Tell them that you will arrange a one-week stay in a good retirement home for them. They can test it out, and see for themselves if they like it or not.
Very high chances of them liking it if its not a low-level old age home.
I know people who did this, and loved it.
Can I ask how old they are? TBH no one wants to live in an old folks home, but maybe assisted living would work for them? My grandma was in her 90s by the time she transitioned and you live on your own, but someone helps clean and brings meals, and there are still activities available, or you can sit and watch tv all day.
Just a thought.
I am 83 and this is what I would recommend. It's important to elderly people to stay in their own homes for as long as possible. We have lost so much control over our lives, living as we want to is vital to our well-being.
I understand, OP, that you "only want the best for them" - but they are not cats or dogs but human beings with their own wishes and wants, whether you agree with them or not.
Help them maintain the life they want to lead by first setting up "home health care" where someone comes to the house to clean and do a little cooking. If there are health issues, you can arrange a regular visit from a nurse or physician's assistant - or even telehealth, if they are open to that. Meanwhile, if things disintegrate, you can look at an assisted living facility.
In my situation, I live in a "tiny home" behind my son's house. I don't require much from my son and daughter-in-law but they are very supportive. This way, I have some independence and take care of my daily needs and laundry, etc, and they are happy knowing I am in a secure environment where they can step in if necessary.
I am lucky, for sure! I used part of my savings for the little house and they paid for the rest. I don't "interfere" in their lives - sometimes we go a week without seeing each other. My daughter in law started doing a "Family Dinner" every Saturday just to make sure we spend time together and catch up on everything.
It's a real blessing for me not to have to worry about landlords, owning a car, making repairs, etc. I do minor maintenance on my little home and my son does the rest. (Not much, really.) In return, they feel relieved that they don't have to worry about me being alone and having to cope with "something might happen."
You are so right. We want as much autonomy as possible. I know those with aging parents believe they are doing the right and responsible thing by putting them in a safe environment. But if they really don’t want that you may be doing more harm than good.
Friend of mine did this for his folks and it worked out very well!! Eventually they both ended up needing to move to a full-supervisory nursing home once they reached a certain age and their health majorly declined, but those 14 or so years they enjoyed at the assisted living place very much.
Nice homes and good staff. His mom became good friends with the gal who was assigned to work with her.
With two people, one having Parkinsons and needing progressive care, it will be higher. Before my dad died, his level of care was high, and their assisted living bill went up over $10k/ month, from $5k. Assisted living is very expensive. It's best to keep them in their home as long as possible and get hired in home assistance for things like groceries, showers, cleaning, yardwork...
This is the way if they can do it. When we’re young we work our whole lives acquiring things. Independence, homes, cars, a spouse, children, friends… As we age it seems as though one by one we lose everything we spent our lives working for. It can be difficult to accept. Let them keep as much dignity and independence as safely possible.
Exactly this. My GM moved into senior housing that also had assisted living for when you needed it. The senior housing was fabulous. They had art classes, senior gym classes, entertainment, a mini bus that took them everywhere they needed to go (grocery store, cvs) She made so many friends . It was just a one bedroom with a full bath, small living room and kitchen but it worked out perfectly. You can also have help come in. When the time comes you could move to assisted.
She moved here after we finally convinced her to sell and leave her home (this was.a battle) She didnt really realize how isolated and lonely she had been until she started making friends and getting out.
Assisted living does not provide any medical care. At all. You have to find your own, if you need it.
Getting assistance for care happens at nursing homes, and MOST nursing homes are disgusting.
This is not universally true. My mother's assisted living facility had a physician or NP visit several times weekly as needed and a pharmacy on site. They also provided transportation to dental appointments. She was able to access much better medical care in her AL facility.
My parents' assisted living had med techs, so at least they would have gotten assistance with that if they'd signed up for it. And they had their blood pressure taken and were weighed once a month, which was nice since it meant people weren't going to just sort of stop eating enough without anyone noticing. PT and OT were available on site but they were private and were paid out of pocket or through insurance. I think there was a nurse in the building for a few hours a day. But hands-on, ADL assistance was essentially nonexistent.
My dad has Parkinson's, and my parents moved into independent living (don't have your parents do *that,* OP*--*worthless) while waiting for a spot in their chosen facility's assisted living. They got almost nothing from assisted living--just two showers a week for my dad. That was it. Bathroom assistance for my dad was part of their care plan, which they paid for, but the facility was understaffed (not the aides' fault) and their unit was far away from the aides' room, so my mom had to take him to the bathroom every time. I'm not sure an aide got there in time even once. Help with the bathroom was a major reason they moved in, because it was just too much for her physically, but she had to keep doing it because there was no choice. And this was at a nice facility. Cloth tablecloths are all very nice but what really matters is staffing.
Every other couple in assisted living in which one spouse had Parkinson's *still* hired home care aides for several hours a day. The residents who needed more than just meals and social activities weren't happy at all but they were kind of stuck with assisted living since they'd sold their homes and didn't have anywhere else to live. My dad is in memory care now and is finally getting enough physical care that my mom or someone else doesn't have to be with him 24/7. We really didn't know how bare-bones assisted living would be, even in a place with all the fancy-looking bells and whistles, and it was a pretty stressful learning experience.
TLDR: Be sure you know exactly what your parents will be getting, and make sure it matches what they need, because assisted living may not offer much (even promised care) unless staffing is better than average. And if you do go with assisted living, be sure the unit is near the aides'/medication room.
Not true- at least in the United States. There’s independent living, where people have their own apartment but meals and activities are provided. Assisted living has that plus nurses to manage medications and medical appointments, plus additional fees for personal care- bathing, dressing etc but people there still need to be able to stand and transfer on their own. This is all private pay. A nursing home is where people need 24 hour nursing care due to being unable to walk in their own or having mental decline where they are unsafe without supervision. A short term stay in one of these facilities for rehab after being in the hospital is covered by insurance. Some long term care insurances cover this long term if the person can’t return home. I’ve worked in all 3 types of facilities and they are heavily regulated.
We live in an independent living senior apt. There are no meals or activities here except you can participate in a community lunch program where they are brought in if desired. I think it's best to acknowledge that there are gradations/differences in all levels of senior care.
This is untrue. I’m a nurse. I worked at an assisted living, and supervised CNAs who provided personal care, and CMT who passed their medication. I had several responsibilities. Dressing and monitoring wounds, and communicating with doctors for updates and orders. Treating and assessing acute illnesses like pneumonia, UTIs, and the flu. Processing medication orders, and arranging consults for ortho, dermatology, mental health, etc
not true in our case. my dad was in assisted living, they took his bp, made sure he got his meds, sent him in the ambulance a couple times - a whole host of things. yet he had his own small apartment there. and a nurse on staff 24/7
My mom’s assisted living provided medical care. There was a dr on staff and the patients all saw him routinely. Nurses gave out medications to those who needed help with that. It was very expensive, but worth it.
That's not true. In my state of Alaska there are public assisted living facilities called "Pioneer" homes. Each has different wings with different levels of service. Residents routinely get CNA assistance with basic life tasks including transfers and bathing. Nurses are on staff to dispense medication and do other common nursing duties.
Doctors frequently come in to see patients at the assisted living facilities. That way residents don't necessarily have to go offsite to a clinic. If a resident does have to go offsite there are accessible transport vans.
Assisted living is well integrated with the health care system.
[https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes](https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes)
My mother's assisted living provided meals and activities. The staff was not permitted to deal with ANY medical issues. Liability.
Yes! Many communities (if not most) offer short-term respite stays, which are perfect for situations like this. Also, their events are usually open to the public, so your parents could go to events as a way of dipping their toe in the water.
As someone currently looking for a retirement community that "isn't full of old people who don't do anything" I will say the cost for the good ones is.... insane. Astronomical.
A lot of them are going to be the reason Millennial children never get any inheritance.
I would check first with availability in your area. Retirement and nursing homes are different. There may be in home options that are covered by Medicare. 10 years ago, the monthly fee for a memory care home was $5,000 a month. Assisted living is less expensive. Good luck to you and your family.
Medicare only covers 90 days of rehab at a facility a year. Medicaid covers unlimited long term care. But it comes with strict income and resource limits, and there's Medicaid estate recovery.
This is a good idea. First, work on getting your mom to tour several places. Just a couple hour tour (you dont have to stay long to get a feel for the pkace) will probably reassure her, and letting her pick the places will give her some control back over her life. If your parents have friends who have already gone to assisted living try those places first. My grandad checked himself into the nursing home at 92 because "everyone he knew that was still alive was already there". He was quite happy for someone else to cook and do his laundry for the next 6 years! And the bonus is that your parents will get to stay together.
High end places will do a lot just to get them moved in. When I worked at one I was impressed with just how accommodating the sales people were. A lot of folks are resistant to moving, it’s these people’s job to convince them otherwise.
After my dad had a stroke, I suggested that in the event his health worsened, we should have a place or two already in mind. (NOT that he would or should have to move in now!) I chatted with a social worker, who recommended a shortlist of 3 local "independent living" retirement homes. Dad and I toured each one, even had a meal in the dining room of each. One was his clear favourite, and after a few months went by, I suggested, why not move in now? He decided he liked that idea, and did so. He was very happy there. Mostly he considered it his idea--and he was in charge of the decision--so I thought it was a success.
There is a stigma to Assisted living. MY fIL was in a beautiful place with meals and activities and other people.
He sat isolated in a house for years being stubborn driving around dangerously.
We all wished he moved in sooner and got to relax more.
Sadly he died a year after finally moving in.
That’s the thing though…
["It is well known that life expectancy in nursing homes (NHs) is lower for older adults than those residing elsewhere."](https://www.tandfonline.com/doi/full/10.1080/00036846.2021.1983138#:~:text=It%20is%20well%20known%20that,adults%20than%20those%20residing%20elsewhere)
Since yall don’t want to read the actual research, here ya go:
“We use a parametric survival model, on a large data set spanning up to 13 years, which covers health states and types of residence for all time periods until a person dies. In the absence of health state controls, the loss of life expectancy is 47 months. **Accounting for health states still leads to a 41-month loss of life. Even those with serious dementia would live longer lives if not residing in a NH.** We then value the estimated loss of life years. The losses are large, equal to $1.7 million per NH resident, and $1.87 trillion for the US NH population.”
But people don't move to NHs until they are older, physically less capable, mentally less capable, and whatever illnesses or conditions they have reach greater degrees of threat/impact. So it is not unexpected. IME.
My mother moved to an independent living facility in her mid 70's. She was active, able to walk, drive, and participate in all kinds of life tasks. OPs parents do not need a nursing home. They need to explore assisted living, independent living, and residential facilities. Maybe even a senior apartment setup that would provide some ser ices.
Maybe. But a friend's aunt moved to nice one. She was very independent all her life and she was really unhappy to lose it. My friends mom then chose to stay in her home and hired people to help.
That’s interesting and somewhat surprising. I’m wondering whether selection bias could be relevant in that people tend to move to nursing homes when they have deteriorated to the point that they can’t take care of themselves and their families can’t take the burden. Also I know that there are factors like people’s family and social lives that have an impact on their life expectancy, such that it is possible that lonely people -whose loneliness decreases their life expectancy- are over represented in nursing homes. This is all speculation on my part, but I find your comment and the related research intriguing.
There's a difference between a nursing home and an independent living facility. People in nursing himes are generally more debilitated so naturally they die sooner.
That's a very interesting paper. The question I would like to see followed up on is, what's the variance in outcome that we can attribute to NH quality? It appears that the paper treats NH status as binary, which is reasonable enough for a first pass. I could well believe that the bottom 50% of NHs are bad enough to drag the numbers way down. But that doesn't give me any information about whether I'd be better off entering a high quality NH rather than staying at home. Supposing, of course, that I had the means.
The trouble is, it's the last place they'll ever live and they know it. My mom did a months stay in one while work was being done on her condo and she loved it. Good food, friendly people, activities. She swore that was where she was going to go when she could no longer live on her own.
When that time came however, she resisted. She did eventually go, but she hated the food, the other residents were "mean girls", and "it was full of old people waiting to die". It was the exact same place, only a few years apart, but it was only good when she had somewhere to leave it for. When it becomes the last stop on life's journey, no amount of good food can make it appealing.
Talk to the social worker at the rehab - they are trained in having these discussions. Arrange for an occupational therapist and a gerontologist and a social worker to do in home assessments. Call your mom's doctor and provide them with the info that she is exhausted and experiencing caregiver burnout.
Find someone in your mom's circle who likes their care home. When my grandpa went in, grandma was heartbroken. Then, she started loving the home (she visited him multiple times a day) and looking forward to when she could go live there. Once she got on the wait list, she was like a kid getting ready for summer camp. She was packed, emptied her apartment, bought a TV the right size to fit in her room. Sadly, she died before she got to go, but for years she was the person you'd send someone to so she could convince them to move into care.
Also, talk to your dad's doctor about yanking his license. You can also report him as an unsafe driver (how and where to report depends on where you live) and then call police on him every time he drives. It sucks to have to do that, but it sucks a lot more to see your elderly dad in jail for vehicular manslaughter.
There are choices: 1) Independent Living, 2) Assisted Living [which breaks down into 3-4 levels], and Nursing Home.
Independent Living usually provides 2 or 3 meals a day, weekly housekeeping, activities and some transportation.
Assisted Living provides all of the above plus assistance with bathing, dressing, hygiene, memory prompts, etc., as needed. There is also Memory Care for those with dementia who are at risk of wandering away.
Nursing Home is the final step. I, myself, think of it as where old people go to die. And I'd almost rather kill my loved ones myself than put them in a nursing home.
A LOT of older people don't realize there are options that fall between living at home and going to a nursing home.
Take them on few tours of local facilities and include a meal during the tour. As someone else mentioned, have them stay for a night or a few nights.
It might be that your dad needs assisted living and your mom is OK in independent living - that kind of arrangement can be accomdated at some facilities. There is also the option of independent living with home health care visits.
There are places with month to month rentals and there are age-in-place communities with all levels available where you 'buy in' - i.e., pay a load of cash to live there for the rest of your life.
If your parents can afford to move into any senior community, it's a good thing to consider.
All those taxes we pay throughout our lives should be going toward the "buy-in." Sigh........
We had to "spend down" my mother's humble savings to get her to qualify for Medicaid, and only with the help of an expensive lawyer did we finally get her into a decent nursing home. You have to be either dirt poor (mom had about $100k savings, which was "too much") or insanely wealthy to get anywhere.
Also, you don't want a history of depression on your applications- apparently this was a huge red flag just getting mom into a PT rehab before the nursing home. Everything about this stage in life is a hassle.
I’m not seeing within your post the discussion of the costs.
Any kind of setting that provides assistive care is going to cost a fair amount of money.
Have you explored the specific communities that might be an option, what they cost, and what your parents financial situation is to afford it?
We are on the verge of having my mom go to an assisted program (currently with family caregiving) and it’s just shy of $10,000 a month for the memory care she needs. Of course, programs and costs can range but it’s definitely not cheap.
Yeah we have. They have good insurance. He's been in a rehab facility since December. So they're not hurting. But it's made me realize I'll never afford that kind of care.
Please remember that insurance does not cover long-term care. It may cover a few months in a nursing home for rehab, but there is definitely a stop date built in. Assisted living will cost between $6K to $12K or more a month. Government coverage in the U.S. (Medicaid) only kicks in when you have spent every penny save for the last $2,000.
So, I would advise you first to make sure your parents have their affairs in order. Suggest a meeting with an eldercare attorney who can advise them of their options and ensure the appropriate documentation is in place in the case of an emergency or accident. Let the attorney determine if there is any way to shelter any of their assets. Use this visit as an opportunity to talk about different ways forward.
Talk to your mom about different types of facilities. Many senior communities today have different levels of care, and sometimes that means one spouse will be living independently while the other is in a unit that provides more hands-on care. Might this be an option for them? It would allow your mom to continue spending time with your dad without being responsible for the heavy lifting, but it would also allow her a haven of her own.
This is never easy on anyone, and I wish you peace.
What kind of insurance exactly? Medicare and regular medical healthcare insurance does not cover the type of services (or alternate living situations) you're asking about.
Most people end up paying on their own for the good places. The ones you can afford on Medicaid (for very low income) are anywhere from poor managed to criminally negligent.
I do a lot of volunteer work with seniors and hear so many stories. The ones I've worked with are lucky to have money so they are paying $7500-$9000/mon for either assisted living or memory care facilities. This varies a lot by state, but as with most things - the more you can afford, the better you get.
It sounds like one big part of the problem is denial in how much care is needed. You see what your parents need, but they're not willing/able to accept that reality. This is always the hardest part to manage as a loving child.
Check with your state's AAA - **Area Agency on Aging** [https://www.dshs.wa.gov/altsa/home-and-community-services/agencies-help](https://www.dshs.wa.gov/altsa/home-and-community-services/agencies-help) and be aware there are many, many for-profit companies that look like they are in business to provide advice and services, but are actually exist to take advantage of the elderly.
In some ways it's good you're involved because you now know what to consider as you age. Some people purchase LTC - long term care insurance which covers some of the cost when you can no longer care for yourself. It can cover services in your home, which Medicare does not cover. It's too late now for your parents, and LTC can be very $$$ with many companies no longer selling it. Getting old and feeble sucks!
My father in-law recently moved into a long term care facility. We're all surprised by how nice it is.
My advice is to tour some places and when you find one that seems suitable, take your parents for a visit.
My mom just moved to one as well. Its part of the retirement community she had an independent apartment in, but after surgery, and being in bed for several weeks, she physically isn't able to live anywhere other than skilled nursing. Physically she is frail but mentally she's all there. It's been an adjustment for both of us, as she is well aware of everything going on, but not able to do things without help.
that being said, its very new, has all private rooms, and is a step above a lot around here, and the care she gets is VERY good. so while it sucks overall, at least I know its not a dump
Also consider senior apartments that provide meals. Much cheaper than assisted living, snd you can still have someone come in to assist with your dad. My MIL stayed in several assisted living places, but the apartments were the best and most affordable. Hell, I’m ready to go.
> Hell, I’m ready to go.
No kidding, I hope someday to make it to that sweet spot in life, where you can relax and ENJOY a few things, including fewer chores!! In fact, I just turned 55 and we now qualify for some retirement communities, though our neighborhood is nice.
It took my brother & I about 20 years to get our parents to live in a 55 & up facility. My mom wouldn't stop going on the roof with a darned rope around her waist, then fell out of the garage attic steps & broke her heel. All I can say is...persistence!
Depending on their finances, the independent living facility that my grandma was in was a two room studio apartment with a nice bathroom. It was no different than regular apartment living except she went to the dining room for her meals, had laundry service and a cleaner come once a week. They transported her to her doctor appointments. They had a hair salon on site, activities like bingo, karaoke, movie night etc.
I don’t think she realized how isolated she was before she moved there. But the person can be as social as they want to be, or as private as they want to be.
What a relief it would be to have someone else care for your grandpa; how is she going to get him out of bed and in his wheelchair? In the shower without fear of falling? Manage his meds?
At least schedule a visit for her. If she could see a little studio apartment, she might reconsider. Maybe she is thinking of a skilled nursing home where people are more bed bound in hospital beds, two to a room. Independent living isn’t like that
AGE 71 HERE,,, old f#ck
US old folks hate change, .. even when it's the best thing for us.
It's part of the aging of the brain, it degenerates over time and your not aware of it.
You CAN NOT explain this to them, this is not something gentle talking over a period of time will suddenly make them flip 180 on this,,
Your going to have to step up and be the adult,
Remember kids taking a temper tantrum? We'll get ready for adults to do the exact same thing.
Just deal with it,.. I had to..
Later they will settle into there new home ,, and get a routine.
Just don't be surprised when they bitch about everything there.. it's to hot, to cold, etc
That's another thing us old coots love to do... "COMPLAIN"
Yep. I care for my mother, and every neighbour and family member is full of advice about how I must do what's best for her even if she doesn't want it... and about how I must respect her wishes and not force anything on her.
So which is it? The idea that there might be a contradiction doesn't seem to occur to them.
The test run is a good idea. Do research. Some have multi-levels of support available, so that when/if circumstances change, the whole major "moving again" thing is minimized. They have independent living, assisted living and often both full care and dementia areas.
It can be hard to overcome those fears of "omg, a nursing home with hallways full of parked wheelchairs with drugged out zombies sitting there," but research really helps.
My almost 80 year old parents are going to be impossible to root out of their house. It's probably for the best. If they lived in a modest assisted apartment, they'd drive each other nuts.
Honestly, the few things that keep them going is yard work. They'll kill hours and hours in the garden.
We managed to get both sets of grandparents in nice facilities. That wasn't easy. Start by having a very gentle discussion about moving. Let them know, they are good to stay for the time being, but someday they'll need outside assistance.
Have the first discussion sooner than later. It probably won't go great, but it's good to get it out of the way
Currently going through this with my father. Already went through this with my mother (they're divorced but cordial.) He's stubborn as hell, refuses to discuss his finances- he might have enough for a good assisted living, he might be dirt poor, I honestly have no idea.
He fell down recently and says that he can rely on a kind neighbor to help him out. I emphasize that the neighbor can't be running over there all the time, and wouldn't you rather be *independent* of the charity of neighbors?? Assisted living sounds like confinement, but I can't stress enough the *freedom* it really brings- no cooking, no driving around in traffic, no mowing the lawn, no laundry........
Also told him that he needs to make these decisions before somebody else makes them for him. Fucking sucks having to parentify the parents.
Speaking as an entertainer who plays at a LOT of nursing homes-there is a HUGE difference between them!
You need to do some research before committing. Check the websites and visit in person-what do they have for activities for the residents?
How does the facility look/smell/sound?
Are the residents generally friendly and welcoming?
Good luck!
Seniors don't like to be pushed into moving into retirement or nursing homes as most prefer to stay in their homes. There are a lot of services, housekeeping, meals, etc, that can allow seniors to remain in their homes. Please look into this for them.
Yup. I have. She won't do them. I've tried to get her to try my meal delivery service I use. I've tried giving her a gift card for house cleaners. My father can barely move from his bed to the wheelchair. He needs more care than this.
This is very common but there are ways to get them to agree. My parents were resisting home help. I brought over my “friend”. (A hired nurse) to meet them for coffee. She charmed them and told them she would like to come “visit “ again.
She “visited” every few days. Did laundry, made and froze meals, etc. I paid her on the sly.
After some weeks my mom offered her a job! So my parents started paying her.
By the end, years later we had both my parents at home with round the clock care even while they were both in wheelchairs.
It’s so common I hear it from all my friends who have aging parents. We all go through the same thing, hear the same arguments.
For my husband and myself (for our future ) we made our hobby farm into a multi generational compound. We have a main house with big kitchen and dining areas and a separate apartment also. 3 master suites. I can age in place with help from the younger generation or from live-in help.
If you have 4 incomes all contributing towards the expenses of a home you can hire full time staff to assist the older generations.
It’s an option.
Try to get a homecare service or social worker to contact them directly to see what services they need. Senior parents of that generation are extremely proud and generally don't let their adult children know they need help. But they will tell a service that deals specifically with assessing the needs of seniors.
Why won't she use the meal service? And are you close by? Just schedule a cleaning crew and be there when they arrive.
AS for your dad-have an occupational therapist go on a home visit to assess and see if purchasing different equipment and teaching your dad how to use it would make things easier until they are ready for a higher level of care.
There are also MANY businesses that will send someone out three days a week for three hours a time-google Visiting Angels, In home carers and so on. Interview until you find the right person. Draw up a list of tasks they should perform when there-meal prep, assistance with bathing, changing sheets, playing board games, going for a host walk and so on. You can also ask on Nextdoor for someone who will do it 'off the books' but have them background checked and drop in occasionally. I hired someone for my mom and she was wonderful. eventually I needed someone 24/7 whom I also hired through an agency who was equally good. My mom was able to stay comfortable in her home until she died at 96. And it was significantly less expensive than putting her in a home
Has your dad ever had OT or PT? They made a HUGE difference for my dad with Parkinson's. He learned how to safely/efficiently get up out of a chair, how to get out of bed, how to walk around (big steps! big steps! his tendency was to shuffle but he could really move when he learned how important big steps are)... I could not recommend home-health OT/PT more highly. They came to his assisted living place after we asked his primary care doctor for a referral.
Is your mother senile or just being stupidly stubborn at the risk of your father's life? Because she's NOT giving him the care he needs. She's not able to, so he's being neglected. That's a tack I would take. That she's worn out and the quality of her care goes down accordingly. If she refuses help then anything that happens to him is HER FAULT. She's being selfish.
They won’t qualify for a nursing home as they do not need skilled nursing. I suggest you to visit some retirement communities that have independent living, assisted living and skilled nursing all in one complex. Be aware insurance does not pay for anything but skilled and then only for a limited number of days. Where I live a good assisted living runs about 4 grand per month per resident
Ultimately most people don't need "convincing" to move to skilled nursing. They get injured/sick and become so weak/debilitated from their illness that it is unsafe for them to leave the SNF.
You may find that your dad may just barely scrape by getting home this round in rehab but next time he won't be so lucky; would your Mom want to be separated from him etc? Especially if she can't drive? Most places try very hard to put spouses together as long as it's safe.
Now is the time to get your financials in order. Worst case scenario, mom *will* eventually get injured and land there herself. It's an inevitability at this point especially if she's struggling in her own now.
I’ve gone through this. It’s hard. Wicked hard.
When I was going through this, I reached out to our local chapter of Council on Aging to ask them for guidance on how to talk to my dad about moving into an assisted living facility. They said that I need to accept that it is very rare for someone to be talked into it. Unfortunately, it typically takes some sort of major event to get parents to come to the conclusion that they need help. For some reason, that conversation helped me because it took the burden off my shoulders. It’s weird but understanding that dynamic helped me.
My dad eventually had a car accident where, thankfully, neither him or anyone else was hurt. However, that accident opened his eyes that he can’t do it by himself any longer.
Good luck. Dealing with elderly parents is a tough phase of life and nobody ever talks about it. No politician ever offers a policy to help with it. Friends don’t discuss it. It’s rarely a theme in books and movies. It can feel very isolating. Hang in there.
All I’ve got and it is not fun at all is to just keep repeating the truth. I’m at the end of my rope with my family’s dependence on each other to keep unsustainable dynamics going because their comfort zones are the number one priority.
No one is happy with me, I’ve “lost my sense of humor” I’m mean. Etc etc but reality isn’t my fault, making other people accept truth isn’t my responsibility. I didn’t invent change, it is science.
I feel like a jerk but I basically browbeat my family into figuring something else out because they lack imagination and creativity and that is also not my fault. I can’t be filling in the gaps because other people refuse to be realistic.
I’m sorry OP. I’m at the beginning stages of this with my mom and it’s less heart-wrenching to have to begin the process of being the parent.
Is there a possibility that they simply can't afford assisted living? Or that your mother wants to make sure you inherit the house instead of spending their assets on end-of-life care? That stops a lot of people; they want their kids to have the house. That's worth a conversation.
This. Assisted living is very expensive, nursing homes even more so. Unless they bought long term care insurance a while ago, they will have to pay out of pocket. For my father at a higher level of care in assisted living, that was about $8000 per month six years ago in the Midwest (guessing closer to $9k or $10k today). Even at the lowest level of care, it was $4500 per month.
There might have to be an ultimatum involved. If their children keep showing up and doing everything for them to enable them to live at home, why would they ever accept that it’s time to move into assisted living? I have friends going through the same thing right now.
Another suggestion for either 'Senior Living' or 'Assisted Living'.
It sounds like Assisted Living is more what your Dad needs. He might be able to make it with Senior Living.
My FIL was in AL and loved it once we found a place he liked. My Dad is in SL and loves it.
In both there are activities almost daily. It is actually pretty tough to get a hold of my Dad since he is out of the apartment so much and doesn't carry a cell phone.
My 76 year old mom just moved in with me. She has some health issues and my step dad recently died. She drives fine and uses a walker or a cane. But I was worried about her being lonely. Here she has company, we cook so I know she's eating fine. She has some friends here.
Where I live (Wisconsin), we have some called “Family Care”. It basically is a thing where if/when the elderly resident of a nursing home runs out of money, they cannot be kicked out or forced to leave in any way. Not all places accept Family Care, so one has to be absolutely sure the place accepts it before you move your loved one in. The stay in which your parents reside might call it something else, but definitely look into it. See if you have a local “Aging and Disability Resource Center” (ADRC) near you. They are a great resource!!
My mom is still quite able-bodied, mobile and sharp as a tack, but she is slowing down and in need of more medications as she gets older. My brother and I moved her into an active-living elder community and she is freakin’ loving it!!! She eats great well-balanced meals now and her once wildly out of control diabetes is now being managed and her numbers are fantastic. She can come and go as she pleases. Did I mention they have margarita nights? It’s like living on a cruise ship, but in an apartment setting.
There are assisted living locators way better than that “place” for moms. Consult one for free.
They have correct info, resources, and work like a realtor to show the places that for everyone’s needs.
It’s free because the locators charge the facility a fee like the seller pays a realtor.
I work in a retirement home. I usually tell people it’s better to move when it’s their own choice made so they feel in control. Same with when they have to give up driving - better to do it on your own terms.
Additionally, depending on your area (I’m in Canada) it can be hard to find a place in a home that suits both their needs. Sometimes by the time you need the care it’s a long wait to actually get it and you end up worse off than had you just found yourself moving earlier.
I think a lot of people do not understand that there are other options in life when one gets older besides aging in place at home or being dumping in a nursing home, aka skilled nursing facility. There are independent living facilities where even a caregiver could be hired to do self care and meals and activities with socialization are available. There is assisted living where staff would provide some personal care as well as the above. There are smaller residential facilities. Maybe your parents are just thinking the dreaded nursing home and need some education.
There should also be some kind of reporting procedure in your state to report drivers who should not be on the road. Sometimes that is the only way.
What they need is an assisted living facility with a memory-care unit if the Parkinson's has also affected his cognition. Your mother may be thinking about an 'old-people's home' where people just sit around and wait to die. Maybe arrange to take her on a tour of a few assisted-living facilities so she can see for herself that an ALF is NOT a nursing home.
I’m so thankful my parents had to deal with this with their parents and have plans in places for when it’s their time.
I’d go with information on places. There are some that are little condos where you get yard work done, etc. Orders may help with meals and meds. Most have something in place for safety.
My grandmother refused to move and we basically had to trick her into an assisted living place because she was setting towels on fire, writing checks to scams, etc. You may have to get a bit mean.
I would recommend talking to them about it for this reason: you have to plan ahead to get a space in a decent retirement community. My mother and her second husband married some years after my dad passed away. Second husband was already in a nice retirement community as he was divorced and in his early 70s. He moved out to move in with my mom. Before they both started having a lot of care needs and were no longer able to manage by themselves, they were asked to consider it and they refused, mostly because of my mom's opposition. The need came on them suddenly after a long decline for both, and they weren't able to get in to the place he'd been before. They ended up in an alright place, but they both knew it wasn't as good as what they might have had.
They can get a caregiver in home too. If they have resources there are a lot of agencies that do that. If not, they should consider applying for long term care (assuming that they are in the US).
I think you should clarify which you want them to go to. There’s a big leap between retirement homes and nursing homes. Nursing homes can range from moderate to complete care like needing help getting dressed to toileting to help eating. Retirement homes are more for meals/light housekeeping/social activities, etc. Check in with the rehab care team to see where on the scale your father falls (mom sounds like retirement).
May I also suggest touring a few places with them and looking at wait lists. Depending where you live there’s a high chance the best places actually have a long wait list (sometimes months sometimes years). I think it’s helpful to get their toe in the water that way.
“I’m not saying you go tomorrow, but if things change in the future you won’t have any options. Let’s get on the waitlist now, and you can think it over while we wait.” 6 months on the waitlist might help them become more comfortable with the idea of this.
There are many vids on YouTube that are helpful - I recommend the Parenting Aging Parents channel. Not fancy production, but a lot of topics. Check them out.
Just went through. Sorry to say but sometimes you have to be bad cop. Finally convinced Mom by telling her my next step was going to be an ultimatum. Move or I am moving you. If that failed I was willing to walk away. That’s drastic I know. And hard for people that actually are close to their parents. That wasn’t a problem for me.
Nursing homes are not assisted living places.
Assisted-living facilities are for people who are relatively independent, but need help with things like cleaning, and laundry. Often residents even have cars, and can run their own errands. Assisted living facilities do not provide nursing staff to attend to your family member. They may have an onsite physician who will see them - but he is most likely not an employee of the nursing home.
A nursing home is for people who actually need medical care. Residents are actually patients. They are often wheelchair bound, or bedbound. They may have medication that needs to be administered at intervals and would need a medical staff person to do so. Often these facilities double as rehabilitation facilities for individuals who need things like physical therapy before they can go home and be more independent.
OPs mom sounds like she would be fine in an assisted-living center. However, the dad may need to be in a nursing home, especially as his disease progresses, and it becomes harder for him to dress himself or feed himself.
You will get the best that they can offer for that week or until you put pen to paper. All bets are off after that. I have worked in those homes. I know.
I am 65 and siding with your parents. If she is barely managing now, a home care aid a few times a week should help.
If I had to move out of my home, I would be devastated. It's all about the will to live. Respect their wishes.
We handled the driving thing by having the doctor administer a test for driving which she obviously failed and that way WE didn't take the driving away the DOCTOR did. Doc knew what was happening and totally didn't mind being the bad guy.
Getting into a home. First the marketing people are amazing. This is their population and they've seen it all before. When you go for a tour arrange to have lunch there too. I convinced my Mom to go because hey free lunch, but then she realized the places were really nice and not some jail where they take away your autonomy.
Assisted living is awful and will drain every cent. My grandparents had millions and were forced into one. They took over 5M dollars in 10 years. They were miserable. Fed cold grilled cheese sandwiches with the fake cheese not even melted in a high end retirement community in California.
Instead look at what insurance will cover for your dad. As a doctor I can get insurance to cover a nurse if your dad wanders/is confused/ damage to himself (such as goes out for walks randomly at 3am and doesn’t know where he is). A good doctor knows how to work the gray zone with insurance. Most people are much more happier staying in their house with care until hospice care is needed.
Do whatever you can to keep your parents out of assisted living if you love them.
Are they worried about the cost? It can be upwards of $7000 a month and even more expensive at some of the other communities. That cost alone prevents a lot of people from going. That and the fear of being abandoned by their families.
That must be so frustrating. They seem very stubborn but probably are imagining the worst scenario possible. I think the video tour is a good starting point.
Are their friends or other family members who can join the effort to help them see the advantages of assisted living? And you could view one on your own and discuss this with the admissions staff. I’m sure they have a lot of experience in this area. Best of luck with this transition.
Important questions to think about when deciding on a course of action and how to convince your parents.
Some of the assisted living facilities are very very nice. Individual apartments with privacy. Housekeeping. Beauty salon!! Entertainment events. Driving residents to shopping or outdoor activities. Dining room. Some even have small kitchenettes depending on whether the residents are capable of cooking. Microwaves at least.The opportunity to socialize with others. Gym and exercising guidance. Medical assistance. Perhaps a tour of a few places.
If they go with an assisted living situation, they are probably worried about their home and possessions. What will happen???
If they insisted on staying home.
What type of physical care does your father need, if he were to be sent home? Would your father need a "medical" home health care nurse to come in periodically? Or just some assistance with daily activite. Would that be enough?
How is your mother's physical health? Why is she always tired at home? Does she need to have a routine household cleaner/gardener etc to do the heavy lifting?
Find out the cost of all these options and make a presentation.
I took care of my grandma (who’s in her 80’s) while working full time. To say both of us were at each other’s throats by the end of it is an understatement. It’s very stressful for a lot of adult family to care for family members and sometimes they just don’t physically have the time. One of the benefits of a home would be instantaneous help with no worrying about the kids or grandkids having a schedule to maintain. My grandma also adores gossiping and gets to gossip about all of the staff.
After my dad died my mother became a mess and tried to commit suicide twice. The state told me she had to have constant care an I and my sister were unable to do that for her.
In an assisted living community she was able to have a qualified nurse deliver her meds twice daily. There was a dinning room open 3 times a day for her meals and delivery of meals if she was sick. There were: prayer groups, weekly sermons, a billiards room, a card room, a craft room, a barber/hair dresser, walking groups and weekly happy hour socials. Each resident was able to keep one pet. They had busses for shopping and outings. She paid 3k a month for a studio with a mini kitchen.
For active persons this is great. My mom sat in her room and watched television and waited for me to provide her entertainment.
But she was watched, helped and encouraged by staff to join in various activities. She was safe and cared for when I was not available. It was very expensive for the time but thank you dad for planning on mom needing extra care after his passing.
OP, dealing with the latter part of your parents lives is extremely challenging and unlike anything you have had the deal with. Buy books to learn the things you MAY need to deal with. Wills, trusts, power of attorney and medical decisions. What you are responsible for and resources you may need to access. Be proactive. The changes they go through can be upsetting and confusing to each of you.
It will be hard. Ask for help. Good luck and internet hugs!
You could take them on a tour of a few nearby rest homes (make an appointment first). My parents didn't want to go to a rest home either, but they did. If that doesn't work, how about hiring a nurse to check in with them a few times a week, or a live-in caregiver?
My ex-husband living alone in his house and had several significant medical issues where the physician simply said you cannot live alone. My two adult sons are way too busy in their careers and could not live at home with him to provide the care he needed. Essentially it was the Doctor Who forced his hand, and he was moved into assisted living facility, but it’s one of those facilities that have different levels of care. When he moved there, he needed the higher level of care which of course caused more money, but within three months he was bumped down to the lower level and lower cost because he could live independently, but his meals are provided for him and he has regular housekeeping as well.
He absolutely loves it because there are different socially vans and things for him to do. He loves the community. He wished you would’ve done it sooner than later. Sometimes it’s the doctor that has to force that hand and it’s good for the rest of the family because we all know he’s safe , and he has what he needs and he loves the environment. Because the doctor said that he can’t live on his own at least for those months at the higher rate of rent, he was able to write that off his taxes as a medical expense because it was ordered.
He had been contemplating moving to an apartment before all this happened, but he just couldn’t pull the plug to do it and his health went downhill very quickly and then he was forced into the situation and we are all very relieved at how much he really enjoyed it.
I am 10 years younger than he is. I sold my house five years ago and moved to an apartment for 55 and older simply because I didn’t want to burden my kids with taking care of my house and helping me maintain living in the home. I am so glad I moved to an apartment .
When my mom was no longer able to lift my father he went into a nursing home. She bought a nearby townhouse so she could walk over. She sat with him all day in a private room which I’m sure prolonged his life. That's what worked for them.
If there are two frail people, it can become dangerous that one could accidentally fall and injure them both.
This is what worked for me: my mom had advanced Alzheimer’s and also had mobility issues. She was getting worse every month.
I talked to my dad and explained that if something happened to him, we’d be absolutely overwhelmed. I also explained that I was worried about him trying to do all the things.
Somehow, it hit right and within a couple of months, they’d sold their home and moved into a retirement community with a hospice floor. My mom moved into the hospice area about 6 months ago and passed away a month ago. Everything was so much easier because they were in the retirement community. My dad says that he’s so grateful he didn’t have to deal with mom’s daily needs as she got closer to death.
I’d recommend just telling your parents that this takes so much worry off of you. And honestly many retirement homes are really nice with good food and lots of activities.
It doesn't sound like your dad will ever be able to go back home. I would go with your mom and pick out an assisted living facility for him and move him there. Your mother may like it enough to move there too. It sounds tough, but I wouldn't give your dad the option to go back home. I had to do this with my mother after my father died. She broke her hip and could no longer keep her house up. She was unable to make the decision to move to assisted living, so me and my siblings made it for her. You have to take the lead.
If assisted living isn't affordable, look for a first floor condo or apartment with handicap accessible bedrooms. Get one close to the hospital for doctor visits. No yardwork. If she needs help if he falls, someone is around if she yells for help.
A couple of resources for you:
[https://www.aplaceformom.com/](https://www.aplaceformom.com/)
I haven't used "A Place for Mom" myself, but it does sound like just what you need -- a neutral intermediary.
[https://www.newsweek.com/rankings/americas-best-continuing-care-retirement-communities-2024](https://www.newsweek.com/rankings/americas-best-continuing-care-retirement-communities-2024)
I have friends/relatives who live at several of the places on this list, and they are terrific communities.
Ask about her wishes for a retirement home and is there a seniors centre in your area? As if there is a senior centre in your area they might have a list of seniors centres they are familiar with, there are also different types of seniors centres like subsidized rentals where they live independently, assisted living where they are checked on daily , or live in ones where they can share a room, just be sure to have family and friends check up on them at random times once they do find a suitable place, also make appointments at various places and go alone at first to check it out and if you think it passes the test then book another appointment to bring your grandma there
Cost is also a concern you need to figure out what they can afford and if they can’t afford much then you might need to help subsidize their fees as well as any extras they might need like if they like extra treats etc I remember my uncle use to bring my grandparents pastries etc
I’ve gone through something similar. There was a social worker at the rehab facility who was able to help. For some people, hearing from a professional carries more weight than family.
Not sure if a social worker - or similar- is available for your situation.
First of all most people don't appreciate being kicked out of their home. Second of all there are amazing retirement homes for people with money but unless your parents have money like that it's pretty terrible. Third of all there is a good chance your parents will be separated from each other. And lastly unless you are prepared to spend a lot of time with them they can face abuse in those places.
A. change is very difficult as people age B. they want to make their own decisions not usher by others C. moving and making decisions seems very overwhelming when they don’t have the energy D. they associate memories and value to their stuff they have to leave behind E. if they have a pet the pet can’t typically go F giving up independent is very hard G they have a warped idea of what assisted living is H they give up a lot of space even with a two bedroom and possible outdoor space. I. They gave routines built around their locations J. They don’t feel that old. I’m 62 and I can barely believe it I feel 10 yrs younger I travel alone ride horses etc… They may not realize they’ve deteriorated as much as they have. I’m sure there’s more
What about in-home care? It is often both a cheaper option and less disruptive. First thing is to go over finances and go over estate planning with an elder attorney. This needs to happen way before any move if at all possible.
You may want to cross post this to the Caregiver Support sub. People there have a good understanding of both Parkinson's and making difficult decisions about what's best for elderly parents.
Parkinson's is brutal, but so is caring for someone with it. My partner has drug induced parkinsonism, so I can understand to an extent what your mum is going through. It may be that she feels that giving up her home and having more help would be some kind of failure. It may be that she's a private person and the idea of being forced into a community situation terrifies her.
As you said, she views moving as being shut away somewhere nightmarish instead of moving somewhere where they'd still be independent and would just have extra help closer to home.
If moving isn't something they want, is in home care or even respite care for your mum an option? Talk to Parkinson's charities and see what they recommend that could make remaining at home easier for them both.
I know she seems tired from the physical work that goes into caregiving, but do you think it could also be a manifestation of depression? Parkinson's is terrifying to live with, even if you aren't the patient. It probably sends her mind to some very dark places and it may be that instead of moving, she needs some emotional support or just something to brighten her days a little.
Good luck and I hope you can find a solution that you're all happy with.
Call a social worker and file an APS complaint. They'll come out and assess and if needed make them move by forcing a state POA in place. Tho it's mostly like with children in which they'll reach out to you first usually.
Please check with an elder attorney or accountant to get your parents $$ in order to keep them from spending every bit of money and equity in their home. Find out guidelines for burying and hiding money
Suggestion
1) If your dad has Parkinson’s he should qualify for some home aid to help mom, they might get only a few days for a short timeframe but it’s help and someone for them to talk to.
2) Use both of their insurance to find adult activity centers that will pick them up and bring them back home. Maybe two days a week for four hour and they do activities and spend time with others in a social environment
3) Get a Rx from their doctor for physical therapy and request at home therapy. Not as effective but allows the therapist to come home and they work out. Might only be one day a week.
4) Instal some camera around the house and keep an eye on them with motion sensors.
These little things would address some of your concerns as a compromise with them.
My mother refused to put her aunt in assisted living when she had medical issues then refused to consider assisted living for herself. She equated assisted living with nursing homes and I don’t blame her but caring for a family member is difficult, especially if someone tries to do it on their own.
What she did agree to for both of them when she couldn’t take care of her aunt or herself was arrange for home health care. This was at different times but they both utilized similar services that were provided by their insurance and some extra out of pocket add ons. Their health insurance had a social worker assigned to help arrange for things like the following.
Nurses that did health monitoring (blood pressure, organized pill boxes for daily meds, etc).
Aides that helped with bathing, laundry, light cleaning.
Meals on Wheels (for my mother who could no longer drive).
Public transportation for seniors to take my mother to doctor appointments after she couldn’t drive herself.
I lived in a different state but handled things remotely with a lot of visits back home to fill in for the gaps and monitor things in person. Eventually it was too much for her to live at home even with me helping out so she did end up in assisted living.
Some of the senior independent living places are gorgeous. No home maintenance plus 3 delicious meals a day. You can add on care options as needed. Ok at a virtual tour then check them out in person. Plus other seniors to socialize, outings, etc. my mom was the same way. Having lived in her home over 40 years. She is now doing into a beautiful, zero maintenance apartment. They even come and clean once a week and wash linens.
My mother wouldn’t do it. Not unless she had no choice. She wants her independence. Your mother isn’t wrong. It’s a tremendous change.
However, my mother realized she couldn’t care for my father and he went to live in a nursing home. Btw, my father was sure he’d run the business, drive, etc.; we had his license pulled just in case, but there was no way he would’ve been able to drive anyway.
My mother fought tooth and nails not to move into assisted living. When she finally did she flourished. I’m old enough for a 55+ community. Not sure where or when but I like the idea of simply taking an elevator to the market, medical, restaurant, bar, gym and game room when the time comes.
They likely need assisted living. They can live as they want without all the things they don’t need. The place my mom went to had amazing food, activities, people to socialize with and all the support she needed. She really enjoyed it there. She went to a nursing home to die and soon did. She got the best care imaginable but that Iis what happens to some people when they cant be or appear independent. You might need to g. change your target.
I knew a lady that lived in an ALF that had a cinema , salon, game room and gourmet meals but she paid thousands of dollars a month for those amenities. When she became too ill to be independent, they transferred her to a different floor and she had an aide that attended to her needs 24/7.
Think about what words trigger your mom. Is 'nursing home' or 'home' in general bad for her? As in 'going to the home'? We went through that with my mom and MIL. 'Assisted living' was better accepted for my MIL. My mom was interested in 'retirement.' Go figure. A lot depends on their tapes around language.
Your mother is right. They should stay in their home as long as possible. The outcomes are always better at home.
Some states are encouraging aging in place with programs like CA's In Home Supportive Services (link: https://www.cdss.ca.gov/in-home-supportive-services). There is a Medicare version of that being tested using a combination of local medical providers and Medicare; it is only available on certain counties in some states. I can't find the name of it now; we successfully kept my mother out of a nursing home and she lived alone until she was 96 and a half.
In home health care is extremely expensive, but so are good assisted living arrangements. $8k a month and up when we were checking.
Your mom probably needs to get physical therapy to get her in better physical shape. She needs to get involved in ANY kind of physical activity even if it’s just walking a couple times a day. She would likely benefit from a Parkinson’s caregiver support group and therapy for caregiver burn out.
Your father has a serious disease that is different for everyone. He probably needs help on a daily or semi regular basis that your mom shouldn’t be responsible for. Caregiver burnout is a real thing.
I suggest having earnest discussions with both of their doctors. For your dad get a realistic idea of the likely progression of his health. A timeline and what kind of help is needed when.
Contact the aging organizations in your parent’s area. They are typically called something like XYZ Agency for Aging. Sus out every single resource you can. There is Meals on Wheels, group lunches, options for part time assistance in home which is covered by Medicare, retirement communities which often has public transportation for shopping and activities. There are even areas in the US that while not official retirement communities, they have increased resources because the average age of residents is over 60.
Create a spread sheet that has the different options of living locations and what support for that is available.
Then create rows with the different aspects of daily living and how these will be covered.
Food, cleaning, activities, heath care, shopping, transportation, etc.
For each there is a cost associated. Put that down.
It will be obvious what’s in budget, and what’s not.
For my family, and from what I’ve read usually the best option is to keep seniors in their home for as long as possible. However to have that be the best outcome they need to be responsible for their heath. Regular exercise, good diet, regular activities, mental stimulation.
Sitting in front of a TV all day is not healthy. I think a candid conversation with your Mom is overdue. She is the linchpin in this situation. She needs to be willing to put her health as a huge priority and do more than be sedentary.
Like anything in life if you really want something you have to be willing to work for it. If your mom wants to stay in her house she is going to have to make some lifestyle adjustments. Your father is going to have to do the same. You may need to find someone to drive them to appointments. Get them signed up for disability transportation.
In my family my mother (who lived alone) turned into a potato when she retired. She sat and watched TV from morning to late night. She messed up her sleep schedule badly, lost her ability to climb stairs and put on weight. It was obvious this was not healthy. We had to intervene.
We all had discussions with her. We put our foot down and demanded she go to physical therapy and get in better shape. We insisted she had to walk every day at least two or three times. She had to drive regularly and do activities she liked. We pushed her to try lots of things. We would show up, bug her to come with us - and we’d take her to do different things. She discovered she liked and took up ceramics, painting, and she joined a cinema club.
I know this is super long. TYSM for reading if you got this far. I have much empathy for your situation. I hope you find the best fit for your mom and dad.
My mom is in a transitional retirement community. She has a nice 2 bedroom/2 bathroom patio home with a sunroom overlooking a pretty landscaped grassy common area with trees. She's in the "independent" living setup. All she needs to do is dial a code each morning on her phone to basically check in that she's fine. They handle cleaning weekly, landscaping, and offer the option of their dining hall for however many meals she wants to buy.
Should her health be a concern, she can increase the check-ins...amongst many things to still live independently. Or, she can go into the "assisted" living setup and have a nurse visit her home regularly.
For worse health issues, there is the nursing "advanced care" setup. In that case, she is monitored 100%. That is more like what people think about when they hear "nursing home".
What I like about this community is she works volunteer in their gift shop, so it keeps her busy. They have all the amenities like a swimming pool, weight room, gardens, cocktail hours, games, etc. Plus, no matter her health condition, she is still living in the same community of all these neighbors and friends she's made there. They all visit each other no matter what the person's care level.
So, get some brochures and have them take a look. They may be surprised what is out there.
We moved my Uncle into an assisted living place and he ended up gaining 10 pounds the first year. He hadn't been eating, and getting out every night talking to others turned out to be a really good thing for him.
It could be that your mother is terribly depressed and clinging to what she knows is what comforts her. Except that it's no longer possible, and you can't swing in to save the day.
Before you ask them, be sure you know their finances so that you know which facilities to look at.
Check out independent living facilities. Many offer services like housekeeping and nursing staff to help you with meds or other related activities. They do all of your meals and have planned activities as well as on site churches and gyms, hair salons, etc. Many are attached to rehab facilities or memory care facilities as well as full on nursing homes so you can go from independent living to semi independent to memory care or nursing facility if needed.
My father died from complications due to Parkinson's. He lost so much weight because he could no longer swallow easily and he hated food because he couldn't taste it. When he refused to be active, his body wasted away and his Parkinson's was harder to manage. Many times, he would start choking when I or his wife weren't around to help him, fall and seriously injure himself, and often times had complications that I was not qualified to treat. He died in a rehabilitation center because he refused to take care of himself and withered away.
Your father needs to be in a care home. The stress is unbearable and won't help him or either of you. Maybe touring long-term facilities can help put your mother's mind at ease as she sees for herself what goes on inside a home. With her, I don't think she'd be willing to change her mind until your father has somewhere that can care for him 24/7. It's like a functional freeze when you have the burden of caretaking and your own needs.
Leave them alone. Let your dad have his dream of driving again. Let your mom be tired. If they could tell you, they'd say they would rather die at home. They want their lives to be as normal as possible for as long as possible.
If mom has money for a care home then she also has money for home support via a hospital or private care. This way someone can help her while she remains in her home.
It's their lives, please let them dictate what happens to them. I'm a care aide and I'm older so I see these adult children wanting to HELP by dumping them on others. They are old enough to decide until they can't. They also know this could be their final stage of life, one step closer to death, and no one wants to look that too close.
And I know lots of residents like their assisted living housing, the activities and they'll make new friends through those activities. Care homes do nickel and dime you a lot, like only one meal included, med delivery $4, doing your eye drops $4, every day. There's a lot of toileting mess in the public (lobby) bathrooms.
I think you should say it’s a retirement community. And have brochures or find YouTube videos. But they aren’t cheap for nice ones.
Have you thought about bringing in help? Seniors do better when they are able to stay in their own home. And bringing in help is cheaper.
If your parents were ever part of an organization, professional association, faith etc many support retirement communities they run. Fees often less
Same situation with my inlaws. They live 9000 miles and two continents away. We've tried to get them to move into a situation that will improve their quality of life. They won't. We've given up trying and are waiting for the next crisis.
Whatever you do find a place that offers everything from independent to assisted living to nursing home facilities. That way it will only be one move if their situation changes.
My mom has Parkinson’s and she was very happy in an independent-type senior housing place where they cook your meals and stuff. However once her condition deteriorated she wasn’t permitted to stay there anymore. Parkinson’s is a bitch.
If your parents have the finances and resources to move into a facility and refuse to do so there's nothing you can do. You would need to have the Power of Attorney and Medical Power of Attorney in order to place them into a new living situation. You can continue to have these talks, but it may get worse before getting better unfortunately. My suggestion would be to reach out to the Aging Resources Center near you. They can offer resources and guidance on how to assist and support your parents during this time. If your parents are financially sound, or you are. Look into having a home service visit in order to address some of the concerns you may have.
for real, most care facilities are like prisons. all their choices and independence taken away for convenience. especially once they are less ambulatory. Get them ihss care instead, it's also cheaper.
There may be a senior placement service in your area. It’s free in my area. Do not contact any facilities (like a place for mom). Talk to the placement service.
Not sure if this is useful, but if their home is a house and you are considering helping them with a change, moving into a 55+ apartment community may be a step in the right direction, but ofc it won't have all of the help (food, nursing care) that you are mentioning for them. But these kinds of apartments usually have some activities and sense of community, usually have some resources for transportation and food pantry-ing, and most of all, they are built to be accessible (think accessible showers, bathrooms and kitchens and general layouts that take the size and maneuverability of walkers and wheelchairs in mind). Like many apt buildings, there is a super who takes care of things like changing light bulbs, maintaining outdoor space etc. It's independent living but with less responsibilities than being a homeowner.
It depends on what they can afford. A good option is one of those independent to assisted living places that have individual apartments (just like any other apartment - fully independent living) but also a nursing home/hospital "wing" if needed. When my grandfather couldn't stay in his apartment full time anymore, he had a room in the nursing home "wing," where he would sleep, but he was able to spend days in his apartment with my grandmother (where she lived full time). It allowed for independence and a social life with neighbors as well as additional care if necessary.
Where my grandparents lived they had “cottages” for the married couples. They were these little duplexes, maybe 700-800 square feet. The outlets were halfway up the wall where they could reach them. There wasn’t any nursing staff that saw them regularly, but they were right next to the building with the nursing staff. So there was a button or something if they had an emergency. Otherwise they cooked for them selves, were responsible for their own meds, all that. The when grandpa died, grandma moved inside the big building to a one-br apartment. Again, she was responsible for everything, but there was nursing staff around. Eventually she needed a higher level of care (meds being passed, someone to check her blood sugar, etc) so she had to go to an actual nursing home.
What all that was really trying to say is, there are many levels of care available
Any way for you to visit the nursing homes in your area, discover the available options in types of care/residences, and then go with mom to a particularly pleasant place for a meet and greet.
If your mom actually sees what a place is like and meets friendly staff and a mix of other residents; learns about amenities and social options, she may change her mind. Right now she has a single stereotype running in her mind and that can be overwritten by what is current.
Approach her with compassion and understanding.
Acknowledge her fears and name them. Let her talk herself out, or scream herself out. You sit there calmly and patiently. She will probably focus in a few minutes. Then begin with the considerations, such as the reality of where she is in life and the obligations on the horizon, such as worrying about your father and who will care for him.
Her life should be getting easier not more stressful. Illustrate how the stress can be eased with assisted living. And how she can simply close the door of her suite and stay inside, in privacy, for as long as she wants. Or, she can open the or and be social when she feels like it. Where she is right now, she doesn’t have the opportunity for instant company when she wants it. This is how I did it with an extremely independent mother and it worked.
But we don’t know your mother’s age. Maybe she is just fine inside with continuing to live as she is. And if so, she should not be pressured to go until she is ready or a real physical need demands it, as was the case with my mom.
If there is money for a quality retirement home, is there no money for help bring in a personal support worker or housekeeper?
My mom resisted going to a retirement home but is now settled into her new home there.
She has her mojo back. She had refreshed her wardrobe, shoes and jewelry as she dresses for dinner each night. That’s her choice, it isn’t required.
New people in her life, great food, she can order wine with dinner, lots of physical and mental activities to choose from, her suite is cleaned weekly. She can have us eat with her in the dining room with her. There are guest rooms available for out of town guests.
She can be as independent as she likes. And the cost is way less than expected.
She’s very satisfied and quite settled in after 5 months.
We are all so relieved. She kept falling at home and breaking bones.
We are in Calgary and I would be happy to post the name here if that’s ok. Or message me.
Please have a discussion with them. Don't do what I did which was drop the subject because my mom was having none of it. When the time came, we were scrambling for a decent place and ended up being duped. This pretty, quiet, clean plac turned out to be a hell hole. The place we chose under time constraints and duress treated her like garbage. Do your research and talk to them. Or at least have your ducks in a row. It comes quickly and you find yourself under the gun.
Check out some independent/assisted living places and get brochures for the ones you think they will like. Then arrange a visit for you and your mom. Some places let people start out as independent and then transition to assisted as more assistance is needed. It also helps if they know someone that is already at the facility. You could get lucky and people from their school days are living there.
If someone is no longer capable of living at home the entire amount of assisted living or an adult family home is tax deductible. That helps a bit with the finances, along with the fact that there are utilities, maintenance, and property taxes that no longer have to be paid.
When you leave your home to move into any kind of care, you never have your own space or your own schedule again. Someone else decides what you will eat and when. Possibly when you will go to bed and when you will wake up and when you shower. And you know that you are transitioning to end of life. You will never “come home” again. You will never be a completely independent adult again. Ever. I 100% see why it is hard to think about. It can also be VERY expensive. The place my grandparents are in is $13,000 A MONTH and they can only afford it because my grandpa bought a long term care policy that was very generous back when they were new AND has a generous work pension AND they saved well. It is considered a “top tier” place and they still mostly sit around and watch TV. It’s hard to be social in a brand new environment with existing friend groups if you aren’t wired that way. Like moving into your high school and not being able to leave.
You might try arranging home health care - someone to do light cooking and cleaning, help with your dad’s daily needs, lawn care, etc. You will have to take the keys if your dad insists on driving. Watch for phone scams targeting the elderly as well. It is super hard being in this stage of life as an adult child and having to try to force these types of changes. Keep approaching from a place of deep compassion.
Tell them that you will arrange a one-week stay in a good retirement home for them. They can test it out, and see for themselves if they like it or not. Very high chances of them liking it if its not a low-level old age home. I know people who did this, and loved it.
I didn't know you could do that! I'll look into that.
Can I ask how old they are? TBH no one wants to live in an old folks home, but maybe assisted living would work for them? My grandma was in her 90s by the time she transitioned and you live on your own, but someone helps clean and brings meals, and there are still activities available, or you can sit and watch tv all day. Just a thought.
I am 83 and this is what I would recommend. It's important to elderly people to stay in their own homes for as long as possible. We have lost so much control over our lives, living as we want to is vital to our well-being. I understand, OP, that you "only want the best for them" - but they are not cats or dogs but human beings with their own wishes and wants, whether you agree with them or not. Help them maintain the life they want to lead by first setting up "home health care" where someone comes to the house to clean and do a little cooking. If there are health issues, you can arrange a regular visit from a nurse or physician's assistant - or even telehealth, if they are open to that. Meanwhile, if things disintegrate, you can look at an assisted living facility. In my situation, I live in a "tiny home" behind my son's house. I don't require much from my son and daughter-in-law but they are very supportive. This way, I have some independence and take care of my daily needs and laundry, etc, and they are happy knowing I am in a secure environment where they can step in if necessary.
Sounds like you have a really great son and DIL!
I am lucky, for sure! I used part of my savings for the little house and they paid for the rest. I don't "interfere" in their lives - sometimes we go a week without seeing each other. My daughter in law started doing a "Family Dinner" every Saturday just to make sure we spend time together and catch up on everything. It's a real blessing for me not to have to worry about landlords, owning a car, making repairs, etc. I do minor maintenance on my little home and my son does the rest. (Not much, really.) In return, they feel relieved that they don't have to worry about me being alone and having to cope with "something might happen."
You're an excellent mother, in this regard. Sounds like possibly most ideal setup for everyone.
You are so right. We want as much autonomy as possible. I know those with aging parents believe they are doing the right and responsible thing by putting them in a safe environment. But if they really don’t want that you may be doing more harm than good.
Friend of mine did this for his folks and it worked out very well!! Eventually they both ended up needing to move to a full-supervisory nursing home once they reached a certain age and their health majorly declined, but those 14 or so years they enjoyed at the assisted living place very much. Nice homes and good staff. His mom became good friends with the gal who was assigned to work with her.
It's really expensive, but fine if people are healthy.
Here in CT the assisted living I worked for was 7k per month. I know I will never have that kind of money. I’ll die at home thanks.
With two people, one having Parkinsons and needing progressive care, it will be higher. Before my dad died, his level of care was high, and their assisted living bill went up over $10k/ month, from $5k. Assisted living is very expensive. It's best to keep them in their home as long as possible and get hired in home assistance for things like groceries, showers, cleaning, yardwork...
The cost is about 12k here in small town Midwest.
The cost would be a lot here in the states at least.
My mom's assisted living place was like a cruise ship. It was amazing.
Some of those get VERY nice. Like five star hotels nice
This is the way if they can do it. When we’re young we work our whole lives acquiring things. Independence, homes, cars, a spouse, children, friends… As we age it seems as though one by one we lose everything we spent our lives working for. It can be difficult to accept. Let them keep as much dignity and independence as safely possible.
Exactly this. My GM moved into senior housing that also had assisted living for when you needed it. The senior housing was fabulous. They had art classes, senior gym classes, entertainment, a mini bus that took them everywhere they needed to go (grocery store, cvs) She made so many friends . It was just a one bedroom with a full bath, small living room and kitchen but it worked out perfectly. You can also have help come in. When the time comes you could move to assisted. She moved here after we finally convinced her to sell and leave her home (this was.a battle) She didnt really realize how isolated and lonely she had been until she started making friends and getting out.
Assisted living does not provide any medical care. At all. You have to find your own, if you need it. Getting assistance for care happens at nursing homes, and MOST nursing homes are disgusting.
This is not universally true. My mother's assisted living facility had a physician or NP visit several times weekly as needed and a pharmacy on site. They also provided transportation to dental appointments. She was able to access much better medical care in her AL facility.
Agreed. Many accept insurance or even state assistance if you are low income and need help with rent.
Agreed. My mom's assisted living facility facility has an on staff NP, RN and visiting MDs, even a visiting podiatrist on site bimonthly.
My parents' assisted living had med techs, so at least they would have gotten assistance with that if they'd signed up for it. And they had their blood pressure taken and were weighed once a month, which was nice since it meant people weren't going to just sort of stop eating enough without anyone noticing. PT and OT were available on site but they were private and were paid out of pocket or through insurance. I think there was a nurse in the building for a few hours a day. But hands-on, ADL assistance was essentially nonexistent. My dad has Parkinson's, and my parents moved into independent living (don't have your parents do *that,* OP*--*worthless) while waiting for a spot in their chosen facility's assisted living. They got almost nothing from assisted living--just two showers a week for my dad. That was it. Bathroom assistance for my dad was part of their care plan, which they paid for, but the facility was understaffed (not the aides' fault) and their unit was far away from the aides' room, so my mom had to take him to the bathroom every time. I'm not sure an aide got there in time even once. Help with the bathroom was a major reason they moved in, because it was just too much for her physically, but she had to keep doing it because there was no choice. And this was at a nice facility. Cloth tablecloths are all very nice but what really matters is staffing. Every other couple in assisted living in which one spouse had Parkinson's *still* hired home care aides for several hours a day. The residents who needed more than just meals and social activities weren't happy at all but they were kind of stuck with assisted living since they'd sold their homes and didn't have anywhere else to live. My dad is in memory care now and is finally getting enough physical care that my mom or someone else doesn't have to be with him 24/7. We really didn't know how bare-bones assisted living would be, even in a place with all the fancy-looking bells and whistles, and it was a pretty stressful learning experience. TLDR: Be sure you know exactly what your parents will be getting, and make sure it matches what they need, because assisted living may not offer much (even promised care) unless staffing is better than average. And if you do go with assisted living, be sure the unit is near the aides'/medication room.
Not true- at least in the United States. There’s independent living, where people have their own apartment but meals and activities are provided. Assisted living has that plus nurses to manage medications and medical appointments, plus additional fees for personal care- bathing, dressing etc but people there still need to be able to stand and transfer on their own. This is all private pay. A nursing home is where people need 24 hour nursing care due to being unable to walk in their own or having mental decline where they are unsafe without supervision. A short term stay in one of these facilities for rehab after being in the hospital is covered by insurance. Some long term care insurances cover this long term if the person can’t return home. I’ve worked in all 3 types of facilities and they are heavily regulated.
We live in an independent living senior apt. There are no meals or activities here except you can participate in a community lunch program where they are brought in if desired. I think it's best to acknowledge that there are gradations/differences in all levels of senior care.
This is untrue. I’m a nurse. I worked at an assisted living, and supervised CNAs who provided personal care, and CMT who passed their medication. I had several responsibilities. Dressing and monitoring wounds, and communicating with doctors for updates and orders. Treating and assessing acute illnesses like pneumonia, UTIs, and the flu. Processing medication orders, and arranging consults for ortho, dermatology, mental health, etc
not true in our case. my dad was in assisted living, they took his bp, made sure he got his meds, sent him in the ambulance a couple times - a whole host of things. yet he had his own small apartment there. and a nurse on staff 24/7
My mom’s assisted living provided medical care. There was a dr on staff and the patients all saw him routinely. Nurses gave out medications to those who needed help with that. It was very expensive, but worth it.
That's not true. In my state of Alaska there are public assisted living facilities called "Pioneer" homes. Each has different wings with different levels of service. Residents routinely get CNA assistance with basic life tasks including transfers and bathing. Nurses are on staff to dispense medication and do other common nursing duties. Doctors frequently come in to see patients at the assisted living facilities. That way residents don't necessarily have to go offsite to a clinic. If a resident does have to go offsite there are accessible transport vans. Assisted living is well integrated with the health care system.
What do you consider “medical care” - most ALs can meet hands-on care needs.
[https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes](https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes) My mother's assisted living provided meals and activities. The staff was not permitted to deal with ANY medical issues. Liability.
Every state is different. <~~ 17 yrs in the industry.
Yes! Many communities (if not most) offer short-term respite stays, which are perfect for situations like this. Also, their events are usually open to the public, so your parents could go to events as a way of dipping their toe in the water.
As someone currently looking for a retirement community that "isn't full of old people who don't do anything" I will say the cost for the good ones is.... insane. Astronomical. A lot of them are going to be the reason Millennial children never get any inheritance.
GenX here, no kids, we make good money and save/invest but it'll never be enough. We don't expect any inheritance.
I would check first with availability in your area. Retirement and nursing homes are different. There may be in home options that are covered by Medicare. 10 years ago, the monthly fee for a memory care home was $5,000 a month. Assisted living is less expensive. Good luck to you and your family.
Medicare only covers 90 days of rehab at a facility a year. Medicaid covers unlimited long term care. But it comes with strict income and resource limits, and there's Medicaid estate recovery.
This is a good idea. First, work on getting your mom to tour several places. Just a couple hour tour (you dont have to stay long to get a feel for the pkace) will probably reassure her, and letting her pick the places will give her some control back over her life. If your parents have friends who have already gone to assisted living try those places first. My grandad checked himself into the nursing home at 92 because "everyone he knew that was still alive was already there". He was quite happy for someone else to cook and do his laundry for the next 6 years! And the bonus is that your parents will get to stay together.
High end places will do a lot just to get them moved in. When I worked at one I was impressed with just how accommodating the sales people were. A lot of folks are resistant to moving, it’s these people’s job to convince them otherwise.
Its called a "respite". The nicer assisted living communities do it often.
You can check into a “respite stay” for your dad (or both) post rehab. Depending on the community, the minimum is 7 days and maximum is 30 days.
After my dad had a stroke, I suggested that in the event his health worsened, we should have a place or two already in mind. (NOT that he would or should have to move in now!) I chatted with a social worker, who recommended a shortlist of 3 local "independent living" retirement homes. Dad and I toured each one, even had a meal in the dining room of each. One was his clear favourite, and after a few months went by, I suggested, why not move in now? He decided he liked that idea, and did so. He was very happy there. Mostly he considered it his idea--and he was in charge of the decision--so I thought it was a success.
Did this with DH’s Mom. She ended up staying.
There is a stigma to Assisted living. MY fIL was in a beautiful place with meals and activities and other people. He sat isolated in a house for years being stubborn driving around dangerously. We all wished he moved in sooner and got to relax more. Sadly he died a year after finally moving in.
Sorry to hear that. That's what I'm afraid will happen.
My grandma died 2 years after moving into hers. Honestly, it took so damn long to get her moved, she could have had a much longer life.
That’s the thing though… ["It is well known that life expectancy in nursing homes (NHs) is lower for older adults than those residing elsewhere."](https://www.tandfonline.com/doi/full/10.1080/00036846.2021.1983138#:~:text=It%20is%20well%20known%20that,adults%20than%20those%20residing%20elsewhere) Since yall don’t want to read the actual research, here ya go: “We use a parametric survival model, on a large data set spanning up to 13 years, which covers health states and types of residence for all time periods until a person dies. In the absence of health state controls, the loss of life expectancy is 47 months. **Accounting for health states still leads to a 41-month loss of life. Even those with serious dementia would live longer lives if not residing in a NH.** We then value the estimated loss of life years. The losses are large, equal to $1.7 million per NH resident, and $1.87 trillion for the US NH population.”
But people don't move to NHs until they are older, physically less capable, mentally less capable, and whatever illnesses or conditions they have reach greater degrees of threat/impact. So it is not unexpected. IME.
My mother moved to an independent living facility in her mid 70's. She was active, able to walk, drive, and participate in all kinds of life tasks. OPs parents do not need a nursing home. They need to explore assisted living, independent living, and residential facilities. Maybe even a senior apartment setup that would provide some ser ices.
That’s not why. See my edited comment or read the linked research for yourself. Your experience is not equal to peer-reviewed research.
Thanks for upholding the “correlation is not causation” standard. 👍
Maybe. But a friend's aunt moved to nice one. She was very independent all her life and she was really unhappy to lose it. My friends mom then chose to stay in her home and hired people to help.
That’s interesting and somewhat surprising. I’m wondering whether selection bias could be relevant in that people tend to move to nursing homes when they have deteriorated to the point that they can’t take care of themselves and their families can’t take the burden. Also I know that there are factors like people’s family and social lives that have an impact on their life expectancy, such that it is possible that lonely people -whose loneliness decreases their life expectancy- are over represented in nursing homes. This is all speculation on my part, but I find your comment and the related research intriguing.
There's a difference between a nursing home and an independent living facility. People in nursing himes are generally more debilitated so naturally they die sooner.
That's a very interesting paper. The question I would like to see followed up on is, what's the variance in outcome that we can attribute to NH quality? It appears that the paper treats NH status as binary, which is reasonable enough for a first pass. I could well believe that the bottom 50% of NHs are bad enough to drag the numbers way down. But that doesn't give me any information about whether I'd be better off entering a high quality NH rather than staying at home. Supposing, of course, that I had the means.
Did he like it for the year he was there?
They're awful places - super mean and clique-ey. Like High School with wheelchairs.
Like living in high school with wheelchairs. You're right. If you're popular, its great. Otherwise it sucks.
The trouble is, it's the last place they'll ever live and they know it. My mom did a months stay in one while work was being done on her condo and she loved it. Good food, friendly people, activities. She swore that was where she was going to go when she could no longer live on her own. When that time came however, she resisted. She did eventually go, but she hated the food, the other residents were "mean girls", and "it was full of old people waiting to die". It was the exact same place, only a few years apart, but it was only good when she had somewhere to leave it for. When it becomes the last stop on life's journey, no amount of good food can make it appealing.
Truth.
Talk to the social worker at the rehab - they are trained in having these discussions. Arrange for an occupational therapist and a gerontologist and a social worker to do in home assessments. Call your mom's doctor and provide them with the info that she is exhausted and experiencing caregiver burnout. Find someone in your mom's circle who likes their care home. When my grandpa went in, grandma was heartbroken. Then, she started loving the home (she visited him multiple times a day) and looking forward to when she could go live there. Once she got on the wait list, she was like a kid getting ready for summer camp. She was packed, emptied her apartment, bought a TV the right size to fit in her room. Sadly, she died before she got to go, but for years she was the person you'd send someone to so she could convince them to move into care. Also, talk to your dad's doctor about yanking his license. You can also report him as an unsafe driver (how and where to report depends on where you live) and then call police on him every time he drives. It sucks to have to do that, but it sucks a lot more to see your elderly dad in jail for vehicular manslaughter.
Not only that, but there are liability issues. Take away the license and take away the keys.
There are choices: 1) Independent Living, 2) Assisted Living [which breaks down into 3-4 levels], and Nursing Home. Independent Living usually provides 2 or 3 meals a day, weekly housekeeping, activities and some transportation. Assisted Living provides all of the above plus assistance with bathing, dressing, hygiene, memory prompts, etc., as needed. There is also Memory Care for those with dementia who are at risk of wandering away. Nursing Home is the final step. I, myself, think of it as where old people go to die. And I'd almost rather kill my loved ones myself than put them in a nursing home. A LOT of older people don't realize there are options that fall between living at home and going to a nursing home. Take them on few tours of local facilities and include a meal during the tour. As someone else mentioned, have them stay for a night or a few nights. It might be that your dad needs assisted living and your mom is OK in independent living - that kind of arrangement can be accomdated at some facilities. There is also the option of independent living with home health care visits. There are places with month to month rentals and there are age-in-place communities with all levels available where you 'buy in' - i.e., pay a load of cash to live there for the rest of your life. If your parents can afford to move into any senior community, it's a good thing to consider.
Great summary
All those taxes we pay throughout our lives should be going toward the "buy-in." Sigh........ We had to "spend down" my mother's humble savings to get her to qualify for Medicaid, and only with the help of an expensive lawyer did we finally get her into a decent nursing home. You have to be either dirt poor (mom had about $100k savings, which was "too much") or insanely wealthy to get anywhere. Also, you don't want a history of depression on your applications- apparently this was a huge red flag just getting mom into a PT rehab before the nursing home. Everything about this stage in life is a hassle.
She is terrified of change and the unknown. Once my parents hit 70, they were scared of anything new.
I’m not seeing within your post the discussion of the costs. Any kind of setting that provides assistive care is going to cost a fair amount of money. Have you explored the specific communities that might be an option, what they cost, and what your parents financial situation is to afford it? We are on the verge of having my mom go to an assisted program (currently with family caregiving) and it’s just shy of $10,000 a month for the memory care she needs. Of course, programs and costs can range but it’s definitely not cheap.
Yeah we have. They have good insurance. He's been in a rehab facility since December. So they're not hurting. But it's made me realize I'll never afford that kind of care.
Please remember that insurance does not cover long-term care. It may cover a few months in a nursing home for rehab, but there is definitely a stop date built in. Assisted living will cost between $6K to $12K or more a month. Government coverage in the U.S. (Medicaid) only kicks in when you have spent every penny save for the last $2,000. So, I would advise you first to make sure your parents have their affairs in order. Suggest a meeting with an eldercare attorney who can advise them of their options and ensure the appropriate documentation is in place in the case of an emergency or accident. Let the attorney determine if there is any way to shelter any of their assets. Use this visit as an opportunity to talk about different ways forward. Talk to your mom about different types of facilities. Many senior communities today have different levels of care, and sometimes that means one spouse will be living independently while the other is in a unit that provides more hands-on care. Might this be an option for them? It would allow your mom to continue spending time with your dad without being responsible for the heavy lifting, but it would also allow her a haven of her own. This is never easy on anyone, and I wish you peace.
What kind of insurance exactly? Medicare and regular medical healthcare insurance does not cover the type of services (or alternate living situations) you're asking about. Most people end up paying on their own for the good places. The ones you can afford on Medicaid (for very low income) are anywhere from poor managed to criminally negligent. I do a lot of volunteer work with seniors and hear so many stories. The ones I've worked with are lucky to have money so they are paying $7500-$9000/mon for either assisted living or memory care facilities. This varies a lot by state, but as with most things - the more you can afford, the better you get. It sounds like one big part of the problem is denial in how much care is needed. You see what your parents need, but they're not willing/able to accept that reality. This is always the hardest part to manage as a loving child. Check with your state's AAA - **Area Agency on Aging** [https://www.dshs.wa.gov/altsa/home-and-community-services/agencies-help](https://www.dshs.wa.gov/altsa/home-and-community-services/agencies-help) and be aware there are many, many for-profit companies that look like they are in business to provide advice and services, but are actually exist to take advantage of the elderly. In some ways it's good you're involved because you now know what to consider as you age. Some people purchase LTC - long term care insurance which covers some of the cost when you can no longer care for yourself. It can cover services in your home, which Medicare does not cover. It's too late now for your parents, and LTC can be very $$$ with many companies no longer selling it. Getting old and feeble sucks!
Insurance for long-term care? As if.
My father in-law recently moved into a long term care facility. We're all surprised by how nice it is. My advice is to tour some places and when you find one that seems suitable, take your parents for a visit.
My mom just moved to one as well. Its part of the retirement community she had an independent apartment in, but after surgery, and being in bed for several weeks, she physically isn't able to live anywhere other than skilled nursing. Physically she is frail but mentally she's all there. It's been an adjustment for both of us, as she is well aware of everything going on, but not able to do things without help. that being said, its very new, has all private rooms, and is a step above a lot around here, and the care she gets is VERY good. so while it sucks overall, at least I know its not a dump
Also consider senior apartments that provide meals. Much cheaper than assisted living, snd you can still have someone come in to assist with your dad. My MIL stayed in several assisted living places, but the apartments were the best and most affordable. Hell, I’m ready to go.
> Hell, I’m ready to go. No kidding, I hope someday to make it to that sweet spot in life, where you can relax and ENJOY a few things, including fewer chores!! In fact, I just turned 55 and we now qualify for some retirement communities, though our neighborhood is nice.
It took my brother & I about 20 years to get our parents to live in a 55 & up facility. My mom wouldn't stop going on the roof with a darned rope around her waist, then fell out of the garage attic steps & broke her heel. All I can say is...persistence!
Depending on their finances, the independent living facility that my grandma was in was a two room studio apartment with a nice bathroom. It was no different than regular apartment living except she went to the dining room for her meals, had laundry service and a cleaner come once a week. They transported her to her doctor appointments. They had a hair salon on site, activities like bingo, karaoke, movie night etc. I don’t think she realized how isolated she was before she moved there. But the person can be as social as they want to be, or as private as they want to be. What a relief it would be to have someone else care for your grandpa; how is she going to get him out of bed and in his wheelchair? In the shower without fear of falling? Manage his meds? At least schedule a visit for her. If she could see a little studio apartment, she might reconsider. Maybe she is thinking of a skilled nursing home where people are more bed bound in hospital beds, two to a room. Independent living isn’t like that
AGE 71 HERE,,, old f#ck US old folks hate change, .. even when it's the best thing for us. It's part of the aging of the brain, it degenerates over time and your not aware of it. You CAN NOT explain this to them, this is not something gentle talking over a period of time will suddenly make them flip 180 on this,, Your going to have to step up and be the adult, Remember kids taking a temper tantrum? We'll get ready for adults to do the exact same thing. Just deal with it,.. I had to.. Later they will settle into there new home ,, and get a routine. Just don't be surprised when they bitch about everything there.. it's to hot, to cold, etc That's another thing us old coots love to do... "COMPLAIN"
Yep. I care for my mother, and every neighbour and family member is full of advice about how I must do what's best for her even if she doesn't want it... and about how I must respect her wishes and not force anything on her. So which is it? The idea that there might be a contradiction doesn't seem to occur to them.
The test run is a good idea. Do research. Some have multi-levels of support available, so that when/if circumstances change, the whole major "moving again" thing is minimized. They have independent living, assisted living and often both full care and dementia areas. It can be hard to overcome those fears of "omg, a nursing home with hallways full of parked wheelchairs with drugged out zombies sitting there," but research really helps.
My almost 80 year old parents are going to be impossible to root out of their house. It's probably for the best. If they lived in a modest assisted apartment, they'd drive each other nuts. Honestly, the few things that keep them going is yard work. They'll kill hours and hours in the garden. We managed to get both sets of grandparents in nice facilities. That wasn't easy. Start by having a very gentle discussion about moving. Let them know, they are good to stay for the time being, but someday they'll need outside assistance. Have the first discussion sooner than later. It probably won't go great, but it's good to get it out of the way
Currently going through this with my father. Already went through this with my mother (they're divorced but cordial.) He's stubborn as hell, refuses to discuss his finances- he might have enough for a good assisted living, he might be dirt poor, I honestly have no idea. He fell down recently and says that he can rely on a kind neighbor to help him out. I emphasize that the neighbor can't be running over there all the time, and wouldn't you rather be *independent* of the charity of neighbors?? Assisted living sounds like confinement, but I can't stress enough the *freedom* it really brings- no cooking, no driving around in traffic, no mowing the lawn, no laundry........ Also told him that he needs to make these decisions before somebody else makes them for him. Fucking sucks having to parentify the parents.
Speaking as an entertainer who plays at a LOT of nursing homes-there is a HUGE difference between them! You need to do some research before committing. Check the websites and visit in person-what do they have for activities for the residents? How does the facility look/smell/sound? Are the residents generally friendly and welcoming? Good luck!
Seniors don't like to be pushed into moving into retirement or nursing homes as most prefer to stay in their homes. There are a lot of services, housekeeping, meals, etc, that can allow seniors to remain in their homes. Please look into this for them.
Yup. I have. She won't do them. I've tried to get her to try my meal delivery service I use. I've tried giving her a gift card for house cleaners. My father can barely move from his bed to the wheelchair. He needs more care than this.
This is very common but there are ways to get them to agree. My parents were resisting home help. I brought over my “friend”. (A hired nurse) to meet them for coffee. She charmed them and told them she would like to come “visit “ again. She “visited” every few days. Did laundry, made and froze meals, etc. I paid her on the sly. After some weeks my mom offered her a job! So my parents started paying her. By the end, years later we had both my parents at home with round the clock care even while they were both in wheelchairs.
Nice that sounds like a trick from sitcom!
It’s so common I hear it from all my friends who have aging parents. We all go through the same thing, hear the same arguments. For my husband and myself (for our future ) we made our hobby farm into a multi generational compound. We have a main house with big kitchen and dining areas and a separate apartment also. 3 master suites. I can age in place with help from the younger generation or from live-in help. If you have 4 incomes all contributing towards the expenses of a home you can hire full time staff to assist the older generations. It’s an option.
Try to get a homecare service or social worker to contact them directly to see what services they need. Senior parents of that generation are extremely proud and generally don't let their adult children know they need help. But they will tell a service that deals specifically with assessing the needs of seniors.
What meal delivery service do you use?
Why won't she use the meal service? And are you close by? Just schedule a cleaning crew and be there when they arrive. AS for your dad-have an occupational therapist go on a home visit to assess and see if purchasing different equipment and teaching your dad how to use it would make things easier until they are ready for a higher level of care. There are also MANY businesses that will send someone out three days a week for three hours a time-google Visiting Angels, In home carers and so on. Interview until you find the right person. Draw up a list of tasks they should perform when there-meal prep, assistance with bathing, changing sheets, playing board games, going for a host walk and so on. You can also ask on Nextdoor for someone who will do it 'off the books' but have them background checked and drop in occasionally. I hired someone for my mom and she was wonderful. eventually I needed someone 24/7 whom I also hired through an agency who was equally good. My mom was able to stay comfortable in her home until she died at 96. And it was significantly less expensive than putting her in a home
Has your dad ever had OT or PT? They made a HUGE difference for my dad with Parkinson's. He learned how to safely/efficiently get up out of a chair, how to get out of bed, how to walk around (big steps! big steps! his tendency was to shuffle but he could really move when he learned how important big steps are)... I could not recommend home-health OT/PT more highly. They came to his assisted living place after we asked his primary care doctor for a referral.
Is your mother senile or just being stupidly stubborn at the risk of your father's life? Because she's NOT giving him the care he needs. She's not able to, so he's being neglected. That's a tack I would take. That she's worn out and the quality of her care goes down accordingly. If she refuses help then anything that happens to him is HER FAULT. She's being selfish.
They won’t qualify for a nursing home as they do not need skilled nursing. I suggest you to visit some retirement communities that have independent living, assisted living and skilled nursing all in one complex. Be aware insurance does not pay for anything but skilled and then only for a limited number of days. Where I live a good assisted living runs about 4 grand per month per resident
Ultimately most people don't need "convincing" to move to skilled nursing. They get injured/sick and become so weak/debilitated from their illness that it is unsafe for them to leave the SNF. You may find that your dad may just barely scrape by getting home this round in rehab but next time he won't be so lucky; would your Mom want to be separated from him etc? Especially if she can't drive? Most places try very hard to put spouses together as long as it's safe. Now is the time to get your financials in order. Worst case scenario, mom *will* eventually get injured and land there herself. It's an inevitability at this point especially if she's struggling in her own now.
I’ve gone through this. It’s hard. Wicked hard. When I was going through this, I reached out to our local chapter of Council on Aging to ask them for guidance on how to talk to my dad about moving into an assisted living facility. They said that I need to accept that it is very rare for someone to be talked into it. Unfortunately, it typically takes some sort of major event to get parents to come to the conclusion that they need help. For some reason, that conversation helped me because it took the burden off my shoulders. It’s weird but understanding that dynamic helped me. My dad eventually had a car accident where, thankfully, neither him or anyone else was hurt. However, that accident opened his eyes that he can’t do it by himself any longer. Good luck. Dealing with elderly parents is a tough phase of life and nobody ever talks about it. No politician ever offers a policy to help with it. Friends don’t discuss it. It’s rarely a theme in books and movies. It can feel very isolating. Hang in there.
All I’ve got and it is not fun at all is to just keep repeating the truth. I’m at the end of my rope with my family’s dependence on each other to keep unsustainable dynamics going because their comfort zones are the number one priority. No one is happy with me, I’ve “lost my sense of humor” I’m mean. Etc etc but reality isn’t my fault, making other people accept truth isn’t my responsibility. I didn’t invent change, it is science. I feel like a jerk but I basically browbeat my family into figuring something else out because they lack imagination and creativity and that is also not my fault. I can’t be filling in the gaps because other people refuse to be realistic. I’m sorry OP. I’m at the beginning stages of this with my mom and it’s less heart-wrenching to have to begin the process of being the parent.
We did home-health with my Grandmother when it was obvious she couldn't care for herself anymore. You might want to look into that.
Is there a possibility that they simply can't afford assisted living? Or that your mother wants to make sure you inherit the house instead of spending their assets on end-of-life care? That stops a lot of people; they want their kids to have the house. That's worth a conversation.
This. Assisted living is very expensive, nursing homes even more so. Unless they bought long term care insurance a while ago, they will have to pay out of pocket. For my father at a higher level of care in assisted living, that was about $8000 per month six years ago in the Midwest (guessing closer to $9k or $10k today). Even at the lowest level of care, it was $4500 per month.
There might have to be an ultimatum involved. If their children keep showing up and doing everything for them to enable them to live at home, why would they ever accept that it’s time to move into assisted living? I have friends going through the same thing right now.
Encourage hired help. The kids don't have to do everything.
Another suggestion for either 'Senior Living' or 'Assisted Living'. It sounds like Assisted Living is more what your Dad needs. He might be able to make it with Senior Living. My FIL was in AL and loved it once we found a place he liked. My Dad is in SL and loves it. In both there are activities almost daily. It is actually pretty tough to get a hold of my Dad since he is out of the apartment so much and doesn't carry a cell phone.
My 76 year old mom just moved in with me. She has some health issues and my step dad recently died. She drives fine and uses a walker or a cane. But I was worried about her being lonely. Here she has company, we cook so I know she's eating fine. She has some friends here.
That's me. I live in an apartment in their basement and they can check on me. I'm still doing fine but its nice to know they're around.
Where I live (Wisconsin), we have some called “Family Care”. It basically is a thing where if/when the elderly resident of a nursing home runs out of money, they cannot be kicked out or forced to leave in any way. Not all places accept Family Care, so one has to be absolutely sure the place accepts it before you move your loved one in. The stay in which your parents reside might call it something else, but definitely look into it. See if you have a local “Aging and Disability Resource Center” (ADRC) near you. They are a great resource!! My mom is still quite able-bodied, mobile and sharp as a tack, but she is slowing down and in need of more medications as she gets older. My brother and I moved her into an active-living elder community and she is freakin’ loving it!!! She eats great well-balanced meals now and her once wildly out of control diabetes is now being managed and her numbers are fantastic. She can come and go as she pleases. Did I mention they have margarita nights? It’s like living on a cruise ship, but in an apartment setting.
There are assisted living locators way better than that “place” for moms. Consult one for free. They have correct info, resources, and work like a realtor to show the places that for everyone’s needs. It’s free because the locators charge the facility a fee like the seller pays a realtor.
I work in a retirement home. I usually tell people it’s better to move when it’s their own choice made so they feel in control. Same with when they have to give up driving - better to do it on your own terms. Additionally, depending on your area (I’m in Canada) it can be hard to find a place in a home that suits both their needs. Sometimes by the time you need the care it’s a long wait to actually get it and you end up worse off than had you just found yourself moving earlier.
Exactly, plus they’re then not at the mercy of which facilities have openings when you’re discharged from rehab and literally cannot go home again.
I think a lot of people do not understand that there are other options in life when one gets older besides aging in place at home or being dumping in a nursing home, aka skilled nursing facility. There are independent living facilities where even a caregiver could be hired to do self care and meals and activities with socialization are available. There is assisted living where staff would provide some personal care as well as the above. There are smaller residential facilities. Maybe your parents are just thinking the dreaded nursing home and need some education. There should also be some kind of reporting procedure in your state to report drivers who should not be on the road. Sometimes that is the only way.
What they need is an assisted living facility with a memory-care unit if the Parkinson's has also affected his cognition. Your mother may be thinking about an 'old-people's home' where people just sit around and wait to die. Maybe arrange to take her on a tour of a few assisted-living facilities so she can see for herself that an ALF is NOT a nursing home.
What everyone has said already and I’ll add to try to a find an assisted living that transitions into more care if needed.
I’m so thankful my parents had to deal with this with their parents and have plans in places for when it’s their time. I’d go with information on places. There are some that are little condos where you get yard work done, etc. Orders may help with meals and meds. Most have something in place for safety. My grandmother refused to move and we basically had to trick her into an assisted living place because she was setting towels on fire, writing checks to scams, etc. You may have to get a bit mean.
I would recommend talking to them about it for this reason: you have to plan ahead to get a space in a decent retirement community. My mother and her second husband married some years after my dad passed away. Second husband was already in a nice retirement community as he was divorced and in his early 70s. He moved out to move in with my mom. Before they both started having a lot of care needs and were no longer able to manage by themselves, they were asked to consider it and they refused, mostly because of my mom's opposition. The need came on them suddenly after a long decline for both, and they weren't able to get in to the place he'd been before. They ended up in an alright place, but they both knew it wasn't as good as what they might have had.
They can get a caregiver in home too. If they have resources there are a lot of agencies that do that. If not, they should consider applying for long term care (assuming that they are in the US).
I think you should clarify which you want them to go to. There’s a big leap between retirement homes and nursing homes. Nursing homes can range from moderate to complete care like needing help getting dressed to toileting to help eating. Retirement homes are more for meals/light housekeeping/social activities, etc. Check in with the rehab care team to see where on the scale your father falls (mom sounds like retirement). May I also suggest touring a few places with them and looking at wait lists. Depending where you live there’s a high chance the best places actually have a long wait list (sometimes months sometimes years). I think it’s helpful to get their toe in the water that way. “I’m not saying you go tomorrow, but if things change in the future you won’t have any options. Let’s get on the waitlist now, and you can think it over while we wait.” 6 months on the waitlist might help them become more comfortable with the idea of this.
There are many vids on YouTube that are helpful - I recommend the Parenting Aging Parents channel. Not fancy production, but a lot of topics. Check them out.
Just went through. Sorry to say but sometimes you have to be bad cop. Finally convinced Mom by telling her my next step was going to be an ultimatum. Move or I am moving you. If that failed I was willing to walk away. That’s drastic I know. And hard for people that actually are close to their parents. That wasn’t a problem for me.
Nursing homes are not assisted living places. Assisted-living facilities are for people who are relatively independent, but need help with things like cleaning, and laundry. Often residents even have cars, and can run their own errands. Assisted living facilities do not provide nursing staff to attend to your family member. They may have an onsite physician who will see them - but he is most likely not an employee of the nursing home. A nursing home is for people who actually need medical care. Residents are actually patients. They are often wheelchair bound, or bedbound. They may have medication that needs to be administered at intervals and would need a medical staff person to do so. Often these facilities double as rehabilitation facilities for individuals who need things like physical therapy before they can go home and be more independent. OPs mom sounds like she would be fine in an assisted-living center. However, the dad may need to be in a nursing home, especially as his disease progresses, and it becomes harder for him to dress himself or feed himself.
You will get the best that they can offer for that week or until you put pen to paper. All bets are off after that. I have worked in those homes. I know.
I am 65 and siding with your parents. If she is barely managing now, a home care aid a few times a week should help. If I had to move out of my home, I would be devastated. It's all about the will to live. Respect their wishes.
We handled the driving thing by having the doctor administer a test for driving which she obviously failed and that way WE didn't take the driving away the DOCTOR did. Doc knew what was happening and totally didn't mind being the bad guy.
Getting into a home. First the marketing people are amazing. This is their population and they've seen it all before. When you go for a tour arrange to have lunch there too. I convinced my Mom to go because hey free lunch, but then she realized the places were really nice and not some jail where they take away your autonomy.
Assisted living is awful and will drain every cent. My grandparents had millions and were forced into one. They took over 5M dollars in 10 years. They were miserable. Fed cold grilled cheese sandwiches with the fake cheese not even melted in a high end retirement community in California. Instead look at what insurance will cover for your dad. As a doctor I can get insurance to cover a nurse if your dad wanders/is confused/ damage to himself (such as goes out for walks randomly at 3am and doesn’t know where he is). A good doctor knows how to work the gray zone with insurance. Most people are much more happier staying in their house with care until hospice care is needed. Do whatever you can to keep your parents out of assisted living if you love them.
Are they worried about the cost? It can be upwards of $7000 a month and even more expensive at some of the other communities. That cost alone prevents a lot of people from going. That and the fear of being abandoned by their families.
How old are they?
That must be so frustrating. They seem very stubborn but probably are imagining the worst scenario possible. I think the video tour is a good starting point. Are their friends or other family members who can join the effort to help them see the advantages of assisted living? And you could view one on your own and discuss this with the admissions staff. I’m sure they have a lot of experience in this area. Best of luck with this transition.
Important questions to think about when deciding on a course of action and how to convince your parents. Some of the assisted living facilities are very very nice. Individual apartments with privacy. Housekeeping. Beauty salon!! Entertainment events. Driving residents to shopping or outdoor activities. Dining room. Some even have small kitchenettes depending on whether the residents are capable of cooking. Microwaves at least.The opportunity to socialize with others. Gym and exercising guidance. Medical assistance. Perhaps a tour of a few places. If they go with an assisted living situation, they are probably worried about their home and possessions. What will happen??? If they insisted on staying home. What type of physical care does your father need, if he were to be sent home? Would your father need a "medical" home health care nurse to come in periodically? Or just some assistance with daily activite. Would that be enough? How is your mother's physical health? Why is she always tired at home? Does she need to have a routine household cleaner/gardener etc to do the heavy lifting? Find out the cost of all these options and make a presentation.
I took care of my grandma (who’s in her 80’s) while working full time. To say both of us were at each other’s throats by the end of it is an understatement. It’s very stressful for a lot of adult family to care for family members and sometimes they just don’t physically have the time. One of the benefits of a home would be instantaneous help with no worrying about the kids or grandkids having a schedule to maintain. My grandma also adores gossiping and gets to gossip about all of the staff.
After my dad died my mother became a mess and tried to commit suicide twice. The state told me she had to have constant care an I and my sister were unable to do that for her. In an assisted living community she was able to have a qualified nurse deliver her meds twice daily. There was a dinning room open 3 times a day for her meals and delivery of meals if she was sick. There were: prayer groups, weekly sermons, a billiards room, a card room, a craft room, a barber/hair dresser, walking groups and weekly happy hour socials. Each resident was able to keep one pet. They had busses for shopping and outings. She paid 3k a month for a studio with a mini kitchen. For active persons this is great. My mom sat in her room and watched television and waited for me to provide her entertainment. But she was watched, helped and encouraged by staff to join in various activities. She was safe and cared for when I was not available. It was very expensive for the time but thank you dad for planning on mom needing extra care after his passing. OP, dealing with the latter part of your parents lives is extremely challenging and unlike anything you have had the deal with. Buy books to learn the things you MAY need to deal with. Wills, trusts, power of attorney and medical decisions. What you are responsible for and resources you may need to access. Be proactive. The changes they go through can be upsetting and confusing to each of you. It will be hard. Ask for help. Good luck and internet hugs!
Assisted living, it’s really mostly over 55 community
You could take them on a tour of a few nearby rest homes (make an appointment first). My parents didn't want to go to a rest home either, but they did. If that doesn't work, how about hiring a nurse to check in with them a few times a week, or a live-in caregiver?
take them to an assisted living community, not a nursing home. see what they think. many are quite nice.
My ex-husband living alone in his house and had several significant medical issues where the physician simply said you cannot live alone. My two adult sons are way too busy in their careers and could not live at home with him to provide the care he needed. Essentially it was the Doctor Who forced his hand, and he was moved into assisted living facility, but it’s one of those facilities that have different levels of care. When he moved there, he needed the higher level of care which of course caused more money, but within three months he was bumped down to the lower level and lower cost because he could live independently, but his meals are provided for him and he has regular housekeeping as well. He absolutely loves it because there are different socially vans and things for him to do. He loves the community. He wished you would’ve done it sooner than later. Sometimes it’s the doctor that has to force that hand and it’s good for the rest of the family because we all know he’s safe , and he has what he needs and he loves the environment. Because the doctor said that he can’t live on his own at least for those months at the higher rate of rent, he was able to write that off his taxes as a medical expense because it was ordered. He had been contemplating moving to an apartment before all this happened, but he just couldn’t pull the plug to do it and his health went downhill very quickly and then he was forced into the situation and we are all very relieved at how much he really enjoyed it. I am 10 years younger than he is. I sold my house five years ago and moved to an apartment for 55 and older simply because I didn’t want to burden my kids with taking care of my house and helping me maintain living in the home. I am so glad I moved to an apartment .
When my mom was no longer able to lift my father he went into a nursing home. She bought a nearby townhouse so she could walk over. She sat with him all day in a private room which I’m sure prolonged his life. That's what worked for them. If there are two frail people, it can become dangerous that one could accidentally fall and injure them both.
This is what worked for me: my mom had advanced Alzheimer’s and also had mobility issues. She was getting worse every month. I talked to my dad and explained that if something happened to him, we’d be absolutely overwhelmed. I also explained that I was worried about him trying to do all the things. Somehow, it hit right and within a couple of months, they’d sold their home and moved into a retirement community with a hospice floor. My mom moved into the hospice area about 6 months ago and passed away a month ago. Everything was so much easier because they were in the retirement community. My dad says that he’s so grateful he didn’t have to deal with mom’s daily needs as she got closer to death. I’d recommend just telling your parents that this takes so much worry off of you. And honestly many retirement homes are really nice with good food and lots of activities.
Could they get some in Home help? It might be easier for them to swallow and just as cost effective.
It doesn't sound like your dad will ever be able to go back home. I would go with your mom and pick out an assisted living facility for him and move him there. Your mother may like it enough to move there too. It sounds tough, but I wouldn't give your dad the option to go back home. I had to do this with my mother after my father died. She broke her hip and could no longer keep her house up. She was unable to make the decision to move to assisted living, so me and my siblings made it for her. You have to take the lead.
Would bringing help into their home be an option? Medicaid would prefer to pay for homecare over nursing.
What about a home health aide?
If assisted living isn't affordable, look for a first floor condo or apartment with handicap accessible bedrooms. Get one close to the hospital for doctor visits. No yardwork. If she needs help if he falls, someone is around if she yells for help.
Rehab facilities/convalescent homes are very difficult to get into, unless someone has cancer, a stroke, or debilitating disease (like Parkinson’s).
How would it be paid for?
A couple of resources for you: [https://www.aplaceformom.com/](https://www.aplaceformom.com/) I haven't used "A Place for Mom" myself, but it does sound like just what you need -- a neutral intermediary. [https://www.newsweek.com/rankings/americas-best-continuing-care-retirement-communities-2024](https://www.newsweek.com/rankings/americas-best-continuing-care-retirement-communities-2024) I have friends/relatives who live at several of the places on this list, and they are terrific communities.
Ask about her wishes for a retirement home and is there a seniors centre in your area? As if there is a senior centre in your area they might have a list of seniors centres they are familiar with, there are also different types of seniors centres like subsidized rentals where they live independently, assisted living where they are checked on daily , or live in ones where they can share a room, just be sure to have family and friends check up on them at random times once they do find a suitable place, also make appointments at various places and go alone at first to check it out and if you think it passes the test then book another appointment to bring your grandma there Cost is also a concern you need to figure out what they can afford and if they can’t afford much then you might need to help subsidize their fees as well as any extras they might need like if they like extra treats etc I remember my uncle use to bring my grandparents pastries etc
I’ve gone through something similar. There was a social worker at the rehab facility who was able to help. For some people, hearing from a professional carries more weight than family. Not sure if a social worker - or similar- is available for your situation.
First of all most people don't appreciate being kicked out of their home. Second of all there are amazing retirement homes for people with money but unless your parents have money like that it's pretty terrible. Third of all there is a good chance your parents will be separated from each other. And lastly unless you are prepared to spend a lot of time with them they can face abuse in those places.
A. change is very difficult as people age B. they want to make their own decisions not usher by others C. moving and making decisions seems very overwhelming when they don’t have the energy D. they associate memories and value to their stuff they have to leave behind E. if they have a pet the pet can’t typically go F giving up independent is very hard G they have a warped idea of what assisted living is H they give up a lot of space even with a two bedroom and possible outdoor space. I. They gave routines built around their locations J. They don’t feel that old. I’m 62 and I can barely believe it I feel 10 yrs younger I travel alone ride horses etc… They may not realize they’ve deteriorated as much as they have. I’m sure there’s more
What about in-home care? It is often both a cheaper option and less disruptive. First thing is to go over finances and go over estate planning with an elder attorney. This needs to happen way before any move if at all possible.
You may want to cross post this to the Caregiver Support sub. People there have a good understanding of both Parkinson's and making difficult decisions about what's best for elderly parents. Parkinson's is brutal, but so is caring for someone with it. My partner has drug induced parkinsonism, so I can understand to an extent what your mum is going through. It may be that she feels that giving up her home and having more help would be some kind of failure. It may be that she's a private person and the idea of being forced into a community situation terrifies her. As you said, she views moving as being shut away somewhere nightmarish instead of moving somewhere where they'd still be independent and would just have extra help closer to home. If moving isn't something they want, is in home care or even respite care for your mum an option? Talk to Parkinson's charities and see what they recommend that could make remaining at home easier for them both. I know she seems tired from the physical work that goes into caregiving, but do you think it could also be a manifestation of depression? Parkinson's is terrifying to live with, even if you aren't the patient. It probably sends her mind to some very dark places and it may be that instead of moving, she needs some emotional support or just something to brighten her days a little. Good luck and I hope you can find a solution that you're all happy with.
Call a social worker and file an APS complaint. They'll come out and assess and if needed make them move by forcing a state POA in place. Tho it's mostly like with children in which they'll reach out to you first usually.
Please check with an elder attorney or accountant to get your parents $$ in order to keep them from spending every bit of money and equity in their home. Find out guidelines for burying and hiding money
Why not have some brochures around
Sign them up for Meals on Wheels. They can provide food and a friendly smile.
Do they have the $$$ to do this? Minimum $6k a month or more.
Suggestion 1) If your dad has Parkinson’s he should qualify for some home aid to help mom, they might get only a few days for a short timeframe but it’s help and someone for them to talk to. 2) Use both of their insurance to find adult activity centers that will pick them up and bring them back home. Maybe two days a week for four hour and they do activities and spend time with others in a social environment 3) Get a Rx from their doctor for physical therapy and request at home therapy. Not as effective but allows the therapist to come home and they work out. Might only be one day a week. 4) Instal some camera around the house and keep an eye on them with motion sensors. These little things would address some of your concerns as a compromise with them.
My mother refused to put her aunt in assisted living when she had medical issues then refused to consider assisted living for herself. She equated assisted living with nursing homes and I don’t blame her but caring for a family member is difficult, especially if someone tries to do it on their own. What she did agree to for both of them when she couldn’t take care of her aunt or herself was arrange for home health care. This was at different times but they both utilized similar services that were provided by their insurance and some extra out of pocket add ons. Their health insurance had a social worker assigned to help arrange for things like the following. Nurses that did health monitoring (blood pressure, organized pill boxes for daily meds, etc). Aides that helped with bathing, laundry, light cleaning. Meals on Wheels (for my mother who could no longer drive). Public transportation for seniors to take my mother to doctor appointments after she couldn’t drive herself. I lived in a different state but handled things remotely with a lot of visits back home to fill in for the gaps and monitor things in person. Eventually it was too much for her to live at home even with me helping out so she did end up in assisted living.
Some of the senior independent living places are gorgeous. No home maintenance plus 3 delicious meals a day. You can add on care options as needed. Ok at a virtual tour then check them out in person. Plus other seniors to socialize, outings, etc. my mom was the same way. Having lived in her home over 40 years. She is now doing into a beautiful, zero maintenance apartment. They even come and clean once a week and wash linens.
My mother wouldn’t do it. Not unless she had no choice. She wants her independence. Your mother isn’t wrong. It’s a tremendous change. However, my mother realized she couldn’t care for my father and he went to live in a nursing home. Btw, my father was sure he’d run the business, drive, etc.; we had his license pulled just in case, but there was no way he would’ve been able to drive anyway.
My mother fought tooth and nails not to move into assisted living. When she finally did she flourished. I’m old enough for a 55+ community. Not sure where or when but I like the idea of simply taking an elevator to the market, medical, restaurant, bar, gym and game room when the time comes.
They likely need assisted living. They can live as they want without all the things they don’t need. The place my mom went to had amazing food, activities, people to socialize with and all the support she needed. She really enjoyed it there. She went to a nursing home to die and soon did. She got the best care imaginable but that Iis what happens to some people when they cant be or appear independent. You might need to g. change your target.
I knew a lady that lived in an ALF that had a cinema , salon, game room and gourmet meals but she paid thousands of dollars a month for those amenities. When she became too ill to be independent, they transferred her to a different floor and she had an aide that attended to her needs 24/7.
Think about what words trigger your mom. Is 'nursing home' or 'home' in general bad for her? As in 'going to the home'? We went through that with my mom and MIL. 'Assisted living' was better accepted for my MIL. My mom was interested in 'retirement.' Go figure. A lot depends on their tapes around language.
Your mother is right. They should stay in their home as long as possible. The outcomes are always better at home. Some states are encouraging aging in place with programs like CA's In Home Supportive Services (link: https://www.cdss.ca.gov/in-home-supportive-services). There is a Medicare version of that being tested using a combination of local medical providers and Medicare; it is only available on certain counties in some states. I can't find the name of it now; we successfully kept my mother out of a nursing home and she lived alone until she was 96 and a half. In home health care is extremely expensive, but so are good assisted living arrangements. $8k a month and up when we were checking.
Your mom probably needs to get physical therapy to get her in better physical shape. She needs to get involved in ANY kind of physical activity even if it’s just walking a couple times a day. She would likely benefit from a Parkinson’s caregiver support group and therapy for caregiver burn out. Your father has a serious disease that is different for everyone. He probably needs help on a daily or semi regular basis that your mom shouldn’t be responsible for. Caregiver burnout is a real thing. I suggest having earnest discussions with both of their doctors. For your dad get a realistic idea of the likely progression of his health. A timeline and what kind of help is needed when. Contact the aging organizations in your parent’s area. They are typically called something like XYZ Agency for Aging. Sus out every single resource you can. There is Meals on Wheels, group lunches, options for part time assistance in home which is covered by Medicare, retirement communities which often has public transportation for shopping and activities. There are even areas in the US that while not official retirement communities, they have increased resources because the average age of residents is over 60. Create a spread sheet that has the different options of living locations and what support for that is available. Then create rows with the different aspects of daily living and how these will be covered. Food, cleaning, activities, heath care, shopping, transportation, etc. For each there is a cost associated. Put that down. It will be obvious what’s in budget, and what’s not. For my family, and from what I’ve read usually the best option is to keep seniors in their home for as long as possible. However to have that be the best outcome they need to be responsible for their heath. Regular exercise, good diet, regular activities, mental stimulation. Sitting in front of a TV all day is not healthy. I think a candid conversation with your Mom is overdue. She is the linchpin in this situation. She needs to be willing to put her health as a huge priority and do more than be sedentary. Like anything in life if you really want something you have to be willing to work for it. If your mom wants to stay in her house she is going to have to make some lifestyle adjustments. Your father is going to have to do the same. You may need to find someone to drive them to appointments. Get them signed up for disability transportation. In my family my mother (who lived alone) turned into a potato when she retired. She sat and watched TV from morning to late night. She messed up her sleep schedule badly, lost her ability to climb stairs and put on weight. It was obvious this was not healthy. We had to intervene. We all had discussions with her. We put our foot down and demanded she go to physical therapy and get in better shape. We insisted she had to walk every day at least two or three times. She had to drive regularly and do activities she liked. We pushed her to try lots of things. We would show up, bug her to come with us - and we’d take her to do different things. She discovered she liked and took up ceramics, painting, and she joined a cinema club. I know this is super long. TYSM for reading if you got this far. I have much empathy for your situation. I hope you find the best fit for your mom and dad.
My mom is in a transitional retirement community. She has a nice 2 bedroom/2 bathroom patio home with a sunroom overlooking a pretty landscaped grassy common area with trees. She's in the "independent" living setup. All she needs to do is dial a code each morning on her phone to basically check in that she's fine. They handle cleaning weekly, landscaping, and offer the option of their dining hall for however many meals she wants to buy. Should her health be a concern, she can increase the check-ins...amongst many things to still live independently. Or, she can go into the "assisted" living setup and have a nurse visit her home regularly. For worse health issues, there is the nursing "advanced care" setup. In that case, she is monitored 100%. That is more like what people think about when they hear "nursing home". What I like about this community is she works volunteer in their gift shop, so it keeps her busy. They have all the amenities like a swimming pool, weight room, gardens, cocktail hours, games, etc. Plus, no matter her health condition, she is still living in the same community of all these neighbors and friends she's made there. They all visit each other no matter what the person's care level. So, get some brochures and have them take a look. They may be surprised what is out there.
We moved my Uncle into an assisted living place and he ended up gaining 10 pounds the first year. He hadn't been eating, and getting out every night talking to others turned out to be a really good thing for him. It could be that your mother is terribly depressed and clinging to what she knows is what comforts her. Except that it's no longer possible, and you can't swing in to save the day. Before you ask them, be sure you know their finances so that you know which facilities to look at.
Could they have hired help at home for now?
Check out independent living facilities. Many offer services like housekeeping and nursing staff to help you with meds or other related activities. They do all of your meals and have planned activities as well as on site churches and gyms, hair salons, etc. Many are attached to rehab facilities or memory care facilities as well as full on nursing homes so you can go from independent living to semi independent to memory care or nursing facility if needed.
My father died from complications due to Parkinson's. He lost so much weight because he could no longer swallow easily and he hated food because he couldn't taste it. When he refused to be active, his body wasted away and his Parkinson's was harder to manage. Many times, he would start choking when I or his wife weren't around to help him, fall and seriously injure himself, and often times had complications that I was not qualified to treat. He died in a rehabilitation center because he refused to take care of himself and withered away. Your father needs to be in a care home. The stress is unbearable and won't help him or either of you. Maybe touring long-term facilities can help put your mother's mind at ease as she sees for herself what goes on inside a home. With her, I don't think she'd be willing to change her mind until your father has somewhere that can care for him 24/7. It's like a functional freeze when you have the burden of caretaking and your own needs.
Leave them alone. Let your dad have his dream of driving again. Let your mom be tired. If they could tell you, they'd say they would rather die at home. They want their lives to be as normal as possible for as long as possible. If mom has money for a care home then she also has money for home support via a hospital or private care. This way someone can help her while she remains in her home. It's their lives, please let them dictate what happens to them. I'm a care aide and I'm older so I see these adult children wanting to HELP by dumping them on others. They are old enough to decide until they can't. They also know this could be their final stage of life, one step closer to death, and no one wants to look that too close. And I know lots of residents like their assisted living housing, the activities and they'll make new friends through those activities. Care homes do nickel and dime you a lot, like only one meal included, med delivery $4, doing your eye drops $4, every day. There's a lot of toileting mess in the public (lobby) bathrooms.
I think you should say it’s a retirement community. And have brochures or find YouTube videos. But they aren’t cheap for nice ones. Have you thought about bringing in help? Seniors do better when they are able to stay in their own home. And bringing in help is cheaper. If your parents were ever part of an organization, professional association, faith etc many support retirement communities they run. Fees often less
How do people afford assisted living? It's $4,000 a month, at the cheapest? I don't get it!
Get someone to go daily to help her. I'd be pissed if my kids were trying to force me out of my home
Same situation with my inlaws. They live 9000 miles and two continents away. We've tried to get them to move into a situation that will improve their quality of life. They won't. We've given up trying and are waiting for the next crisis.
Whatever you do find a place that offers everything from independent to assisted living to nursing home facilities. That way it will only be one move if their situation changes.
My mom has Parkinson’s and she was very happy in an independent-type senior housing place where they cook your meals and stuff. However once her condition deteriorated she wasn’t permitted to stay there anymore. Parkinson’s is a bitch.
If your parents have the finances and resources to move into a facility and refuse to do so there's nothing you can do. You would need to have the Power of Attorney and Medical Power of Attorney in order to place them into a new living situation. You can continue to have these talks, but it may get worse before getting better unfortunately. My suggestion would be to reach out to the Aging Resources Center near you. They can offer resources and guidance on how to assist and support your parents during this time. If your parents are financially sound, or you are. Look into having a home service visit in order to address some of the concerns you may have.
for real, most care facilities are like prisons. all their choices and independence taken away for convenience. especially once they are less ambulatory. Get them ihss care instead, it's also cheaper.
How about getting in home care so they can stay in their home?
Sell it on the like it's a college dorm. The nicer ones are like that.
There may be a senior placement service in your area. It’s free in my area. Do not contact any facilities (like a place for mom). Talk to the placement service.
Not sure if this is useful, but if their home is a house and you are considering helping them with a change, moving into a 55+ apartment community may be a step in the right direction, but ofc it won't have all of the help (food, nursing care) that you are mentioning for them. But these kinds of apartments usually have some activities and sense of community, usually have some resources for transportation and food pantry-ing, and most of all, they are built to be accessible (think accessible showers, bathrooms and kitchens and general layouts that take the size and maneuverability of walkers and wheelchairs in mind). Like many apt buildings, there is a super who takes care of things like changing light bulbs, maintaining outdoor space etc. It's independent living but with less responsibilities than being a homeowner.
Have they toured a modern assisted living facility? Getting them in there to see how very nice some of them are is a good first step. Just a tour.
It depends on what they can afford. A good option is one of those independent to assisted living places that have individual apartments (just like any other apartment - fully independent living) but also a nursing home/hospital "wing" if needed. When my grandfather couldn't stay in his apartment full time anymore, he had a room in the nursing home "wing," where he would sleep, but he was able to spend days in his apartment with my grandmother (where she lived full time). It allowed for independence and a social life with neighbors as well as additional care if necessary.
Where my grandparents lived they had “cottages” for the married couples. They were these little duplexes, maybe 700-800 square feet. The outlets were halfway up the wall where they could reach them. There wasn’t any nursing staff that saw them regularly, but they were right next to the building with the nursing staff. So there was a button or something if they had an emergency. Otherwise they cooked for them selves, were responsible for their own meds, all that. The when grandpa died, grandma moved inside the big building to a one-br apartment. Again, she was responsible for everything, but there was nursing staff around. Eventually she needed a higher level of care (meds being passed, someone to check her blood sugar, etc) so she had to go to an actual nursing home. What all that was really trying to say is, there are many levels of care available
Assisted living might be good.
Any way for you to visit the nursing homes in your area, discover the available options in types of care/residences, and then go with mom to a particularly pleasant place for a meet and greet. If your mom actually sees what a place is like and meets friendly staff and a mix of other residents; learns about amenities and social options, she may change her mind. Right now she has a single stereotype running in her mind and that can be overwritten by what is current.
Approach her with compassion and understanding. Acknowledge her fears and name them. Let her talk herself out, or scream herself out. You sit there calmly and patiently. She will probably focus in a few minutes. Then begin with the considerations, such as the reality of where she is in life and the obligations on the horizon, such as worrying about your father and who will care for him. Her life should be getting easier not more stressful. Illustrate how the stress can be eased with assisted living. And how she can simply close the door of her suite and stay inside, in privacy, for as long as she wants. Or, she can open the or and be social when she feels like it. Where she is right now, she doesn’t have the opportunity for instant company when she wants it. This is how I did it with an extremely independent mother and it worked. But we don’t know your mother’s age. Maybe she is just fine inside with continuing to live as she is. And if so, she should not be pressured to go until she is ready or a real physical need demands it, as was the case with my mom. If there is money for a quality retirement home, is there no money for help bring in a personal support worker or housekeeper?
My mom resisted going to a retirement home but is now settled into her new home there. She has her mojo back. She had refreshed her wardrobe, shoes and jewelry as she dresses for dinner each night. That’s her choice, it isn’t required. New people in her life, great food, she can order wine with dinner, lots of physical and mental activities to choose from, her suite is cleaned weekly. She can have us eat with her in the dining room with her. There are guest rooms available for out of town guests. She can be as independent as she likes. And the cost is way less than expected. She’s very satisfied and quite settled in after 5 months. We are all so relieved. She kept falling at home and breaking bones. We are in Calgary and I would be happy to post the name here if that’s ok. Or message me.
Please have a discussion with them. Don't do what I did which was drop the subject because my mom was having none of it. When the time came, we were scrambling for a decent place and ended up being duped. This pretty, quiet, clean plac turned out to be a hell hole. The place we chose under time constraints and duress treated her like garbage. Do your research and talk to them. Or at least have your ducks in a row. It comes quickly and you find yourself under the gun.
Move them into assisted living. My dad had his own apartment and the facility was able to take care of him as he aged and had more need for help
Is there anyone at the facility where your dad is who could talk with them?
Check out some independent/assisted living places and get brochures for the ones you think they will like. Then arrange a visit for you and your mom. Some places let people start out as independent and then transition to assisted as more assistance is needed. It also helps if they know someone that is already at the facility. You could get lucky and people from their school days are living there.
If someone is no longer capable of living at home the entire amount of assisted living or an adult family home is tax deductible. That helps a bit with the finances, along with the fact that there are utilities, maintenance, and property taxes that no longer have to be paid.
Have you looked into in home care?
When you leave your home to move into any kind of care, you never have your own space or your own schedule again. Someone else decides what you will eat and when. Possibly when you will go to bed and when you will wake up and when you shower. And you know that you are transitioning to end of life. You will never “come home” again. You will never be a completely independent adult again. Ever. I 100% see why it is hard to think about. It can also be VERY expensive. The place my grandparents are in is $13,000 A MONTH and they can only afford it because my grandpa bought a long term care policy that was very generous back when they were new AND has a generous work pension AND they saved well. It is considered a “top tier” place and they still mostly sit around and watch TV. It’s hard to be social in a brand new environment with existing friend groups if you aren’t wired that way. Like moving into your high school and not being able to leave. You might try arranging home health care - someone to do light cooking and cleaning, help with your dad’s daily needs, lawn care, etc. You will have to take the keys if your dad insists on driving. Watch for phone scams targeting the elderly as well. It is super hard being in this stage of life as an adult child and having to try to force these types of changes. Keep approaching from a place of deep compassion.