Hi all, I filed this under 'working caregiver' as that is me, caring for my elderly mother (and not paid by her to do so) with several major health issues (such as but not limited to): diabetes, going blind, congestive heart failure, COPD, 2 different cancers, morbid obesity, severe mobility issues, many more. She lives in her own home and obvi doesn't drive. Walker or wheelchair always. Countless meds daily. At what point is enough enough with the constant in person doctor/specialist appointments? While they may agree to an occasional video call, they all want to see in person. I currently drive her and it's very difficult to work around my own demanding career, even though I work from home. A 1 hour appointment easily turns into 3. Routine dentist cleaning turns into pulling a tooth that doesn't want to come out. Every appointment turns into something else she asks me to do that day. I could go on. Juggling my own meetings, constantly wondering when my manager is going to point blank say 'where are you all the time?' (I also travel by airplane and I MORE than make up any time spent on mom, but my career is 100% extremely difficult as it is, with no Mom responsibility. Add in Mom and I'm so exhausted I want to crawl in bed and sleep for 3 solid months). We live in a small town without the resources of a larger city... ie, limited transportation options, and even when I can find a 'driver' they don't (due to insurance liability and how they are licensed) typically do the added things like open doors for those without handicap buttons, they don't help the elderly out of their home and into the vehicle. Ie, they only 'drive'. It's very hard moving someone who can barely walk. You'd never think of how many public places don't have easily accessible offices, but I can assure you, there are a lot of them, at least where we live. OF COURSE all these docs want you to 'follow up' with them every few months.... She's got great insurance. She's never going to change the bad habits that landed her in this position, so why keep seeing these doctors? Does anyone ever just 'stop' with these constant check-ups?? Decline one every 3 months and agree to every 6? Practically speaking, how long can this go on? I supposed where they get you is in convincing you they need the meds... if you want the meds, you need to see the doctor.... how are other caregivers doing this with allllll the doctor appointments?
Now, on to the important issue. Who is propping up her "ability to live alone". This is you, right? There will be no solutions for anything while you are the solution to everything. Cut your in person visits way back, and when that's met with complaints your answer is "that's why you need to move to assisted living". She has chosen to take poor care of herself and somehow that makes it your responsibility to take care of her? That's not right, help her make better decisions by stopping making up for her bad ones.
What kind of "great insurance" does she have? Is she older that 65 and on Medicare yet? Or is it still private insurance? We will need to know the answer to this in order to give you the most appropriate guidance.
But the bigger issue is that no one is forcing you to be her total solution. She may be wheelchair bound but how is her mind? Does she have a mobile phone? If so, she's the captain of her own destiny. It's ok to tell her that you're 100% overwhelmed. If she has no empathy for your situation, all the more reason to back completely away. Keep referring her to social or private services. Tell her to find a Geriatric Care Manager. Or she transitions into a AL facility and you'd be willing to help her with *some* things on the condition that she assigns you as her durable PoA.
You are a prisoner of your own choices. You have an unhealthy relationship with her and apparently no boundaries. No one is going to judge you for taking care of yourself first. Please consider seeing a therapist to help you find healthy boundaries and make a better life for yourself -- you deserve it!
It is up to you to decide when it is no longer necessary or beneficial to go to medical appointments. Of course, every doctor and dentist office wants to prompt you to come in, so they can bill for it. But, if it is not necessary for her, just stop making appointments.
You might look to see if there are any doctors in her area who make house calls. With many elders and disabled and house-bound people in their homes, this is becoming more common. You can call her insurance and ask if they have any mobile providers.
My husband has had in the last year; A Nurse Practicioner monthly, EKG, Lab work (blood draws), x-ray technicians, a wound care nurse, and mobile dermatologist all come to see him at home. He even had someone come in with a hoyer lift to weigh him. Dragged that thing out of a van and into the house!
I decline to schedule any colonoscopies, dental, and vision care. I even questioned why someone felt it was necessary to come get an EKG, which turned out to be unsuccessful because my husband fought the guy off of him.
I'm sure someone just saw an opportunity to bill for more services. They asked if I wanted to re-schedule that. "No."
Use your best judgement. If she has a condition which needs to be addressed to keep her comfortable, then seek out in-home treatment.
Obviously, it would reckless not to take someone for dental care if they needed it, or for new glasses so they can see comfortably. But maybe cut back on the frequency of "exams".
Your mother needs a live-in caregiver who will also take her to doctor's appointments. Your mother (or you if you're the POA) will have to sign paperwork for the doctors stating that the caregiver can be present during appointments and they can speak with them about your mothers medical care. This is one possibility.
The other is that your mother has to go into assisted living. Her health may be too deteriorated for AL and she may need to go into a nursing home.
You can't go on trying to work a demanding job while also working as a full-time caregiver to your mother. This is too much for any one person to be doing. I was in your same situation for a long time and will tell you it almost killed me. People don't understand it unless they've lived it and both of us have. Many people in this group have also. There has to be a new plan made for your mother's care needs. If she gets stubborn and refuses to 'allow' anyone but you to serve her (and this happens all the time), tell her she's on her own then. Its hard to do, but there comes a point in caring for a needy family member when the decision of (it's them or me) has to be made. It sounds to me like you've come to that point.
Set your mother up with live-in homecare. Look at some profiles on care.com and meet some. You can negotiate the pay if they're hired privately. Ask any one of your mother's doctors to put you in touch with a social worker who can help your mother get the care and even placement she needs. You can't do it all. Good luck and keep us posted.
My 94 y/o father became a fall risk and had difficulty walking and getting into/out of my car. When the risk to take my father out of the house became greater than whatever checkup he was going for, I stopped taking him to the doctor. He wasn't on any medications except for a baby aspirin so I didn't have to worry about seeing a doctor to renew meds..
If he had a health crisis, I would have had him taken by ambulance to the hospital.
I became pragmatic. Most of his appointments were to benefit the physicians' pockets. They weren't necessary for him. This was a few years ago. He's still alive in a nursing home so I don't feel my decision to forego these checkups was a bad one.
I cut back on Moms specialists. IMO, once they are stable with the problem they have, a PCP can take over. If a problem arises, you go back to the specialist. I had Mom on a 6 month and 12 month appts at one point.
Your Mom, I would bring in Hospice if there will be no improvement only decline. No doctors or hospitals with Hospice.
Tell Mom you can no longer transport her all over. She needs care you can't give her and she needs placement. An AL I doubt will take her. They don't do that kind of care. So it means a nice LTC facility. This is how I looked at it, it was just me and I was doing all the caring. Because of that, I made decisions in my best interest too.
Now that hubby and I are at the same age as my parents once were (80), we fully understand why my parents were going to see so many doctors. It got them out of the house. They actually felt better afterwards. I know that feeling.
But I can fully understand what you were going through regarding taking time off from work. It wasn't easy, the logistics can be a nightmare. My boss wasn't very understanding. In fact, I looked for new employment in the same field, and found a boss who fully understood what I was going through, it turned out changing companies made a world of difference since my parents lived into their late 90's (Mom refused to move in senior living).
We live in a large metro area where senior transportation is available, but my Mom refused to ride with strangers. Dad, on the other hand, didn't care. Mom always won the debate, so I had to drive them using their car (which I truly hated to use) as Mom couldn't any longer get up into my mid-size SUV. I know I should have set boundaries at the very beginning but I didn't know I could.
Area I'm at as STC (Senior Transportation ) as well. They sometimes use the big vans and put out a step for riders to enter and exit, only offering their hand to balance and help.
Look up the options
find out what needs to becfibe
then
hard but respectful conversations
mum
I’ve been struggling a long time trying to look after you - meet appointments-work and deal with my own health complaints
I’ve spoke. To the doctor and they have agreed I have to give up sone responsibilities
so I have researched some nice places that can look after you as well
have a look
Any throwbacks
this isn’t negotiable mum
unable to cope anymore
but I’ll see you and speak to you as usual but you’ll have care around you looking after you and company throughout the day and night
failing that can mum assessed and let them tell her officially she needs to go into somewhere where they can look after her properly
caring for someone is hardwork
when it impacts your health and possibly work it’s time you must address it
it would be best for you and your mother
All medical supplies and equipment would be ordered by the nurse. All personal supplies would be ordered by the CNA. All would be delivered to her home.
But Hospice would mean no curative options.
She could remain in her home without a caregiver as long as she is safe to be alone. Hospice would let her/you know when they feel she needs 24/7 care.
Another option would be mom moves to an Assisted Living facility and staff can help her as much as she needs,. Usually transportation is provided to doctor visits. If she needs someone with her you could meet her at the dr office or if mom has the funds a Care Manager would be helpful in taking some of this off your plate.
I hear you on the accessibility issues as well. Crazy what can pass as a safe ramp, etc. I have started using a transfer chair (foldable wheelchair that fits easily in back of SUV) to take him to many of these appointments. Where he can safely access, and make it in time (another issue), I encourage him to get steps in with the walker. But some offices just aren’t safe to with his level of mobility and balance issues, or you can’t snag a handicapped space and have to park in the boonies.
If your town has a reliable Care Manager, I second that suggestion. Going into all this (first with my mom, now dad)—I didn’t know what I didn’t know and during multiple hospitalizations we secured a CM to help navigate. I keep her on a monthly “touch base by the hour” basis for guidance. But I know ours can and does take clients to their appointments and asks questions and helps navigate. Can be expensive, but that may be an option to help….
our town has a senior bus that will take people to appointments
and if she is on state aid she can get one as well.
Another thing which may or may not apply to OP, but you don't have to accept whatever time the doctor's office gives you for an appointment. I always negotiate the time for myself, so I was shocked when my husband complained that his mother's appointments were always at the most inconvenient times. She would just accept whatever time the scheduler threw out. She had nothing else to do, so she didn't care. Once my husband started insisting that HE make the follow-up appointment (because he was her ride), it got better.
If I were in your shoes, I think I would be advocating for hospice care, which would mean the end of most or all those appointments and a nurse who visits her in her home once per week plus as needed for emergencies. All meds needed for comfort would continue.
The LTC Medicaid program is “at need” for BOTH medically AND financially. The financial is what families get all concerned about as it involves doing a spend down to get impoverished to the 2K in nonexempt assets most States require and look back on their finances so that there was no “gifting” issues. But the medical at need is equally as important and can be daunting if your elder hasn’t been seeing health care providers regularly. Their health chart will not show “at need” for skilled nursing care. Having a health history that shows need for skilled care will have to be there to get medically eligible.
If you are not ready to do that, you need to take each piece and create a solution, and be ready to deal with it again when things break down. For example, find and hire a regular driver for Mom who will help get her into and out of buildings and vehicles. Arrange for weekly or twice-weekly days for rides to be available, and schedule all of Mom's appointments on those days.
Contact a local church and see if there is a healthy retiree who has a car and would like to make a little money. On days that Mom has no appointments, they can schedule shopping or other errands. Get a handicapped tag that the person can use when transporting Mom.
Is Mom eligible for hospice yet? Find out.
Your health is more important than Mom's. If something happens to you, she sinks too. That includes your sanity. Best of luck with your life and your career!