Tag: parents

Making the transition to Assisted Living when your parents refuse – Part I

no drivingI have been writing about my family’s struggle in helping my two parents with moderate dementia for more than a year. While my parents had an apartment in a retirement community, they kept their town house and divided their time between the two homes. They were unwilling or unable to make the move and as a result, they were always about two steps behind being in the place they should have been for their own happiness, health and safety.

While I know my parent’s relished the independence, they really struggled to keep up with two homes. They were starting to become targets of elder-care abuse, and we had several instances where we had to intervene on their behalf.

In looking back, there were three keys to our success in finally getting my parents into the level of care they needed. Today I will address the first item: Driving.

For more than two years, I would not allow my parents to drive my children. Their cars continued to get a little more battered and scratched. They kept telling us they would be moving full-time into the retirement community … but each new milestone came and went and they failed to move. We realized the movement between homes became my parents’ only real activity.

For the past two years, my siblings and I had face-to-face conversations with our parents requesting they consider moving full-time and give up the driving. They rebuffed our suggestions.

Finally, almost 9 months ago, they showed up in two different hospital emergency rooms in two days that was staffed by the same doctor. She was so alarmed at my parent’s confusion she championed the cause to have their licenses revoked and wrote to the DMV.  We had previously asked their doctor (who diagnosed the dementia) if this was possible, and he was not aware he had this capability.

If you are in this situation, call your state DMV office to request the forms and under what circumstances will a license be revoked. Our parent’s licenses were revoked in less than two weeks of the doctor’s form submission. Surprised.

Related Blog Posts:

Dementia and Driving Issues

Driving is a Right, and I think that is Wrong

When are you too old to drive?

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.

My mom’s not here

purgatoryWe are in Day 2 of purgatory. My parent’s were notified they will be transferred to Assisted Living and we are managing through “the day after notification”. Tomorrow, the movers will come.

After being notified by the Executive Director they were being transferred, my mom was angry and defiant and my dad was resigned to make the move without a fight. During the course of the day, my mom got my dad to agree that they should have 30 days to move. I would agree that seems fair, however, they can’t recall how many times the retirement community has encouraged them to make changes that would keep them in Independent Living (they refused to hire an aide several times).  They also do not remember (or believe when you tell them) what happened that forced the community to require them to move swiftly into Assisted Living.

We took the advice of the retirement community that suggested we communicate the news and make the move swiftly. My parents have lost the ability to plan ahead so we are just biding time until the movers show up tomorrow. In reality, the retirement community could move my parents without any notice if they are concerned for their safety or the safety of others.

My mom found the name of a lawyer listed in the resident’s directory and made an appointment for 1 PM today. What my mom failed to do was write down the appointment. She will be playing bridge and won’t be at the apartment when the lawyer is scheduled to arrive. My oldest brother, W., is on site to meet the lawyer.

At 12:30 my dad decides to go eat lunch so W. hangs back. The lawyer arrives at 1 PM and my brother greets him and tells him “My mom’s not here” but welcomes him into the apartment. During the course of the conversation, my brother suggests the lawyer talk with the retirement community staff and lets him know my parents have each been diagnosed with moderate dementia.

We wondered if we should have paid the lawyer for his time, but decide that we didn’t call him and had he done some qualification when my mom called him, he could have saved himself the trip. Averted.

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.

The town house has been sold

soldOne of my brothers is a realtor and has been the family resource on all home sales. He called and shared the news with my parents. My mom was pleased with the news initially, and reiterated her pleasure when my sister called. When I told my parents “E” (one of two of my brothers) was coming into town to help them with the final items, my mom was excited.

When my brother E arrives to help transport them to the town house, my mom is now outraged about the sale. “Prove it” she challenges as my brother is kindly driving and help them pack final items. He quickly learns to not bring up the topic anymore but to provide simple directions and the trips go better.

After three days of travel and moving, E reports that my mom started taking things from the retirement community back to the town house. She’s returning the things she rescued the day before.

She is unable to maintain the memory and has no systems other than her calendar to help her remember. By day four he just sits next to my dad as my mom rummages through the town house with no specific idea of what she wants. All the items they want and need are already at their apartment, but we hoped this would help provide closure.

As frustrating as the process has been, sadness fills all of us linked to the event. My mom is frustrated and angry and does not seem to understand. My brother is tired. The knowledge of the lie we told weighs heavily on our hearts. We need to close down this chapter so we can guide our parents to options that will keep them safe and make the most of each day they are still here with us. Saddened.

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. 

Your parents agreement with the retirement community is being terminated

telephoneAbout three weeks ago, I got a call that changed everything. The Executive Director from my parents retirement community called to tell me “Your parents agreement with the retirement community is being terminated.”

“What did they pay for when they moved in?” was all that came out.  The Executive Director clarified that they were going to require that my parents moved from Independent Living to Assisted Living — this was really a transfer, not a termination.

Someone mentioned this to me a few months ago. It didn’t register, but now I understand that if a resident is a danger to themselves or others in the community, the community will invoke it’s right to force a resident to make a change. My parents would not (and possibly could not) make the decision to accept live-in support in the Independent Living apartment, nor would they opt for this move on their own.

Enough events have occurred that the retirement community is going to force this transition. So much has happened and we are still moving through this process.

I have many things to share … and hope to be get back to writing.  Engulfed. 

We are going to the townhouse

taxiIt’s 9:30 a.m. and I can see that my parents are calling me. I answer the phone, assuming it’s my mom. She’s always the one who calls me. I’m surprised when I hear my dad’s voice “Hi Kay, we are going to the townhouse. We will be there for several days and wanted you to know.”

Wow. I wonder if my dad got frustrated because he really wanted to go and was aggravated that I kept talking my mom out of it. Does he remember that when he can’t remember that he is going to get dessert at the buffet?

I respond by asking him what time the doctor appointment is today. “What doctor’s appointment?  Wait, here’s your Mom.” The phone shuffles as I consider if my Mom urged my dad to call because somewhere she knows I keep foiling her plans to get back to the townhouse.

Yesterday, when I returned home, I found 4 phone messages from my mom on voicemail. Within the course of two hours, she called, each without any reference to a prior call and all of them regarding a trip back to the townhouse. Two of them asked if I could call her to tell her why I don’t think they should go to the townhouse.

Thankfully, the retirement community alerted me to the fact that my mom went to the health care center regarding my dad and they have arranged a follow-up appointment. It’s today.

At first, my mom has no recollection of the appointment. I then mention a few key items “You visited the health care center to see if someone could see Dad because he was acting strange … they couldn’t see him but did arrange to get you an appointment today … they are picking you up and driving you to the appointment.”  My mom recognizes that this did happen and I confirm that pickup is at 12:30 today. “That’s right,” she responds.

I remind her my brother is coming to town in a few days and will drive them to the townhouse. I only get one follow-up phone call confirming the appointment details. Today, they are staying at their retirement community. Redirected.

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.

Did you know that a Durable Power-of-Attorney won’t help with financial institutions?

durablepoaIf you haven’t already faced this, you will find that the Durable Power-of-Attorney (POA) doesn’t work with U.S. financial institutions. At least that has been our experience, and I have heard from dozen’s of others who found the same issues.

Most financial institutions and insurance companies want the POA to be their version.  A court battle would most likely get you what you need, but we all were thinking this legal tool would be easier to use than it has been.

Three months ago we started to pursue filing a lawsuit for guardianship of my parents. After meeting with many professionals and a little soul-searching, we wanted to first exhaust all other methods. We knew our parents would understand the nature of the lawsuit. Our parents were (and still are some days) resistant to any assistance. We had their friends, doctor and the retirement community suggesting that we do something to help my parents move forward with more dignity — most suggested we pursue guardianship which would allow us to make all the decisions for our parents that they would be unable to overturn.

We recognize how hurt our parents were with the loss of their cars. They didn’t remember that a doctor had written a note to the DMV and their licenses were revoked — so my dad continued to drive. While they initially handed over the keys, they continued to tell everyone their kids stole their car.

We felt the move for guardianship would be a direct hit on my parent’s dignity. There had to be another way to move forward without causing more hurt.

I upped my weekly visits and I have worked to adapt to better serve my parents needs on their terms. Most days, my mom understands they are on the waiting list for assisted living and while I’m sure this won’t be easy, we are moving closer to the right solution for my parents. Reflected.

Christmas and Parents with Dementia

FaithfulI am finding the holiday’s to be quite trying. The benefit is the variety of evening programs with music at the retirement community. The curse has been the additional tasks that come with Christmas holiday.

My mom has been asking where the 2011 Christmas card list was since Thanksgiving. On this topic, she knows we are in the 21st century.  On almost every visit, my mom has asked to return to their town house to get the card list. I let her know that we visited their townhouse, and checked every desk, cabinet and file folder with no success. Thankfully, I marked it on the calendar and ask her to check the date which helps redirect the conversation.

When I arrive yesterday, my mom is upset. She can’t find her gold necklace and wants to get to the town house to look for it. I know it was at their retirement apartment because she recently showed it to me. As we are checking all the usual hiding places, I find the 2011 Christmas Card list. I pass it to my mom.

We  have found the list!  As we move through the day, and I see all the card piles sitting untouched around the apartment, it dawns on me that my mom probably can’t get this simple project done. Her brain was fixated on the list. She knew she should be getting out cards but couldn’t problem solve that without a list, she could have mailed out cards as each one arrived. Even with the list, she is unable to figure out the next step.

I ask my mom to sit down and help me put the 2012 Christmas Card list together. I get her stuffing while I address the cards. As we are working through the cards, I ask her about the people. Today, my mom is unable to tell me about any of the people on their list.

How many of us are wondering if this is the last Christmas we will spend where our parents still recognize who we are?  Today, I will savor the moments. Cherished.