need to identify what help he might want.
"taking care of the checkbook"
This can be done monthly by one of you, in concert with him. Perhaps you can talk him into either online bill payment or allowing you to change the billing address to one of you and then you schedule payments through the account. With few exceptions, I haven't done any auto-payments, I changed billing address to mine and scheduled them myself in her account when she was still in the condo. Now I do all her finances and taxes.
"staying on top of investments"
Same as checking - these can be reviewed monthly or more often if he is concerned and hopefully an online account is set up and can be shared with you all.
"worries about mom."
What are his worries? Her care now? She seems to be relatively capable from your comments. Her care if something happens to him? Reassure him you'll all see to her care and use that as springboard to get all documents in place or updated.
"the funeral director told me is that if someone dies at home, the police must be called."
That may be state rules. This web site discusses that and various scenarios:
https://www.seniorsmatter.com/what-to-do-when-a-loved-one-dies-at-home/2492367
I would think given age there would be no need for an autopsy unless there were obvious signs or concerns by family. Hospice can sign a death certificate, but there are rules about who qualifies.
Despite being 97, living in MC over 3.5 years (dementia), little to no hearing, losing eyesight to Mac Deg, unable to stand/walk without major help, incontinent AND recently having a stroke, leaving her with right side weakness, slurring words, drooling, etc, hospice DENIED my mother!!! Doctor must make determination whether she might qualify (hospice needs doc orders) and then hospice does eval to determine if the person qualifies. Seeing as we can't get it, I don't know what they would do for the person - general things I have heard/read say supplies, sometimes med equip, periodic checks and help with bathing, etc., clergy, perhaps some "company" from time to time. Every hospice place is different and from reading on this site, some are great, some not so good. You CAN change hospice if you aren't happy with the one brought in. This is a good site to check:
https://www.medicare.gov/what-medicare-covers/what-part-a-covers/how-hospice-works
From that site: "You have the right to change your hospice provider once during each benefit period."
Knowing that 2 of you are not local would change how to address any issues that need to be taken care of. It's also great when there are neighbors who are NEIGHBORLY and keep an eye on others and/or lend a hand now and then. Just beware that they aren't tasked with too much - they could resent it! My mother's neighbor (55+ condo community) was helpful for me. Mom had hearing issues and was starting down the dementia path, so it was great to have her in case mom needed a little bit, like milk or juice, between my visits (1.5 hr away.) We set up cameras to keep an eye on things (mainly the entrance, inside and out.) Mom had a habit of forgetting to replace her hearing aid battery, so there were times I called the neighbor to check on her (even the local PD one time when neighbor was away - mom managed to turn the sound off on her wall phone, misplaced the portable handsets and wasn't responding to my calls!) I did get them a gift card to a local popular restaurant, which she was reluctant to accept, but she did take it. It was well worth the cost, even though it wasn't often I/we needed her help, but it was helpful to me!
"So, that brings me to now, where Dad is definitely anxious about having all matters in order for their end of life and worried about my mom who seems to be more and more tired."
Hopefully all the POAs, will, and burial arrangements are set. If not, discussion about these and why they ARE important is in order! Yours should be as well. I noted you contacted a funeral place - make sure you know what their wishes are, such as burial or cremation, services, memorials, etc. Mom and dad, thankfully had set up and were pre-paying. Dad passed before it was paid up, so when I took over financials, I noted about $2300 was paid by mom. It wasn't until I took over her finances and after we moved her to MC that I found the 1099 for the burial trust in the mail, so I had a contact point! She is almost paid up now (dad passed in 2008, plan was started in 2007 and mom is now virtually paid up at 97.)
Other concerns will be addressed in another post - exceeded characters again!
However, if they are stressing about normal household chores, this might be the time to suggest moving to senior apartments or assisted living. Maybe checkout a few facilities on your own and then take your parents to visit the better ones.
If you are concerned about your parents' thinking abilities, then it would be time to take a close look at such things as (1) are medicines being taken ( and it would be good for you to make a list of all prescription and over the counter meds they are taking), (2) are bills getting paid on time (maybe setting up some for auto payment would help), if bill paying stresses them moving to assisted living would reduce the number of bills that need to be paid, (3) food in fridge - is old food stacking up, (4) signs that food is getting burnt like pans that haven't been cleaned or missing pans.
Definitely need to make sure POA, will, health care documents are all complete and up to date.
There are a few cautions I would suggest. First, be sure that whatever you do, do it as a sort of partnership with your parents. They need to feel that they are in control of their lives. Talk honestly with them about developing issues and what they would be willing to get a little help with. You may be surprised. Rather than trimming the roses for them, they may want you to vacuum the floors so that they can trim the roses. Or vice versa. They will want to continue to do the chores that bring them pleasure while they may not mind a little help with something that they find tedious or the things that tend to tweak an arthritic joint. Help with small things first, perhaps while visiting about fond memories of the past. As they become used to the idea that you really want to help and are not just feeling obligated, they will become more open. Stress that you enjoy being with them, whether anything needs to be done or not.
What we found worked best with our mother was to make regular vists on certain days. I arranged with Mom that I would visit her on Tuesdays and that we would do lunch. I either would take her out or bring lunch up. Sometimes we just sit and visit, sometimes I take her for a drive and lunch (or did pre-pandemic, at least). Sometimes there will be other things to do. While we are out we may pick up prescriptions, go to the post office, go shopping, or whatever needed doing in the way of errands. When visiting at her house we would sometimes sit outside by her flower beds and talk while we weeded the beds. Sometimes we just visit. Over time she came to expect that on Tuesday she could ask for favors and if I could, I would help her out.
I am assuming that they are not interested in moving into a senior residence, so the job you are taking on is to help them keep up with living in their home. You will be helping them with some of the small tasks of living to enable them to stay in their home. That will take some careful conversations. "Mom, I noticed that the plates in the display case are getting a bit dusty, could you use a little help cleaning them?" is better than "Oh, wow, look at all that dust, I have to clean that." Another tack may be to ask if she has difficulty raising her arms long enough to deal with surfaces above shoulder level.
Another caution: Be aware that your parents' needs will continue to grow and your ability to meet those needs may decline. You need to talk about limits right from the beginning. You need to be saying, "As long as I can do this, I would love to spend some time with you and help out a bit." Too many of us have started out caring for aging parents and end up begrudging the work or resenting the time and effort. Also, be aware that each of you takes on what you choose to do. If one of you takes on more than the others that is what is chosen. You are taking on these chores because you treasure your family, keep your obligations in line with what you can do happily or you may jeopardize the family relationships that are meaningful to you.
Love how it is never something they did, eh? YB didn't tell me about an accident she had, so when she needed to renew license, she had note from Eye doc and I took her to the registry. Bad idea! Not long after, she "brushed the pole", resulting in about 6k in damages (repairman told me then that he had replaced the whole nose not too long ago, the accident I wasn't told about.)
After that, first was the back of the driver side mirror - it was there the last time I drove it! Sure it was mom, we just pulled it off to blame you!!!
Note to others: check the inspection sticker - mom's was MONTHS out of date!
Then came the white stripes on the front fenders (from garage door trim.) The only good news is she had already stopped driving at night and her "circle of comfort" was seriously curtailed by her, but still...
The final straw for me was going to help her with a "flat tire", only to find the tire split from rim to ground, the rim damaged too, and the metal around the wheelwell half off and bent. What did you hit mom? I didn't hit anything... Oi!!!
Glad you were able to take the car to have it "serviced" and not return it. YB had the "talk" with mom and I had him disable it when we were leaving with the key. I was sure there was another key. Next day, she forgets HE did the talking and taking of the key and accused me! Day after, more nasty accusations and demand that I get there and fix whatever I did to her car. So, she DID have another key AND managed to locate it!
She whined about it a lot. Her complaints eventually morphed into 'the worst thing she did was to give up her "wheels"', like it was HER idea!!! It took a while (we removed the car shortly after the key removal), but eventually she dropped it. I managed to sell it (that was fun - first when taking over her finances, I discovered she never reregistered it in her name, so reg, ins, etc was in her name and dad's! Got ins to remove him, and when sold, I gave copy of death cert and POA to the buyer in case he had any trouble with title or reg, because I signed off on everything. Good news is he was well known to my mechanic, so I trusted him with these docs.)
Have your parents had any blood work recently? The things that you said they were experiencing could be some nutritional deficiencies. My dad gets tired and I set him up on a B complex, Vitamin C, probiotics (mornings) and magnesium and zinc at bed time. He sleeps better and has more energy. My mom was stressing about everything and she is doing so much better after being put on the same regiment.
I know that people will have a fit about supplements, but I personally have seen the benefits for my family and friends. As we age we process food differently, our bodies don't produce certain essential nutrients as efficiently, we just don't get the nutrients that we need without supplements. It is worth a try, if it can improve their quality of life what do you risk?
I order my parents an 8 month supply from Swanson vitamins and it costs me around 7.50 monthly per person, it has truly improved their lives, they feel better, and mine because I am not hearing all about their physical ailments as the only topic of every conversation and knowing that they don't have to suffer with some of this stuff.
Obviously, you should run the list by their pharmacist to ensure that they can safely take these supplements without worry of drug interactions.
Best of luck finding the best assistance for your parents to allow them to safely age in place.
I did fail to mention in my original post that none of us three siblings live in the same town as my parents. My older sister lives within 2 hours of them but my brother and I are a plane flight away.
Since COVID, we have just now begun visiting again. Fortunately, my parents have wonderful, supportive neighbors who have grown children living in the area who offered to shop for them too. My sister began driving up again back in June and she has since delivered groceries for them. Dad has also begun to go for quick grocery trips now too since he's more comfortable with wearing a mask, using hand sanitizer, etc.
About 2 years ago, we all agreed that when we visit, we should not stay in the house anymore. I think they did not understand that. It seemed less disruptive for them and their schedule. I suspect their feelings were hurt. We also agreed that visiting at most 2 days at a time was best too. I think they are missing getting out more and seeing us and friends (the few they have remaining :-()
We tried about 10 years ago to have discussions about moving out of their home but they decided they want to age in place so we honor that and are doing what we can to support that.
So, that brings me to now, where Dad is definitely anxious about having all matters in order for their end of life and worried about my mom who seems to be more and more tired. She still has days where she feels pretty good, she's conversant and still writes in and sends birthday cards, only gets confused occasionally (not been diagnosed with dementia but she has had several mini-strokes over the past 10 years or so). She can be more clear-headed and remember things better than Dad sometimes. They both cook, but don't eat as much as they used to so a home-prepared meal and occasional takeout go a long way. Anyway, it's difficult to do justice to everything about anyone's life in a few paragraphs but we see Dad feeling overwhelmed with the responsibility of making sure my mom's and his medicines stay filled and taken, taking care of the house, taking care of the checkbook and staying on top of investments and worries about mom.
We siblings had our phone conversation yesterday and it was productive. We all agreed we'd like to have a family meeting and my sister is going to visit them tomorrow and will broach the subject. We will need to figure out a good time for all of us to gather, hopefully by the end of the month or the beginning of November at the latest. In the meantime, I've contacted the funeral home that I believe my parents want to use and picked her brain with all kinds of questions. Among many things I learned, something the funeral director told me is that if someone dies at home, the police must be called. And then the body must be taken to a medical examiner to determine cause of death. However, if the deceased is under hospice care, hospice can sign the death certificate. I am wondering if anyone "out there" is an expert in hospice and can confirm that or provide any more detail.
Also, a friend of mine says that hospice provides much more than just palliative care in the last days. Her mother is in a nursing home which provides all her basic needs, but they felt she needed more stimulation than they could give her there so they have hospice care come in addition to what the nursing home provides. Is there anyone who can speak to what all the services are that hospice can provide? I plan to do some Google research myself . Thank you all again for your thoughtful answers.
The death inquiry is mainly to ensure no one 'helped' them die to end suffering or to benefit after death. Living in a small town, older folks dying at home don't often go through autopsy process - the justice of the peace shows up, pronounces them dead, and body goes to funeral home. It could be that in a small town so many people are already familiar with the person and the family, so red flags don't get raised. I hear about it more often in bigger cities in the state where I am.
Most of the time hospice is called in when there is an expected 6 months or less to live, however pallative care may allow more time to be started. Just ask all of the hard questions should you consider it - will she continue taking her meds, will there be any therapies to maintain physical strength, etc. Be sure everyone is on board for what hospice will actually do, or not, for your mom/dad.
if you want to get a weekly housekeeper in you could use the I know someone and they really could use the money approach. Basically get them to think they are helping the person actually helping.
if you want to clean their kitchen you can do it the sneaky way by having a big family dinner, haul in pre cooked main and then you guys just have to make side dishes so you clean while pretending to cook.
mom they are fixing my water line can I come over and wash couple of loads then you just wash their clothes as well or instead of basket you brought.
mon I have to go to x store do you want to come and do your shopping too?
I think it works better to be honest and up-front. Hiring a housekeeper is a good idea, I got my mom a housekeeper for her birthday one year and she was really pleased. Beyond that, when you visit, offer to make tea. Then wipe down the counters as you wait for the water to come to a boil. That is just a habit in our family, while you are in the kitchen you doodle around cleaning up the surfaces. Don't even try to clean out the refrigerator unless your mom/parents are involved. If you do, they will notice and complain that you threw out something that was "perfectly good." My sister has found that she needs to be really careful about such things. Mom is 96 but she will know if any little thing disappears. She needs to ask Mom, "you don't want this cottage cheese with the mold on the top, do you, Mom? Is it ok if I throw it out?" Otherwise, Mom will complain about "someone" throwing out her "perfectly good" cottage cheese.
A little thing here and there may be appreciated but trying to engineer massive projects may end up with a lot of resentment. All changes need to be made with the parents' cooperation and approval or their will be problems down the line.
My dad says it best, "I can do everything I need done. It just takes me longer, but what else do I have to do?"
Aanxiety can be addressed with some medications or maybe it is just what it is. My stepdad was a nervous nelly and that was how he was wired. If you handled everything he worried about, he would worry about the neighbors problems, he worried and he was anxious.
Support your parents and love them, but let them do what they want as long as they are not setting fires or something else dangerous.
To your point that they will not appreciate what you do: quite possible. But, at some point the child becomes the parent and must do things even if not appreciated. They did it for us and at some point, when appropriate, we should take on the responsibility.
The suggestions to have each of you spend some time there are good. I wouldn't spend an whole week, but would rather drop in different days, so you can get a better idea of what they do every day/week. Each of you could stop in on a different day, then swap days later, just to get more ideas. Each of us would likely see something different.
Just spending time with them is a benefit, but also you can observe while visiting. This would allow each of you to make mental notes about what tasks appear to be difficult for them. You might each observe something different. Spending time WITH them is a bonus in itself - bring supplies to make lunch or dinner, so they aren't spending the time "waiting on you" as their guest. If you each can spend a day here and there, over time you can come up with a list of issues for you 3 to discuss and make plans for. If they are doing "chores" while you are there, offer to lend a hand, just because you want to help out AND then be able to spend more time with them. This might also give you some insight into what chores they might need more help with.
As others noted, don't just swoop in and take over! Some people are more independent than others and might resent someone stepping in on them. Others might take advantage of what you all do and get you to do more and more that you didn't bargain on!
I would think the most likely "chores" that they might appreciate help with are the more demanding ones, like lawn care, heavy cleaning, maybe laundry (bigger loads like bedding, etc.), maybe even making some meals that can be frozen and thawed quickly for an easy meal. Hauling groceries can become difficult too - go shopping with them during this fact gathering, it allows you to spend more time with them AND you can help with bringing it all in too.
Once you each have a list drawn up, then you could get together and discuss which tasks you think they might like help with and which of you might want those tasks. Then you have to broach the subject. It can be done without it seeming like intervention - once you know their routine (what days for lawn care, groceries, laundry, major cleaning, washing windows, etc), you can make a point to "drop in" on those days, and ask if you can help, rather than suggesting you take it over - as others said about mowing - dad, you do the front, I'll tackle the back, then we can watch the game! Over time it may result in mostly you 3 doing the work, as they age more, but while they can still participate without struggle, let them! Keeping active, mind and body, is good for everyone!
Do beware if they become the type who not only give up these tasks to you, but also start asking you to do more and more, without real reason.
Don't take away anything that involves getting up and walking if both are still steady on their feet. What you take away, also takes away their abilities and those abilities do not come back. It is very easy to take a mobile person and turn them into invalids all in the name of helping them.
Look for short cuts they might take in preparing meals. Instead of eating a healthy meal, you observe a peanut butter sandwich or similar. So food prep and freezing meals might be a huge help to them. Maybe some of the heavier housecleaning every couple of weeks, while they do light duty things. If keeping up with bills is becoming an issue, that's an easy task for anyone to take on from their own home with online access to nearly every bill you owe.
Does a parent go to the bank to get cash for misc items? If so, nip that in the bud. Have them use a credit card for any and all purchases no matter how small the bill is. Too easy to get robbed coming out of a bank or being followed.
Observation will be your biggest tool to determine how you can help. Don't ask if they want/need help, just show up and do it. Some folks simply do not want to ask or appear to be a burden.
Don't do things that they can do for themselves. The more I helped my father the more helpless he got. Don't rush in and fix everything. Right now it just may be someone takes them shopping and runs errands. Another helps out with cleaning and laundry. Last sibling looks over finances. Try to avoid getting to the point where they call and expect your to drop everything and come over. If each of you could offer so many hours each week and just handle whatever needs to be done during that time frame.
And yes look into outside help so this doesn't snowball and become more than you each can handle.
https://www.agingcare.com/articles/warning-signs-that-elderly-parent-needs-help-138989.htm
https://www.agingcare.com/articles/should-elderly-parent-continue-living-at-home-95665.htm
Shopping can be delivered or curbside, although you can encourage them to make lists and help place orders if necessary
A cleaning service once or twice a month for inside tasks, a yard service for outdoor ones
Bills can be set up as auto pay
Meals on wheels is a great way to ensure they are getting regular meals
There are all kinds of panic button services or devices to help them summon help if needed
Hire a dog walker if they need one
Home care agencies can help with personal needs like shower assistance
It wouldn't hurt to go through their home with an OT that could point out hazards and give helpful tips on modifications that can make things easier and safer.
If they are still driving figure out what kind of alternative transport is available and how to use it
Do not go in with a "take over" attitude, always allow them to ask or direct you. imo.
Go home when they are napping. However, you can use this time to be in the kitchen wiping things down, mopping the floor, quietly.
That is what I did, because in those comfortable chairs, they fell asleep alot. I was able to clean out the whole refrigerator one in one nap time. They barely noticed, but other family members did, and now could bring groceries, being able to see that nothing was edible but before was a full looking fridge and freezer.
If no one was there to watch the process, everyone would have thought a huge pork roast was defrosted properly, fully cooked,and ready for dinner just out of the oven that night.
Defrosted at room temp. x 3 days, uncovered. Cooked slowly in a roaster oven all day, barely covered, too big. Then, not refrigerated. Placed in oven for two hours, ready to serve. Yum, we all were excited, except for me having to inform the others. Inside was still frozen and uncooked.
I agree with what others have posted so far. Keep a check list running and remember that everything doesn’t have to be taken care of all at once.
Voice your concerns in a ‘matter of fact’ way. So many times when people get stressed or frustrated they don’t use a calm tone. It’s not just what we say but how we say it. It is important how we say something.
One thing at the time. Check off completed tasks and onto the next when someone can get to it.
Best wishes to you and your family.
I am sure you will each have picked up on different things. Once you have a master list of things you have all noticed, see if there is a thread that runs through it.
Are the folks able to manage meals? This means getting groceries, the right ones in the correct quantity, preparing healthy meals, and cleaning up afterwards. Where does the system break down? Cannot get to the store, either cannot prep and cook food or it is unsafe. Cannot clean up. Spoiled food in the fridge?
Hygiene, are they bathing, wearing clean clothes? Can they manage the laundry? My Dad cannot physically change his sheets, but would never ask for help doing it. Can they still reach into the machines? Dad cannot, he has a gripper thing, but it does not work well in a washing machine with an agitator and a front loading washer is impossible he cannot bend.
Money, are they paying their bills on time? Does someone have POA? Is there lots of cash in the house? Over due notices?
Once you have an idea of the different areas where as a group you see them needing help, assess which are safety concerns, which are not likely to be an issue for them to relinquish and which ones will be more challenging.
Next think about which sibling can best address which item on the list. With my Dad, only my brother can do things in person with him. Anything I suggest will be shot down immediately. So when Dad is not home, I give it a deep cleaning. Pre-Covid, i arranged for a cleaning lady. I toss old food, medications, use copious amounts of bleach in the bathroom and on the kitchen counters. Change the sheets etc.
With Mum, I review financial stuff with her, bring her meals now that she is laid up post op, etc. Mum needs far less oversight.
My parents are divorced, so we are not dealing with them in the same place.
that’s what us 3 sisters do about our parents.
I find there seems to be two types of people, those that need to keep busy which is a good thing and those who will take advantage and have you do everything. With the ones who want to stay independent you have to make sure they feel needed. So go slowly when approaching them about helping. Like with mowing the lawn. "Hey Dad how about I come over and do the back while you do the front then we get the job done in half the time."
The one who takes advantage, these people need boundries and need to be made to do what they can or you disable them. Like if standing and doing dishes are too much for Mom, you do the dishes and she sits and dries them. Used to do this with one of my Aunts. What you want to do is help.
Now, you are starting slow, so learn this can only be done a step at a time. First step, as you said, recognizing there has to be more help.
You recognize that with this call, and now discuss how much time you each have and what you CAN do. They may need help with shopping, appointments, housekeeping, etc. You each make a list of what time you have on what days and what you can do, and a list of what you have seen and what you believe their needs may be. Try to stay IN THE DAY, recognizing that this will be progressive. Do you all live in the same town?
Start slow, avoid argument; try to listen more than talk, give yourselves time to talk, leave phone a day or so to digest, come back with thought from your talk. So just go SLOW, recognize you are dealing now with three siblings with different lives, different abilities, different schedules, different families and jobs, different thoughts and opinions. Go SLOW. Day at a time. You have made the decision now to talk together about what you are seeing and thinking. Do that. See where you stand. Leave phone. Digest. Meet again.
Good luck. This won't be easy. Allow yourselves the time, be honest, but be GENTLE GENTLE GENTLE. This is going to be difficult and challenging.
Sure wish you the best and hope you will update us. I was the sibling alone where my bro was concerned. Some things about that are almost easier, but many things are more difficult and you do feel so alone.