If/when your parents sat you down to discuss the facts of life, it was probably pretty awkward. Turnabout is no fun either. I’m afraid that my siblings and I have to have an uncomfortable talk with my parents, and I am not looking forward to it at all. If you have any advice, I would love to hear it.
My parents are approaching their 80s. They’ve been relatively healthy and independent, but are definitely showing signs of age. My mom was diagnosed with congestive heart failure, has been on oxygen and medication, and seems to be ok. She’s much less energetic than she used to be. Growing up, my dad was always overweight. When he got up above 300 pounds, he decided to get gastric bypass surgery. He looked great and weighed less than me for the first time in my life, getting down to about 200 pounds or so.
About 3 years ago, he was trying to be active, riding an adult sized 3-wheel bike (really a tricycle) and tipped over, breaking his hip. I was very concerned when I wrote about it 3 years ago. As a result of that break, one leg is about an inch or two shorter than the other, so he has to have special shoes. Obviously he couldn’t exercise and gained back a lot of weight. On a recent trip to the grocery store, I was surprised that he rode around the store in a motorized scooter.
I didn’t realize how hard it was for him to move. I invited my parents to attend my son’s baptism last weekend. They agreed to come, but it’s not just their physical health that is suffering. I invited them to stay our house–they live about 4 hours away and have been to my house several times, but they wanted a bit more privacy and got a hotel in Orem, Utah instead. They tried to check in, but it was too early and they wanted to see my sister who lives in Bountiful. My dad knew that University Avenue runs into University Parkway which takes you to the freeway. That’s true if you’re heading south, but my dad was heading north. The hotel told him to turn right, but since he was heading the wrong direction, he ended up getting on I-80 (rather than I-15) and drove all the way to Park City before he realized his mistake (a drive of about an hour!) He eventually made it to Bountiful, but my sister was quite worried wondering where they were. To make matters worse, they got lost on the return trip from Bountiful to Orem, and called 911 three times because they couldn’t find the hotel that they had previously found in Orem. The police were kind and finally escorted them.
The next morning, my phone rang at 7 am, waking me up. I didn’t get to the phone in time and he didn’t leave a message. A few minutes later, he called back telling me he was lost trying to find my house. Even though he was close, it took me 25 minutes to talk him through how to find my house. I couldn’t believe how difficult it was for him to understand. When he got here, he told me about his adventure to Park City the night before. Then he told me that his credit card was frozen by his bank. Apparently he has been filling out “surveys” for free products–you just have to pay for shipping! His credit card had charges from Iceland, Germany, and other places, and I’m glad the bank froze his credit card to prevent more fraud.
He’s become one of those old people susceptible to scams. It blows my mind because he always spotted them before. I was greatly alarmed to see how poorly his decision-making was. My sister told me that I shouldn’t have invited them to the baptism–I now understand that he is much worse than I realized. She was right. I’m not inviting them to my house anymore, but will try to visit them more often than I have in the past. Walking up the 3 steps to my house was a chore for him. His mobility is much more limited than I realized.
My dad and I have always had a rocky relationship. I couldn’t wait to move out of the house as a teenager because he was not the most pleasant person to live with (and I don’t know how my mom has done it for 50 years!) People talk about how hard it is to live the rules on an LDS mission, but I felt so free! I would gladly have my mother live with us, but even in the best of circumstances, my dad is unbearable to live with. I never stay at their house when I visit because I know that we will fight. Staying in a hotel or friend’s house is much better for our relationship.
I know they need help. I told him to quit filling out these stupid surveys, and just saw that he filled out another one of Facebook for a free iPad. I know we need to have a talk with my parents. My siblings and I discussed getting power of attorney to help them with finances, health care, and end of life issues, but I do not look forward to this conversation one bit. I fear they forget if they have taken medication and may take it twice or not at all. I wish someone lived closer to them, but they are the ones who moved from us to take advantage of the nicer weather in St. George. (You don’t shovel heat!) Do you have any advice for me?
Wheat & Tares 
Can you find someone in St. George to help with their care? Someone who can maybe check in a couple of times a week to make sure they are eating, taking their meds, etc., and can keep you informed of any changes in their health or ability? The hardest conversation I had with my dad had to do with his driving. He thought he was an excellent driver (he always had been) and I could see a real difference in not only the quality of his driving, but how stressful it was for him. But when I broached the “at some point you will need to think about giving up your license” his response was “just kill me then”. Not a positive direction for a crucial conversation. He passed away before it got to the point where we had to take away his license. What I’m trying to say is, those conversations are difficult. I suggest you and your siblings have them together with your mom and dad, with someone taking notes which then are copied and provided to every sibling. That way everyone is on the same page. Good luck!
I have no suggestions, but am glad you posted the question. We have this upcoming with my parents as well and my sibs and I aren’t quite sure what to do.
I never lived in St. George, so I don’t know anyone, but my sister did. She was so concerned about my dad’s driving (and getting lost) she called their current bishop and asked for the home teachers to stop by to make sure they made it home Sat. night. They did. She’s going down for Easter, and the siblings are thinking about going down at the end of the month to have “the talk”, but the 4 of us remaining siblings all live far away. They live in a senior community, and my dad has in past years talked about helping the elderly. I hope he’s open to receiving help, but very unsure. Since he’s filling out these scams, I don’t know that home teachers are going to help with that. (I left a message on his facebook page asking him again to quit filling out these scams.)
My sister knows their doctor, (discovered he was on a mission) and left a message with the office. We’d like to get them in to see the doctor to see if they might be more open to a doctor, rather than a child’s message, but without an appointment I don’t know how to get them in. There are FERPA laws too, so we’d like to get a medical authorization so we can better understand the medical issues.
I have no good answers for this post but lots of empathy. My sisters and I are going through the same thing with our Mom.
This really doesn’t help you now, but it may help someone else reading this post, and dreading finding themselves in the same situation: start “the talk” about aging with your parents long before they have aged enough that you need to intervene in their lives and care. Have them make a will, power of attorney, and general “this is what I want my life to look like as I get older” decisions in their 50s or 60s, or sooner if they already have health problems that will accelerate aging. Aging-related problems are fundamentally about loss of control. So let them control the process while they can, so that as that loss gradually comes, you can remind them you’re following the decisions they made. They’ll probably still resist when it comes, but you’ll always have “We talked about this and you made the decision years ago” to fall back on.
STH, thanks for that advice. Maybe we’ll try that approach and see how it goes.
No advice, but best wishes…
My mother spent years as the administrator of a residential dementia facility and a bit with home health care as well. These are the main tips she’s always repeating to me (though they may or may not be of use in your current situation):
1. Everything STH said. Power of attorney is key as well as medical permissions and decisions (like a DNR or “no heroic measures”)
2. Consider hiring a reputable home health care service. You can start with small things. If you get an aide or helper who comes for an hour a day, they can handle the medication, help with shopping, clean up a bit, and more. Most importantly, if you or a sibling has power of attorney and such, they can get regular reports from the health care aid.
3. Hygiene. As the aging brain deteriorates, complex processes involving many steps become difficult and frustrating. Many people don’t continue bathing regularly because they can’t remember all the steps. Having an aide or someone start the shower and remove unnecessary products from the shower area can reduce anxiety around this. Whether your father has reached that point or not, it’s on the horizon, and it’s a pretty key indicator of loss of independence.
4. Recognize the toll this will take on the caregiver. If a family member takes on this role, be sure that they get frequent “subs.” If one parent is still of sounder mind than the other, they will need breaks. If you and your siblings are involved in helping, be clear about what each person is going to do. Clarity may seem too blunt, but ambiguity will strain all of your relationships.
5. Emotions are key. Even as the memory and processing parts of the brain suffer, emotional reactions remain strong. If something upsets or frustrates them, they may only remember why they are frustrated for a short period, but the anger and agitated feeling will linger for hours. The bright side is, the same is true of positive emotions and experiences. You can use this to ease tough moments. When you are all ready to have the talk, make sure you gather in a place that’s familiar to your parents (perhaps their own home), and only begin the talk after setting a positive tone by doing something your parents enjoy.
You can create little daily happy moments to help your parents cope. My family is going through this right now with an elderly relative who loves history, and especially WWII. He gets frustrated when he reads his old books, though, because it’s becoming too complex. We bought several books about WWII that are full of photos, and we’ve strategically left one or two next to all the places he likes to sit. His mood has improved considerably. You have to find ways to simplify things they enjoy so they can still enjoy them.
6. If/when you have to move them, you will notice a drop in their functional abilities. A person who can’t keep track of the steps to brush their teeth can often cover by drawing on a memory from brushing their teeth 20 years ago, as long as the toothpaste, faucet, and toothbrush are all in the same places and work the same way they did 20 years ago. When they move, you’ll see just how much they’ve been covering because they can’t remember where the toothpaste is in the new place, and turning on a single lever faucet is different than two knobs, etc. It’s easier for you the caregiver to handle this transition if you’re mentally prepared for what to expect.
Sorry this is so long winded! Having the talk is hard, but setting clear expectations will help. Wishing you the best!
I’m so sorry–what tough spot to be in.
Professionally, I sometimes get to talk with people about having these types of difficult conversations. I often tell my patients, “it’s often easier to have sixty 1-minute conversations than one 60-minute conversation.” I’ll then have them start with a short conversation about something that isn’t as overwhelming, and build from there.
Advanced directives are often a good place to start. “Dad, I wonder if you and mom have given any thought to drawing up some advanced directives?” Or, as STH suggested above, “Dad, what do you and mom want your life to look like as you get older?”
You might offer to provide a brochure and check back in. Or even say, “We don’t have to talk about this today, but I do want to make sure I understand your wishes as you age.”
We start talking about advanced directives with all of our patients annually once they hit 65–in part to help normalize the process. Their physician may have done that, and they might be afraid to bring it up with you.
If it’s helpful:
http://www.caringinfo.org/i4a/pages/index.cfm?pageid=1
This is a challenging topic and others have given excellent advice. It’s been 10 years since I and siblings had these talks with our parents (both of whom have since passed away). Conference calls among the siblings were vital so that everyone was on the same page, had all their concerns in the open, shared all information that each had about parents’ situation, needs and desires, and presented a united front and the same story to parents.
The impetus for when to talk is when health, safety, and financial problems are present. From your story, this time is already here. As said before, get the legal documents in order ASAP. Critical talks should also take place on a conference call so everyone is present and hears the same things.
RE health and safety, take the opportunity when visiting with them to investigate and visit assisted living options. This helps to initiate conversations about what is important to them. When time comes to move, I recommend moving them as close as possible to whichever sibling will be the primary overseer of their care. It needs to be as easy as possible for that person.
RE financial, get one sibling to be a co-owner of their bank accounts (only one signature required so parents still feel some control, but the child can watch all transactions online). Also, change the credit card to a prepaid card with a relatively low limit. Then the potential loss is lessened.
I’m grateful that my parents had so many things in order before their mental capacities declined dramatically. Even so, the talk and transitions were difficult. I’m now aware that it’s time for me to make similar arrangements so my children can take over as needed.
God be with you as you do all things with love.
I really appreciate the good advice and kind words from everyone. Thank you all so much. You’ve given me some great ideas.
As a retired family doc I can attest that these were the hardest conversations that I had to have with families. As far as what to do, it’s crucial to have a primary care physician, either an internist, geriatrician, or family doctor to try and be an objective third party helping your father to agree to the needed changes. The next is to try and get your parents to consider assisted living and finally some sort of limitation/control of finances. Sometimes the tipping point comes when one spouse can see that the other is not able anymore to take care of him/her. Sorry for your troubles and good luck.
MH, you have my sympathy and my prayers. This is not an easy stage of life. For those of us who are younger and whose parents are still relatively healthy and hale, I think that STH’s advice is excellent – have the talk early! For those of us who are getting into the difficult times, it’s never too late to try.
My father will be 78 in a couple of months, and while he’s still mostly sharp mentally, his physical ability is declining rapidly, mostly due to the long-term effects of diabetes. He’s had one auto accident in recent months that had been of great concern as well. He’s said for years that “the day will come when you guys will have to take away my car keys.” That day may be coming. (My mom died almost 15 years ago.)
Unfortunately, the decisions which need to be made for any of us are a lot more involved than whether or not our aging parents drive. Where do they live, and what sort of care will they need? Who will provide it and how will it be paid for? In our case, we both work, and it isn’t economically feasible for one of us to leave the workforce to become a full- or part-time caregiver. My wife’s parents have long-term care insurance with some applicable benefits, but my father doesn’t, and could never have qualified in any case. Still, figuring out who, among myself, my wife, and my two unmarried sisters, provides what for Dad will be difficult, and it will need to be done soon.
In addition, don’t neglect the questions about what happens after your parents pass away. Who is the executor of the estate? What is kept, sold, or distributed – and how? Who decides? Is there a will or trust? The disposition of major assets and items with great sentimental value (Mom’s china closet, Grandma’s china, etc.) should be decided by family council in advance of death, not afterwards in the midst of sorrow and emotion. I’ve seen families torn apart by a senior’s or senior couple’s unwillingness to consider what will happen at their passing.
MH, you’re correct, it will be a difficult and painful conversation. Probably worse than the ones they had with us when we were teenagers.
But it’s one of the most important things we can do for our parents and ourselves and siblings, out of that weird state of heart that is love in a family.