Tag: Assisted Living and Dementia Care

It takes all four of us to manage the move

fourkids (2)The past year has made me regret not having more than two children. Since I grew up with four kids in my family, I always believed I would have four children myself. That was until I had the first one! He was a tough baby, or possibly, I was an ill-prepared mom.

I started late, having my first at 33, so that by the time I was ready and actually did get pregnant, my second arrived to a 38-year-old mother. Given all the high-risk discussions and the additional needs just a second child brought, my husband and I felt for us, it was too late to have more. I am lucky to have two healthy kids.

On the day of the move with my parent’s, we can barely manage my mom between the four of us. Our game plan was that two of us would give our parents a specific task to keep them busy while the other two would manage the move and movers. My mom always behaved nicer when there were two children in front of her — she would often bully you if you showed up alone.

When the movers arrived we have them start with the bedroom. While they are loading up the furniture, we task our parents to decide which sofa set they want in the new apartment. My sister and I invite my dad to go to the new apartment.  My mom is furiously trying to redirect the movers. My dad invites my mom along and she comes with us to the new apartment. Our job is to kill time so the movers can move.

After we linger in the apartment, we suggest getting lunch. On our way to the dining room, my mom sees their furniture being moved down the hall and takes off for their old apartment. My dad decides to follow me into the lunch room. My sister takes off to the old apartment after my mom.

My dad and I order lunch and try to find a topic to discuss. It’s only been two hours since breakfast so I’m unable to really eat anything. I know if I don’t eat, my dad won’t eat so I try to at least fill up my plate with a salad and some fruit and move it around on my plate.

My dad is ready for this move and does not want to fight it. My mom is making him very uncomfortable. I ask if he will come with me to the grocery store and we can pick up some of his favorites snacks for the new apartment. He agrees.

My mom and sister make their way to lunch and we tell them of our plans. We invite my mom along with us. She is not interested.

We all go back to the apartment and my mom is very upset. She keeps trying to tell the movers to put the furniture back and runs to the office of the Executive Director. I leave my mom to my siblings to manage and take my dad out to shop. Wandered.

We have a meeting with the Executive Director at 11 a.m.

jerkToday is the day when my parents will be told that they are being transferred to Assisted Living. My mom knew she had this appointment with the Executive Director and has been asking me if I think it’s about moving the frame chopper into their apartment. When I arrive today my mom is anxious.

My parents didn’t ask me to accompany them, but the retirement community requires that I’m at this meeting since I hold my parents power-of-attorney. My parents are happy to see me and my mom wants to discuss all the reasons they should be allowed to move the frame chopper into their apartment. We spend some time walking through the measurements again.

I feel like a jerk. I know what’s coming. I sit down and we talk through how the chopper would fit in their guest bedroom. She shares that she’s worried they might be asked to give up the second half of their apartment. They took a 2 bedroom and connected it to a 1 bedroom.

I remind her that they moved into this retirement community because they wanted help managing through the retirement years. The apartment they created and decorated was featured on many of the open houses the community hosts for prospective residents. It is a nice, gracious apartment. She tells me I’m a good talker and I stated that so well, I need to speak on their behalf at the meeting today. Double Jerk!

We have been concerned for my parents safety and enough events have occurred that the retirement community is exercising their right to transition my parents to Assisted Living. My parents have resisted every change or suggestion of change. We knew this would be difficult, so my siblings and I worked with the Executive Director on how to best communicate and make this transition.

I tell my mom that the Executive Director called this meeting and we just need to show up to hear what she has to say. I know I played a role in orchestrating how this news would be communicated and while I know it’s the right decision, the process has made me uncomfortable. Shamefaced.

Let’s put my frame chopper in the guest bedroom

framemaster-cutting-machine-250x250On the day we communicated that  the town house transferred ownership, my brother and I arrive at my parent’s apartment together. My mom is too aggressive and confrontational to send any one in alone.

We show up and immediately run to the jigsaw puzzle set up in the living room. We started a 1000-piece puzzle a few days ago as an activity we could all do together. While neither of my parents would start a puzzle now, we used to do them when we were younger and it gives us a neutral activity

My mom paces around the room like a caged tiger. She is ready for activity. My dad is happy sitting alongside us and will accept direction. He seems to find a safe harbor from my mom’s agitation.

My mom will come in the room and demand to know where the items from the town house are. We tell her we moved it all into storage and have it labeled. We can arrange to go get anything from storage — what does she want?

“I want my frame chopper. I just got permission to put it into the apartment yesterday and want to move it in here.”

If you haven’t seen one, it’s a pretty large piece of equipment and it belongs in a workshop, not a bedroom. However, this isn’t going to be a reasonable conversation, so we just agree to act on her request. We tell her we will call to have it arranged to be delivered. She demands that we drive her to the storage facility and load it in the back of the car.

We suggest we start measuring to figure out where it will go and where to place it. My mom get’s her yardstick and we talk through the project. We discuss which pieces of furniture that would need to be moved. We offer to move the bureau and put the pictures into the storage unit but my mom does not want help, she just wants to know when the chopper will be moved into the guest bedroom.

We patiently take turns working alongside or repeating the conversation to keep her busy. It is the only topic and activity that seems to bring her peace now. Practiced.

Setting the stage before my parents are notified

stageOur parents had a town house and had transferred ownership to me and my siblings. They suggested we sell it on and off for several years now, but continued to want to stay there several nights a week. From the time the retirement community initially met with my parents to suggest they consider accepting a personal companion and they refused, I increased my visits.

I found if they had things to do in the retirement community on the calendar they wouldn’t jump in a cab to return to the town house. For two months, I saw my parents every other day and we would go to the commissary, I’d stop by for a visit take them to the town house to look for my mom’s gold necklace, or join them for a meal.

During this time, we were also working to move their last few items to the retirement apartment and my siblings had already come on two visits and had made good progress.

Given the impending notice that my parents were being moved to Assisted Living, we knew we had to get the town house off the table. There was no way for us to physically prepare and sell the townhouse within a week, so we created the story and timeline to communicate the sale.

I share this story with mixed feelings. I think lying is the coward’s hideout to telling the truth. I knew that for the well-being of my parents, in this case, we needed to be sneaky. I still reflect on the psychologist telling me this would be required as we help our parents almost a year ago and I initially fought the idea. I want to treat my parents as I would want to be treated. In every instance, up to this event, I had a conversation with them about what was happening. In most cases, they never recalled the conversation, but at least I tried (as well as did my siblings.)

I realized that to help them make this transition, which was desperately needed, we had to manage the options around them so their only choice is to accept the move since cognitively, they are unable to make this choice.

Each sibling has a role in our plan – from making a phone call to coming to town to move their final items out of the town house, everyone is ready to help. United. 

Preface: The forced transition into Assisted Living

timebombSo many things have happened since I got the call that my parents were being terminated from the retirement community. I wanted to write, but was afraid of putting out a series of Tarantino-esque blog posts that did not convey what was happening, make sense or share what we have been learning from this experience.

Before I got the call from the retirement community Executive Director(ED) notifying me that they were going to require that my parents move into Assisted Living, many warning shots were fired. Two months prior the ED and Manager of the Independent Living community requested a meeting with my parents. I also attended. They provided my parents with a list of concerns and suggested that they consider hiring a personal assistant to help them – particularly in the afternoons and early evenings. My parents refused.

After this meeting, enough events had happened that the retirement community made a report to Adult Protective Services (APS).  APS visited several times and did follow-up calls with both myself and brother. APS closed the case since they did not see an immediate danger to my parents or others.

We chose not to pursue guardianship. We were not willing to initiate this court proceeding of which our parents would understand we were declaring them incompetent only to move them into Assisted Living.

There were several events where my parents were disruptive or a concern was raised that they could harm others. My parent’s behavior was getting bizarre in late afternoon. The Independent Living community was not the right fit for my parents any longer.

Their dinner companions, their life-long friends, the retirement community staff and several doctors have all suggested my parents consider getting an aide or moving into Assisted Living. My parents refused or were unable to accept the need to make changes.

The retirement community invoked their right to move my parents into the next level of care. Over the next few weeks, I hope to share what we went through and what we learned. Explained.  

Add the Retirement Community to the List of Concerned Parties

chairWhen my brothers were in town two months ago we met with the staff at the retirement community. We were surprised to learn that their impression is that my dad is in more need of support than my mom.

After my brothers spent several days with my parents, they understand why. My dad has no short-term memory and no real interest in doing anything. They offered to take him to play racquetball and he wasn’t interested. One brother commented that every time they entered a room he would seek out a chair and immediately sit down.

When my dad broke his hip several years ago, he made an amazing recovery because he was in such good physical shape. Within three months, he was back on the racquetball court at the age of 79. He loved to play racquetball but now has no interest in playing.

In our meeting with the retirement community, we are told the concern for our parents is a dignity issue. My dad has been getting very agitated in public and yelling at my mom. We know that on several evenings he has had to be escorted back to their apartment.

We believe my parents need to transition to assisted living, or consider getting a companion, but our parents will not consider any changes to their current set-up.

Independent living is no longer the solution for my parents. They need someone who can help them adapt to the retirement community and to a new schedule so they can make the most of their days. Hoping we can figure out how to make this happen. Challenged.

It’s been a long time since I waited in the “waiting room”

shocked babyOn our follow-up visit with the geriatrician, my dad get’s called back … alone. Both parents saw the doctor a week ago, but he didn’t do more than talk with and cognitively test my parents. Today was so he could do some additional medical tests. 

For almost a year I have sat in on every medical appointment except one or two when my siblings have been in town. Due to the cognitive states of my parents, the doctor’s required someone was with them during each appointment.

I immediately go to the front desk to raise my concern. They let me know it’s fine, the doctor wants to see my parents alone.

While I waited with my mom, she wanted to talk about why we were here. I share that this is the primary care doctor and he’s reviewing their medications. For the first time, my mom pulls out her checkbook and recites that she is on Lipitor and Aggrenox. You would have really seen my shocked face. My mom has denied she was prescribed any medicines for so long, I avoid the topic. However, just last week she wanted me to explain the medicines in her bathroom. I told her they would help her memory and prevent her from having a stroke. I knew those were two carrots she would stretch to grasp.

The conversation meanders to my father. I remark that Dad has been given an “Alzheimer’s diagnosis.” I know she really didn’t catch it when the neurologist reported it, but the past few weeks she has been very open to discussing the difficulty in helping my father if we are alone.

As if on cue, the social worker stops by to visit with us. My mom tells her that we were just discussing what the care options were for helping with my dad. This social worker really is the “elder-whisperer” — my parents are very private people and my mom is openly sharing with not just me, but the social worker. We discuss that they could move into assisted living or she could hire someone to get dad on a routine while she runs errands or plays bridge and they stay in independent living.

My mom asks if my dad could move into assisted living while she says in the independent living apartment. The naval blockade has cracked. My parents have been so united for the past year, I did not think my mom would consider him going to assisted living without her. Surprised.