How do you know when it is time to help an elderly parent?

[kacaju]

My Mom fell yesterday, outside and she could not get up. (she is very overweight and landed on her back) She called out for help and the neighbor came over to help her. She went to the ER and everything is fine. The ER dr. wanted her to consider the lifeline button for her to wear in case she fell again.

Mom lives in a townhouse with two full flights of stairs. Myself and my brothers are worried about her. Worried since she is not steady on her feet she will fall down the full flight of stairs.

There has been a lot of other things going on with mom. She can always come up with excuses as to why she forgot something, misplaced something. She has lived in the same town for 37 years. 32 at the house I grew up in and then the last 5 in this townhouse which is about 6-7 miles from the house. Recently she got lost trying to come to my brothers house because there was a detor near her house and she could not figure out an alternate route. She is getting forget full with her bills. Right now we are not sure if she has health insurance (she called my SIL in a panic Friday afternoon) We cant do anything until tuesday to check.

I can go on and on... somedays, like yesterday she is willing to want to consider moving. I spoke with her today and forget about it. She is very adamant that she does not need to move and she is fine, she comes up with excuses as to why she fell yesterday.

So my question is... how and when do you know it is time to get involved?? How do you go about *making* a parent realize they need to stop driving/move and that they need help?

She never should have moved into this townhouse 5 years ago but there was no stopping her. My Dad was in a nursing home dying and she could not afford to stay in the house. We all tried to get her to a 1 level condo, but she has so much crap she *needed* to take with her she flat out refused to look at anything else but a townhome.

I will say she has always had issues so some of this is *normal* Mom, but her normal is not normal anymore..if that makes sense?? I can always excuse her behavior as... Mom is always like that... but when I really take a step back and look... she is getting worse.

 

[diz8297]

Well, I can only speak to what I know where I live. Basically, she can make her own decisions unless she is declared incompetent. Given what happened yesterday, you are already helping her. I suspect that what you want to do is convince her to go to a safer environment. Ultimately, it's her call. You can sit down with her calmly and voice your concerns and reasons. Aside from that, ask her what you can help her with. Groceries, light housework, etc? Or would she be receptive to having a homemaker aide? If she is in danger, you can call your department of elderly affairs and have them come in, but that is extreme. I feel for ya. Nothing like being the filling in the generational oreo cookie.

 

[minkydog]

Have you had the opportunity to talk with her doctor about all this? Its very hard for these elders to give up their freedom, but it sounds like the time is here to open that conversation. Perhaps if you contact the doctor ahead of time. He cannot talk to you specifically about your mother (HIPAA), but he can listen. Doctors are good at getting this kind of thing going.

 

[Kirby]

I would definately get with her and voice your concerns. And possibly contact her doctor.

I'm very fortunate that my mother is adjusting gracefully to life changes like no more driving.

 

[Imzadi]

I will say she has always had issues so some of this is *normal* Mom, but her normal is not normal anymore..if that makes sense?? I can always excuse her behavior as... Mom is always like that... but when I really take a step back and look... she is getting worse.

I could have written part about my own mom. I feel for you. My mom should go somewhere, too. But she won't.

You said at times, she is willing to move. Right now, she probably isn't because that fall really scared her. She doesn't want to admit she is as frail as she really is. Give it a bit of time.

In the meantime, can you look around for another townhouse where she is on the bottom floor?

My mom was adamant about a 1st floor place. She still goes shopping for stuff alone. I was lucky in that I found her a place where she ended up on the second floor, but it has an elevator.

She also doesn't drive anymore. She takes cabs everywhere.

I found out about netgrocer.com/ in which I can order and have groceries sent to her. Delivery charges are actually pretty cheap. Another DISer told me about it. I sent myself some stuff to check the quality, then had other things sent to her. They are part of Shop Rite supermarkets.

Another alternative is to see if supermarkets near you do deliveries.

As for the LifeAlert. They only work if the elderly person actually wears it - and that they are wearing it when they fall. Many elderly won't wear one because of what it represents. So, it is a very expensive piece of equipment.

You might think about getting her a Tracfone prepaid cell phone, with a clip, so she can hang it off her pants, if she doesn't already have a cellphone. With a cell phone, she has the option of calling 911, a neighbor or you, your brothers or SIL.

When my mom fell in front of the bank, she was able to call 911.

A Tracfone can be as low as $10/month. Lots cheaper than the LifeAlert, *I think.* However, if she becomes disoriented during a fall and can't give her address or location, some areas don't have very precise GPS tracking yet, and they may not be able to locate her quickly. She'd need to call one of you.

Again, sending hugs to you.

 

[ZeitgeistDuck]

I've been in your shoes. I don't know what the 'right' way to make that decision is, I only know how I made it: when I had a hard time living with the notion that mom wasn't safe than I did living with the notion that I was taking away her independence. For me, taking away my parent's independence was a very grave decision and one I didn't arrive at lightly, but when I felt her safety was in that much jeopardy, it was time.

Good luck, I know how gut wrenching this is

 

[kacaju]

Thanks everyone. My brother and sil went to her house yesterday and had a long talk with her. She does agree that it is probably time to move. The problem is she wants to clean up the townhouse first. She said to give her a year!!!

It is just an excuse, because she pulled this on us about a year ago when we talked to her then about moving

They got me her Dr. name and number. I will call the Dr. today and voice our concerns. She is very good at hiding any problems she has with Dr's due to a bad experience she had 30 years ago.

oh and she still has medicare, it is the medigap insurance she has not paid all year.

My brother in the mean time is takng over all her bills. She has money in the bank, but can never pay them on time so she ends up paying late fees.

 

[golfgal]

I could have written part about my own mom. I feel for you. My mom should go somewhere, too. But she won't.

You said at times, she is willing to move. Right now, she probably isn't because that fall really scared her. She doesn't want to admit she is as frail as she really is. Give it a bit of time.

In the meantime, can you look around for another townhouse where she is on the bottom floor?

My mom was adamant about a 1st floor place. She still goes shopping for stuff alone. I was lucky in that I found her a place where she ended up on the second floor, but it has an elevator.

She also doesn't drive anymore. She takes cabs everywhere.

I found out about netgrocer.com/ in which I can order and have groceries sent to her. Delivery charges are actually pretty cheap. Another DISer told me about it. I sent myself some stuff to check the quality, then had other things sent to her. They are part of Shop Rite supermarkets.

Another alternative is to see if supermarkets near you do deliveries.

As for the LifeAlert. They only work if the elderly person actually wears it - and that they are wearing it when they fall. Many elderly won't wear one because of what it represents. So, it is a very expensive piece of equipment.

You might think about getting her a Tracfone prepaid cell phone, with a clip, so she can hang it off her pants, if she doesn't already have a cellphone. With a cell phone, she has the option of calling 911, a neighbor or you, your brothers or SIL.

When my mom fell in front of the bank, she was able to call 911.

A Tracfone can be as low as $10/month. Lots cheaper than the LifeAlert, *I think.* However, if she becomes disoriented during a fall and can't give her address or location, some areas don't have very precise GPS tracking yet, and they may not be able to locate her quickly. She'd need to call one of you.

Again, sending hugs to you.

Adding a phone to your cell plan is usually less expensive then a Tracphone and you don't have to worry about adding minutes, keep track of the minutes, etc. and you get to see if she is using it, etc.

Thanks everyone. My brother and sil went to her house yesterday and had a long talk with her. She does agree that it is probably time to move. The problem is she wants to clean up the townhouse first. She said to give her a year!!!

It is just an excuse, because she pulled this on us about a year ago when we talked to her then about moving

They got me her Dr. name and number. I will call the Dr. today and voice our concerns. She is very good at hiding any problems she has with Dr's due to a bad experience she had 30 years ago.

oh and she still has medicare, it is the medigap insurance she has not paid all year.

My brother in the mean time is takng over all her bills. She has money in the bank, but can never pay them on time so she ends up paying late fees.

I think it might be a good start to ask is she WANTS some help doing some things around the house vs NEEDING help and hire a home health care aid to come in. Then, they can evaluate her situation, observe from day to day and make recommendations. Sometimes it is a LOT easier to hear that from a "professional" then it is your own kids. She may not need to move if she can have someone come over for an hour or two a day-it is a lot less expensive to do that then put her into assisted living.

 

[DMRick]

I may have missed it, but I'm curious about your mom's age, if you don't mind sharing it.

 

[kacaju]

Mom is young, she is 68. She can still take care of her house, doing housework etc.
My concerns are:

As I said she has money in the bank, yet she doesn't pay them in time so she spends more money on late fees.

We have to call and remind her if we have an event to go to. (example, my dd 8th grade graduation, I had to call her to remind her and even with her writing it down she called me and thought it was a different date)

Mother's Day she tried to go to my brother's house and got lost because there was a detor near her house. She couldn't remember any other way of going. (brother has been living in his house for 6 years and Mom has lived in her town for 37 years)

She is telling us her friend won't drive with her because my Mom keeps making an illegal turn on one of the roads near her home. Mom claims she only does it when *no one is around* ummm it is a highway she is turning on to...there is ALWAYS someone around.
When you ask her way she does it she claims it is because *they* changed the road and she forgets. They, the town, reconfigured the road about 4 years ago.

She is getting intolerant of others... she keeps making comments about the spanish people who live near her and how it wasn't like this when she moved in. They are nice Mom says, but she doesn't like that they have parties on the weekends and use the common gorunds for their blow up pool and volley ball net. (they clean up by dark, so they are not having wild parties all night)
Meanwhile, these *spanish* people who she doesn't care for are the ones who came to her aid.

She made a comment about my cousin, I have one brother who is becoming friendly with this cousin after many years of the cousin not having anything to do with family. The cousin is adopted (he is 40 now) and now she is telling us, well he is not related, he is not really family.
This is completely out of character for her.

Her medigap insurance. Instead of calling one of us when she couldn't figure out the bill she just put it in the pile and just has not been paying it. Friday she was in a panic and called my SIL to ask my brother to come over and help her because she thought she had no insurance.

She got a letter from DMV, they said she had no car insurance and was going to suspend her license. Turns out, she didn't pay her car insurance and the policy got canceled. Once it got canceled she went out and bought new insurance. DMV didn't have the new insurance info.

The biggest problem we have is Mom has a lot of *stuff* she is a hoarder to some extent. Her home is neat and clean (unlike the houses on the show) but she keeps everything in boxes.

She would have no problem moving to a place near me and my brother as long as it was big enough for all of her stuff. She needs storage she claims.

This is why she moved into this townhome 5 years ago. We all tried to get her into a 1 floor place but she would have nothing to do with it. At that time she was dealing with a lot (we all were) My Dad was in a nursing home and was dying. She could not afford to live in the house anymore. It was a 3 bedroom house with a two car garage filled with crap, and the basement and attic also were full, and even though we did throw a lot away, she still needed to take a lot with her.

She is not steady on her feet. She had knee replacement 3 years ago. She has a bad ankle. She has fallen in her kitchen, bedroom and now this weekend she fell outside and could not get herself up. If she falls down one of her full flight of stairs, she will seriously hurt herself.

She gets fixated on one thing and cannot let it go. I have one brother who sleeps there in the house (this is a whole other story) bottom line is he does nothing for her so he is of no help to her.
This is the brother (40 years old) who was talking to my cousin, mom overheard him telling the cousin if he wants to go fishing, come up here and you can sleep in the basement so we can go out fishing early the next day. Now Mom is fixating on removing the couch downstairs because she fears my brother will bring home 3-4 friends and have then have them all sleep down in her basement.
Then the next sentence will be, that she thought when they moved there the basement would be a good place for my brother and his friends to hang out. Now, my brother has never had any friends over to the house ever... I don't know why she is so fearful he will bring friends over.

I can go on...but the bottom line is the home she is in with the two full flight of stairs is fast becoming unsafe for her to be in. She fell simply walking out of her home, and she could not get herself up. She is unsteady on her feet and if she fell inside her home, down one of thoese flights of stairs she will get hurt..if not more.

 

[golfgal]

I think your next step is to call her doctor, express your concerns and get her in for a physical. It could be Alzheimers or it could be another medical condition that is easy to treat. The Dr can't discuss anything with you but he/she will listen to your concerns and observations. You could also contact a place like LivHome and they will come out and do an assessment of her situation and make recommendations. I agree that a one story home would be a better option for her, but with a basement. There is a townhome that my parents are looking at that would be perfect for her, it is quite large but one level living with an unfinished basement that can hold a lot of stuff. If you can find something like that she would probably be fine.

I also think you and your other brother need to do something about the other brother--either kick him into gear and help or get the heck out of the house (I know, easier said than done).

 

[poohfriend77]

First of all, (((HUGS))) to you during this scary and stressful situation!

I know you're worried about your mom's physical state and her ability to get around a house with stairs. But her personality/behavior changes are pretty disturbing too. You said she won't tell the doctor the whole story, but can you? I know the doctor can share her medical info with you without permission, but surely a good doctor would LISTEN to your concerns and take a closer look next time she goes in.

I also had a thought about her "stuff." What if you found a self-storage place to put her boxes so she could move into a smaller condo? I'm sure she wants her stuff with her, but maybe you could play up the fact that the place is guarded, so all her things will be extra safe!

 

[kacaju]

I just tried to call her Doctor. She won't be in until 1pm the answering service said.
Thank you for all your advice. The more I think about this the more I am realizing that we have been in denial for a while now on how bad Mom is getting.

I guess if it comes to it we can look for a storage unit for her. The problem will still be getting her to move all the stuff. When we moved her 5 years ago it was painstakingly long drawn out because she had to go through each box to see what was in it.
I know we will work it out...it is just so hard...

As far as my brother who lives there. I have given up. He will not move out until she does. I don't even want to go there. I have 3 brothers so the other two and I are stressing that we are doing this for Mom and her safety, we decided we are not going to bring that one up in our talks. this has nothing to do with him.
I did call him, as he was away this weekend and told him mom fell (he then told me she has fallen before in the house and he had to help her up) I told him we need to seriously talk about getting Mom into a safer place for her and told him to start looking for a place of his own.

 

[Pea-n-Me]

I would say it is time.

Without offering an "armchair diagnosis", I'd say she's showing signs of early dementia (I had a relative who did the same). If it were my Mom, I'd have her evaluated by a Geriatric Specialist (available at a teaching hospital) who can do cognitive testing and rule out other [medical] causes. There will also be a network of specialists available who can help guide you with what to do. (Many don't take advantage of this and lose out on good information when they most need it.) If it is thought to be dementia, there is a medication they can put her on to slow the progression.

BTW, a diagnosis of Alzheimer's can only be made on autopsy by studying changes in the brain. Prior to that, it's an educated guess, so the more accurate term is "dementia". With that said, there are hallmark signs of Alzheimers that one can see as the disease progresses if that is what it is. You will hear that diagnosis late in the game as there are "stages", but early on, it'll be called dementia.

You should deal with legalities soon - Power of Attorney, Health Care Proxy, etc.

If she's having difficulty driving, you may need to make a decision FOR her if you think she's unsafe or a public threat. Good judgement is needed for driving safely. Of course, this opens up other issues of how she will get what she needs like groceries and such, and how she'll get to doctor's appts, etc.

You should also begin to think about an identification bracelet for if she gets lost and can't remember her name. It may seem a ways away, but it happens frequently and people are taken to the ER if they can't state who they are and where they belong. There's nothing worse than getting that call.

I have a friend who's the same age as your Mom who is showing the same type of behaviors. Her family was telling me about it last week. They're going through the same type of decision making. It sucks.

 

[M5ward]

Mom is young, she is 68. She can still take care of her house, doing housework etc.
My concerns are:

As I said she has money in the bank, yet she doesn't pay them in time so she spends more money on late fees.
If your brother is taking over the responsibility of paying her bills, he is going to need a power of attorney to access her accounts.
We have to call and remind her if we have an event to go to. (example, my dd 8th grade graduation, I had to call her to remind her and even with her writing it down she called me and thought it was a different date)
Forgetfulness is often one of the aspects of aging. If she is forgetting things like turning off stove burners or locking the doors at night, then I would be far more concerned.

Mother's Day she tried to go to my brother's house and got lost because there was a detor near her house. She couldn't remember any other way of going. (brother has been living in his house for 6 years and Mom has lived in her town for 37 years)
I think that detours can be confusing to anyone. We all have "our way" and get thrown off when that's changed.
She is telling us her friend won't drive with her because my Mom keeps making an illegal turn on one of the roads near her home. Mom claims she only does it when *no one is around* ummm it is a highway she is turning on to...there is ALWAYS someone around.
When you ask her way she does it she claims it is because *they* changed the road and she forgets. They, the town, reconfigured the road about 4 years ago.
Four years is a drop in the bucket when it comes to having done it one way for the 33 previous years she lived in that area; but, yes, making an illegal turn the wrong way onto what I assume is a one-way street is a huge safety issue.

She is getting intolerant of others... she keeps making comments about the spanish people who live near her and how it wasn't like this when she moved in. They are nice Mom says, but she doesn't like that they have parties on the weekends and use the common gorunds for their blow up pool and volley ball net. (they clean up by dark, so they are not having wild parties all night)
Meanwhile, these *spanish* people who she doesn't care for are the ones who came to her aid.
This may also be an aspect of aging. As I get older I find myself far less tolerant than I used to be..of many things; someone going too slow or too fast, a cashier who takes his/her own sweet time to check out my order, etc.

She made a comment about my cousin, I have one brother who is becoming friendly with this cousin after many years of the cousin not having anything to do with family. The cousin is adopted (he is 40 now) and now she is telling us, well he is not related, he is not really family.
This is completely out of character for her.
She is entitled to her opinion. If I had a relative (blood or not) who had ignored my family for years, I don't know how accepting I would be.

Her medigap insurance. Instead of calling one of us when she couldn't figure out the bill she just put it in the pile and just has not been paying it. Friday she was in a panic and called my SIL to ask my brother to come over and help her because she thought she had no insurance.
We do automatic withdrawal for my husband's supplemental insurance. It's easier than trying to remember when it's due.

She got a letter from DMV, they said she had no car insurance and was going to suspend her license. Turns out, she didn't pay her car insurance and the policy got canceled. Once it got canceled she went out and bought new insurance. DMV didn't have the new insurance info.

The biggest problem we have is Mom has a lot of *stuff* she is a hoarder to some extent. Her home is neat and clean (unlike the houses on the show) but she keeps everything in boxes.

She would have no problem moving to a place near me and my brother as long as it was big enough for all of her stuff. She needs storage she claims.
Either rent a small storage space for her "stuff" or divide it up among you and your siblings and store it in your basements/garages/attics. Chances are she will forget all about it.

This is why she moved into this townhome 5 years ago. We all tried to get her into a 1 floor place but she would have nothing to do with it. At that time she was dealing with a lot (we all were) My Dad was in a nursing home and was dying. She could not afford to live in the house anymore. It was a 3 bedroom house with a two car garage filled with crap, and the basement and attic also were full, and even though we did throw a lot away, she still needed to take a lot with her.

She is not steady on her feet. She had knee replacement 3 years ago. She has a bad ankle. She has fallen in her kitchen, bedroom and now this weekend she fell outside and could not get herself up. If she falls down one of her full flight of stairs, she will seriously hurt herself.

She gets fixated on one thing and cannot let it go. I have one brother who sleeps there in the house (this is a whole other story) bottom line is he does nothing for her so he is of no help to her.
This is the brother (40 years old) who was talking to my cousin, mom overheard him telling the cousin if he wants to go fishing, come up here and you can sleep in the basement so we can go out fishing early the next day. Now Mom is fixating on removing the couch downstairs because she fears my brother will bring home 3-4 friends and have then have them all sleep down in her basement.
Then the next sentence will be, that she thought when they moved there the basement would be a good place for my brother and his friends to hang out. Now, my brother has never had any friends over to the house ever... I don't know why she is so fearful he will bring friends over.
If it's your mom's house, then it's her rules! That's only fair especially if your brother doesn't help out physically or financially. I would have a hard time with my 40 year old son who STILL lived with me and contributed nothing but who felt he could invite people over whenever he felt like it. NO WAY!

I can go on...but the bottom line is the home she is in with the two full flight of stairs is fast becoming unsafe for her to be in. She fell simply walking out of her home, and she could not get herself up. She is unsteady on her feet and if she fell inside her home, down one of thoese flights of stairs she will get hurt..if not more.

You're right, the stairs are a definite risk. You need to get your mom on one floor. You should probably also consider some kind of medical alert system for her.

 

[Pea-n-Me]

M5Ward, with respect to your opinion, the types of behaviors the OP described are not part of the normal aging process, especially at 68. My mother will be 85 soon and she doesn't do any of these things. Although her sister did get Alzheimer's and this is exactly how things started, just as the OP's described. Forgetful, intolerant, unable to manage simple tasks, getting lost in the town she'd lived in most of her life, etc. These are major red flags.

It's common to either not recognize signs, or brush them away as quirks or "aging". The OP herself even offered that she's probably been in denial for a while (very common). Even medical doctors do it, as happened with my Aunt as well. It wasn't until my aunt was found in another *state* driving erratically and stopped at a tollbooth waving wads of cash around and held by the state police until my cousin could go and get her that people started to recognize it for what it was. And actually, a table full of my nurse friends at my baby shower had predicted it years before. She was evaluated then but was left with a diagnosis of "dementia" without much real help or support in what to actually do about it. We had to learn the rest as we went along. That's why I suggested hooking up with a geriatric service as there is information available there that makes it a lot easier than trying to figure it all out yourself.

 

[Pea-n-Me]

Some links you might find helpful.

http://www.medicinenet.com/dementia/article.htm

The U. S. Congress Office of Technology Assessment estimates that as many as 6.8 million people in the United States have dementia, and at least 1.8 million of those are severely affected. Studies in some communities have found that almost half of all people age 85 and older have some form of dementia. Although it is common in very elderly individuals, dementia is not a normal part of the aging process. Many people live into their 90s and even 100s without any symptoms of dementia.

http://memory.ucsf.edu/Education/Topics/normalaging.html

http://alzheimers.emedtv.com/dementia/dementia.html

http://www.ninds.nih.gov/disorders/dementias/dementia.htm

 

[kacaju]

Pea-n-me Thank you for those links. I will be reading them and also sending them to my brothers to read.

M5Ward:
Thank you. I do agree that some of this could be from aging, but when do you realize it is aging, or there si something else going on??

The detour, what had us so worried is after she tried to find her way around the detour she got herslef even more lost and it took her 2 hours to get back home. From what we were able to gather from her talking, she was always within 5 miles of her home, she just kept going in circles and got herself lost.

my cousin, no one has hard feelings for him.. he made some bad choices in his life. There is no reason for her to start commenting that he is not family...that was uncalled for and to be honest I went through most of my life not even knowing he was adopted so there is no reason for her to start talking like that.

She was trying to set up the automatic withdrawals and when she got confused she just set it aside and never told any of us she had problems. Now that the Dr's are billing her she is in a panic.

We may have to look into a storage place for her.

I completely agree it is her house her rules. Here is the thing... my brother has never brought anyone over to her house. My cousin slept over 1 night so they could go fishing and she knew about it. Because she overheard my brother saying to my cousin he can come again, she is fixated that he will bring other friends over. He has never mentioned bringing friends over to sleep. This is all in her mind and she gets so worked up over the fact that she fears he will bring someone over. This goes on every time one of us talks with her. The first we heard mention of it was on my dd's graduation.
That was June 23rd. Everytime since then she is all worked up that he will bring someone over. I do not see this as normal aging behavior.

 

[mogranny]

I do not believe anyone has suggested calling the elder abuse line in your town. They really can help. Know this first hand.
They have many resourcses.
Barb

 

[TheZue]

We went through this for years with my mom. She never did let us help her or let anyone in her house to help her. What we did was document everything. When she got confused about something we wrote down the date and what happened, when she got a full body rash from not bathing we wrote it down, when she was injured we wrote it down. Finally when she ended up in the hospital after messing up her meds we had our documentation ready for the doctors and social workers. She was admitted into a nursing home three years ago now. I wish she had gone sooner; I'm sure she'd be much healthier right now.