Elderly Parent Dilemma (Full Version)

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zondie -> Elderly Parent Dilemma (1/1/2008 8:14:05 PM)

Our family is in sorrow because of our mother's fate. She suffers with manic-depressive disorder and relies on medication to get her through the day. She claims she don't want to live anymore and can't be encouraged or inspired to do anything for herself anymore. She's now tried living with 3 of her 5 children and is not happy staying with any of us. We've all noticed how much better she does when she's hospitalized or in a medical facility environment. Especially when there's other people in her age group thats around. She won't agree to go to Senior Citizens Group anymore, or even to church. In fact it gets her more nervous if going anywhere is mentioned!

We (the children), have always believed that our elderly parents should be taken care of, by their able-bodied children when the time came for them to need constant care. And not trying to make excuses...we've tried everything we know to try! It aches our hearts to think that she'll have to be placed in some facility and not with a family member. My sister is her legal guardian and has gone as far as she can go with her. Mom's only 73, but acts 95! She wants the kind of pity and attention that the most elderly people receive. Her therapist don't even understand why she wants this type of life-style! My sister is going to contact social services soon, to see where mom can be placed to live out the remainder of her days (unless she gets better). That being said, here's what I'm wanting answers to...


Is this decision we've come to an abomination in the eyes of God? Doesn't He expect us to take care of our own?
Will others think that we've all just given up on her?
And should it be a nursing home or an assisted living home?
Has any of you had to face this decision on behalf of a parent before?
Please give us some advice. Biblical or experienced. (We are praying.)



manda59 -> RE: Elderly Parent Dilemma (1/1/2008 8:27:41 PM)

If your mother would be happier (and safer) in a care home, then surely that is the most loving thing to do for her.

What does it matter what "others" might or might not think, so long as it's the best decision for all who are directly involved?



Closie -> RE: Elderly Parent Dilemma (1/2/2008 8:01:24 AM)

You're staying prayerful and that's the right approach. Listen to the Holy Spirit, not those who don't know your situation. Use the resources the Lord has provided: Social services, support groups, church ministries, and so on. Research the types of facilities that seem to appeal to your mother. Involve her in the decisiion.

My family was concerned about having my grandmother live in a nursing home. Her children finally chose one that was closest to their homes, but it wasn't necessarily the best in the county. But its proximity allowed all of us to visit her regularly. She never went a day without at least one child or grandchild going by. Within a couple of months, we noticed how she seemed to be getting better. The next thing we knew she was calling us to bring her special clothing for movie outings or mall trips. She started doing crafts again. She attended the worship services. She loved us and knew that we loved her. Where she lived during the last couple of years of her life didn't change that.



Szaftoo -> RE: Elderly Parent Dilemma (1/2/2008 10:06:53 AM)

Both my mom and my MIL live in senior only apartments where they are self-sufficient and love it. My aunt and uncle live in an assisted living facility and they also love it. They are with people their own age who are in the same situation. The Bible is clear that we are to take care of our parents when they no longer can. I believe that means we do whatever works for them and for us. If your Mom is happier in a faciltiy, maybe that is what you should consider.



HisCovenant -> RE: Elderly Parent Dilemma (1/2/2008 3:58:29 PM)

I think it's great that you have such a burden for caring for your mom yourself, but there is nothing Biblical that says that you can't do so with the help of a facility... especially if your mom is happiest there. As long as the decision is not detremental to her and is affordable, go ahead and make it.

Don't worry about others approving of your decision...you need only worry about God's approval. Others who share your lives will understand because they constantly see your heart.



peace77 -> RE: Elderly Parent Dilemma (1/2/2008 6:32:07 PM)

If your Mom is happiest at the assisted living facility, then letting her live there is not a failure on your part.

Using the place that she is happiest in is certainly never an abomination to God.
Your love and support is not limited to having her live in your home or your sibling's home.

You can show your support by making she that she have what she needs. When my MIL was in a nursing home, some of her things disappeared. It was believed that she threw them away unaware of what she was doing.
So, we frequently replaced things like slippers and socks, combs and toothbrushes.

You and your siblings could consider contributing to the cost of her care.

Whether it is an assisted living facility or nursing home depends on her needs and the level of care that she requires. The admission staff can help with that. Sometimes, there is no choice, if she needs more care than the assisted living facility can provide. You may want to consider a place that has both. Then, if she needs to move to get skilled care, she will still be in a familar place.


Peace,
Anne



agapetos -> RE: Elderly Parent Dilemma (1/3/2008 5:26:36 PM)

quote:

Is this decision we've come to an abomination in the eyes of God?
Not if it's the right thing for your mother.
quote:

Doesn't He expect us to take care of our own?
Taking care of our own doesn't mean that you have to have them living with you. Taking care of our own means that you will have her best interests at heart ~ and for your mother (right now) this seems to mean going to live in a facility. It doesn't mean that you've given up on her or that you're locking her away and forgetting about her. If you were to put her into a facility and never speak to her again then you would be doing wrong.
quote:

Will others think that we've all just given up on her?
Others will think what they will. Don't worry about them. Worry about your mother.
quote:

And should it be a nursing home or an assisted living home?
Your mother has bipolar, can she make any decisions herself? I have bipolar to and am able to make my own decisions (though I'm not your mothers age). If she can, then get her involved in her care too. If she can't, seek advice from people who are involved in her care.

You never know, with time, you may find that this has been the best help for your mother.



jodavi -> RE: Elderly Parent Dilemma (1/3/2008 7:18:31 PM)

My father is in a nursing facility right now and it's not by our choice. If we can bring him home with us, we would but because of various medical reasons, doctors and social workers advice us not to. He had stroke and bed ridden and not able to talk to us. He's not that far from us so we take turns in seeing him. This is his second nursing home and I have to tell you that I want to see my Dad everyday and I see him every 2-3 days but it's so discouraging and heartbreaking just walking through the halls of nursing homes. I hate to say but for one, I can't tolerate the smell. If you do, however, decides to bring choose on a nursing facility, make sure that there will be one person to be her voice. My Mom has been the voice for my Dad for over a year now and she just have to toughen it up most of the time. There were a few times that I ended up having arguments with a nursing assistant insisting that my Dad has been cleaned but he hasn't been changed or turned at all. The constant presence of family members in the nursing facility will help to make sure your Mom is getting the care she needs. My husband always say, animals gets better treatment sometimes than our elders. I'll be praying for you and your family. You're entering a different stage of life decision that is never easy.



zondie -> RE: Elderly Parent Dilemma (1/3/2008 7:19:18 PM)

THANKS SO MUCH for the advice and support so far!
I agree that if we deserted her that that would be wrong. I've also been told (by others) that as long as the family is closely involved in the care of a family member in a nursing facility, they're better taken care of. We couldn't stand the thought of mother being mistreated! She's not the lady she use to be, she's developed an attitude of demands. And she's not willing to try to do anything herself anymore! She expects it all to be done for her. I'm afraid that with this type of attitude she's gonna bring more hardship on herself! Maybe though, the facility chosen will have a way to inspire her to do more than her own family can. I sure hope so! Please remember her and us in your prayers.



zondie -> RE: Elderly Parent Dilemma (1/5/2008 7:03:11 PM)

I e-mailed my sister with your replies to this post (because she is the guardian of mom) and is so heavily burdened with this decision. Here is what her reply back was...

quote:

The one verse in the Bible that haunts me is this:

1Timothy 5:16 --
If any woman who is a believer has widows in her family, she should help them and not let the church be burdened with them, so that the church can help those who are really in need.

I do understand that Paul was trying to relieve the church from financial burden when the family should be responsible for their own. I do understand that he was an apostle and that means he was busy establishing churches and the church in those days took care of the followers much like how our society suppose to work in caring for the people. They provided housing, food and finances. And I know today our government has established facilities to care for those in Mom's condition. BUT the guilt I feel for having to make a decision like this is almost smothering me! It's like I'm being FORCED to do something that has always been the biggest NO in my life, in other words, I feel I can't survive the crush of this ugliness of going against my convictions.

I absolutely hate what she is MAKING me do!!! I absolutely hate that she has rejected all that I have tried to achieve for her. I absolutely HATE satan!!!!!

Thanx for sharing this with me, I really did gain some strength from those who know what we're dealing with.

Any comments?



jodavi -> RE: Elderly Parent Dilemma (1/6/2008 1:15:16 AM)

Honestly, I'm not sure if the guilt will ever go away. There were some situations that has happened before my father's stroke and between my sister and my Mom and myself, we could have put the blame game with each other from causing my Dad's stroke. Like I mentioned before, it's a difficult stage in all of our lives. My Mom could make the decision of bringing my Dad home because we do feel guilty everytime we leave the nursing facility. His birthdays came, Christmases and other family celebrations and we're not able to share any of them with him the way that we would want and yes, again, there's that guilt. But then the consequences of bringing him home and finding out that my Mom would end up doing all of his medications, feeding, changing and other things would also lead us to another guilt if for some reason some other things happens to my Dad. My Mom's biggest fear is that, she's not trained to know if my Dad's sugar or pottasium will be high or low (he's also diabetic) since he can't communicate with us. We are just finally entering in a stage now that we have accepted that my Dad will have a long term care in the nursing home and might be in bed (he's 75) for ...I don't know...until the Lord brings him home. But everytime we see him nodding or shaking his head or just making some facial expression, it does gives us hope. The hope takes away the guilt. So I guess the guilt will be there but don't let this situation break your family apart, make this situation keep you all together.



zondie -> RE: Elderly Parent Dilemma (1/6/2008 1:52:41 AM)

jodavi wrote:
quote:

We are just finally entering in a stage now that we have accepted that my Dad will have a long term care in the nursing home and might be in bed (he's 75) for ...I don't know...until the Lord brings him home. But everytime we see him nodding or shaking his head or just making some facial expression, it does gives us hope. The hope takes away the guilt. So I guess the guilt will be there but don't let this situation break your family apart, make this situation keep you all together.


So sorry about your dad's condition. I'm glad to know that all of you are supporting him and your mother though. I only hope and pray that this will be the response of our family. We should all stand together and just try to reassure her of our love and devotion to her. I don't want her to think any of us are neglecting her. But that we're doing what we feel is best for her and the family. All the children are older now and have health issues of our own also. At a nursing facility, they have fresh help about every 8 hours. That way they're not so easily worn down with all the care they must provide. At home it's you or nobody.

BTW-I love your signature line.



Szaftoo -> RE: Elderly Parent Dilemma (1/6/2008 10:02:34 AM)

Verse 8 says we are to "provide for our own" which means we are to see they are well taken care of and sometimes that means moving, not putting, them into a facility. Assisted living and nursing homes have trained health professionals, healthier food, planned exercise and activities with people their own age. My aunt and uncle love where they live. They now walk every morning, play bingo, listen to music every night and interact with the other residents.
Guilt comes from moving family and then forgetting about them and I doubt you sister will do that. She needs to consider all the options for your mom before she starts to resent her and the time and attention she takes. Good for all of you that you want the best for her.



zondie -> RE: Elderly Parent Dilemma (1/6/2008 9:17:33 PM)

Szaftoo wrote:
quote:

Verse 8 says we are to "provide for our own" which means we are to see they are well taken care of and sometimes that means moving, not putting, them into a facility.


Thanks Szaftoo! I never even thought of it as a 'move'! Mom's moved at least 3 times since dad passed away and none of us rebuked her for it! That's such a good way for us to look at this and just come to terms of making life as good as we can for her. I'm gonna mention this to the rest of my siblings and see if it helps to lift some of their burden also.

[sm=angel.gif]Thanks again, dear one![sm=angel.gif]



Szaftoo -> RE: Elderly Parent Dilemma (1/7/2008 9:36:17 AM)

Zondie, I will pray for God's will and timing for all of you.



jodavi -> RE: Elderly Parent Dilemma (1/7/2008 10:10:51 AM)

I hope you don't mind me asking you-- how's your family financial resources? Your Mom's? The reason I asked is that this is another thing that will be looked at when looking for care for your Mom. My Dad has insurance & Medicare but with his condition, he needed a long term care that the social worker had my Mom apply for Medicaid for him.



zondie -> RE: Elderly Parent Dilemma (1/8/2008 6:38:33 PM)

jodavi wrote:
quote:

My Dad has insurance & Medicare but with his condition, he needed a long term care that the social worker had my Mom apply for Medicaid for him.

Mom also has insurance and Medicare. She still receives a disability check from my dad's 'black lung' also. Can a person be approved for Medicaid if they're already receiving Medicare?
But my sister is concerned about what will be done about the mobile home mom still owes for. It's real close to being paid off. She is wondering if they'll let her sell it, pay off the debt and bank what's left for a burial fund of some sort. We don't know about all these things, so I've suggested to her to contact the Social Services and inquire about it. Will they take everything mother owns? I mean, what if she gets better enough to come back home? Who knows?



jodavi -> RE: Elderly Parent Dilemma (1/8/2008 8:29:10 PM)

From what I understand when we were planning long term care for my Dad, Medicare would only cover the first 100 days. I'm not sure if that's the accurate number of days or it might be different from different states. And since we knew that he'd be in a long term care, my Mom applied Medicaid for my Dad and that took I think 90 days to process. When he've used all his Medicare, Medicaid took over. Medicaid is a bit confusing. My Dad's case worker mentioned that they don't even know how Medicaid determines on how they take monies. Sometimes they'll take all of the monies, sometimes they take half of it and sometimes they don't even take anything. In my Dad's case, they did not take anything away and we were just assuming that it's because my Mom has not received her Social Security yet but that can change this year because Mom will start getting some money of her own. But yes, these are questions you might need to ask your Mom's case worker. We've met a few of them and they've all been very helpful.



Kat_D -> RE: Elderly Parent Dilemma (1/8/2008 10:47:11 PM)

The first thing you should do if you want to place your Mom in a skilled nursing facility is to check and see if her diagnosis fits the criteria for admission. Medicare/Medicaid will only pay if she has a covered diagnosis. Some mental illness diagnoses are not covered.

If you are thinking of an assisted living facility, neither Medicare or Medicaid pay for residential facilities.

I cared for my Mother when she became ill with Severe Parkinson's/Dementia. I moved her in with me until her condition deteriorated to the point that I could no longer care for her by myself. We first tried home nursing and that was well over $5,000/month (out of pocket). She only had Medicare and did not qualify for home nursing care. I finally ended up placing her in an Assisted Living Facility that cost $3,500/month (out of pocket). When her condition became terminal, she got a Hospice Care bed at the same facility. We still paid the $3,500/month but the Hospice Nursing care was covered by Medicare until she passed away.

I feel for you and and your family...it is a difficult thing to go through.

ETA: The sad thing is that some people, like your mom, may not be happy no matter where they live. Besides my Mom's dementia, she also suffered from mental illness most of her life. She was not "happy" when she lived with me and was not "happy" in the assisted living facility either. She, like your Mom, refused to do the things that would have helped her, like going to the Senior Center or seeing friends, etc. Once I placed her in assisted living, she would rarely leave her room and refused to participate in any of the activities there. She was in a constant state of anxiety and the dementia only compounded it; making her even more withdrawn and depressed. This made it very difficult on me as her caregiver, because no matter what I did, she was miserable a great deal of the time.



Szaftoo -> RE: Elderly Parent Dilemma (1/9/2008 9:45:04 AM)

quote:

ORIGINAL: zondie

jodavi wrote:
quote:

My Dad has insurance & Medicare but with his condition, he needed a long term care that the social worker had my Mom apply for Medicaid for him.

Mom also has insurance and Medicare. She still receives a disability check from my dad's 'black lung' also. Can a person be approved for Medicaid if they're already receiving Medicare?
But my sister is concerned about what will be done about the mobile home mom still owes for. It's real close to being paid off. She is wondering if they'll let her sell it, pay off the debt and bank what's left for a burial fund of some sort. We don't know about all these things, so I've suggested to her to contact the Social Services and inquire about it. Will they take everything mother owns? I mean, what if she gets better enough to come back home? Who knows?


I rceived so much help with our local senior citizens center and it cost nothing. They have experts who can advise you in the laws of your state, Medicare and supplemental insurance, housing, and finances.



Kat_D -> RE: Elderly Parent Dilemma (1/9/2008 4:29:57 PM)

HERE is an outline of the criteria for Skilled Nursing Facility admission.

Eldercare is also a good resource link.



zondie -> RE: Elderly Parent Dilemma (1/9/2008 10:52:29 PM)

Szaftoo wrote:
quote:

I rceived so much help with our local senior citizens center


That's a good idea! Thanks. Mom attended a senior citizens center for almost a year before she became ill. I'm sure they'll still remember her.

Kat_D wrote:
quote:

The first thing you should do if you want to place your Mom in a skilled nursing facility is to check and see if her diagnosis fits the criteria for admission. Medicare/Medicaid will only pay if she has a covered diagnosis. Some mental illness diagnoses are not covered.


We've already checked in on that before. At first she didn't qualify because she was still able to bath and dress herself. (Even though she couldn't be trusted to fix herself something to eat.) But now she's beyond any of that.

Kat_D wrote:
quote:

ETA: The sad thing is that some people, like your mom, may not be happy no matter where they live. Besides my Mom's dementia, she also suffered from mental illness most of her life. She was not "happy" when she lived with me and was not "happy" in the assisted living facility either. She, like your Mom, refused to do the things that would have helped her, like going to the Senior Center or seeing friends, etc. Once I placed her in assisted living, she would rarely leave her room and refused to participate in any of the activities there. She was in a constant state of anxiety and the dementia only compounded it; making her even more withdrawn and depressed. This made it very difficult on me as her caregiver, because no matter what I did, she was miserable a great deal of the time.


It sounds like you know our mom! You've described exactly how she's been acting! She wants to stay in the bed most of the time now. Just to keep from facing another day. And she's also miserable no matter what you try! I've told my sister that within the first week of admission into a facility that mom will start complaining and probably start accusing the staff of being 'mean' to her.
{Mom has suffered with mental health issues her whole life too. She was diagnosed with dementia, some time back but we were told from the last hospital she was in that she didn't have dementia! We don't know who we can believe or trust anymore!} They just don't take mental health as serious as they should in this part of the state, IMO.

Thanks for the links. I'm going to check them out now.



Szaftoo -> RE: Elderly Parent Dilemma (1/10/2008 9:52:14 AM)

quote:

ORIGINAL: zondie
Szaftoo wrote:
quote:

I rceived so much help with our local senior citizens center


That's a good idea! Thanks. Mom attended a senior citizens center for almost a year before she became ill. I'm sure they'll still remember her.


If you get help from the senior center, go alone for first time. Ask questions and find out what your resources are without any input from your Mom. You are not hiding things from her, you just need help without any interruptions from her.



hotsaucygma -> RE: Elderly Parent Dilemma (1/10/2008 10:07:31 AM)

Zondie, you've gotten good advice here. I would suggest calling Social Services first thing- ask to speak to a Financial Worker that deals with Nursing Home payment (they would have the best information on how the mobile home would be treated and other financial information), and a Social Worker that works with Elderly Services (they would be best to discuss the type of facility needed and other services that might be helpful). Often they take care of the two different "sides" of Care. In Minnesota there are different programs that can help with payment for both Assisted Living and Nursing Home, different states may have different programs though- or no help at all. Medicade should be pretty much the same nation wide as it is a Federal program, although there may be some differences in how states administer the program, I'm not sure on that. Also in Minnesota there is a Senior's program that helps with, or gives advice about, Medicare, financial and insurance issues for Seniors free of charge, ask if your state has something similar. Also ask if there is a program called Information and Referral or First Call for Help, or try dialing 211 on your phone (it is a national number like 411 or 911 that goes directly to a Information and Referral if your state has decided to participate in the "211" system). The Information and Referral program has a data base of Community Services and could tell you if there are any other programs in your area that could be helpful to your Mom or the family (like the free Senior advice, or free legal aid for Seniors etc.).

I understand how your sister feels about having to make the decision on what to do for your Mom, but remember that is just what she/you as a family are doing- it for your Mom. Also remember that if her situation were to change, she would not be required to stay in the facility she is placed in. If her condition improved to the point you or someone could care for her in their home, and both your Mom and the family member wanted to do so, you could!

You are providing for your Mom's care. You are fulfilling Paul's admonishment to care for her, imo.



HisCovenant -> RE: Elderly Parent Dilemma (1/10/2008 10:38:27 AM)

quote:

ORIGINAL: zondie
{Mom has suffered with mental health issues her whole life too. She was diagnosed with dementia, some time back but we were told from the last hospital she was in that she didn't have dementia! We don't know who we can believe or trust anymore!} They just don't take mental health as serious as they should in this part of the state, IMO.


Trust yourselves. You & your sibs know your mom and have her best interests at heart. Unfortunately, many of those who serve in our medical fields (be it Drs or RNs) don't have the compassion, knowledge, or correct morale to serve well in their chosen field. You have to sift through them and find the ones that are caring and who do know their stuff- and that can be hard for you to discern. It's really sad when a family is going through such a difficult time that the medical field adds to their burdens, but they do.

When my father was in the hospital for 1 year (acute facilities mostly, but a few physical theraphy facilities for more acute problems) we had to stay on Drs at one facility and RNs at the next. It was a constant fight about something. When it was the RNs we had to have the Drs write orders in such a way that they couldn't laze their way out of caring for my father. When it was the Drs, we really didn't find any recourse except to argue with them- which was like trying to argue with a sign post. Fortunately, my father is able to be at home alone now (which one of the doctors told us would never happen- we should just put him in a nursing facility and get over wanting him to get better)... but I dread the day we have to have Drs and RNs constantly involved in his care again.



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