Care options for parent (mental health, death of spouse)

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XtremeSki2001
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Care options for parent (mental health, death of spouse)

Post by XtremeSki2001 » Wed Jun 17, 2020 2:26 pm

Hi All - Have always received great advice from the members of this forum. Asking again for some input and guidance.

My father (70) passed last week and my mother (67) relied on him heavily. She has mental health issues, primarily anxiety and depression, and spent the better part of 2019 going in and out of an inpatient facility (w/ electroconvulsive therapy (ECT) and the whole 9 yards) after her mother passed away. My father controlled her medications. She has otherwise been mentally stable for 2020 though she doesn't really go anywhere / do anything. She meets with a therapist once a week and talks to someone from her outpatient program weekly (more like telehealth/wellness check). I'm still in the process of getting waivers signed so I can speak to all her doctors.

She's living with me and my sister for the time being, but we're seeking longer term care options for her. For many reasons, it's not realistic for her to live with me or my sister long term. I see this as a two-step process:

1 - Near term care options while she lives in her current home.
2 - Long term care options after she sells her current home.

Seeking input for #1 right now. My mom can basically take care of herself/drive a car/etc., but when depression hits it's usually sudden, she won't answer calls, won't get out of bed, etc. So really we need more like a daily wellness check and medication control. Not sure if anything like this exists, but provided financials below since obviously costs are a big factor here. Thank you so much in advance for any help!

Income/Retirement
- Retirement Accounts - $500k
- Pension (includes all medical) - $40/yr
- SS - ~$30k/yr
- Other - ~13k/yr (for the next 3 years, then ends)
- Dad's Truck - probably get ~$10k for it

Debt
- Mortgage - $160k (house worth ~$340k)
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ThankYouJack
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Re: Care options for parent (mental health, death of spouse)

Post by ThankYouJack » Wed Jun 17, 2020 2:44 pm

I'm sorry about your loss, mother's health struggles and difficult situation.

I would check with your county's Division of Aging (or Housing) department. They may have or know of some resources and have social workers who could be helpful.

Also, I don't know a lot about this company, but this may be an option - https://www.homeinstead.com/

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Re: Care options for parent (mental health, death of spouse)

Post by LilyFleur » Wed Jun 17, 2020 4:30 pm

It seems like after losing your father, it is a loving decision for you and your sister to have your mom living with you. Does your mom have friends? Isolation, as I am sure you already know, is risky.

When my grandmother went into a nursing home, my mom organized her three siblings to each call grandma on a particular day of the week. Minimally, once your mom moves elsewhere, you and your sister could come up with a schedule for phone calls.

I think as you are able to talk to her doctors you will understand more of what will be best. My mother had dementia-related mental health challenges (paranoia), and because my sister and I were far away, we hired a private-pay geriatric-care social worker who was absolutely wonderful at helping us understand our mother and make decisions for her care. My mother refused her meds about half of the time and her behavior would be much worse after that. Unfortunately, it is illegal to make someone take their meds. If your mother is cooperative with taking her medicines, that is a positive.

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Re: Care options for parent (mental health, death of spouse)

Post by stan1 » Wed Jun 17, 2020 5:25 pm

Sorry to hear the news.

Her inpatient treatment facility should have social workers or patient advocates (terms vary) to help find the services she now needs that she didn't when discharged. They will know the local options and will at least have additional points of contact. Can also facilitate coordination with medical teams. We've found these staff to be very helpful and compassionate transitioning family members into home-based services and long term facilities.

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Re: Care options for parent (mental health, death of spouse)

Post by XtremeSki2001 » Wed Jun 17, 2020 5:39 pm

LilyFleur wrote:
Wed Jun 17, 2020 4:30 pm
It seems like after losing your father, it is a loving decision for you and your sister to have your mom living with you. Does your mom have friends? Isolation, as I am sure you already know, is risky.
Some mutual friends of my fathers, but no friends of her own ... unlikely she would go out with these mutual friends without my father.
LilyFleur wrote:
Wed Jun 17, 2020 4:30 pm
When my grandmother went into a nursing home, my mom organized her three siblings to each call grandma on a particular day of the week. Minimally, once your mom moves elsewhere, you and your sister could come up with a schedule for phone calls.
Absolutely.
LilyFleur wrote:
Wed Jun 17, 2020 4:30 pm
I think as you are able to talk to her doctors you will understand more of what will be best. My mother had dementia-related mental health challenges (paranoia), and because my sister and I were far away, we hired a private-pay geriatric-care social worker who was absolutely wonderful at helping us understand our mother and make decisions for her care. My mother refused her meds about half of the time and her behavior would be much worse after that. Unfortunately, it is illegal to make someone take their meds. If your mother is cooperative with taking her medicines, that is a positive.
Thank you for your input. My mom has never really resisted her medicines, but she has abused them on a few occassions.
stan1 wrote:Sorry to hear the news.

Her inpatient treatment facility should have social workers or patient advocates (terms vary) to help find the services she now needs that she didn't when discharged. They will know the local options and will at least have additional points of contact. Can also facilitate coordination with medical teams. We've found these staff to be very helpful and compassionate transitioning family members into home-based services and long term facilities.
That's a good idea ... thank you!
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Re: Care options for parent (mental health, death of spouse)

Post by Mudpuppy » Wed Jun 17, 2020 7:14 pm

There are options for in-home health aides, but since your mother does not sound like she needs assistance with most activities of daily living (ADLs) and instead needs medication management, you would likely have to pay out of pocket. Most companies require a contract with a minimum number of hours per day, and often with a non-compete clause that you won't hire any of their employees "on the side". Some companies do have a one-hour shift option for clients who need only a minimal level of assistance, but that's very rare. Most require at least a 4-hour shift (or longer). So it's an option, but it would likely be expensive, particularly if all of the local providers required a 4-hour shift.

Edit: Also, the in-home health aides I've worked with were not certified to dispense medication. They could prompt my relative with "It's time to take your pills" but they would not fill the pill minders or actually hand over the pills. There was an in-home nursing option from the same company that could provide a higher level of service, but with a higher price tag of course.

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Re: Care options for parent (mental health, death of spouse)

Post by Katietsu » Wed Jun 17, 2020 7:35 pm

What about a home health aide to come in for a couple of hours a day/5 days a week to help with cleaning, laundry, maybe make lunch, be there during shower time if falls are a concern, etc. Then, besides the practical help, you would have someone to warn you if mental health problems worsened. The contact with another human being on a daily basis might even help to avoid a return of the mental health issues.

You could hire someone directly in my area for $15-$20/hr or through an agency at $25-$30/hr. The other 2 days a week, you or your sister could stop in with lunch for a visit.

If you have a serious concern about medications, there are high tech options for medication. We looked at a device that you (or an RN) would fill once a week. It would be programmed to dispense the right medication at the right time, sort of like a gum ball machine.

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Re: Care options for parent (mental health, death of spouse)

Post by 123 » Wed Jun 17, 2020 8:46 pm

How far is her home from yours? Distance can make things difficult for routine drive-bys/visits.

Would she be open to video conferencing with your or your sister a couple of times a day or maybe a couple of security cameras that you could monitor her over the web (kind of a granny cam)?

We have an elderly neighbor who lost her spouse over a year ago. While she is still able to take care of herself she didn't like living alone and wasn't interested in moving to assisted living. The family resolved the situation by having various family members do a sleep-over at her house at night (family members involved live within a few miles). I think the widow prepares dinner and breakfast for the visitor so it keeps the widow occupied as well. I've noticed that one family member tends to do worknights and another weekends. Of course this arrangement works best if there are a lot of family members (which including children/grandchild) willing and able to participate.
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Re: Care options for parent (mental health, death of spouse)

Post by XtremeSki2001 » Thu Jun 25, 2020 11:49 am

Thank you for your thoughtful responses. My mom has been with us now for about a week and seemingly takes care of herself so long as there's no major tasks. For example, she can shower, make lunch, carry conversation fine but if asked to do something independent like call and update Social Security she is overwhelmed.

I spoke with her outpatient care provider and they stress not disrupting her from anything she's been doing (e.g., on her laptop for 6+ hours a day) and wait 3-6 months before making any major life decisions. As you can imagine, we're taken back by this advice.

We have found some great technological devices to control medication, complete with notifications to my phone if it's being tampered with. However, my mom has stressed repeatedly she does not want to be alone.

I think the best course of action is to have her live in an independent housing place that also has games, outing, and assisted care (if ever needed). That way she's not alone, we're close by (within 20-50 mins), and she has social options. The real challenge is waiting 3-6 months to have these conversations. Not sure we can wait.

Mental illness is hard for me to grasp. My in laws are much older than my mom and very high functioning. My mom is also high functioning but unwilling to do things that require effort and wants others to do things for her.

Sorry, kind of a rant!
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Re: Care options for parent (mental health, death of spouse)

Post by Mudpuppy » Thu Jun 25, 2020 12:56 pm

It's okay to rant from time to time. Caregiving is a very stressful thing, and it's good to have health ways to vent.

I have to wonder if the pandemic is playing in to the 3-6 month timeline more so than concerns about disrupting schedules. But you can use this time frame to really evaluate the housing options. Look into what sort of levels of care they provide, such as how they handle transitions to higher levels of assistance.

Also look into various facets such as staffing levels, how secure the facility is when someone needs that level of care (i.e. protecting against them wandering off once cognitive decline becomes severe), how they've rated during evaluations, and so on. Their response to the pandemic will also be telling of how they operate day-to-day outside of crisis.

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Re: Care options for parent (mental health, death of spouse)

Post by clip651 » Thu Jun 25, 2020 10:42 pm

Realistically, she's a new widow that was relying heavily on her husband for support. She's going to need a lot of support going forward. Short term, family is probably best to provide this for her to the extent that that's possible. I don't think a 3-6 month adjustment period is out of line at all. She wasn't in great shape to begin with, and this is a big life change for her. It sounds like you or your sister will need to personally support her with tasks that need taking care of (paperwork, appointments, etc).

I realize this is a lot coming at you all at once if you weren't previously involved much in her care due to your father/her husband's support of her. And you are undoubtedly grieving your father as well. As a caregiver for a family member myself, I sympathize that this can be overwhelming.

If this were my own family member, given the current pandemic, I would be very reluctant to consider new group housing options (assisted living or nursing facility) for someone in her age group, unless there were really no alternatives. You are unlikely to be able to visit much due to visitor restrictions due to infection concerns. And her risk of becoming infected may be very high in such a situation. And I doubt you'd even be able to visit to really see how the place is run at the moment. [Edited to add - social options (games, outings, even going to the next room to have a chat with another resident) may also be extremely limited at this time due to efforts to prevent coronavirus infections. So she might mostly be alone in her room all day at a facility.] YMMV of course, just my 2 cents.

Since she doesn't want to be alone - do you or your sister work from home? Can either of you be in the same house with her most of the time (perhaps taking turns) as she grieves and starts to adjust to her new reality?

Otherwise, home health services may need to be hired. If she mostly just needs a companion to keep her company and keep an eye on her, rates for that are generally lower than for nursing care. But it depends on how much help she needs with medications and what tier of care that puts her in with an agency. And if she wants someone there all the time (or perhaps all waking hours) this will get pricey.

Another option, if she wants to stay in her current home (or even with you and/or your sister), is to get her a live in caregiver. This would be one person, full time (with some breaks for vacation, etc, that you and your sister might need to cover yourselves or hire someone to do so). Arrangements vary, but typically your mom would provide room and board for this person, plus a salary. While this sounds like a lot - it can be cheaper than paying for help by the hour or paying for full time residence in a facility that can provide the care she needs. Talk to local home health agencies and/or a social worker at the facility where she was previously treated for details on what might be available in your area, and whether a full time live in caregiver might be a good solution for her.

best wishes,
cj
Last edited by clip651 on Thu Jun 25, 2020 11:17 pm, edited 3 times in total.

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Re: Care options for parent (mental health, death of spouse)

Post by clip651 » Thu Jun 25, 2020 10:44 pm

duplicate post - deleted

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Re: Care options for parent (mental health, death of spouse)

Post by clip651 » Thu Jun 25, 2020 10:47 pm

Another thought is that you may want to consider counseling for yourself and your sister. This may help you to better understand your mother's condition, and to deal with the stresses of caregiving and working towards future decisions for her.

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Re: Care options for parent (mental health, death of spouse)

Post by XtremeSki2001 » Mon Jun 29, 2020 8:53 am

Thanks again for the thoughtful posts. It's becoming clearer each day the road will be long. Although my mother is young (68) and functioning, her attitude is defeatist. Everything from preparing a meal or asking her to call Social Security is 'too much'. However, she has a hair appointment in another state and suddenly can live alone, make her meals, do her laundry, and drive back to my house (1+ hour). I don't get it.

CJ I think you're right. My mother relied heavily on my Father more than I appreciated until now. She essentially will only do things if 'forced' and otherwise is basically another child I must care for (I have 4 children under 7). My sister will have twins tomorrow so just me for now I guess.

Tried to start probate today. Gave my mother the phone number and she said she didn't know what to do and left it at that. This is the kind of stuff I'm facing. Ultimately, I'll probably just go it alone because we need to start moving forward. No idea what to do with a 2,500 sqft house in another state that's sitting vacant. Mother wants to 'wait until the fall' before making any decisions about anything. :shock:

Prior to this we saw my mother 10 or less times a year. She never called us unless she needed something (fix her laptop, etc). No relationship with our kids before or now. It's overwhelming and I just feel like I'm trapped with no way out.

Fortunately I work from home so I'm here with my mom. She's on her laptop all day except for meals. She's not active or eating healthy. I don't know where to draw the line with some of this stuff.

We did talk about a caregiver or living an a independent care housing place yesterday. Neither was well received. We only brought them up to plant the seed. Our fear is waiting too long and allowing her to become too comfortable with everything being done for her while living her.

I'm definitely whining :) and I accept that.
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Re: Care options for parent (mental health, death of spouse)

Post by Carefreeap » Mon Jun 29, 2020 9:19 am

XtremeSki2001 wrote:
Mon Jun 29, 2020 8:53 am
Thanks again for the thoughtful posts. It's becoming clearer each day the road will be long. Although my mother is young (68) and functioning, her attitude is defeatist. Everything from preparing a meal or asking her to call Social Security is 'too much'. However, she has a hair appointment in another state and suddenly can live alone, make her meals, do her laundry, and drive back to my house (1+ hour). I don't get it.

CJ I think you're right. My mother relied heavily on my Father more than I appreciated until now. She essentially will only do things if 'forced' and otherwise is basically another child I must care for (I have 4 children under 7). My sister will have twins tomorrow so just me for now I guess.

Tried to start probate today. Gave my mother the phone number and she said she didn't know what to do and left it at that. This is the kind of stuff I'm facing. Ultimately, I'll probably just go it alone because we need to start moving forward. No idea what to do with a 2,500 sqft house in another state that's sitting vacant. Mother wants to 'wait until the fall' before making any decisions about anything. :shock:

Prior to this we saw my mother 10 or less times a year. She never called us unless she needed something (fix her laptop, etc). No relationship with our kids before or now. It's overwhelming and I just feel like I'm trapped with no way out.

Fortunately I work from home so I'm here with my mom. She's on her laptop all day except for meals. She's not active or eating healthy. I don't know where to draw the line with some of this stuff.

We did talk about a caregiver or living an a independent care housing place yesterday. Neither was well received. We only brought them up to plant the seed. Our fear is waiting too long and allowing her to become too comfortable with everything being done for her while living her.

I'm definitely whining :) and I accept that.
You're not whining but I do think you will find a support group helpful. This is a tough journey. I will PM you with a link to another financial group chat which has a Elderly Parent Support thread. Lots of support and resources.
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Re: Care options for parent (mental health, death of spouse)

Post by dbr » Mon Jun 29, 2020 9:51 am

Been here and done this twice, actually three times. Issues have been Alzheimer's, senile dementia, substance abuse, and mental illness (multiple combinations).

It can be a very long story and I am not writing novels today so I will make a couple of points:

1. Your county social services organization and your mother's physician(s) can be very helpful at locating resources. This requires physicians of more than one specialty. There are also community services and help organizations that do a lot, for her and for you. Explore all of them. Especially explore how these things can be paid for. If you think the IRS is a byzantine empire, welcome to the world of social services.

2. In two cases the ultimate solution that worked was to get the person under care in a facility, whether assisted living, mental assisted care, or a nursing home. At-home care can be more time and stress* for the family or can work very well. My third case was that a full-time live-in care giver worked, but that was because the person hired was unique.

*So, one of those weekly pill minders managed by a visiting county nurse stops working when the patient identifies it as a cake, frosts it, and puts it in the oven starting a fire.

A second anecdote, not going into detail, is that this kind of caregiving requires massive dedication and expertise on the part of the caregiver. Did you know that many medications can cause rather than help dementia, and you may be the only one to figure out which one is which? I won't recite the long and painful story about this. But it has a happy ending, relatively speaking.

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Re: Care options for parent (mental health, death of spouse)

Post by DebiT » Mon Jun 29, 2020 10:39 am

My condolences to you on the loss of your dad, and the tough situation you find yourself in,

Is it possible to sell her house and use that money to try an apartment in your town? It sounds like you are overwhelmed with 4 kids under 7 and now your mom. Maybe an apartment would be a trial compromise between returning to her home (where she has no friends, but does have mental health workers) and assisted living (which would cost a great deal more).

You have my sympathies, as does she. I was widowed last year, thankfully without the problems your mother has in terms of functioning. It is a giant adjustment under the best of circumstances, let alone COVID. Think baby steps

If she can’t or won’t do the legal things that need doing, it may be easiest to get a POA and just start doing them yourself, one at a time. Possibly your sister can help with research, some phone calls, etc, although with new twins time and and energy may not be present.

Deep breaths. At least she sounds like she occupies herself in your home. My sympathies, and also condolences on the loss of your dad,
Age 62, life turned upside down 3/2/19, thanking God for what I've learned from this group

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Re: Care options for parent (mental health, death of spouse)

Post by dbr » Mon Jun 29, 2020 10:54 am

DebiT wrote:
Mon Jun 29, 2020 10:39 am


If she can’t or won’t do the legal things that need doing, it may be easiest to get a POA and just start doing them yourself, one at a time. Possibly your sister can help with research, some phone calls, etc, although with new twins time and and energy may not be present.

On that note, it is absolutely essential you have a durable POA and a health care POA. Also it essential that you actually get those on file and exercise them at financial institutions and health care offices while she can still say yes, as often these POAs are not recognized.

In one of our cases refusal to grant a POA caused a family member to have to go to court to get custody or, in effect, leave a person to die in their own dementia. Having to do custody under court order is the last and least desired way to manage this. In another case we had POA but the county was able to take the legal steps that saved that person's life. Remember a POA does not allow someone to force another person to do something even if not forcing them means death.

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Re: Care options for parent (mental health, death of spouse)

Post by Mudpuppy » Mon Jun 29, 2020 1:17 pm

clip651 wrote:
Thu Jun 25, 2020 10:47 pm
Another thought is that you may want to consider counseling for yourself and your sister. This may help you to better understand your mother's condition, and to deal with the stresses of caregiving and working towards future decisions for her.
I would second this recommendation for counseling for everyone, including the OP's mother. The intersection of grief and mental illness is complex for all involved. Individual and group counseling can help them navigate these difficult times.

The OP might also want to see if there is a NAMI family support group in the area.

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Re: Care options for parent (mental health, death of spouse)

Post by fleetwdl » Mon Jun 29, 2020 2:08 pm

"on her computer 6 hr's/day" raised a red flag for me. Even as you work through these near term and long term decisions, you should also attempt to protect her financial resources, as many elderly are taken advantage of, and many of those instances begin through the computer.

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Re: Care options for parent (mental health, death of spouse)

Post by Nutmeg » Mon Jun 29, 2020 10:09 pm

dbr wrote:
Mon Jun 29, 2020 10:54 am
DebiT wrote:
Mon Jun 29, 2020 10:39 am


If she can’t or won’t do the legal things that need doing, it may be easiest to get a POA and just start doing them yourself, one at a time. Possibly your sister can help with research, some phone calls, etc, although with new twins time and and energy may not be present.

On that note, it is absolutely essential you have a durable POA and a health care POA. Also it essential that you actually get those on file and exercise them at financial institutions and health care offices while she can still say yes, as often these POAs are not recognized.

In one of our cases refusal to grant a POA caused a family member to have to go to court to get custody or, in effect, leave a person to die in their own dementia. Having to do custody under court order is the last and least desired way to manage this. In another case we had POA but the county was able to take the legal steps that saved that person's life. Remember a POA does not allow someone to force another person to do something even if not forcing them means death.
I agree that a durable POA and a health care POA are essential. In my case, I also arranged by telephone for my relative to authorize the medical insurance company to talk to me. For another relative, if an issue arose with a company, I would add the relative to the phone call with a company to obtain authorization for the company to talk to me about that particular issue, which just entailed having my relative answer security questions.

When you obtain a durable POA, be sure that the POA authorizes you as agent to do everything the principal could do, not just in general language, but specifically. Some states require the principal to specifically state that the agent has the power to make gifts, even to himself, or name a beneficiary, even if that is himself. This could be important powers to have in order to carry out the principal’s wishes, which presumably would be to name both you and your sister as beneficiaries. If the original POA is recorded, you can obtain certified copies of it, which can help when you are attempting to convince an entity to accept it.

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Re: Care options for parent (mental health, death of spouse)

Post by dbr » Mon Jun 29, 2020 10:17 pm

Nutmeg wrote:
Mon Jun 29, 2020 10:09 pm


When you obtain a durable POA, be sure that the POA authorizes you as agent to do everything the principal could do, not just in general language, but specifically. Some states require the principal to specifically state that the agent has the power to make gifts, even to himself, or name a beneficiary, even if that is himself. This could be important powers to have in order to carry out the principal’s wishes, which presumably would be to name both you and your sister as beneficiaries. If the original POA is recorded, you can obtain certified copies of it, which can help when you are attempting to convince an entity to accept it.
Yes, in our state they have a list like that with checkboxes or an election that all boxes are checked.

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Re: Care options for parent (mental health, death of spouse)

Post by XtremeSki2001 » Mon Jul 06, 2020 3:59 pm

Hi All - Thank you again for the thoughtful posts and PMs. Thank you also to those I didn't respond to specifically and for the guidance on POAs should I/we need one.
dbr wrote:
Mon Jun 29, 2020 9:51 am
1. Your county social services organization and your mother's physician(s) can be very helpful at locating resources. This requires physicians of more than one specialty. There are also community services and help organizations that do a lot, for her and for you. Explore all of them. Especially explore how these things can be paid for. If you think the IRS is a byzantine empire, welcome to the world of social services.
She's in a paid outpatient program now (was inpatient pre-COVID). Speaking to the counselor several times I question the effectiveness of the program. Seems more 'keep thing status quo', not goal-oriented, don't really know my mother, etc. We have a meeting with a local counselor we know tomorrow to reassess things.
dbr wrote:
Mon Jun 29, 2020 9:51 am
2. In two cases the ultimate solution that worked was to get the person under care in a facility, whether assisted living, mental assisted care, or a nursing home. At-home care can be more time and stress* for the family or can work very well. My third case was that a full-time live-in care giver worked, but that was because the person hired was unique.
This is slowly starting to look like the best bet, even though I don't think she needs assistance. For example, she was able to stay at home alone for a night, go to get her hair done, go to the mechanic to fix a flat tire, and return to my house all independently. When she got home and I asked what she had for breakfast or lunch, she had nothing in the house so just didn't eat. To me this is just laziness and not any mental issue, but I am not a doctor. This week we planned out a calendar and identified activities she must complete each day. Things like clean the bathroom, go get a pedicure, go for a walk, etc. When we asked about cooking dinner one night, she said she couldn't handle it because she doesn't like cooking ... these are the kind of things that will wear out her welcome quickly.

We also had an issue with her taking a pill before she was allowed. Caught her twice just to double confirm it wasn't a mistake. She made a series of sneaky decisions to enable taking it twice so she was not very happy when we confronted her about it.
dbr wrote:
Mon Jun 29, 2020 9:51 am
A second anecdote, not going into detail, is that this kind of caregiving requires massive dedication and expertise on the part of the caregiver. Did you know that many medications can cause rather than help dementia, and you may be the only one to figure out which one is which? I won't recite the long and painful story about this. But it has a happy ending, relatively speaking.
Not a prescriber, but I did research the drugs she's taking. Some are more prone to abuse than others, which is really what I was looking for. The one I mentioned above is prone to abuse. Now I won't even put out a days worth so she has to find me to get her pills at certain times of the day. It's a small role I play in this regard, but it's still time consuming on top of normal life activities.
DebiT wrote:
Mon Jun 29, 2020 10:39 am
My condolences to you on the loss of your dad, and the tough situation you find yourself in,
Thank you so much!
DebiT wrote:
Mon Jun 29, 2020 10:39 am
Is it possible to sell her house and use that money to try an apartment in your town? It sounds like you are overwhelmed with 4 kids under 7 and now your mom. Maybe an apartment would be a trial compromise between returning to her home (where she has no friends, but does have mental health workers) and assisted living (which would cost a great deal more).
Going through probate now and then will try to convince my mom to sell the house. I don't see a scenario where she should keep it and she sounds like she'll sell it, but she's still thinking 'I need to make X for the house' instead of 'we need it off our hands'. It was for sale all of last year and they only had a few people come see it. Asking too much.

There are a handful of places here that offer independent / assisted living. Most offer 'leases' where you can give it a try for a few months. Probably what we'll do, but so far my mom has been talking smaller house not living facility.
DebiT wrote:
Mon Jun 29, 2020 10:39 am
You have my sympathies, as does she. I was widowed last year, thankfully without the problems your mother has in terms of functioning. It is a giant adjustment under the best of circumstances, let alone COVID. Think baby steps
Sorry for your loss! Baby steps are not my forte but we are trying. We saw / talked to my mom maybe a dozen times a year so this is just an incredible adjustment when there's absolutely no relationship.
DebiT wrote:
Mon Jun 29, 2020 10:39 am
If she can’t or won’t do the legal things that need doing, it may be easiest to get a POA and just start doing them yourself, one at a time. Possibly your sister can help with research, some phone calls, etc, although with new twins time and and energy may not be present.
So far, from what I can tell, it's more 'I don't want to do that' or 'I don't feel like it' or 'I can't I don't have their phone number' ... anything to avoid having to do something. I went ahead and kick started probate, but still not sure about POA but it's on the table.
fleetwdl wrote:
Mon Jun 29, 2020 2:08 pm
"on her computer 6 hr's/day" raised a red flag for me. Even as you work through these near term and long term decisions, you should also attempt to protect her financial resources, as many elderly are taken advantage of, and many of those instances begin through the computer.
Thank you - I did confirm it's only a game and not linked to any bank accounts. I also monitor her accounts and have not seen any suspect charges to date.
A box of rain will ease the pain and love will see you through

Sun88
Posts: 46
Joined: Sun Jun 05, 2011 8:08 am

Re: Care options for parent (mental health, death of spouse)

Post by Sun88 » Mon Jul 06, 2020 4:19 pm

Meals on Wheels may be of some help if your mother elects to stay in her own home. Along with providing 1-2 meals per day, she would get brief contact with a friendly human being. Volunteers will call in if no one answers the door, and are also instructed to report any obvious issues. They're not medical professionals but do provide a low key wellness check.
Along the same lines, most of the customers on my route have a pet. That can help with engagement and companionship if your mom likes animals.

Mudpuppy
Posts: 6159
Joined: Sat Aug 27, 2011 2:26 am
Location: Sunny California

Re: Care options for parent (mental health, death of spouse)

Post by Mudpuppy » Mon Jul 06, 2020 4:46 pm

I want to gently reiterate my suggestion that the entire family seek counseling services. Some of the issues that you describe, particularly those related to apathy (e.g. skipping meals because there wasn't food in the house), are fairly common signs of depression and mental health issues, which can be exacerbated by grief. It can be very frustrating to deal with mental health issues as a caregiver, which is why it is important to get support for both your mother and yourself. A therapist or support group can help you navigate what can and cannot be expected, and how to deal with your own grief on top of the sudden caregiver duties. It's a very large burden.

To relate a personal perspective relative to this point, the OT for my elderly relative says to have her do all sorts of tasks for daily living that would be relatively routine for you or me, and within her physical limits to accomplish, but they are too taxing for her mental health. For example, the OT told me to have her to spray the bathroom sink with cleanser and then rinse it as part of her daily therapy. That resulted in her getting overwhelmed, leaving cleanser all over the counters and sink, and having a small breakdown.

I remind myself that her world is very small, so even what I would perceive as a minor task can seem like a huge mountain to her. It's important to recognize that, and try to find routines that minimize those challenges. But it's also important to preserve as much independent function as possible and not just rush in and take charge. It's a very delicate balance, and it will take time to find those balances.

For my relative with the above bathroom scenario, the solution was to have her use a sanitizing spray that doesn't need to be wiped off or rinsed to clean her bathroom, then I periodically go in and deep clean. She still gets the accomplishment of cleaning, without getting overwhelmed by the process.

But while you are adjusting and finding routines, I'd really recommend therapy for everyone involved.

clip651
Posts: 657
Joined: Thu Oct 02, 2014 11:02 am

Re: Care options for parent (mental health, death of spouse)

Post by clip651 » Mon Jul 06, 2020 5:08 pm

XtremeSki2001 wrote:
Mon Jul 06, 2020 3:59 pm

She's in a paid outpatient program now (was inpatient pre-COVID). Speaking to the counselor several times I question the effectiveness of the program. Seems more 'keep thing status quo', not goal-oriented, don't really know my mother, etc. We have a meeting with a local counselor we know tomorrow to reassess things.
Keep in mind, she was inpatient and is now outpatient. Keeping things status quo means she's able to continue as an outpatient. While I sympathize with your frustration, and while being proactive with looking for the best counseling for her is good, please realize it is a big deal for someone who needed inpatient mental health help to be able to continue to do sort of OK as an outpatient. Especially when compounded by the added challenge of the recent death of her spouse and main support person. Status quo is actually big progress from where she was when she required inpatient care. Maintaining that without backsliding is not a small goal.

And in general with depression and other mental health issues, forward progress can often be slow.

Agree with Mudpuppy re counseling for all. Mudpuppy expressed it well, so I won't try to do it again, but a +1000 to that post.

I'm sorry for the difficult situation your mom is in, and by extension you and your family are in.

best wishes,
cj

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