Hi!
I am a POA of my Mom, my father passed away unexpectedly in August. He had been taking care of my Mom who had some back issues, he dies, then the month later she breaks a hip. Mom is in an assisted living facility and she is doing very well with her recovery and physical therapy. She has memory and repeating issues, but is very very sharp on so much, she will repeat and forget but it is not all the time, she hasn't been diagnosed by a neurologist for possible dementia. She knows she repeats, and laughs it off She is 80 and is a very independent, feisty woman. Well, since she has been in the assisted living place, we have been telling her that this is a step down place for her to get stronger. Well, she is stronger, she is having PT there 3 times a week and her therapist is great. She mentions many times a day that she can't wait to get home, she is ready. Time to go.
I live in another state but spend much time there, with all business deals. etc. I have a few family members who want to keep her there, and not tell her that it is HER money that is being used to stay there, which you know it is outrageous. It is a beautiful place, but my Mom isn't rich, she could easily live there for up to 5 years without any issue, but after that, where and what would we do with her. She has longevity in her family and she could easily live to be near 90. I have been talking to home health agencies, and me myself could go there frequently I am retired. Other family members could help and her neighbors and friends would be there to pitch in too. Mom has a one floor small home and I would love for her to be able to go home. It is heartbreaking not telling her that she is there and it is HER money that is being used to pay. Mom is very very frugal and keeps up with her money issues, asks me every day about her bills (are they being paid) how much is in her bank. I am lying to her, and I know if we don't tell her the truth she is going to hate me too.
She trusts me and the other family members think she should stay there but I think giving her a shot at home, see how she does, stipulate stipulate stipulate that she can't do silly things that could cause her to hurt herself again. I need to discuss this with my family who want her there, I need to step up for Mom, it is heartbreaking to hear her say she can't wait to go home. So much has happened in a short period of time, Dad, her back, her hip, and now being put into a place that she wants to leave. Her room is very nice, but it is a room, the place is nice but it is an assisted living, not a lot of activity (or enough for her) going on there. I need to tell my family that she NEEDS to know she is paying for this place, she thinks Medicare is picking up the cost. Nope.. thank you all.. I am going crazy..
You have not done this full time. I have. It is extremely hard. As far as relatives or anyone else. If they have not come forward to volunteer they will not now. Just telling you the hard truth.
Also, even if anyone would agree to a limited amount of time, how long do you really think that would last? Do you really want to take that risk? Trust me, it’s a gamble. Don’t gamble on something this important.
I also understand the situation with staff being short handed. How about this? I am reluctant to tell you this but I just want you to consider it please. I know you feel guilty about money but could you spend money on a sitter for the weekends? See how that works.
Look, the money she has now is well spent on her care. You are not wasting her money! That is what it should be spent on, right? What could possibly be more important?
Please let go of this guilt. I applaud you for contacting this group to get advice. That is admirable. I can see in your words how much you care. That doesn’t mean that you have to do all of the hands on work yourself and turn your life upside while doing it.
I also don’t think that you should recruit others to do what you aren’t able to do. It isn’t their responsibility and do you really want people whose heart isn’t in it to be caring for your mom?
Rethink your ideas. In this case, use logic and not your heart. Your mom will adjust and accept in time and she will come to know that a facility is the best choice for her.
Would you want to be a burden to others if you were in her shoes? I have two lovely daughters who love me, just like you love your mom. While I appreciate their love tremendously, I don’t ever want either of them being burdened with my care.
Do you know why I don’t want my daughters to be my caregivers? Because I want them to live their own lives and visit me as my daughters. I don’t want them to ever see themselves as my caregivers instead of my lovely daughters.
Step one. Diagnosis. No more denial. You need to have this.
Step two: Meet with the family who lives there. No dependence on "friends" as that does not ever last. Come up with a care plan.
Step three: Give it a try. Be HONEST and scrupulously so with your Mom. Some of us worry you cannot be alone on your own at home anymore. If this cannot work you will need to move to assisted living.
Is the home HER OWN HOME? If so it can be sold and you will have likely another five years of care for her.
Wishing you luck and hoping you will update us.
When put so clearly, I can see people in my family are still stuck at Step One (in denial of diagnosis). Which is why Step Two (care plan) is inadequate & cannot accept Stage Three (next logical consequences).
Thank you.
So back to basics. Get the facts.
Get all the info first. Then sit down & have a good cry if you need :( Change, old age & long distance are all hard. ((Hugs))
They may see signs of trouble that you can't see as a remote caregiver. (Nothing against remote caregivers. I've been one.)
In any case, there's no way to get people to cooperate with plans they do not agree with.
I do like NeedHelpWithMom's idea - perhaps consider moving her closer to you. Or, you may want to consider moving closer to her.
Why should they? It is not their responsibility to do it. Why would they give up their lives?
You don’t mention if you are a son or daughter. Which are you? Just curious.
Sell her home. You will have extra money.
I am not heartless. I cared for my mom for a bazillion years! It’s very hard! Why should they give up their lives? If the OP wants her to have a shot at home then let the OP move in with her. That would become a wake up call to reality.
Where's the cat staying?
Good point!
Still, you say she chose you and you have the authority to choose what you feel is best.
Do you really think others will care for your mom and be able to maintain what a professional staff does? Do you really think that you can handle an emergency that may occur being out of town?
As a visiting child you can’t do everything that she needs. It is a lot different than visiting a person in a facility. I did care for my elderly mom at home and it became too much for me.
Why don’t you discuss your concerns with her doctor? Get a professional opinion on where she should be. Ask the doctor to explain that she cannot be left alone.
Then you are no longer lying to your mom. Your profile says she has dementia so what makes you think she could go home just because she wants to leave where she is?
Most people say it is cheaper to be in a facility than to hire 24 hour care at home. So no need to feel guilty about the money being spent where she is now. Yes, old people can be frugal. My mom is extremely frugal but nothing in life is free!
She has 24 hour care where she is. That is a plus. What are the advantages of being alone at home while you are in another state?
Is this about what mom wants or is it about how your mom views you? Do you feel guilty? Do you fear mom will be angry with you knowing that she has to live in a facility? Have the doctor explain it is for her own safety if you can’t tell her yourself.
No one wants to see a parent lose their independence but I think you have an unrealistic view of what it takes to care for an elderly person. I do know what it’s like and I can tell you that it isn’t a walk in the park or a day at the beach. It is extremely hard work. It’s the toughest job that I ever had.
Best wishes to you and your mom.
I've had my mother in AL (not Skilled Nursing, there is a BIG difference) for 5+ years now, and there are a TON of activities to participate in. Not so much with Skilled Nursing. I agree with WorriedinCali that you have to go there YOURSELF to determine what's happening! Mother's money will run out in approx 18 months now and then I will apply for Medicaid to get her into Skilled Nursing. That's the routine..........you private pay until the money runs out, then Medicaid kicks in if the person qualifies. If not, you spend down your mother's money until she DOES qualify, then she goes into Skilled Nursing/Long Term Care.
Nobody knows how long a parent will live. What we do know, however, is that they must be kept as safe and secure as humanly possible while they are alive. Living at home with dementia, or with the start of dementia, and being expected to cook, clean, grocery shop, pay bills, or rely on family members to do it all FOR them becomes unrealistic after a while. If she's relying on others to do everything FOR her, then she's no longer truly living 'independently', either. To wait for an accident or emergency to occur before placing the parent in Assisted Living is not a good idea either, because then you're under the gun and stressed out to the max.
As far as the money matters go, I don't give my mother ANY information about her finances. She cannot really comprehend any of it ANYWAY, because my dad took care of all the money matters before he passed in 2015. I took over as financial and medical POA in 2014, and have been handling the finances ever since. I find it easier that way, instead of having to explain every transaction to my mother 100 times. She obsesses over money even NOT knowing how much she has in the bank, so what's the point in exacerbating her anxiety? Again, it's my goal to keep her as safe as possible, both physically AND mentally, until God decides to take her Home.
If you feel you MUST let your mother know about her finances rather than 'lie', then go ahead & do so. But prepare yourself for the additional headaches & aggravation that goes along with having her fight you tooth & nail on every single financial decision you NEED to make moving forward.
Best of luck!
Mom has always been frugal and has penny pinched all her life. Dad, was another story, she always says that if it wouldn't have been for her, they would have had nothing. She asks me daily about the incoming bills, the money in her checking account and they weren't rich by any means. The way it stands now, she could live in the AL facility for 5-6 years max, and longevity runs in her family on both sides. It hurts me badly when she asks daily about if this is costing her money, again, I tell therapeutic lies. She thinks that since she was in rehab before AL that the physical therapy people sent her to the AL (she doesn't know it is an AL) to get stronger, etc. She has gotten a lot stronger and gets around very well with her walker. She is bored to death there, the place, as beautiful as it is, doesn't seem to have sufficient activities for the residents. The women there, eat and usually go back to their rooms until the next meal. If it weren't for the television she has in her room she would go crazy she says.
I also have a brother and his wife who tell her she is staying at her "new" place and it is the best thing for her, and maybe it is, but the wife seems to have her opinion only to the point of telling my Mom that she can't have her beloved cat there (Mom could have the cat and it might make it better for her) Sister in law really has no business telling me what to do. I feel that I do owe to my Mom to tell her about Medicare not picking the cost of the AL. and the AL doesn't accept Medicare, it is a private facility. It is bothering me terribly and tonight when she asked again (for the 100th time) I almost told her, but I wanted to clear it with my brother. I am the POA and I don't and I am not trying to pat myself on the back, but my Mom chose me to do the business and I have been doing it all, even out of state. I also have medical. I just feel that Mom needs to know. I know I am maybe wanting something that isn't feasible, but sometimes quality of life is more important in my opinion I guess. I do appreciate your response and all responses on here. thanks!
You cant expect friends and family to help her stay in her own home. Especially if she has dementia. They may be willing to help in the beginning but they will either burn out or be unwilling to deal with her dementia behaviors.
Your mother needs appropriate testing so you can make informed decisions with her input; how much weight you give your mother's input depends on what the testing reveals. No more lying. Your mother needs to be able to have complete faith in you.
You also need to accept your mother is not completely safe anywhere. She can fall again at home. She can also fall in IL, AL, MC, or even NH. When you consider arrangements you need to consider more how much time would pass before a fall would be detected and your mother receives help/treatment unless or until the fall risk is significant.
An adult day care with transportation to pick up your mother from her home and return her afterwards could allow your mother to continue living in her home while having a lot of activities and oversight. Bundled with some in home care to assist with housekeeping, meals, medication, etc each night could allow her to live safely in her home for some time.
I encourage you to consider assisting your mother to remain as independent as possible for as long as possible both because she will be happier and because it will extend the length of time her funds last.
thanks!
Driving
medication management
ADL’s
Cooking
Bill paying
Active
Life line for safety / if a fall occurred.
Yard and or snow removal set up
Agree to some Hone Care services.
💗
If your mom is in a nice place, I would find out if they have Medicaid beds. If she runs out of money while there, they cannot kick her out if she goes onto Medicaid. Some places do not accommodate Medicaid recipients, so don't make any assumptions, find out for sure.
You mom does sound like she still has most of her faculties so you owe it to her to have the discussion of her future care and payment for it. From reading the many, many posts on this forum I would NOT depend on family, friends, neighbors chipping in to help (in the long-run) as her care will just increase and caregiving is unending and exhausting. Also, NHs provide healthy social interaction, which she will not have much of in her home. Loneliness is a huge and crushing problem for seniors.
It is unpleasant (to say the least) to disappoint and go against our parents' wishes. She will be very unhappy about not returning home but a care community seems the best for her based on your post. She's been through so much profound change in a short time. The money your parents saved is for just this use right now: her care, and hopefully not to leave an inheritance. I wish you clarity and confidence as you and your mom navigate her care decisions!
Are you prepared to view her promise to you that she won't repeat that as something she will be able to remember?
Again, I think you need a "needs assessment" before you make any firm decisions.
Your mother gave YOU power of attorney. She trusted YOU to make decisions for her, to act for her, when she couldn't do things for herself.
So although it is fair and sensible to *discuss* options with the family, it is YOUR judgement that rules. Don't let others' opinions stop you doing what you believe is best for your mother.
I wouldn't waste time or risk going back over what your mother has already been told, who's been "lying" to her, whose idea it was to do whatever. From here, just look ahead. Tell the truth to your mother. You are here. Your needs are x, y, z. You have x much money, your income is $x per month, your household budget is $y, your care and health budget is $z. These are your options... 1) 2) 3)... and we can review them in (say) three, six, twelve months' time.
At the moment, with no diagnosis of dementia (and presumably no formal assessment of mental function?), not one of you has any right whatsoever to withhold information from your mother about your mother's affairs let alone make decisions that you know are in direct opposition to her wishes.
Who are these family members who are making you act against your better judgement? Do they know your mother and about her lifestyle much better than you do, or something like that which makes you defer to them?
Has Mum had a consult with a neurologist? You say she has not been diagnosed with dementia by one, but you do not indicate if any testing has been done. If she has not been tested, that is where I would start.
Also as you are not there full time, Mum could very easily be show timing for you. What things are the rest of the family seeing that cause them concern and want her to stay in the AL?
You say there is not enough activity in the AL for Mum, what is missing and how can it be provided? What things would she be doing at home that she cannot do in the AL?
I slept at her house for 3 or 4 nights and SHE told ME to go home and I did. She continued to live by herself until she fell five years later in her home and broke her hip. The affects of THAT injury revealed full blown dementia, and after an unsuccessful (for all parties) stay at my house, she entered residential care and died there 5 1/2 years later.
We spent nearly a million on the 5 year’s residential care, and it was her money, and worth every cent, because she came to live a wonderful life within nursing home care.
My mother KNEW how much she paid for her original hospitalization, and paid all her bills herself. She thought the costs were HORRIFYING but understood why they were necessary. IF you decide to allow her an attempt at semi-independence for her you might be able to save face on keeping the facts about the bills from her by explaining that you ALL knew she’d be distressed about the costs but that the best medical advice was to move forward with her rehab, so that was why you did.
Has she had any OT aimed at assessing her skills with what she’d need to be able to do if/when she returned home? The OT’s input might be helpful to your decision making.
Your mom sounds SO MUCH like the situation my own dear mother was in, I think you might want to give her a chance. I knew she risked falling and other mishaps if she went home, and she had begun to show more symptoms of dementia before she fell.
In spite of all of it, I think I was right by giving her that chance to have the last 4 1/2 years in her home, and I suffer zero guilt or regret that I did it.
Highest hopes that the decision you and your family make is the best choice for all of you.
I agree about exploring her diagnosis and prognosis. Even if she mobile, if the memory and repeating continues, it could mean that she is not able to live alone. She wouldn't be able to cook at all, due to risk of fire. Relying on various family members, neighbors, friends, etc. to chip in, stop by, etc. often turns out to be inadequate. People have their own busy schedules and if she starts to be disagreeable or unpleasant (this often happens with normally nice people if dementia is involved) they would not likely continue. If you are dealing with dementia, I'd read the book The 36 Hour Day. It would provide a good look of what the progression looks like and explains how the condition affects all areas of a patients life.
It's good you take the role of DPOA as serious. I might even consult with an attorney to see what your obligations are. I'd keep in mind that people who have cognitive decline or dementia, often lose the ability to use good judgment or to view their predicament clearly. They often have magical thinking about how things will work inside their home with them, since they don't remember what they just did or said, can't recall how to use appliances, don't recognize dangers inside the home, like starting fires and even call alert buttons don't help, because they forget to press them.
Once you have her diagnosis and prognosis, you might get an assessment to see what level of care she needs. I'd be sure to have input, since she might tell the person doing the assessment that she can manage fine alone inside the home. I recall that after a diagnosis of significant dementia, my LO insisted that she was able to live alone with the help of neighbors checking on her a few times a week! The reality was that she needed assistance with all areas of her life and it was not safe for her to be left unsupervised for any time period. So, it might be that your mom would not ever be able to accept the help she needs long term. It may not be in her ability to do this.
So, with regard to money, my mother was diagnosed with Mild Cognitive Impairment; before we knew this, we moved her to an Independent Living facility. My brother had POA; he certainly did not sit her down and get her "permission" to spend 5K per month on this, but if she had asked, we would have told her. And when she asked US to do stuff and we said "no, ask the staff" and she said "I don't want to bother them", I shot back with "Ma, for $5,000 a month, you d@mn well SHOULD bother THEM and not me while I'm at work".
The thing is, you have been given the reins and are charged with acting in your mother's best interests. You shouldn't be lying to her, but you need to be realistic with her about what she is and isn't capable of doing (and what the professionals say about that should be your guiding light, not what mom tells you) and what her NEEDS are going to cost.
If your mom needs daily supervision, you can't just have friends and family who are going to burn out quickly. My mom did well (with MCI) in Independent Living, which costs less than AL; have you looked in to that option? Have you checked out how much in-home caregiving would cost?
She doesn't have to stay in that facility, do the leg work, research others, compare the pluses and minuses, and the costs. Research the cost of home health care, she will need help, a feisty mind does not mean she has a feisty body.
Slow down, think explore all options, this is not about what you want, it is about her needs, both today and tomorrow. Sit down with her, tell her the truth, no more hiding stuff from her, get everything out in the open.
What kind and how much help? Realize that you can't direct others what to do. Are these the same family members who want her to stay in the AL place?
There is much more to "living at home alone" than just being able to walk.
You need a professional assessment of mom's cognitive skills, her judgement and her ability to do her Activities of Daily Living. That will lead to knowing what level of care mom needs.
You talk about family and neighbors "pitching in". Does that mean someone ordering her groceries online for delivery once a week, or does that mean that mom insists on an all day trip to three grocery stores to get the best bargains, stopping to chat with everyone she meets?
Does she need a cab service arranged for her to take her, alone, to one doctor appointment a month, or does she need to be helped and transported to three appointments a week?
You see the difference?
Who is mom's POA? Ultimately, THAT is the person who is making the money decisions and who should be talking to the doctors about what level of care mom needs and how to best conserve her money.