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88-year-old dad and 82-year-old mom are living at home together in Florida. He is mostly okay cognitively but has a heart condition. She is mostly okay physically but has cognitively declined. I live in Illinois and am visiting them at the end of the month to take them to the hospital for his heart surgery. She refuses to see a neurologist or be assessed for Alzheimer’s/dementia. I have health care POA over both. I’m wondering if I should try to set something up with the social worker the hospital previously recommended to help with placement in AL/MC to get her assessed while in the hospital. I don’t know if that’s even possible or if it would be a bad idea to do it while her husband is on the operating table. He thinks he’s doing what’s best for the family by keeping her in the home, but I suspect he isn’t. It sounds like she’s pretty much bedridden and not getting the care she needs. He also wants to save money for his children by not spending it on AL/MC for her or himself, but I question that decision too.

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A few days to be with Mom and Dad are woefully inadequate to develop a care plan for frail elderly parents. Read that again a few times. Then change your flights to come earlier and stay longer. Meet their doctors. Talk with their PCP. Make sure you have ongoing care in place for them and are in contact with those care providers.

Ask Dad who will take care of Mom, and how, if something happens to him. Ask Mom who will take care of Dad and how if something happens to her. Have these conversations separately. (Divide and conquer!) Now get everything in writing.

Who does the shopping and cooking? Who schedules medical care? Do you have medical POA? You also need a HIPPAA waiver, so that their health care providers can share information directly with you even if they are able to make their own decisions.

If they are still driving, plan for that to stop. Arrange alternative transportation for them while Dad is "recovering." Take Mom's license if she still has one. Take Dad's license while he is in the hospital. "Mostly OK" is NOT good enough to drive safely!

Agressively independent seniors often make foolish decisions, and can overestimate their own abilities. This can be dangerous for them and others. Get an occupational therapist to do a home visit/safety assessment.

As we said to our parents, "Spend our inheritance!" It's their money, they earned it, and it's shame on us if their educated adult children need Mommy and Daddy to take care of them.
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Beatty Nov 17, 2023
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Greg--

Take a BIG step bacakwards and re-assess Mom & Dad.

Your view that they're 'mostly OK' is not the proper dx.

They are NOT taken care of, and someone who doesn't get out of bed--that's not right. You admit you think she's not being cared for, and I bet that's true.

Your being town for a few days will give you a chance to look at the overall picture and make some decisions about their care 'going forward'.

Time to put to rest dad's desire to leave an inheritance for you kids. Seriously, I so wish my MIL would use all her money for a lovely NH and not pinch every dang penny until it screams. She needs to be in care and never will be. The 'inheritance' is, to me, a dirty word. I'd give up every cent if she would agree to FT care.
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Greg, I think you need to be in touch with the hospital SW before you arrive.

You need to outline for her what is going on with your mom, both physically and mentally BEFORE your dad's surgery. Sure, he may only be in the hospital overnight, but you have a golden opportunity here to address what is going to happen in the future, when (not if) mom falls or dad becomes unable to care for her.

You're not going to get a cognitive assessment while dad is in surgery, but maybe mom can meet the SW while dad is in the hospital and make a connection, see her as an ally.

How are you getting her to the hospital if she's bedridden, by the way?
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Beatty Nov 17, 2023
"She is mostly okay physically but has cognitively declined".

Maybe mood/lack of initiation appearing as bedridden?

The hospital SW will have a caseload of patients already in the hospital. I've never heard of meeting a SW pre-admission - but worth a try? There may be an outpatient allied health services clinic. A needs assessment for BOTH parents could be a goal.
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Thanks, everyone. To answer some of the questions above, he had a pacemaker put in back in May. He was having trouble with it and had to go back to the hospital a few times. The doctors determined the leads need to be readjusted or repositioned and that operation is scheduled for December 1. They told my sister it’s a low risk operation and he could be sent home the same or next day. But at 88 I’m aware the risks are greater of something going wrong. My flight home is booked for December 4. I don’t know what I’ll end up doing if things go bad but am hoping the hospital staff and social workers will help.
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AlvaDeer Nov 17, 2023
As an old cardiac nurse I have to be so curious Greg. I hope the docs give you further info. It doesn't make sense to me that a REQUIRED pacemaker is put in and lead placement isn't right and that is not addressed EMERGENTLY as in at ONCE. My own mom had lead slippage (they do not at once get embedded well in some instances until they scar in a bit), and was right back in that OR. It seems negligent to me to hear that the leads "aren't right" but that won't be addressed until some future time. We are talking a cardiac pacemaker here. This is just so odd, and in all my years dealing with pacemaker implantation I have never heard anything like that; hee hee you can tell his docs that.
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"She is mostly okay physically but has cognitively declined." and then "It sounds like she’s pretty much bedridden and not getting the care she needs."

If she's mostly okay physically, why is she pretty much bedridden?

There may be a lot that you don't know and even more that is being concealed from you.

You're fortunate to have health care POA over both. Get ready for some big reveals. It seems as if they both need much more help now, and trying to manage that in their home when you're in Illinois is a huge job.

It would be a lot easier for you and better for them if you could find a nice assisted living where residents can progress to memory care when necessary. There are many such places in Florida, so start scoping it out now. Moving them to Illinois might set them back healthwise because it's harder to adjust to major changes when sick and old. Plus the winters are difficult when they're used to Florida.

Good luck.
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This is a stressful situation for you. What are your primary concerns right now?

Do your parents have any outside help? Are they planning on hiring help if they don’t already have someone to assist them?

If a social worker offered to help you plan for their future needs, I would take them up on that offer.

It’s better to be prepared as far as knowing what is available for them should they need it now, rather than having to find solutions at a more inopportune time later on.

Best wishes to you and your family.
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You are the POA. I would discuss this with the Social Worker in hospital for advice, or see elder law attorney. Realistically, your father may not survive this surgery. And he may need long rehab. You will be in charge of Mom. This is the time to do it. Your father may WELL be unable to resume caregiving for his wife.
Again, discuss this as soon as you can to see what your options are with expert advice.
Sure wish you well and hope you will update us.
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BarbBrooklyn Nov 11, 2023
Maybe he's just getting a pacemaker.

More details will get you better answers.
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BarbBrooklyn asked the critical questions that need answers so we can give you the best guidance. Please provide more information.
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Welcome, Greg!

What is Dad's/your current plan for mom's care during his surgery and recovery?

Are we talking about an outpatient procedure where he goes home that day or will he be in the hospital for several days and possibly rehab afterwards?

What restrictions will he be under after surgery and for how long?

Is mom still able to toilet herself? Are you willing/able to change her diaper?

Do they have any sort of home care coming in? Housekeeper or home care aide?

Have you spoken to the hospital social worker about getting some in home help for Dad after the surgery?
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Any family near mom and dad to keep a close eye on them now and after his surgery??
I agree; WATCH THAT FIRST STEP!!
If you feel you are financially set without that extra dollar from your parents, then by golly, tell them to move into a facility..that allows them to “Age” in place.. the rent will go higher as their needs go up, but they will be in the same facility.. at least look into it..
when aging parents start happening, it’s almost like starting over with “your new family” instead of a gender reveal party, it’s a revelation moment: “what is going to happen to us at their age?”
What would I want my kids to do with me..?
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Your folks have their plates filling up.. your's too, as you have stepped in to help them. Stepping from Supportive Son to hands-on Caregiver-Son for your Mom through Dad's coming surgery. This major heath event. Mind that step! "The first one is a doosy" as they say.

Sending supportive thoughts your way for starters.
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waytomisery Nov 13, 2023
I agree. It may be time to go to assisted living , before things get worse .
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