Elderly grandparents moving in with parents; what should they plan for?

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Ladeedaw
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Elderly grandparents moving in with parents; what should they plan for?

Post by Ladeedaw » Fri Jul 05, 2019 7:51 pm

My grandparents are moving in with my parents. My parents are in their late 60’s and grandparents are both in their early nineties. Both have been in reasonably good health until this year. Grandpa broke his hip and spent a couple of months in rehab. Grandma has seen a rapid decline in her memory and has fallen recently as well. It’s been determined by their children that they shouldn’t live alone. My parents both want to do this for my grandparents. I’m concerned that there appears to be very little concrete communication and that my parents don’t really know—or can’t think about—what they are committing to. Neither of my parents have medical background or training. My grandparents will move from another state to be with them. None of my dad’s three siblings live in the same state as my parents, though they have said they will visit occasionally to help with care. I imagine this might mean twice/year per sibling.

My parents are comfortable, but not wealthy. My grandparents are not wealthy with few assets and live off of SS and a very small pension.

My concerns are primarily financial and practical (i.e. daily care giving). I’m trying to help my parents come up with items that should be discussed and planned for.

For those of you who have had or seen a similar circumstance, what needs to be discussed? What should be planned for? Any other advice?

Note: this is a done deal. There will be no talking my parents out of this. They’ve already gone to pick up my grandparents and bring them back with them.

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ResearchMed
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by ResearchMed » Fri Jul 05, 2019 8:00 pm

Ladeedaw wrote:
Fri Jul 05, 2019 7:51 pm
My grandparents are moving in with my parents. My parents are in their late 60’s and grandparents are both in their early nineties. Both have been in reasonably good health until this year. Grandpa broke his hip and spent a couple of months in rehab. Grandma has seen a rapid decline in her memory and has fallen recently as well. It’s been determined by their children that they shouldn’t live alone. My parents both want to do this for my grandparents. I’m concerned that there appears to be very little concrete communication and that my parents don’t really know—or can’t think about—what they are committing to. Neither of my parents have medical background or training. My grandparents will move from another state to be with them. None of my dad’s three siblings live in the same state as my parents, though they have said they will visit occasionally to help with care. I imagine this might mean twice/year per sibling.

My parents are comfortable, but not wealthy. My grandparents are not wealthy with few assets and live off of SS and a very small pension.

My concerns are primarily financial and practical (i.e. daily care giving). I’m trying to help my parents come up with items that should be discussed and planned for.

For those of you who have had or seen a similar circumstance, what needs to be discussed? What should be planned for? Any other advice?

Note: this is a done deal. There will be no talking my parents out of this. They’ve already gone to pick up my grandparents and bring them back with them.
If it's truly a "done deal", then I'll hold off on some initial comments...

I'd suggest that they (are you nearby?) contact the local "Elder Care" type office in their town.
They may have all sorts of suggestions about in home help/services that might be partially subsidized, or perhaps some respite care (to give your parents an occasional break).
Or some help with daily care that might be physically challenging for your parents at some point.

Also speak with whoever becomes their primary care physician, who may also have suggestions/referrals...

The biggest initial red flag is the memory problem. Is there any "wandering"? Or doing dangerous things at home?

Good luck to all of you!

RM
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SoonerD
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by SoonerD » Fri Jul 05, 2019 8:18 pm

Ladeedaw wrote:
Fri Jul 05, 2019 7:51 pm
My grandparents are moving in with my parents. My parents are in their late 60’s and grandparents are both in their early nineties. Both have been in reasonably good health until this year. Grandpa broke his hip and spent a couple of months in rehab. Grandma has seen a rapid decline in her memory and has fallen recently as well. It’s been determined by their children that they shouldn’t live alone. My parents both want to do this for my grandparents. I’m concerned that there appears to be very little concrete communication and that my parents don’t really know—or can’t think about—what they are committing to. They raised you and did a great job, right. Taking care of people doesn’t require any medical background nor any advanced communication. Neither of my parents have medical background or training. My grandparents will move from another state to be with them. None of my dad’s three siblings live in the same state as my parents, though they have said they will visit occasionally to help with care. I imagine this might mean twice/year per sibling.They should expect their siblings to do nothing or way less than promised that way they won’t be too disappointed. This is where your concern for your parents and grandparents can be put into action. You can pick up groceries, mow the lawn, take them to appointments and most important is giving your parents some days off by staying w the grandparents for the day, weekend, week etc.

My parents are comfortable, but not wealthy. My grandparents are not wealthy with few assets and live off of SS and a very small pension.

My concerns are primarily financial and practical (i.e. daily care giving). I’m trying to help my parents come up with items that should be discussed and planned for. their SS checks will cover most living expenses. You can help them apply for any aid they become eligible for. This is a big area of need for elderly.

For those of you who have had or seen a similar circumstance, what needs to be discussed? What should be planned for? Any other advice?

Note: this is a done deal. There will be no talking my parents out of this. They’ve already gone to pick up my grandparents and bring them back with them.

delamer
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by delamer » Fri Jul 05, 2019 8:22 pm

ResearchMed wrote:
Fri Jul 05, 2019 8:00 pm
Ladeedaw wrote:
Fri Jul 05, 2019 7:51 pm
My grandparents are moving in with my parents. My parents are in their late 60’s and grandparents are both in their early nineties. Both have been in reasonably good health until this year. Grandpa broke his hip and spent a couple of months in rehab. Grandma has seen a rapid decline in her memory and has fallen recently as well. It’s been determined by their children that they shouldn’t live alone. My parents both want to do this for my grandparents. I’m concerned that there appears to be very little concrete communication and that my parents don’t really know—or can’t think about—what they are committing to. Neither of my parents have medical background or training. My grandparents will move from another state to be with them. None of my dad’s three siblings live in the same state as my parents, though they have said they will visit occasionally to help with care. I imagine this might mean twice/year per sibling.

My parents are comfortable, but not wealthy. My grandparents are not wealthy with few assets and live off of SS and a very small pension.

My concerns are primarily financial and practical (i.e. daily care giving). I’m trying to help my parents come up with items that should be discussed and planned for.

For those of you who have had or seen a similar circumstance, what needs to be discussed? What should be planned for? Any other advice?

Note: this is a done deal. There will be no talking my parents out of this. They’ve already gone to pick up my grandparents and bring them back with them.
If it's truly a "done deal", then I'll hold off on some initial comments...

I'd suggest that they (are you nearby?) contact the local "Elder Care" type office in their town.
They may have all sorts of suggestions about in home help/services that might be partially subsidized, or perhaps some respite care (to give your parents an occasional break).
Or some help with daily care that might be physically challenging for your parents at some point.

Also speak with whoever becomes their primary care physician, who may also have suggestions/referrals...

The biggest initial red flag is the memory problem. Is there any "wandering"? Or doing dangerous things at home?

Good luck to all of you!

RM
Excellent suggestions. Their county should have an Office of Aging or something similar.

Legally, your parents should obtain both financial and medical powers-of-attorney for your grandparents so that they can act on their behalf.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by HomeStretch » Fri Jul 05, 2019 8:26 pm

Involving town “Senior Services” department and new primary care physician (perhaps one that specializes in geriatrics?) as suggested are good ideas.

Any help you can give your parents/grandparents will most likely be welcome and ease the load.

Building a network of doctors/specialists in a new area can take time and research.

If your grandparents are interested and able, perhaps your parents’ town has a senior center that offers activities, flu shots, etc. so your grandparents can have some social interaction outside of the home.

Hopefully your grandparents have estate matters taken care of and power of attorneys/directives for financial/healthcare matters naming your parents.

Perhaps having your parents’ home assessed to ensure it’s aging friendly (and making modifications as necessary) would benefit both your grandparents and parents. Things like grab bars in bathrooms, etc.

As I go through this with my parents and in laws, I have found it’s also helpful to research things (even if not yet needed) that could be helpful to aging-in-place - medical alert devices, visiting nurse, transportation when they can’t drive, laundry service, RX/medical supplies by mail or local pharmacies that deliver, cleaning service, home aide service, etc.

Best of luck.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by tibbitts » Fri Jul 05, 2019 8:40 pm

Ladeedaw wrote:
Fri Jul 05, 2019 7:51 pm
My grandparents are moving in with my parents. My parents are in their late 60’s and grandparents are both in their early nineties. Both have been in reasonably good health until this year. Grandpa broke his hip and spent a couple of months in rehab. Grandma has seen a rapid decline in her memory and has fallen recently as well. It’s been determined by their children that they shouldn’t live alone. My parents both want to do this for my grandparents. I’m concerned that there appears to be very little concrete communication and that my parents don’t really know—or can’t think about—what they are committing to. Neither of my parents have medical background or training. My grandparents will move from another state to be with them. None of my dad’s three siblings live in the same state as my parents, though they have said they will visit occasionally to help with care. I imagine this might mean twice/year per sibling.

My parents are comfortable, but not wealthy. My grandparents are not wealthy with few assets and live off of SS and a very small pension.

My concerns are primarily financial and practical (i.e. daily care giving). I’m trying to help my parents come up with items that should be discussed and planned for.

For those of you who have had or seen a similar circumstance, what needs to be discussed? What should be planned for? Any other advice?

Note: this is a done deal. There will be no talking my parents out of this. They’ve already gone to pick up my grandparents and bring them back with them.
It sounds like you aren't too enthusiastic about this situation, so what would have been a reasonable alternative?

I would say from my experience that while medical training would be helpful, it's not the biggest factor - or maybe even one of the more important ones.

I'm not sure exactly what you think your parents are committing to. Realistically if things don't work out or deteriorate, there are alternatives. Essentially at some point you have to have the grandparents and parents (or at least one of the siblings) somewhat physically close together, and that seems to be what's happening.

delamer
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by delamer » Fri Jul 05, 2019 9:19 pm

tibbitts wrote:
Fri Jul 05, 2019 8:40 pm
Ladeedaw wrote:
Fri Jul 05, 2019 7:51 pm
My grandparents are moving in with my parents. My parents are in their late 60’s and grandparents are both in their early nineties. Both have been in reasonably good health until this year. Grandpa broke his hip and spent a couple of months in rehab. Grandma has seen a rapid decline in her memory and has fallen recently as well. It’s been determined by their children that they shouldn’t live alone. My parents both want to do this for my grandparents. I’m concerned that there appears to be very little concrete communication and that my parents don’t really know—or can’t think about—what they are committing to. Neither of my parents have medical background or training. My grandparents will move from another state to be with them. None of my dad’s three siblings live in the same state as my parents, though they have said they will visit occasionally to help with care. I imagine this might mean twice/year per sibling.

My parents are comfortable, but not wealthy. My grandparents are not wealthy with few assets and live off of SS and a very small pension.

My concerns are primarily financial and practical (i.e. daily care giving). I’m trying to help my parents come up with items that should be discussed and planned for.

For those of you who have had or seen a similar circumstance, what needs to be discussed? What should be planned for? Any other advice?

Note: this is a done deal. There will be no talking my parents out of this. They’ve already gone to pick up my grandparents and bring them back with them.
It sounds like you aren't too enthusiastic about this situation, so what would have been a reasonable alternative?

I would say from my experience that while medical training would be helpful, it's not the biggest factor - or maybe even one of the more important ones.

I'm not sure exactly what you think your parents are committing to. Realistically if things don't work out or deteriorate, there are alternatives. Essentially at some point you have to have the grandparents and parents (or at least one of the siblings) somewhat physically close together, and that seems to be what's happening.
The parents who will be providing the caregiving to frail elders, including one with dementia, are in their late 60’s. It is entirely possible that the parents might compromise (or even ruin) their own physical, financial, and/or mental health trying to care for the grandparents.

The OP has every reason to be concerned about how his/her parents will be affected.

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Ladeedaw
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Ladeedaw » Fri Jul 05, 2019 9:52 pm

Thanks for the comments. I've looked up the Aging Services office for their state and county. I hadn't thought of that, and I think that will be a very good resource.

To answer the comment/question, it's not that I don't think that my parents should do this. It's what they want to do. As far as alternatives, on their income, I don't think they could afford to move into a care center. They might be able to do that if their house was sold and used for that. But this is likely the easiest alternative for most people involved--my grandparents, my dad's siblings, and, maybe, my parents.

My concern is that they don't seem to have thought through the complexity or potential family issues. Actually, my huge concern is if one of my parents has a major health issue (or, heaven forbid, passes away) while my grandparents are still alive. I'd like them to discuss alternatives for such a scenario with the extended family. I also don't want it to cause a health problem for my parents, but there are many variables to that.

Thanks again for the suggestions offered thus far.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by bayview » Fri Jul 05, 2019 10:15 pm

Also, see if there is a PACE program in your parents' area:

https://www.cms.gov/Medicare-Medicaid-C ... /PACE.html
https://www.npaonline.org/pace-you
https://www.npaonline.org/pace-you/find ... ighborhood

PACE replaces Medicare and becomes a healthcare hub (outpatient care, adult day care, transportation, etc etc) for those it serves. It's pretty pricey if you have a lot of income, but it works well for those who don't.

I admire your parents for what they want to do, but DH and I are in the same situation, and we agreed that we just couldn't do it. Dementia is incredibly draining and heart-breaking for caregivers, and then add in the physical issues. If there is any wandering ("sundowning" - behavior changes accelerating in late afternoon and evening), they'll have to make their house a fortress. They really need to have home health aides at a minimum, and now you're talking about having two elderly parents moving in and assorted strangers coming and going.

Maybe you can urge them (if they're determined) to give this an all-out try for three months, and then give themselves permission to say "we just can't do this."
The continuous execution of a sound strategy gives you the benefit of the strategy. That's what it's all about. --Rick Ferri

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by willthrill81 » Fri Jul 05, 2019 10:18 pm

I second the recommendation to speak with an elder care attorney immediately. If they are deemed to be mentally capable of doing so, they really need to give power of attorney to your parents right now. Once their mental state is in doubt, they can no longer do so, and managing their finances can turn into a nightmare.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by celia » Fri Jul 05, 2019 10:32 pm

This scenario has been playing out for hundreds of years where elders live with their younger relatives. Frankly, I wish there was more of it as each generation has something different to offer the extended family. The oldest members usually know the family history best and what kinds of illnesses and challenges each person had. They are often wise in taking care of people, since they raised one of your parents, at least. Your parents may soon feel that they are "sandwiched" between trying to help their own parents and possibly their own children at the same time. They will need some relief from time to time, even for things they don't realize (having some time for themselves, adapting to several changes, learning of illnesses their parents might exhibit, and going to new doctors). The younger generation might notice ways to simplify things, such as with the use of technology, making things simpler, doing physical tasks.
delamer wrote:
Fri Jul 05, 2019 8:22 pm
Legally, your parents should obtain both financial and medical powers-of-attorney for your grandparents so that they can act on their behalf.
Not only should your grandparents have financial and medical POA, but so should your parents. While you're discussing it, you should have it too. How about everyone making this your family's goals for the next month?

There's no "law of the universe" that says the grandparents will die first, followed by the parents, followed by the children, although the odds are that is usually what happens.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Sandtrap » Fri Jul 05, 2019 11:18 pm

ResearchMed wrote:
Fri Jul 05, 2019 8:00 pm
Ladeedaw wrote:
Fri Jul 05, 2019 7:51 pm
My grandparents are moving in with my parents. My parents are in their late 60’s and grandparents are both in their early nineties. Both have been in reasonably good health until this year. Grandpa broke his hip and spent a couple of months in rehab. Grandma has seen a rapid decline in her memory and has fallen recently as well. It’s been determined by their children that they shouldn’t live alone. My parents both want to do this for my grandparents. I’m concerned that there appears to be very little concrete communication and that my parents don’t really know—or can’t think about—what they are committing to. Neither of my parents have medical background or training. My grandparents will move from another state to be with them. None of my dad’s three siblings live in the same state as my parents, though they have said they will visit occasionally to help with care. I imagine this might mean twice/year per sibling.

My parents are comfortable, but not wealthy. My grandparents are not wealthy with few assets and live off of SS and a very small pension.

My concerns are primarily financial and practical (i.e. daily care giving). I’m trying to help my parents come up with items that should be discussed and planned for.

For those of you who have had or seen a similar circumstance, what needs to be discussed? What should be planned for? Any other advice?

Note: this is a done deal. There will be no talking my parents out of this. They’ve already gone to pick up my grandparents and bring them back with them.
If it's truly a "done deal", then I'll hold off on some initial comments...

I'd suggest that they (are you nearby?) contact the local "Elder Care" type office in their town.
They may have all sorts of suggestions about in home help/services that might be partially subsidized, or perhaps some respite care (to give your parents an occasional break).
Or some help with daily care that might be physically challenging for your parents at some point.

Also speak with whoever becomes their primary care physician, who may also have suggestions/referrals...

The biggest initial red flag is the memory problem. Is there any "wandering"? Or doing dangerous things at home?

Good luck to all of you!

RM
+1
Also Power of Attorney, Medical Power of Attorney.
It is normal that your parents will try to handle "everything" at risk for their own health. They might even resist outside help a day or two days per week.
However, daily care for two elderly folks with hip and cognitive issues, etc, is 24/7 and tough work for even the professionals. Either of your parents cannot afford to get sick or injured or over stressed physically or emotionally. That's tough. I would be vigilant. IE: Dad helps grandpa in the shower, slips, has a heart attack or gets hurt. Now, who helps dad? Who helps grandpa?

My MIL is 96 with dementia and cognitive issues, memory, etc. She has 24/7 home care with skilled nursing and medical staff visits as well.
DW flies 3000 miles and stays for many weeks, 4-6x/year to make sure systems are in place and everything is running well, catch up on appointments, restocks the house, etc. It can get tough.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by willthrill81 » Fri Jul 05, 2019 11:38 pm

Sandtrap wrote:
Fri Jul 05, 2019 11:18 pm
My MIL is 96 with dementia and cognitive issues, memory, etc. She has 24/7 home care with skilled nursing and medical staff visits as well.
DW flies 3000 miles and stays for many weeks, 4-6x/year to make sure systems are in place and everything is running well, catch up on appointments, restocks the house, etc. It can get tough.
I've witnessed that first-hand. When I was a teenager, my maternal grandparents were involved in a serious traffic accident and were both bedridden for almost six months. They lived with us during that time, and my mother, a former RN, took care of them full-time with very little help from her siblings. After a few months, she literally had to get away to keep from having a mental breakdown. It can be very taxing. In a way, I believe that it's actually more difficult than parenting a young child because at least you can tell the child what to do and enforce it.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by BarbBrooklyn » Sat Jul 06, 2019 3:39 am

Agingcare.com is a good resource for support.

In most states, the local Area Agency on Aging can be enlisted to do a Needs Assessmnet to determine what level of care the elders require and what resources are available locally. They are also good for finding out eligibility/means testing for various programs. Adult daycare can be quite a boon when you have 2 elders at home.

Regular respite, to allow your parents time to take vacations and recharge is also essential. You can help by researching local Assisted Living/LTC facilities that provide respite services.

Make sure that your parents and grandparents understand at least the rudimentary rules of Medicaid eligibility. No one should get any clever ideas about hiding assets, transfering the house, without talking to a certified eldercare attorney. The rules for Nursing Home Medicaid when there is a Community Spouse involved are state specific and require the expertise of an attorney in that state. Your grandparents' assets, not your parents', should be used to fund care. No comingling.

Your parents should identify a local geriatrics practice to manage grandparents' healthcare.

Yes, this worked in past generations. Dementia is a game changer. The paranoia, accusations and elopement that often accompanies it can drive strong caregivers mad and cause burnout and deterioration of health.

Read Atul Gawande On Being Mortal.
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by gd » Sat Jul 06, 2019 5:49 am

I would talk to the parents about hypothetical situations at which they'd agree limits can be set and alternatives found-- end games, excuse the expression. Example might be requiring qualified care for activities of daily life bringing outsiders into the house daily for most of the day. Not that it will change the done deal, but might help slightly when the situation goes downhill, and give them more internal permission and less guilt to call it off.

I would also try to get specific commitments from other relatives for support. "I imagine this might mean" isn't enough; that's, as you say, your imagination. Don't be surprised when it doesn't happen.

Final harsh comment-- this is your parent's situation, not yours. It's a done deal, so just to put it in perspective this is the point at which the grandparents would normally be moving to an assisted living center, not with relatives. If they wanted you to give up your life as well, they needed to negotiate that with you in advance. You also need to set those specific commitments for yourself.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by BarbBrooklyn » Sat Jul 06, 2019 6:11 am

[/quote]

Final harsh comment-- this is your parent's situation, not yours. It's a done deal, so just to put it in perspective this is the point at which the grandparents would normally be moving to an assisted living center, not with relatives. If they wanted you to give up your life as well, they needed to negotiate that with you in advance. You also need to set those specific commitments for yourself.
[/quote]

+1 on this last. But be informed so as to the basics so that you can be a resource for information.

I would, upfront, make sure that they understand the rules of Medicaid before they make any irrevocable financial errors.
BarbBrooklyn | "The enemy of a good plan is the dream of a perfect plan."

Skiffy
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Skiffy » Sat Jul 06, 2019 8:11 am

From real life experience: weekly doctor appointments, hard transition especially for “memory problem” person, parents won’t be able to go anywhere together anymore, grandparents won’t ever get better just progressively worse, loss privacy and enjoyment in own home, like bad roommates that don’t care what house rules are-they will do what they are used to. One of the things that is hardest for me is loss of personal care, won’t change clothes, shower, brush teeth. . . Almost like taking care younger cranky children, it is harder than anyone from outside can imagine.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Katietsu » Sat Jul 06, 2019 8:51 am

Skiffy wrote:
Sat Jul 06, 2019 8:11 am
From real life experience: weekly doctor appointments, hard transition especially for “memory problem” person, parents won’t be able to go anywhere together anymore, grandparents won’t ever get better just progressively worse, loss privacy and enjoyment in own home, like bad roommates that don’t care what house rules are-they will do what they are used to. One of the things that is hardest for me is loss of personal care, won’t change clothes, shower, brush teeth. . . Almost like taking care younger cranky children, it is harder than anyone from outside can imagine.
I am very sorry for your stress. I can understand. May I say that routines in the modern USA includes a lot more “hygiene” than has been historically necessary. Sometimes, accepting a different standard can make everyone happier. I know this depends on the person. Who cares if someone has worn the same food stained shirt for 3 days ( well my sister did on her visits). I say those things are small stuff and don’t sweat the small stuff. Worry about where the keys to the car are hidden and things that could really kill someone. Much more peace and ability to find moments to enjoy this way for me. I hope your path is as easy as it can be.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by willthrill81 » Sat Jul 06, 2019 9:03 am

gd wrote:
Sat Jul 06, 2019 5:49 am
I would talk to the parents about hypothetical situations at which they'd agree limits can be set and alternatives found-- end games, excuse the expression. Example might be requiring qualified care for activities of daily life bringing outsiders into the house daily for most of the day. Not that it will change the done deal, but might help slightly when the situation goes downhill, and give them more internal permission and less guilt to call it off.
My mother and one of her sisters clearly saw in the last month of my grandmother's life that she required 24/7 care, and neither they nor their other two siblings could provide that. But the two who weren't involved in caring for her didn't want my grandmother to go into a LTC facility. When asked if they would be willing to provide her the 24/7 care, they acquiesced.

Frankly, there are situations, especially where one's mental state is very poor, that the physical side of the care is simply beyond what most people can provide in their home. There are many cases of those so afflicted doing things that are very harmful to themselves and others. Such behavior may reach a point where committal to a facility is the only viable option. It's a very difficult decision, but sometimes that's the only choice.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by ResearchMed » Sat Jul 06, 2019 9:24 am

willthrill81 wrote:
Sat Jul 06, 2019 9:03 am
gd wrote:
Sat Jul 06, 2019 5:49 am
I would talk to the parents about hypothetical situations at which they'd agree limits can be set and alternatives found-- end games, excuse the expression. Example might be requiring qualified care for activities of daily life bringing outsiders into the house daily for most of the day. Not that it will change the done deal, but might help slightly when the situation goes downhill, and give them more internal permission and less guilt to call it off.
My mother and one of her sisters clearly saw in the last month of my grandmother's life that she required 24/7 care, and neither they nor their other two siblings could provide that. But the two who weren't involved in caring for her didn't want my grandmother to go into a LTC facility. When asked if they would be willing to provide her the 24/7 care, they acquiesced.

Frankly, there are situations, especially where one's mental state is very poor, that the physical side of the care is simply beyond what most people can provide in their home. There are many cases of those so afflicted doing things that are very harmful to themselves and others. Such behavior may reach a point where committal to a facility is the only viable option. It's a very difficult decision, but sometimes that's the only choice.
You used the term "committal"... but sometimes, regardless of whether there is "difficulty" with the decision, even the patient ends up happier, sometimes much happier (or "content", or whatever term is most appropriate) in a professional care setting.

Those facilities (the good ones) can have staff that are on duty part of their day, then they go home, and return refreshed, etc. They have professional training and they've "self selected" (that is, *chosen*) to do this type of work.
There are all sorts of "aids" and "aides" (mechanical and personnel) to help make the care easier. This can include getting in and out of bed, hygiene, etc.

And then there is the social aspect. Even if there aren't close friendships made, just having activity around can be stimulating/enjoyable.
Likewise, large screen movies, or live concerts, etc.

There are likely to be more choices of food at each meal, prepared as needed (soft chewable, blenderized, etc.).

And... SAFETY... there will be no exposed stairs, there will be handrails where needed, etc. And perhaps "stronger arms to assist when needed.

And family can visit as much as they wish, and sit with the relative all day IF they want to, etc.
--> And visiting is always important, including occasional unannounced visits...

They should seriously consider using something like this minimally for respite care, BEFORE the parents get totally burned out. And they may then start to agree that "this is better".

NOW is the time to check out some such facilities and also payment options, including Medicaid.
In some nicer cases, if one has the money to pay for a relatively short stay, one can get into a decent facility that will then switch to Medicaid. But some of those won't take someone already on Medicaid.

The Elder Care services and/or attorney can help with this but time might be of the essence.

RM
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by champ_telecom » Sat Jul 06, 2019 9:32 am

Ladeedaw,

I certainly sympathize with you and your parents. My mother (88 yrs old) got hospitalized
2 years ago and basically never fully recovered. She uses a walker but we believe she
went through some hospital dementia and now in her words, "I'm still sick". So she needs
assistance with dressing, toileting and bathing and can not be by herself for longer than
3-4 hours. She has been with us for 2 years after it was determined that the nursing home
where she was doing rehab would no longer continue the 100 days of rehab because she was
"not making progress".

So, what have we learned?
-Definitely get medical power of attorney and power of attorney forms done as soon as possible
-Your parents will now be their medical advocates. So they need to be prepared to go
to every doctor visit and almost become the major medical contacts. They don't
necessarily need medical training, but believe me - we have learned way more about
diabetes and kidney disease that we ever thought we would.
-They may need to consider adding things like shower bars in the showers and purchasing
a shower seat and a three-in-one toilet seat. We purchased all these when Mom came from SC.
-At some point ... either sooner or later ... they will need help. Caregiving is extremely
taxing and becomes even harder if you have to do things like help your parent out of bed
or worse, picking them up. If your grandparents did any military service, there may be
services that provide discounts. But it will be important to either find elder care services
or even private help. They can not do it themselves - they will wear them selves out.
-Your parents need to proactively plan time away. My wife tries to find some time away
(even if it's a weekend hotel getaway) every 6 weeks. They will get tired and they need
to take care of themselves. This also means that any siblings need to realize this and
help.
-It's important for your parents to determine how easy your grandparents are to get along
with. Unfortunately, we don't always adapt, learn and change as we grow older. My mother
can be difficult to get along with at times and we've learned that some of her ways and
habits will never change. So, we've had to be the ones to adapt. Ha ... we even had some couple's
therapy and read "Coping With Your Difficult Older Parent : A Guide for Stressed-Out Children"
by Grace Lebow. Even the counselor was saying ... "that's difficult" (ha ... the book was
more helpful than her :-)

Hope that helps and my heart goes out to you,

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by willthrill81 » Sat Jul 06, 2019 9:35 am

ResearchMed wrote:
Sat Jul 06, 2019 9:24 am
You used the term "committal"... but sometimes, regardless of whether there is "difficulty" with the decision, even the patient ends up happier, sometimes much happier (or "content", or whatever term is most appropriate) in a professional care setting.
I entirely agree with your excellent post. :thumbsup

My great-grandmother spent the last several years of her very long life in an ALF, and it was the best thing for her. Two prepared meals a day, friends around her, nice activities every day, family visiting often, etc.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Broken Man 1999 » Sat Jul 06, 2019 9:38 am

The single best piece of advice I would offer is this: Caring for someone in the circumstances you have shared will be a soul-draining experience for your parents. Someone needs to be willing to spell your parents, either a family member or occasional use of home healthcare aides.

Soon your parents will see everything begins revolving around caring for your grandparents. Don't let your parents become isolated from at least some of their current activities.

It would be a great idea if someone could drop in on your parents, not to see how your grandparents are doing, but how your parents are doing. If there are problems, you parents may not tell you the truth. A visit can cut through the facade one can build during a phone call.

I am not exaggerating how draining an experience caring for parents/grandparents can be. I watched it happening when DW took care of her mother, who sadly didn't seem to appreciate the care she was receiving. But, DW soldiered on until the end.

Best of luck!

Broken Man 1999
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by dm200 » Sat Jul 06, 2019 9:38 am

Many excellent suggestions!

I don't know if any of this might be covered by the grandparents' insurance, but it might be a good idea for your parents to have some kind of outside assistance for the care from time to time - so that they can recharge their caregiving batteries.

If your parents do not have any knowledge or experience with caregiving - perhaps they could get, perhaps a nurse, to help train and educate them about caregiving.

I wish all of them well!

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by TN_Boy » Sat Jul 06, 2019 9:39 am

Katietsu wrote:
Sat Jul 06, 2019 8:51 am
Skiffy wrote:
Sat Jul 06, 2019 8:11 am
From real life experience: weekly doctor appointments, hard transition especially for “memory problem” person, parents won’t be able to go anywhere together anymore, grandparents won’t ever get better just progressively worse, loss privacy and enjoyment in own home, like bad roommates that don’t care what house rules are-they will do what they are used to. One of the things that is hardest for me is loss of personal care, won’t change clothes, shower, brush teeth. . . Almost like taking care younger cranky children, it is harder than anyone from outside can imagine.
I am very sorry for your stress. I can understand. May I say that routines in the modern USA includes a lot more “hygiene” than has been historically necessary. Sometimes, accepting a different standard can make everyone happier. I know this depends on the person. Who cares if someone has worn the same food stained shirt for 3 days ( well my sister did on her visits). I say those things are small stuff and don’t sweat the small stuff. Worry about where the keys to the car are hidden and things that could really kill someone. Much more peace and ability to find moments to enjoy this way for me. I hope your path is as easy as it can be.
The problem with elder care in this situation is that there will be a thousand small things along with many big things. It is likely to take over the parents' life. This may be okay with them. But the likely burden should not be minimized.

I do not think you understand the potential size of the hygiene problem .....

Parents should definitely look at area home health organizations to come in for a few hours a day and provide some respite care.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by dm200 » Sat Jul 06, 2019 9:41 am

From some family observations concerning elderly relatives, it can often be beneficial to these elderly folks to have visits from family members with small children. Depending on the details, I have often been surprised how visits from children can improve the spirits of such folks.

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Ladeedaw
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Ladeedaw » Sat Jul 06, 2019 10:40 am

Thank you all so much. I knew Boglehead Nation would come through with great insights and suggestions. I'm feeling one part overwhelmed, two parts empowered with all of the information and suggestions. I think I'll be able to present some of the things that needs to be done immediately to my parents (like POA) and as those items are taken care of, start having larger conversations about limits, their health, options if/when my grandparents need more care. I realize, as some of you pointed out, that this is my parents' decision, but that I can be a resource. That's what I'm aiming for. I don't live close enough to my parents to help daily or probably even weekly, but I can do research, offer options, help look at in care health options, and research Medicaid. I also thank those of you who shared poignant personal experiences. I'm hoping for the best but want to be realistic in where this new phase of life might end up. I thank every one of you for your thoughts and contributions and pointing me in the right direction.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by pennywise » Sat Jul 06, 2019 10:55 am

TN_Boy wrote:
Sat Jul 06, 2019 9:39 am
Katietsu wrote:
Sat Jul 06, 2019 8:51 am
Skiffy wrote:
Sat Jul 06, 2019 8:11 am
From real life experience: weekly doctor appointments, hard transition especially for “memory problem” person, parents won’t be able to go anywhere together anymore, grandparents won’t ever get better just progressively worse, loss privacy and enjoyment in own home, like bad roommates that don’t care what house rules are-they will do what they are used to. One of the things that is hardest for me is loss of personal care, won’t change clothes, shower, brush teeth. . . Almost like taking care younger cranky children, it is harder than anyone from outside can imagine.
I am very sorry for your stress. I can understand. May I say that routines in the modern USA includes a lot more “hygiene” than has been historically necessary. Sometimes, accepting a different standard can make everyone happier.
I do not think you understand the potential size of the hygiene problem .....
+1

My MIL is 95, has severe dementia and has been in ALF care for almost 4 years. My husband has an unvarying routine of taking her out at least twice weekly to have lunch or dinner. However she is now at the point mentally/physically at which she cannot reliably control her bowels. As noted, the response about overlooking hygiene isn't about a shirt that has some food stains. Imagine a person who can barely walk and is incapable of understanding how to physically care for herself in a toileting accident. Regardless of filial dedication, trying to clean up a fecal explosion from undergarments to public restroom facilities is beyond what any family caregiver should try to handle. After not one but several of these occurrences, my husband is coming to the realization the outings will soon be ending. Another example: she lacks range of motion now to be able to wash her hair anywhere behind her ears. She refuses to allow the staff to help her. On those outings I have to be sure we have a cover over the car headrest because the dirt and grease from her head will permanently stain the upholstery and we have to be careful where vents are aimed because the smell is pretty overwhelming if you are downwind. That one's not a health hazard per se but it's exceedingly unpleasant to experience when with her. And so on...

And taking care of someone with a child's capacity always comes with the subtext that an elderly person is not a child-there is no growing independence, just a terrible loss of independence and in many/most cases unawareness shading into stubborn refusal to admit by the elderly person that they are no longer capable of taking care of themselves. Make no mistake, taking care of the super-elderly requires skills and experience that in most cases cannot be duplicated by family. Family members usually feel the strong pull of duty and guilt about the 'never put me in a home' dynamic. Often the path starts out by adult offspring taking on more and more of the invisible support so someone elderly can live 'independently' in their own home. But eventually that means the supportive children are sacrificing their entire lives to allow their elderly relatives to maintain the fantasy that they are still coping well and living 'independently'.

My MIL for example stayed at home 'independently' years longer than she should. Toward the end (she lived a block from us) between my husband and me we were there for 5 separate visits daily; he was handling all her banking, taking her to the grocery store and managing what she bought since she was incapable and we were either doing or managing all home maintenance and repair tasks. Even today, she tells me consistently that she is perfectly capable of living alone, she just needs to have my husband come by and take her out for groceries every week. Meanwhile aside from the above mentioned issues, she can no longer even get a straw to her mouth to drink a beverage on her own, and she thinks the house she will return to live 'independently' is the one where she grew up in the 30s. We are watching my father, 84 YO, starting down the same path. It's heartbreaking and unfortunately it only goes one way.

My late stepmother nailed it-she was a geriatric occupational therapist. She said that families who with the best of intentions take on caregiving for the very elderly (85+) are basically attempting to turn themselves into an individual assisted living facility in which they will serve as the director, nursing and custodial staff all alone. Add to that becoming the financial manager, government and private program administrator and medical case manager for the elderly parent. Eventually no matter the herculean family effort, in many cases (presuming there is enough financial means to make a choice) it becomes a stark decision as to whether someone is willing to sacrifice their entire life-including physical and mental health-to attempt to replicate professional support that simply needs to happen in a professional care environment. The truth is that a well run living facility WILL be a safer, cleaner and more consistently managed living environment for the people who need it.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Rudedog » Sat Jul 06, 2019 11:13 am

God bless your parents for offering to help their parents. I've been in this situation, some observations:

The siblings who live far away will not be visiting much. They'll talk a good game, but they won't be dependable. My sister lived 50 miles away, she acted like it was 500 miles, maybe visited for an hour or two once a month.

As I was told by several doctors, nurse practitioners, etc.........your parents are not trained to take care of the elderly. Unless they have siblings who are willing to help several times a week, they will not be able to take the stress of this responsibility. They will ruin their health and possibly their marriage.

Don't be surprised by anything that happens.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by TN_Boy » Sat Jul 06, 2019 11:31 am

pennywise wrote:
Sat Jul 06, 2019 10:55 am
TN_Boy wrote:
Sat Jul 06, 2019 9:39 am
Katietsu wrote:
Sat Jul 06, 2019 8:51 am
Skiffy wrote:
Sat Jul 06, 2019 8:11 am
From real life experience: weekly doctor appointments, hard transition especially for “memory problem” person, parents won’t be able to go anywhere together anymore, grandparents won’t ever get better just progressively worse, loss privacy and enjoyment in own home, like bad roommates that don’t care what house rules are-they will do what they are used to. One of the things that is hardest for me is loss of personal care, won’t change clothes, shower, brush teeth. . . Almost like taking care younger cranky children, it is harder than anyone from outside can imagine.
I am very sorry for your stress. I can understand. May I say that routines in the modern USA includes a lot more “hygiene” than has been historically necessary. Sometimes, accepting a different standard can make everyone happier.
I do not think you understand the potential size of the hygiene problem .....
+1

My MIL is 95, has severe dementia and has been in ALF care for almost 4 years. My husband has an unvarying routine of taking her out at least twice weekly to have lunch or dinner. However she is now at the point mentally/physically at which she cannot reliably control her bowels. As noted, the response about overlooking hygiene isn't about a shirt that has some food stains. Imagine a person who can barely walk and is incapable of understanding how to physically care for herself in a toileting accident. Regardless of filial dedication, trying to clean up a fecal explosion from undergarments to public restroom facilities is beyond what any family caregiver should try to handle. After not one but several of these occurrences, my husband is coming to the realization the outings will soon be ending. Another example: she lacks range of motion now to be able to wash her hair anywhere behind her ears. She refuses to allow the staff to help her. On those outings I have to be sure we have a cover over the car headrest because the dirt and grease from her head will permanently stain the upholstery and we have to be careful where vents are aimed because the smell is pretty overwhelming if you are downwind. That one's not a health hazard per se but it's exceedingly unpleasant to experience when with her. And so on...

And taking care of someone with a child's capacity always comes with the subtext that an elderly person is not a child-there is no growing independence, just a terrible loss of independence and in many/most cases unawareness shading into stubborn refusal to admit by the elderly person that they are no longer capable of taking care of themselves. Make no mistake, taking care of the super-elderly requires skills and experience that in most cases cannot be duplicated by family. Family members usually feel the strong pull of duty and guilt about the 'never put me in a home' dynamic. Often the path starts out by adult offspring taking on more and more of the invisible support so someone elderly can live 'independently' in their own home. But eventually that means the supportive children are sacrificing their entire lives to allow their elderly relatives to maintain the fantasy that they are still coping well and living 'independently'.

My MIL for example stayed at home 'independently' years longer than she should. Toward the end (she lived a block from us) between my husband and me we were there for 5 separate visits daily; he was handling all her banking, taking her to the grocery store and managing what she bought since she was incapable and we were either doing or managing all home maintenance and repair tasks. Even today, she tells me consistently that she is perfectly capable of living alone, she just needs to have my husband come by and take her out for groceries every week. Meanwhile aside from the above mentioned issues, she can no longer even get a straw to her mouth to drink a beverage on her own, and she thinks the house she will return to live 'independently' is the one where she grew up in the 30s. We are watching my father, 84 YO, starting down the same path. It's heartbreaking and unfortunately it only goes one way.

My late stepmother nailed it-she was a geriatric occupational therapist. She said that families who with the best of intentions take on caregiving for the very elderly (85+) are basically attempting to turn themselves into an individual assisted living facility in which they will serve as the director, nursing and custodial staff all alone. Add to that becoming the financial manager, government and private program administrator and medical case manager for the elderly parent. Eventually no matter the herculean family effort, in many cases (presuming there is enough financial means to make a choice) it becomes a stark decision as to whether someone is willing to sacrifice their entire life-including physical and mental health-to attempt to replicate professional support that simply needs to happen in a professional care environment. The truth is that a well run living facility WILL be a safer, cleaner and more consistently managed living environment for the people who need it.
Pennywise's post is so good a version of it should be put in a wiki covering long term care issues.

The last paragraph is especially clear on the issues and scope of the responsibilities. The second paragraph covers the emotional issues very well (and why it is NOT like parenting a child. At all).

Another way to understand the scope of the work is that you have to *think* for the person you are caring for all. All the time. You are running their life, even if they are not in full cognitive decline. Because you have to schedule dr appointments around your time, errands ... it's never ending.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by TN_Boy » Sat Jul 06, 2019 11:32 am

dm200 wrote:
Sat Jul 06, 2019 9:41 am
From some family observations concerning elderly relatives, it can often be beneficial to these elderly folks to have visits from family members with small children. Depending on the details, I have often been surprised how visits from children can improve the spirits of such folks.
Yes, children often liven things up. Well mannered dogs can also provide a lift.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by JPM » Sat Jul 06, 2019 1:51 pm

Many of the replies on this thread have been dire in viewpoint, but it doesn't always work out that way. Depends a lot on the health and mental status and disposition of the elderly person.

Second the advice on powers of attorney for healthcare and property. Elderhealth lawyers are very helpful as laws vary state to state.

Medical is naturally a big item for the very old if sick as well. Getting prescription meds from a mail service is convenient but not always cheaper than Walmart. If the old folks not already in a Medicare Advantage plan that may be worth looking into. Has part A, partB, and part D all rolled into one plan. AARP was recommending United's Advantage plan last I looked. It has an extensive nationwide network, but need to check local docs and hospitals if not in a big urban/suburban area.

MIL gradually declined after FIL's death. First we turned off the gas to the stove in her condo. Then we took away the car because she was getting lost. She would see a gas station or bakery that looked familiar and stop in and the proprietor would call the police or my SIL. SIL had teenagers at the time so she would take one of them when she got the call from the police or business person who found her lost and the teen would drive grandma's car home for her. For a time she could organize herself to meet the daily bus to the elder daycare but once she could no longer do that, we placed her in an ALF. After a couple years there, the ALF told us we needed to place her in a custodial nursing home or get her a live-in at the ALF. SIL and us chipped in and paid for the live-in. She had always been chatty and social and enjoyed living at the ALF. Eventually got cancer and died of that in her late 70s.

Friend couple cared for wifes mom until she was 96. Limited their lives quite a bit. By her mid 90s was very docile and not very ambulatory so wandering wasnt a problem and they could go to church, senior movies, Panera breakfast, etc. For trips to visit their own kids, they placed GM in a nursing home for a week at a time for respite care. They shopped for price and quality of the respite placement. At 96 or 97 GM had an acute illness and had to be placed in a nursing home where she lasted only a few months.

Second friend couple cared for Dad until he was 96. Sentient to the end. Developed pneumonia at 96 and family plan was to keep him at home and let nature take its course rather than call 911 to take him to hospital. Pneumonia is a relatively easy death for the very old.

The longevity revolution has caused many changes in society and society is not organized to deal with it very well. Only one of my grandparents lived to 60 but now people are living into their 80s and 90s frequently. My parents were in their 20s and 30s when their parents sickened and died. Now people in their 60s and 70s are trying to take care of their parents at advanced ages when often they themselves face health issues. ALFs are a way of handling this but their expense is often out of reach and neither medicare nor medicaid cover ALFs.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by BarbBrooklyn » Sat Jul 06, 2019 3:21 pm

Yes, there are a LOT of different "endgames" out there with regards to elders.

My mom fortunately had the funds to pay for a NH (11K per month) for the 4.5 years that she needed to be there.

Go to AgingCare.com and you will meet many folks whose parents don't have the funds, or those who thought that "gifting" monies to children was the way to go. Also parents with pre-existing mental health issues that are exacerbated by dementia. Currently, 35 to 40% of family caregivers pre-decease the folks they are caring for.

As I've said before, dementia is a game changer. Formerly trusting, intelligent parents suddenly accuse their adult children of abuse, call Adult Protective Services and invoke all kinds of legal hassles. Happened to my DH.

We would all like to think that this is gonna be like an episode of the Waltons, but it's not.
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by fru-gal » Sat Jul 06, 2019 5:43 pm

Now that I am reading this depressing thread, I remember that Justice Sandra O'Connor's husband with dementia was apparently in a care facility the last years of his life. I am thinking that is better than elderly children trying to care for such parents, if it is at all affordable. Probably better for everyone.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by bayview » Sat Jul 06, 2019 6:06 pm

I will add one thing that I didn’t see mentioned: even with the best intentions, the grimmer parts of caring for the demented elderly often fall more on the wife (daughter.) Not that many men are willing to take on changing their mom’s or MIL’s dirty diaper. Going out and about, and mom needs to use the bathroom?

Something to consider for your mom’s sake.

If PACE is not available, see if there is adult daycare. I can’t stress enough how important it is to have a break. There aren’t multiple generations under the same roof to pitch, just your mom and dad.
The continuous execution of a sound strategy gives you the benefit of the strategy. That's what it's all about. --Rick Ferri

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Watty » Sat Jul 06, 2019 6:18 pm

Ladeedaw wrote:
Fri Jul 05, 2019 7:51 pm
My parents are in their late 60’s....
One permutation that has not been mentioned is that if your parents are retired then in some situations they might be able to go back to work part time in their old field to bring in money to pay for trained assistance to come in to take care of your grandparents.

Going back to work will obviously not be a realistic option for many people in their late 60's but if they happen to be in a field where they can still earn significantly more than a nurses aid costs then this can be cost effective.

That would also get them out of the house so that they are not dealing with the grandparents 24 hours a day.

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Christine_NM » Sat Jul 06, 2019 6:27 pm

Sorry to say that I agree with most others that this move should be seen as temporary arrangement, preliminary to ALF or hospice or nursing home. Caring for the elderly, especially with dementia, is dangerous even for professional nurses and aides. (I'm a former RN.) Make this move, then have needs assessed by someone who knows what they are doing for each grandparent and go from there. It is expensive if you do not choose hospice, but it is even worse if your parents take on more than they can handle.

Doing the POAs is OK but the most important thing is keeping everyone as physically safe as possible. You are right to be very concerned. Stay on this, don't get scared away, and it will be a learning experience for you. Elder care is a world unto itself.
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by clip651 » Sat Jul 06, 2019 6:53 pm

Social workers can be a great way to learn about local resources for these situations. Your parents should consult with one if possible.

best wishes,
cj

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by BarbBrooklyn » Sat Jul 06, 2019 7:06 pm

Watty wrote:
Sat Jul 06, 2019 6:18 pm
Ladeedaw wrote:
Fri Jul 05, 2019 7:51 pm
My parents are in their late 60’s....
One permutation that has not been mentioned is that if your parents are retired then in some situations they might be able to go back to work part time in their old field to bring in money to pay for trained assistance to come in to take care of your grandparents.

Going back to work will obviously not be a realistic option for many people in their late 60's but if they happen to be in a field where they can still earn significantly more than a nurses aid costs then this can be cost effective.

That would also get them out of the house so that they are not dealing with the grandparents 24 hours a day.
+THIS!!!!
There is a reason that ALs and NHs have 3 shifts of young, trained, rested caregivers.
Folks in their 60s doing elder care? Not a great idea.
BarbBrooklyn | "The enemy of a good plan is the dream of a perfect plan."

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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by tibbitts » Sat Jul 06, 2019 7:52 pm

I think the OP needs to provide more details about the medical conditions involved. Everyone has kind of jumped to assuming an immediate 24x7 bedridden mode, and that might come, but it's not clear from the original description.

TheDDC
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by TheDDC » Sat Jul 06, 2019 7:53 pm

JPM wrote:
Sat Jul 06, 2019 1:51 pm
Second friend couple cared for Dad until he was 96. Sentient to the end. Developed pneumonia at 96 and family plan was to keep him at home and let nature take its course rather than call 911 to take him to hospital. Pneumonia is a relatively easy death for the very old.
Okay this downright sinister. Witholding medical care for a pretty routine illness that can affect anyone is elder abuse. Did you call the police?

-TheDDC

bayview
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by bayview » Sat Jul 06, 2019 8:09 pm

TheDDC wrote:
Sat Jul 06, 2019 7:53 pm
JPM wrote:
Sat Jul 06, 2019 1:51 pm
Second friend couple cared for Dad until he was 96. Sentient to the end. Developed pneumonia at 96 and family plan was to keep him at home and let nature take its course rather than call 911 to take him to hospital. Pneumonia is a relatively easy death for the very old.
Okay this downright sinister. Witholding medical care for a pretty routine illness that can affect anyone is elder abuse. Did you call the police?

-TheDDC
This is in my advanced directives...
The continuous execution of a sound strategy gives you the benefit of the strategy. That's what it's all about. --Rick Ferri

tibbitts
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by tibbitts » Sat Jul 06, 2019 9:14 pm

TheDDC wrote:
Sat Jul 06, 2019 7:53 pm
JPM wrote:
Sat Jul 06, 2019 1:51 pm
Second friend couple cared for Dad until he was 96. Sentient to the end. Developed pneumonia at 96 and family plan was to keep him at home and let nature take its course rather than call 911 to take him to hospital. Pneumonia is a relatively easy death for the very old.
Okay this downright sinister. Witholding medical care for a pretty routine illness that can affect anyone is elder abuse. Did you call the police?

-TheDDC
It's a very common request in healthcare directives for no efforts to be made to render medical assistance, including when they would likely be sufficient to keep a person alive.

Sailorgirl
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Sailorgirl » Sat Jul 06, 2019 9:35 pm

My parents are both 93 years old and have similar health issues as your grandparents. All of their children lived in different cities and 7 years ago we had them move to assisted living closer to one of their children. Last summer after many falls we decided that even with drop in help they could no longer live on there own and it was time to move them to assisted living. We found a nice assisted living facility within 6 miles of my sister in a different city. This facility was cheaper than the city that the currently lived in. We moved them lock, stock and barrel in just a few weeks. Since last year their memories have declined further and just 6 weeks ago my father broke his hip. We moved them again to another apartment in their current facility but just two doors down from the nursing station.

At this age and there level of frailty they need constant care and attention. They were pendents but often forget to push the buttons when they need assistance. Which is for everything. They are no longer allowed to get up and go to the bathroom on their own. Trained staff showers them twice a week. They are often cold and wear multiple layers of clothes with the thermostat set on heat and 78 degrees. They wear sweaters and cover themselves with shawls.

Your late 60 parents can not give them the attention they need without putting their own health at risk. My parents also have SS and a small pension. They have no assets left. My father was a veteran and gets help from the VA. This pays for 90 of the cost with their three daughters chipping in the remaining 10 percent. They are visited 4.-5 days per week. They spend lots of time sleeping in their chairs. Their current costs are fixed until January of next year. My parents are greatly loved. We are happy to have found a great facility with loving and caring staff. There is no way that my sister and her husband both retired and in their young 60’s could have given them the care they need without impacting their own health and relationship. Someone will fall again and we will have to think about the next stage.

Please find a way for you and your siblings to talk to your parents about how best to care for your grandparents and they themselves.

SR II
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by SR II » Sat Jul 06, 2019 10:04 pm

OP--

Maybe I missed this, but what is happening with the grandparent's residence? If they were renting, get everything out and give the house/apartment back to the owner ASAP to cut costs. If they own a house can it be sold or rented out to help with some in-home assistance costs?

For what it is worth, I've been through this with my parents (who were divorced for years) and my in-laws. MIL is the last one alive. She is nearly 94, demented, physically extremely frail and in a memory care facility.

Topic Author
Ladeedaw
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Ladeedaw » Sat Jul 06, 2019 11:05 pm

Thank you again for your insights. To answer a few questions brought up, the level of my grandma's memory problems is unclear to me right now. two months ago, she'd have some small memory hiccups, repeating herself in conversation or mixing up when recent things happened. Grandpa has been in care the last 6 weeks for hip replacement recovery, and in that time, her memory seems to have deteriorated much more rapidly. She calls, panicked, because she can't find my Grandpa (who has been gone from the house for weeks). She has fallen and bruised herself badly, but can't remember falling. During part of this time, she's had family members staying with her, but the increased frequency of these occurrences when left alone is what prompted my parents' decision that the grandparents can no longer live alone. And I think they are right in that assessment.

As of two months ago, both grandparents could still feed themselves, walk (with a walker), bath themselves, and had control of their bladder and bowels, which I think is why my parents are willing to take them into their home. They've slept a lot and aren't very crabby or antagonistic. I'm not sure which of these details have changed since Grandpa broke his hip. I realize things can change very quickly.

Regarding grandparents' residence, they own it outright. It's not worth a ton (I'm guessing $150k, not knowing the local market). There is some question, unrelated to their health, as to what will happen to the house. It may stay in the family; it may be sold. I've not been privy to the conversations about that decision, but will ask my dad soon.

I'm grateful for the personal experiences and observations shared here. I'm seeing that a) my parents will need help in caring for my grandparents, even short term and b) if my grandparents' conditions deteriorates any further, they will probably need professional care 24/7. I believe my parents will be resistant to that idea right now, but I will start researching and talk to them in the next couple of weeks about limits: at what point they will agree that they can't do this full time on their own.

InMyDreams
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by InMyDreams » Sun Jul 07, 2019 12:18 am

clip651 wrote:
Sat Jul 06, 2019 6:53 pm
Social workers can be a great way to learn about local resources for these situations. Your parents should consult with one if possible.
And, alluded to elsewhere, an Occupational Therapist to do a safety eval of your parents' home.

Did either grandparent see active military service? They may be eligible for Aid & Attendance (even if they did not see action personally). Also, if service and financially eligible, they do not need to be in a facility - it can be used to pay for home services.

You could also inquire about Adult Day Care in the area. Ahem, you could investigate a backup ALF plan. It's a decision best investigated with some time for info gathering and evaluation

Best wishes.

BarbBrooklyn
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by BarbBrooklyn » Sun Jul 07, 2019 7:19 am

Please be certain that your parents and their siblings are aware of the "5 year lookback" Medicaid imposes on property and asset transfers before they make any decisions about your grandparents' home.

If grandparents' income is over the limit for Medicaid, be aware of Miller or pooled income trusts as a means of qualification.
BarbBrooklyn | "The enemy of a good plan is the dream of a perfect plan."

Shallowpockets
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by Shallowpockets » Sun Jul 07, 2019 7:59 am

In regards to the OP original question. Your parents should prepare for an all in situation. Their lives will be dominated by constant care. As if they were raising newborns, but with the added difficulty of size. Much easier to dress and toilet a baby than an adult. Your parents lives will consist of all day, all the time care. Simple getting up and dressed and eating in the morning may take 2-3 hours. Yes, your parents in their late 60s will take a hit on their own health and wellbeing. They can easily suffer back problems from lifting. And from what you describe there may be a lot of that.
While their hearts may be in the right place, they have to realize that as long as the situation is late 60s parents caring for even older grandparents, their lives are essentially over as far as time management goes and they expose themselves to all the physical wears and tears to a much greater degree than before.
It is a bad move because even now you describe problems that need addressing on a greater magnitude than is available. Best to go straight past your parents house and into some sort of facility.
Maybe time will tell, but I think that time is shouting right now.

delamer
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Re: Elderly grandparents moving in with parents; what should they plan for?

Post by delamer » Sun Jul 07, 2019 9:15 am

tibbitts wrote:
Sat Jul 06, 2019 7:52 pm
I think the OP needs to provide more details about the medical conditions involved. Everyone has kind of jumped to assuming an immediate 24x7 bedridden mode, and that might come, but it's not clear from the original description.
I don’t see any indication that anyone is assuming the OP’s grandparents are bedridden.

There are in their 90’s. One is recovering from a broken hip and one has dementia. All of that will put a big burden on the OP’s parents, even if their health is otherwise good.

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