They do not both meet the requirement of failure to do two ADLs, which is required by their long term care insurance that they have paid into for many years. But, they are not showering or doing laundry. And her cooking is worrisome, with her memory loss. She is also mean to my Dad, yet jolly to those on the phone. How can we help them when she won't allow it?
Sadly, we are seeing more and more posts like yours on this forum. I wish I had the perfect solution for you! It really does become challenging to care for parents when they behave this way.
Do you live near your parents? Is it possible for you to let them in the first time or two and then reassure her that they are there to help?
Give us more information on your situation and we will try to help you further.
Best wishes to you and your family.
A doctor must say that they cannot do two of the ADLs for 90 consecutive days for he insurance to pay. My parents can physically raise the fork to their mouth, so they are "able to eat." Not fair, but the long-term care policy rules. They can do all of the other ADLs, currently, but have chosen not to, over time. My parents have paid over $100,000 into long term care insurance, over 30 years for it to be available when they need it, but do not yet qualify. My dad is 86, and mom is 82.
My brother and his wife do all they can, but cannot be there enough for them. They have POA. They do all their financial work. My mother says she takes her medication. She does not. We can see that by the "refill" dates. And she cannot cope with doctor appts., the scheduled appt. is too threatening. She will not go. Also, shs particularly rude to my sister-in-law, who is trying so hard to help.
My father is perhaps less functional than my Mom. But he is amenable to most ideas and compliant, other than going to AL. She is the problem. They also have an older, beloved dog that she will not leave. She does not want to be obsolete. Nobody does. She commonly lies about doing things, like showering and laundry which are easily noticeable. She believes going to AL and taking away her yard and outdoor space is tantamount to punishment.
Her short term memory is terrible, but she passed the memory assessment TWICE! We have no idea how. We are a loving family, and could never have predicted her behavior. I know there are others out there like us. Any suggestions are truly appreciated.
Lots of people say that their loved ones have early stage dementia. Maybe that’s a way to deny what is really going on. I don’t know in this case, but it seems like more than early stage from what you describe.
sounds to me like they need live in home care or assisted living. Sounds as if Mom may need 24/7 supervision to be safe at home and it may be too much for Dad to handle.
Call your local Agency of Aging . They will send a social worker to assess their needs. Perhaps the social worker can talk Mom into allowing help in the house , or assisted living if that is needed.
But for you - who IS providing assistance to them? You?
How did LTC determine that they could do their ADLs when you're thinking that they're really not? That's annoying.
How long have they not been showering? Why did they stop?
I put child locks on my stove for my mom when her dementia diagnosis came through so that she wouldn't burn my house down. When their memory is bad, putting something on a burner and walking out of the kitchen is a real concern!
Is she still deemed to be competent? Does anyone have POA?
Over time they have chosen not to shower. Their "assistance" is only happening for my father, who is agreeable. My mother will accept no help. She "can do everything by herself". She is basically being neglected because of her attitude. She does not take her medication, does not bathe or do laundry very often. Their diet is poor.
We would like to keep them in their home, with in-home health. She is relentless in her opinion of her independence. I believe it's all fear driven. She is verbally abusive, DEFENSIVE, and only blames others. The fight will be the burden on my brother who has cancer and does not cope well with the family stress.
We have found no approach to get her to relent to help. One would think they would glady accept assistance. I am starting to think this is more of a personal choice or power struggle for control, than dementia.
Can you get her to an exam or meeting with one of those people? Would one of them come to meet with your mom at her house?
Cxmoody
7/28/23
You can’t reason with dementia patients, though. This is dementia. From what you describe, I have no doubt. Proceed with that thought.
Right now the person with dementia is running the show. You’re the one to stop it so they can be safe and live their best lives.
"How did LTC determine that they could do their ADLs when you're thinking that they're really not?"
This seems important.
A Functional Assessment (or needs assessment) can uncover the independence level. I think it was a SW or could have been an OT that did one for my LO.
Meals:
Self reports: Can cook. All sorts of meals.
Family reports preparing breakfast, sandwiches & reheating frozen meals.
Observed: cupbboards contained poor quality breadfast cereals, evidence of takeaway meals, fridge has over use-by items.
It goes on, personal tasks bathing, toileting, medication. Household tasks, cleaning, laundry. Community tasks, shopping, socialising, transport. Financial matters too.
It can be personal choice to eat frozen meals, not bathe or change clothes as frequently as relatives would like.
However, not taking medication, not using walking aides, not keeping hygenic, not eating/hydrating well all become 'risky' behaviour. Increasing risk of falls & other calamities.
They grey zone between *living independantly* & *not coping*.
What would happen if your brother & wife stopped helping?
I would have everyone back off, let them flounder and see what happens. Maybe the light bulb will go on.
Whatever you do, don't let them move in with you. That would be a very bad move.
I am in another state. My brother has poa and lives there. They will never be allowed to move in to his home.
Happiliy today, LO loves the 'ladies' (& the occassional man) that come. Trust was gained & they provide excellent company & assistance.
My LO is happy for others to do household chores, laundry & any other boring tasks.
However, if you have a housepround housewife who's identity is connected to keeping house herself - this is different.
Still need to build trust, but the worker will need to involve Mom, let her think she is in still charge of the task.. they can do *together* rather than the task bekng taken over. As trust grows, Mom can let go a little. 🤞
We had to install a keybox for EMS to gain access. (Another choice: agree to the keybox or lay on the floor forever).
The care staff also use the keybox now. (Another choice: let staff let themselves in or risk them leaving when not let in)
* Staying home as long as possible *
At some point, the line into *not* possible is in view. I see it not far ahead..
Interesting...
Stubborness.. Anger? Fear of change? Fear of losing control?
Sometimes people think: If I don't accept help = I am independant. This is faulty thinking.
If I am become hearing impaired, I can choose to get advise to see if hearing aides will help me. If so, I can wear them & (hopefully) hear better.
Refusing hearing aides will not mean I can still hear.
Being open to change takes bravery, strength & trust.
We started out saying the caregivers were going to come and do a little housekeeping & laundry. Slowly the caregiver started assisting with bathing & meal help.
Once they felt comfortable and liked the caregiver they enjoyed a friendship & looked forward to them coming.
I guess we will have to get the In Home Health care order reinstated when she finally relents. She currently sees nothing wrong with their lifestyle. Thank you.
When we noticed medication consistency lapsing, we bought Mom an Alexa and programmed reminders. You could do similar for meds, laundry day, put the trash out, pm safety check—-doors are locked, faucets and stove off. We kept Mom in her own home 700’ from us until it was no longer safe. She is thriving in AL. Best wishes as you journey.
make sure they know all of it.
they paid for the insurance and you are listing more than 2 ADL needs - batheing dressing grooming light housekeeping taking medication as prescribed, even if inability is due to dementia it should be considered.
need an advocate - try the local Area Agency in Aging, estate lawyer, social worker, physician… wait and see is dangerous IMHO. Medication may help.
(Dripping water hallows out stone not through force but with persistence - Ovid) keep dripping!
Someone needs to be there to let the nurse in... don't know who that might be. Could the nurse or agency have a key to their house? A neighbor who is at home during those hours?
We are keeping observation notes on my MIL's condition. Her PCP says he doesn't need any testing as our notes are sufficient for him to diagnose her.
The choice is either cooperate with home/health coming in or APS comes in and they both get placed against their will if they are vulnerable elders.
I say this all the time. Nothing gets a senior a one-way ticket to a nursing home faster than being stubborn.
Sometimes you have to wait for something to happen before you can make a move and get them the care they need.
In the meantime, you should ask the police to make regular wellness checks on them. They will let the police in an the cops will see that they aren't coping on their own anymore and they will call APS.
This does not necessarily mean they will be taken from their home and placed. It means that they will have to accept help and they will.
Seniors will be stubborn, ornery, and even downright nasty to their families when it comes to accepting "help". They usually change their tune when it's forced on them by the state.
It’s gone surprisingly well. Not one rejection of a caregiver. Please do make sure you find on compatible to them.
If you live far away (didn’t check profile) perhaps a trip for the “friend introduction”. Just get them the car, who needs their approval. My mom is also mean to family and nice to everyone else. Your mom might enjoy it after a day or two. Good luck. Stay strong.
NHWM
Will your father go along with your Mom if your Mom agrees or vice-versa?
It does sound like you have to convince Mom first, and Dad will just come along.
I would suggest that you take your Mom out to eat or for coffee or somewhere that you get her full attention. Then ask her why she won't allow people to help her until you finally get a reason.
In my case, after I got through all the crying, angst, etc. with my Mom, the real reason she didn't want anyone was because she was afraid they would get to know her too well, and attempt to steal from her. She doubted her ability to stop them from doing what she didn't want them to do. For instance, she didn't want the caregiver using her bathroom, her sink or her toilet. She wanted them to use the "other" bathroom at all times. She didn't want them to do the dishes because they might get the floor wet and ruin the floors. My brother at the time, pointed out that she had nothing of value to steal, however, I truly think it was the fact that she just didn't trust them.
Once she finally agreed to a trial, she realized that I was more "picky" with the caregivers than she was, and she allowed her guard to be down. My sister and I stayed overnight with her, so that gave her the comfort that the caregiver would not hurt her.
However, in your case, you might not have that option. A better option might be to move both of your parents into Assisted Living so that they can stay together, and have someone else do the cooking and the cleaning and the laundry. Then put their house up for rent.
I'm sorry, this is one of the tough parts of caring for the elderly....convincing them to do something that will make their life safer and potentially, your life easier.