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I spent the afternoon looking for my Mom’s purse- she hid it under the bathroom sink! He gives her meds, cooks, drives, but won’t accept home help or Meals on Wheels. Thinks he can handle it all. Mom has moderate to severe vascular dementia and he wants to drive her to FL from MI next month! He is minimizing her impairment. He is 86 and she is 87. How to get through to him that flying and shipping the car is a safer option?

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Oops just looked back and seen that there are other concerns re your dad’s driving.
Glad you’ve got it resolved
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There is medical recognition that flying can make dementia worse. On board the aircraft, factors such as cabin pressurization, a crowded cabin, and seating restrictions (safety belts) may also trigger unexpected behaviours.
“For some years I have advised my patients with dementia – especially those with significant vascular aetiology – to avoid flying if possible. If flying is essential, I advise that they sit near the front of the plane (where there is higher oxygen saturation), drink plenty of non-alcoholic fluids and move as much as possible during the flight.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5451656/

Would he will be able to go to the bathroom on the flight and leave her by herself? Or will she be able to navigate the toilet by herself?. Im also wondering if he will be able to get travel insurance for her.

A long car journey might be better in some ways. He could try not to travel for more than two hours before having a break. If he plans the journey carefully, factoring in regular breaks from driving, and listen to traffic updates before they set off. He can try to ensure that she is comfortable, maybe a cushion or rug available if necessary, and that her seatbelt is properly secured
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If he is planning to stop at motorway service areas, he should consider that these can be big and confusing, and it is easy to get lost or disorientated, or separated from travelling companions.

Personally I can only admire his spirit at 86, caring for someone with moderate to severe dementia and planning a journey like that. However if he is minimising her problems that much, you may need to step in via their doctor for their safety. If the doctor feels it isn’t suitable yet your father is still it’s ok, insisting you might have grounds for POA.
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Thankfully, Dad has agreed to ship the car to FL and fly there nonstop! Hooray, and thanks to all who cared to reply.
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Is Dad actually used to driving on busy interstates? I lived and drove the LA freeways for many years, but retired to a very quiet area of California. Drove locally - not much traffic and a slower way of doing things for the residents of this area. Visited in LA and discovered I had forgotten the traffic patterns, the rush, the drivers cutting corners.  When I visit down there now, I have changed my driving patterns. Avoid freeways, do not drive at night.  You see you can have the same skills, but have gotten unused to the pace, the urgency of the big city and expressways. If Dad drives around his area it may not be at all like what he would encounter on a trip to Florida, unless he plans to stick to slow country roads all the way. There comes a time when a driver must make changes in their routine or even stop driving altogether.
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Lizard, you have answered your own question here. “Dad is an OK driver, just slower reaction time, and doesn't look both ways or over his shoulder. He wears a hearing aid. I don't know if he would pass a driving test, but haven't had the heart to report him.” You know this is an unsafe condition and you can’t let him drive it. Can you imagine him trying to navigate around the Washington Beltway? So your question is how to get through to him? Tell him it’s not safe, not happening, and you will have to have him evaluated if he tries to insist. Help him figure out how to ship the car. My GFs elderly parents were both killed in an accident in Florida running a red light. She knew they shouldn’t be driving but didn’t really push the subject. Luckily they didn’t kill anyone else. Shipping the car kicks the can down the road, literally. But it’s better than the 2000 mile Russian Roulette.
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Insurance in case they have a fatal accident? What if they kill others along with themselves? I really think it's a bad idea for anyone of that age to take on that much driving. It would take a toll on ME and I'm 54, healthy and really like driving. I fully support flying. It's quick and as long as someone can meet them at the airport, should go pretty smoothly. What about renting a car in Florida instead of having theirs shipped? What is the cost of that vs. the cost of shipping the car? If your parents have two homes, I am presuming they have the means to pay for a rental car for a couple of months. Most rental agencies would give a good discount for that length of time. Even if they bought a used car on arrival and then sold it when they leave.
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AlvaDeer Sep 2019
Yes! You can get great lease deals by the month now. This is of course the way so many do it, and my brother ended where he is now with refusal to understand he could not/should not drive anymore. Came within feet of an elderly man in a w/c.Luckily hurt no one but himself, but that quite badly. This whole screnario is so common.
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You won't like this, but if I were you I think I'd be happier about them doing a week-long (or longer, see below) road trip than a flight. It's not the length of the journey, it's the wear-and-tear on the body systems I'm thinking of.

If they always take a week over it, and your father has been accustomed to your mother's back seat driving for over sixty years, I doubt if you'll stop him trying. Maybe you would have more luck getting him to build in some additional precautions such as:

plan to take longer, with more frequent rest and comfort breaks.

have an exit strategy, so that if the journey is NOT working or he just doesn't feel confident he can back out without losing face and knows what to do - whether that's to head for a hotel, return home and book an alternative means of transport (train? Can it be done by train?), call someone for help, or whatever would work at various points in the journey.

make sure the car is thoroughly checked over, and well stocked with emergency supplies.

In previous years when somebody has shared the driving, how big a share has your Dad done? Is he annoyed that no one is able to join them this year? - is that making him even more determined?

I have to ask - having insurance to have their bodies shipped home if they're killed in a road accident gives you peace of mind? Really???
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Lizard61 Sep 2019
The travel funeral insurance is if they die 100 miles from home for whatever reason. They stay in FL for 6 months, so we feel better knowing that our local funeral home will deal with details to get them home for funerals.
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As for his responsibility of taking care of the house and taking care of his wonderful wife, I might try to explain to him that those chores are preventing him from spending precious time with her. Time that he will lose forever because he is vacuuming the house or washing dishes.
He could be promoted to household supervisor. Explain that he would still be in charge of the chores and be the official tester of food preparations. Meals on wheels does make, in most cases, pretty good food. If a meal should not meet his approval, he could still prepare a really good meal for her or if the meal was up to par, He would still be responsible for her snacks,
I would not buy him any white glove to inspect the cleaning. But the nice weather is a good time to spend sitting outside with a glass of iced tea and discuss the old days and upcoming plans
Just because someone else washes the clothes, he will be held responsible selecting what she wears. That will be like a bill board for others to see just how much he cares for her.
Some companion services will do light house keeping and a few other chores around the house.
The driving thing? I am not sure. I know there are services that will deliver a car by driving it to a destination for the owners. We used to have a friend that did this. Then he her could start their annual honey moon on a nice relaxing flight to FL. Having their friends meet them at the air port and having a light lunch before attacking the job of unpacking might be nice. It will alsogive them a few more days to actually visit with their friends.

Just a few thoughts since I have nothing else to do., yet.
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Small suggestion that doesn't address the Florida trip - if dad wants to stay in charge and do everything, is there a way you can ask him to let you "be more involved"? This could work to take some things off his plate but it would be his choice. And you could get closer to the situation to assess how things are going in more detail.

I can imagine all kinds of dynamics that would lead to this situation. His denial about his own ageing; this is the way he shows love to his wife; this helps him feel alive and engaged in his elder years; pride...

I agree with others: an 86 year old man driving from MI to FL with his 87 year old wife who has dementia is a pretty bad idea.

No two ways about it, this is a difficult situation. Best of luck with it.
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Crumbs. That's a long old drive.

Is it a journey your parents have often undertaken before?

Who has assessed your mother's vascular dementia, and are there other significant medical problems?

One thing you might mention to a man who's fond of his car is that motion sickness can develop in previously good travellers who have vascular dementia. If she needs him to stop at the wrong moment so that she can vom out of the window he may have a choice between crashing or ruining the upholstery. (Or take a sick bag, I suppose, but you don't have to tell him that!)

I expect your mother was in a rush to get to the bathroom, put her purse down while she was "busy", then pushed it under the sink so that she didn't trip over it, and plain forgot. I admit that I speak as a woman who has before now begun to put crockery in the washing machine (no, I didn't leave it like that, and better than clothes in the dishwasher I guess); but what you describe does not sound terribly disabling. Very annoying for you, I'm sure! - but that's not quite the same.

I don't think the changes in air pressure would be fun for your mother's head, though, if they were to fly. Do you have any particular concerns about your father's ability to handle the car journey? Will they be having to stick to a timetable or under pressure to get there at any fixed time?
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Lizard61 Sep 2019
I think Mom does OK on airplanes- especially a 2 hour nonstop flight from MI to Orlando. She flew last year from FL to my sister's in Houston just fine. She is more debilitated this year, walking the terminal may be an issue, but they have carts for that. I am concerned if they drive- 20hrs one way, he will be distracted by her and get into a wreck! I made them buy travel funeral insurance so if that does happen, the body/bodies would be shipped home to MI.My sibs and I paid for it, for our piece of mind. In past years we have taken turns helping Dad drive, but this year no one can. It's 3 days of crazy nonstop talk by my Mom. I don't know how he stands it, but they've been married 63 years! She is anxious but generally loves to go for drives. Horrible back seat driver! They take detours to my relatives' houses along the way so it takes them a week usually.
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Sorry, I forgot to address the title of your post.   I'm somewhat familiar with the area in which you live.    I'm guessing b/c of the population that there are tighter knit communities in the area.    Are there friends who could attempt subtly to influence your father and alert him to your mother's issues?   Family who could do the same?  

What about your parents' medical team?   Perhaps you could squeeze in a quick wellness checkup before the planned trip.   Hopefully the medical team includes someone who's friendly and caring, and is very familiar with both your parents, but especially your mother, and could attempt to dissuade your father from his planned trip.

Parents may often listen to others before listening to their own grown children.

If he won't change his mind, then the next best thing you can do is make plans for a quick extraction of both of them if something goes wrong, especially on the trip down.   I don't intend to create any more anxiety than already exists, but speaking from experience, that trip I had to make to Texas was very stressful; I just wasn't prepared to fly down to rescue my parents and bring them back, and was very fortunate that I had support all the way, including from American Airlines.

Good luck!
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Are your parents Winter Floridians?   And if so, is the trip intended to last through Winter until Spring?   Either way, there are potential major issues that could accelerate.

If the plan is to stay through the Winter, there's the issue of their being alone, w/o your involvement, as well as the need to acclimate to a new environment, surroundings, people, medical situations, etc.

If it's for a vacation, the issue of short term acclimation arises, as well as confusion for someone with dementia.  

I also share other's concerns about his driving ability.  

Even though flying and shipping the car is safer (which suggests to me that this is for the whole Winter), there's still an adjustment to flying.  And it can be just as disorienting as driving. 

I have the impression that your father is very controlling of your mother, or perhaps it's his own way of denying fragility and vulnerability.

If he can't be convinced to stay here (which is the better solution by far), I would start trying to create a support environment in Florida.   Contact the Senior Centers, local police, RV park or wherever they're staying and put them on the alert. 

Identify and put in place emergency arrangements, especially someone to provide wellness checks on them and report back to you.  

And make your own plans for an intervention.    I had to fly from Michigan to Texas to bring my parents back during their Winter Texan trip.   Dad had developed pneumonia, wouldn't stay in the hospital and leave Mom alone in the trailer, and I knew that it would only be a matter of time before something worse happened, health or otherwise.  

And make sure he's able to operate his phone, or better yet, get him a medical alert button to wear in the event something happens.  You might want to get one for your mother too, so she can get help if he's out of the trailer/apartment, or wherever they're staying.  

You might also ensure that you have the necessary documentation to fly; it was easy back in 2000, it's more complicated now.  If there's an emergenct, you'd probably want to fly out ASAP.

As to persuading your father, unfortunately, men sometimes are just not open to that, regardless of age.   And he may be even more adamant if he's still trying to prove to himself that age isn't affecting him.   Do you have ANY leverage over him?

And I wholeheartedly agree that estate planning documents should be prepared if they're not already.

Alternately, could your persuade your mother to stay with you, or a relative, while he's in Florida?
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As a Senior who needs help but doesn’t want to make her kids feel “obligated” as they both have their own lives and issues and also doesn’t want to admit the need for help, I can understand how your dad feels. Your parents have seen a lot of Life at their ages and your dad probably is of the opinion he can darn well handle anything that comes along. You are, after all, his child and he has spent the better part of his life “raising (you) up”. Parent as child is not an easy concept to accept. Success with this is all in the approach. You and I both know that they are not in a good situation. Dad is Mom’s caregiver and you probably aren’t 100% totally aware of everything he does for her. My kids aren’t really aware of all I do for their bedridden father. But they’re smart enough to know they have to wait until I ask for help. Suggestions by them are made in an “oh, by the way” tone of voice. I know what they’re doing and I appreciate their tactfulness. But, you do need to step in. Do so with the attitude of helping and not taking over. Dad will not appreciate being told “you can’t”. This idea may be crazy, but if they’re not actually moving to Florida, can you turn it into a family vacation? I can guarantee you that offering help and minimizing the supervision and “taking-over” aspects will work better. Like said, it’s all in the approach.
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Lizard61 Sep 2019
Thanks for your common sense advice. You are living the caregiver life, like Dad. He is stoic and in good health, other than aches/pains, hearing aid. He uses a smart phone and navigates the internet well. Mom can't. Their house/cottage in MI is on the side of a hill with outdoor wooden flight of stairs, so isn't a good place in the winter. They have been going to FL for 25 years, usually in a 55 plus park, but now staying in a home with a 92 year old deaf friend! I have driven them in the past, but this year they want to go in mid October and I can't. They can fly, and have done so, but Dad is worried about shipping his car and having it at the airport on time. I did drive their car down one year and flew home. Maybe I can find a relative/friend to do this again.
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Based on what you disclosed, his trip to FL seems to be the least of the concerns. This is just the beginning of a journey for you and your family, so I hope you have all the important ducks in a row before you set off to help your parents.

Does someone reliable have durable PoA for each parent? You won't have control if you don't have at least this. If not, this needs to be done sooner rather than later, and since your dad seems to be a little "resistant" already, be sure to take a finessed approach so that he doesn't completely shut it down. If they do leave for FL, make sure you know where all their important paperwork is in the house, names of docs, medications, etc. Does he have a mobile phone? Even a flip phone like a Jitterbug? This would be an important safety tool for them.

Next, is your Dad still a safe driver? If you are not sure, get in the car with him and see. Does he have good judgment; can he see well enough; can he turn his head to check the blind spot; can he hear well enough? etc. You can anonymously write to the MI DMV and make the case as to why he should be retested. I've done this with 4 different relatives. If he passes, that's good. If not, then no more driving to FL and this issue is solved without you being the "bad guy".

Your mom's decline: has she ever been formally tested for cognitive levels by her doctor? Sometimes an untreated UTI can mimic the symptoms of dementia and can be resolved with antibiotics. Talk to your dad about this as it is less threatening of a beginning conversation about the whole of it. The elderly don't always recognize or can express the symptoms they are having and UTIs are extremely common and constant. This is what I did that worked: Offer to take her to the doc to get checked for UTI (after all, your dad won't want her to suffer all the time they're in FL, right?). Don't have your dad go. At her appointment do 2 things: have your mom sign the form that allows her healthcare providers to release all medical info to you and for you to talk to them about her. Then, discretely tell the nurse or doc you also want her given a cognitive test. They will gladly do this. Everyone who loves your mom needs to know this info and cannot dispute it if it comes from the doc. This is ammo you take to your dad when you have your discussion about getting more care for her. This forum has lots of great info so keep searching it for more wisdom. You're not alone!

If you can get to this point, you've laid some good groundwork to help them. Let us know how it goes. Good luck!
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Are they moving there to live? Is this just a "roadtrip"? It sounds truly unsafe. It is the two of them alone? Is your Dad fully capable and appropriate, but just in denial? I don't know that there is a lot you can do. What support will there be in MI when they get there?
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Lizard61 Sep 2019
They spend the winter at the house of a friend, who is 92 and deaf. She doesn't drive, so my Dad is their chauffeur. I have given my Dad info on the senior services in FL, and so far they haven't used them. Dad is an OK driver, just slower reaction time, and doesn't look both ways or over his shoulder. He wears a hearing aid. I don't know if he would pass a driving test, but haven't had the heart to report him.There are a few friends in FL they spend time with, who are older and in similar condition.
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