Assistance
Appreciated ...

... Assuming it's female ...

And
Attrractive!

o j

Silliness aside ...

... I feel for you.

Before I read your message, I wondered how aware your dad may be of the situation. And how realistically he may assess it.

How much easier to deal with a situation where that is the case.

It's obvious to me that there needs to be a change - this is being unfair to youngest sis. As you said - she may be approaching burn-out.

Can she take part-time work, to have enough time to care for your Dad? Could the rest of you (or Dad) give her some extra funds, to cover the shortfall? Could some of the rest of you spend time looking after him on weekends? But it sounds as though that'd be expecting too much of her, even so.

Does Dad (or you guys/gals) have assets to afford to pay her to look after him, and would such be acceptable to her?

Do you know of someone known to the family who would help, for a wage? How would such work out, dollar-wise, in comparison with him going into an institution?

Otherwise, it looks as though it's necessary to have him in a retirement home at the present. That would be less attractive than having him in the same facility as your Mom, unless there's a big difference in the fee structure.

It certainly would be better, from the point of view of his peace of mind, if he could be in the same facility as she, unless the fees there are a great deal higher.

Of course, as you say, he's probably going to bi!ch about the competence of the staff - but that could be true (probably would be) were he in a different residential/retirement home. It's quite likely that the staff won't be doing things right, wherever he may be.

Does he own their home? Is it held jointly with Mom? If he should go into an institution, could it be sold in order to help finance his care?

Does one or other of you have Power of Attorney over his affairs? This becomes even more important if there is concern about his continued mental competence. If one or other, or a couple of the offspring, were made power of attorney, is there a possibility that there might be family friction over some actions that s/he/they might take relative to Dad's property/assets?

Also - is some of the property in joint names with Mom? If so, POA may be more difficult to arrange.

If it wouldn't seem appropriate to sell the home, at present, how about getting a mortgage or Home Equity-based Line of Credit, to deal with various financial issues, if there's a shortage of other investments and fairly liquid assets?

Does Dad have a will? If not ... bettter get him to make one, while he's still in possession of his faculties, as thery are deteriorating.

Does Mom have one? Does she have assets? If so, it might be well to get the various difficulties related to dealing with her property both now and on death dealt with now, for if it hasn't been resolved prior to her death, quite likely it might be held up and have run-arounds dealing with it, to result in there being little left.

I can't think of much else to offer, at the moment.

And don't feel concerned about dealing with the issue here, even at length - it's hard to be able to offer any realistic information unless one has not just the major oversight of the situation, but some of the smaller details, as well (including shaking fingers!).

ole joyful

Where do your parents call home? House or apt? Have you considered an alternative that would save you a lot of money, and would certainly make them both much happier?

What about hiring one of the live-in ladies to take care of Mom and Dad at home? They're usually from one of the islands and come here for about 6 months at a time. You can go through an agency to find one. They're not nurses, but I've had friends who have used them so that they don't have to move their families from their beloved homes, and they were VERY well-satisifed. One gal, a nurse, was so happy with the solution, that she became the director of one of the services that helps people hook up with these hard-working gals. Often, when the woman you hire's work visa is up, she will be able to recommend a family member to take over until she's eligible to come back.

Maybe that will work for you, maybe not--but it's an alternative worth considering.

There are assisted living facilities that have various levels of care and accept Altzheimer's, with activities for Altzheimer's and dementia.

Unless your mother needs medical care, Assisted living may be better for her, also. They could be together in same apartment, eat together, etc. yet have different levels of care (monthly payment is dependant on level of care, for each). Most take medicare and many take state medicaid, also.

Check out places like New Seasons, Brighton Manor, etc.

My mother had several aides from 'the islands' as Azzalea mentioned and one from Russia who had been a school teacher back home. Some were better than others but the price was much more reasonable than assisted living and she could stay in her apartment with Dad. Mentally she was very sharp and only needed assistance with personal care, cleaning and cooking. My Dad was frail and it had become too difficult for him to help move her.

Ole joyful's post is full of things to consider.

It's a tough situation especially if your Father resists your suggestions. I wish you well with your decision.

Someone needs to get power of attorney (medical and financial) for your parents, then get a prescription recommending assisted living from their primary care physician. Then it's just a matter of finding a facility they like and are comfortable in.

Monica beat me to the advice I was about to suggest. I think you dad would do much better if he could be with mom.

No one will measure up is correct but he may just find himself happier at the nursing home or a facility that they can be at together or near each other.

Lots a good suggestions here, & kayjones is right. Make sure the power of attorney is DURABLE POA so that med & fiancial is covered. W/out the med being stated in the POA, drs & hospitals will not recognize it.

Isn't it true that the assisted living will take medicare & medicaid only after their assest are all gone? Like the home, cars, any savings accounts etc? I don't know for sure. Does any one else know for sure? Sometimes, I think, things need to have been in place for x amount of years before their assets can't be touched/attached.
It a hard decision to make Leslie, I know. But I think Dad would be happier being where Mom is too. Plus, there's activities for him to do and still be with Mom.
Leslie (the Nebraska one)

I think keeping your Dad in his house with some sort of live-in help would be the best step. I've done live-in nurse work for my grandparents and for an agency in the past. It's hard work and I can see how your sister would be getting burnt out. If you have a relative that needs a place to live rent free, that might work since it sounds like your Dad doesn't need someone 24/7 at this time. That would give your sister a much needed break. If you need to pay someone to live-in, I'd consider having your Mom move back depending on how much care she needs.

I hope you can find a way for them to be together with assistance. I'll tell you a story about an elderly couple that still breaks my heart. The husband was my patient, he came into our hospital walking, perfectly with it mentally. His wife was in a nearby hospital dying of cancer. She would call every night asking how he was doing, telling me he was the best husband and to tell me to tell him that she loved him.

It wasn't long before he couldn't even walk and was going downhill fast, mentally and physically. I would ask the doctors if there was anyway for him to be moved to the same hospital she was in, they would only agree that it was a sad situation but that he wasn't medically stable. He ended up dying alone on another shift. His obit was in the paper and a few months later her's. They were both long obits and detailed story of their lives together. It still bothers me that someone couldn't find a way for him to be transported to the other hospital, which was less than 5 minutes from ours.

The "lookback" period for qualifying for Medicaid assistance with long term care is 5 years now.

I really don't have anything to add but there's another GW/KT site called "Caregivers" that you may want to look at. It's tailored to your problem. Whatever you decide, good luck!

Thank you all for your perspectives and concern. I won't address each individual post but I'll try to summarize my response.

Here in NW Kansas small towns, there is only one nursing home and one assisted living facility per town. Unless Dad is willing to move him and Mom to a bigger town, they don't have other options.

Mom is unable to do anything. She has Post Polio syndrome (too weak to walk, can't use right arm anymore), a colostomy from rectal cancer, and Alzheimer's which has robbed her of even being able to identify or relate to anything or anyone. She was forgetting how to get up and walk or how to stop walking once started right before Dad finally decided she needed to be in a Home. She can't feed herself and sometimes forgets how to swallow. The Home has to use a hoist/sling to get her into and out of bed. She's in a wheelchair that she can slowly move around in by pushing on the floor with her one good foot. She can't participate in any activites because she just doesn't relate to anything.

Dad has a lot of assets. Youngest sis is POA and Durable POA. He pays out of pocket for anything that Medicare and his supplemental insurance don't cover. He is a retired stockbroker who was always very sharp and his forgetfulness is bothering him greatly. He also has a great hearing loss even with hearing aids and total health care ignorance which just confounds things he has to deal with.

However, I've just realized that we're all thinking that Mom will go first and Dad is her POA and DPOA. Well, what if Dad goes first? We need to know if one of us can be named Mom's POA and DPOA in case of Dad's death.

They had home health care 2 or 3 times when Mom was still at home for different medical reasons. Dad absolutely hated having someone else in the house. In fact, he was upset that none of us "kids" moved in to take care of them...well, Mom because she's #1!! Oh, and there are no live-in ladies or green card caregivers that I've ever heard of in this area.

FWIW, Dad has never been a warm, fuzzy kind of dad...no sitting on his lap, little hugs, no patience for hurt feelings, etc. He's a tough it out kind of guy...put a smile on your face and get out in the fresh air. Mom was kind of that way, too, but she was a lot warmer.

We "kids" are kind of incidental to their relationship. He's always put Mom as #1 and we just fell into place. But, we love them to pieces and are just trying to figure out what's best for them at this time of their lives.

DH and I are going there tomorrow and spend the day. I hope we can get a conversation going about some of this stuff. Dad needs to realize that youngest sis is about to cave in from worry. (Here's an aside...she has a daughter who is mentally handicapped and lives far away in Knoxville in a Christian based independent living and working arrangement.)

Sorry if this is TMI. I really appreciate your responses. Any more thoughts are welcome.

Leslie/KS

You probably will need to meeet with your dad and with his attorney -- I would think that your dad has a long time relationship with someone there in the town. Given dad's age, I would think that his atty would be able to see you all on short notice. Moving to a larger town may be one solution, given that he appears to prefer being near your mom. My 97 year old great aunt lives in the nursing home, but the umbrella facility also has assisted living and indpendent living on site. Had she better short term memory, she would have been in the 'assisted living'.
Be honest & upfront with dad & his attorney.. about family needs and his & mom's..and the intersection of everyone's concerns.
hugs to all

I feel for you Frazoo...you just described my parents life back in the mid to late 90's,and onto 2000.

I too was in your exact situation.

Have them placed together,wherever.

The "love affair of the County" deserve to live out their lives together....even tho they suffer thru obvious dementia and Alzheimers.

Good point, cate52! None of us has thought of meeting with Dad and his attorney. We just keep waiting for Dad to tell us what to do or tell us what preparations he's made, I guess.

Good food for thought. Thanks!

Leslie/KS

This reminds me of the movie The Notebook.
My 2 sisters and myself, went with Mom to her lawyer, when she changed her will to a living trust or something like that. I just forgot the correct name of it. That way, we could all voice our concerns. There was only one that my younger sister and I both had. And we had it written up in the wording. My older sister wants Mom's house. So, we said she'd have 1st option. She'll never qualify for a loan, as their credit is down the drain. But we gave her like 60 days to get the loan. If she can't get it, we'll put it on the market. But, my point is, we were all there, and heard the same thing. Mom knows we'll give my sister a fair chance to obtain her house. I think a family meeting is the best way to go. No hard feelings later.
Leslie

Did I hear you say that Dad's retention of all of his marbles is none too secure?

Even if he is here but his mind unable to function well, he wouldn't be able to deal with a number of the issues that need to be dealt with, in any case.

It will likely be hard to get a man with the independence and pride that he has carried throughout his life to agree to give such things up, but ...

Good wishes as you go about making the plans that you trust will be best for all.

ole joyful

Have any of you just asked your dad if he would be happier in a semi private rm with your mom where she is? Even though it might be an early placement for him it may be where he would be happiest. It would also take a lot of burden off the sibling that lives in the town.

I'm hearing that most nursing homes have assisted living attached. Is this not a possiblity for him? He could visit her daily but not have to be bothered much by the staff daily. Is this a possibility?

I really feel for you. My DM is not alive but my DF is and both in-laws so I know my day will be coming. My parents are barely in their 70's and still in pretty good health.

I'll keep you and your family in my prayers. Sorry that I cannot offer any real advise.

I just called Dad to remind him that we're coming tomorrow to spend the day. He said youngest sis and her DH are over there right now. Seems he's misplaced a box of blank checks and they're looking for them. That's what's wearing on my sis....never knowing when or what time of the day or night that Dad might need help. Recently, he misplaced his garage door opener which was always on his car's visor. No one could figure out why he took it off the visor, nor could he...anyway, they had to order a new one for him after youngest sis went through all kinds of drawers, cabinets, pants and jacket pockets, etc.

Oh, and youngest sis only gets a 30 min. lunch break. Sometimes Dad will plead with her to come over and look for something or do something during her lunch break. Or, he might meet her at her house. Not long ago, he couldn't remember how to run the washing machine and called her at work. So, she went over on her lunch break but decided to gather up his laundry and do it herself after work.

We have talked to him about moving in with Mom, but he isn't ready for that, he says. He'll mention assisted living sometimes, but hasn't committed to that idea, either.

His town doesn't have an attached nursing home/assisted living center. However, the town where my brother and middle sis live does have that. They've given him the info on it and we've encouraged him to go visit. Brother and middle sis and families would be glad to have them there.

My folks were raised in their town as were we kids. Dad was a community leader, chaired some fraternal organizations, donated to community causes, served on city council and was mayor, etc. As ole joyful pointed out...it's Dad's independence and pride that need to be overcome.

Thanking you all,
Leslie/KS

Hi fraternal member of the zoo,

I'm sure that you'll be able to arrange an alternative, or successor, or "fall-back" Power of Attorney, and it'll be necessary to have each of the various alternatives (who gets incapacitated, dies, etc. first) provided for ... though with your Mom being deeply into Alzheimers, there's no way that she can be POA for Dad.

You need both the financial situation, and the medical issues dealt with.

I like the idea of having all/most of you have a meeting with lawyer and Dad. In fact, if Dad's lawyer isn't pretty well aware of the various ramifications at the moment, it might be a good idea for some of you to meet with him/her prior to your and her/his meeting with Dad, to get him/her up to speed.

I wouldn't be at all surprised if he'll likely be able to convince your Dad of some stuff that you can't/haven't been able to, up till now.

A while ago one of the posters around here, in the finance forum, told of talking till she was blue in the face with her husband about some financial situations that she, who is fairly literate financially, thought that they should do, to be met with world-class foot-dragging.

When the financial planner, that they've been with for years and respect deeply, suggested pretty well the same thing(s), he agreed to pretty well everything like a little lamb. Well, not exactly that docile, I guess ... but sort of close.

Whether her grinding had worn him down somewhat and the meeting with the planner pretty well was the tipping point, or whether he'd have gone along meekly if he hadn't heard such proposals earlier, I can't say, of course.

But quite a few of us will go along with something proposed by a professional, when we wouldn't hear of it from someone else ... even a spouse (especially a spouse, perhaps?).

I rather like the idea of them going into a facility in the place where two of the siblings live, if they can be together, would welcome/accept that idea and you feel that the siblings are willing and able to provide a great deal of the care that he needs (and will need increasingly, no doubt). And would actually come through, if that arrangement were to be set up.

Has your Dad enjoyed a substantial amount of direct interaction with the folks who were his buddies through the years of his life, especially in recent years? Would he be able to phone them were he to move to the other city? Would he find that satisfactory?

That seems to be about all that I have to suggest, at the moment.

Good wishes to you all as you go about making the necessary decisions and putting them into effect.

I send some good thoughts and hopes to you, with a prayer that you all may choose well and all be pleased with those choices after a period has elapsed.

ole joyful

We spent the morning with Mom on Friday and the rest of the day with Dad. He told us he's not interested in moving to a different town...Mom is comfortable where she is and "the kids" wouldn't visit very often anyway. When I asked if he's thought about moving into Assisted Living in their town, he said that he thinks about that... but why should he? His house is paid for and if he moves out, he'd be making payments to live in a facility. He wasn't very receptive to talking about moving anywhere.

DH and I had supper with youngest sis and her DH while Dad went to the Home to help with Mom's supper. We talked about our day with Dad and Sis's every day with Dad, then about the 4 of us getting together to talk to Dad and how that since 3 of us don't live there, Dad will probably accuse youngest sis of complaining.

It looks like Mom's and Dad's wills cover the bases for incapacitation and death. He doesn't mind talking about that kind of stuff...just gets anxious over moving out of his home.

Thanks again for the input that was given. It helped a lot to have your thoughts with me.

Leslie/KS

Leslie,
Is dad still driving? If he one day "can't remember how to operate the washing machine," I'm not sure he is safe behind the wheel.
Tough situation. Hugs to you and your family.
Rita