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Despite 2-4 kids in town most weeks of the year (sometimes 5), some are scared they will be on their own at the worst time and are now asking the other siblings to schedule their entire year « just in case ». This came to a head when mom broke her hip when the 2 siblings who have handled all other hospitalizations (me and a sister) were both out of town and the other 2 found out how much work is involved.

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Is this about moving into a NH or is this trying to plan care at home for an “entire year”? Very different.

not meant to be snark, but honest answer, if it’s her staying in her home, why should those not in favor of this sign up for “duty” and schedule an entire year? I’m not taking moral sense of duty / familial responsibility but legally kids do not have to do squat for thier parents…. ever.
Why is a plan on mom moving out of wherever she lives and into a facility with oversight needed not an option?

So she recently broke her hip, what happened after her hospital discharge? Was she sent to rehab in a NH/SNF type of facility? If so, how did that go? and what did her needs assessment look like when she finished rehab? Was her exit from rehab assessment realistic for how she lives in her home?
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Heathg22 May 2022
She is in an assisted living facility. When she broke her hip, one sister (the one on vacation, recently returned) and I (still on vacation) researched a post-op home care solution but it turned out not to be needed. She just went back to assisted living with some physio exercises to do - she’s a tough old bird !
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Mom needs to get accustomed to other caregivers that aren’t family. My dad was hugely opposed to anyone outside family helping him, but his needs became too much for us to handle. After a fall that left him on the floor for many hours, thankfully uninjured, but also unable to get up or call for help (he’d taken his alert button off to charge it) we had a harsh meeting with him and said either he hire a helper or move to where he’d have help. He accepted the long overdue help. She won him over and quickly turned into a trusted friend to him. She was truly a godsend. Please don’t believe that family can or should do it all, whether they are close or not. It often ruins relationships to even try
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notgoodenough May 2022
I agree 100%.

The kids ALSO have to reconcile the idea of mom's other caregivers not being family members as well.
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Do you have a plan for your mothers care that you all agree with? For example, if she needs a higher level of care, are you all in agreement she will go into a care facility or will one of you do it? Who provides most of the care now?

Before I ask the family to plan out their year I would have a detailed care plan you all can agree with. If you have that in place, there is less need to plan a year in advance. Without this, even if someone was in town, would be able to or know what to do? My advice, get a detailed plan if you don't have one and then consider if you need to plan your year.
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What??

Siblings want to OTHERS to schedule their YEAR around their feelings (of WHAT exactly?) that something MIGHT happen & they MAY need help??

Again, what??

I have SO many questions... starting with why?
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Is she ready for Assisted living?
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So mother is already in assisted living so that most of her care is being looked after, and in an emergency, mother was hospitalized. I'm sorry but I don't quite understand their concern: "Some are scared they will be on their own?" Do you mean they are afraid they will have to deal with medical staff and plans should your mother experience an incident while you're away for a weekend? I mean it doesn't sound too onerous. Isn't dealing with incidents that are stressful or unpleasant part of adulting? Just inform them that they will have to work with medical staff in case of emergency and then you can discuss as a group the next steps to take. I'm presuming that the other siblings are capable adults and are not debilitated by physical or mental health issues.
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Good Morning,

Folks, nothing prepares you for this. An emergency is exactly what is say it is. Life happens, there are no guarantees. Of course you can expect the best, but make a plan for the worst.

Basically, where there is a fall or an incident at a NH and the patient is transported to the hospital they "the ER" run all kinds of test to rule out the "big things". You may be able to be by their bedside and hold their hand for a while but after that the medical personnel take over.

You could all have access to the patient portal and contact the docs via the portal which is usually much quicker than the olden days sitting by the phone.
These will give you access to tests/bloodwork, etc. All reports then go the PCP.

A list of meds in your wallet and/or on the refrigerator also help--a POA, bank access, know what 's going on financially.

This is called life. The more you do it, the more familiar you become and you keep your cool. You're more centered. Some people don't want to do it at all. I think it's wonderful in your situation that so many people want to help but it's sounds like they don't want to be alone handling this.

I agree...I am that person. I have been "alone" by my mother's bedside at all hours of the day and night. I hold her hand, don't say a lot and stay calm. If I'm calm, my mother stays calm. I tell her she is in good hands. I stay grounded.

Basically just show up and hold their hand, stay out of the nurses way and thank people. Let the docs know if they are blood thinner, wear hearing aids or have Dementia. Be prepared as best you can. Keep in mind the older they get the more incidences they have.

Don't be afraid...just stay calm and face them when they are in the hospital bed, sit so they can see you. Ask them if they are in any pain, or hungry or thirsty.

Amen...
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SURPRISE! Taking care of an aged, multi handicapped adult with dementia is hard, unpleasant, unrewarding work, and it is INFINITELY EASIER to be a low participation opinion contributor until CRISIS HITS.

WHEN THAT HAPPENS (and it ALWAYS DOES) the next easier step is to complain bitterly that “WE DIDN’T KNOW HOW HARD THIS WAS!!”.

Hoping that a a DNR and Final Directives document is in place. If so, the process is to be sure the AL/SNF is fully aware of the legal expectations of family, and do what they do best, and notify you.

Let NO family member expect anyone else to do what EVERYONE should have been doing sooner, but be sure that all of the “loving children” know where all of the legal documents are if they are needed, and DON’T be bulldozed into providing a schedule a year out.

I have lived this as a single POA and as a part of a “team” (LOL) of caregivers.
TRUST ME- in MANY WAYS, it’s EASIER to do it on your own.

Good luck with this, and remember, there are often NO “good” SOLUTIONS.
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We were 3 adult kids living 10 minutes, 1.5 hours and 3 hours from mom's nursing home.

We all had medical poa.

We started planning vacations so that all of us would never be out of the country at the same time.

We all kept up to date on mom's meds, conditions and what her wishes were as far as end of life treatment.

We all agreed that if mom died while one of us was away, funeral would be delayed until we returned at the scheduled time.

AND while mom lived in her NH for 4 1/2 years, from the time she entered (she was 90) we all accepted the fact that each time we said "bye, Mom" it could be the last. We don't do "rushing to the sick or deathbed" in my family.

Now that mom is gone and my 2 daughters with little kids rely on us for childcare, my ex and I schedule our vacations so that we're not away at the same time.

These siblings who found out how hard all this is now are prepared for "next time". Send them notifications of when you will be out of town and ask them to do the same.
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If mom is in a facility, wouldn't her needs be met within the facility? A family "caregiver" or visitor would be nice, but not essential to her care. I was in a rehab facility for a month and no family "caretaker" was involved at all.
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Much better for all concerned if you are visitors and NOT long-term caretakers - too many families are torn apart my this situation (I've learned many lessons here and have taken steps to insure that our children will never be our caretakers).

Better to get everyone on a FaceTime Calendar and let the pros take care of Mom. Contact an Elder Care Lawyer and have a family zoom meeting.
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Have a folder with all of mom's information in it: insurance contacts, doctor contacts, medical history, surgical history, current medications and times she takes these medications, allergies and what happens if she gets those meds, her usual routine... Having this information helps in any emergency.
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It sounds like Mom was living at home when she broke her hip, and the two who did most of the work were on vacation. So the ones who were more hands off got put on duty suddenly, and didn’t like it so well!

I agree with the others, make a binder with all of her info. Make sure her complete current meds, DNR, POA are in it. Make sure everyone knows where it is. That’s it. They go with Mom wherever she goes and support her.

They can do it, it’s just unfamiliar territory, so it’s good that they’re getting their feet wet. You two shouldn’t have to do it all.
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Heathg22: I tried to have a plan for my late mother's aged years, but it was I who had to move in with her from out of state. Best of luck.
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I would take a different tactic.

1. Start getting your Mom's info together, covid vaccine card, pill regimen both summary and listing by the time of the day the pill is taken, copy of state id, medicare card, any other insurance cards, any kind of special programs that required id like the handicap placard. Make a digitized copy and put it somewhere where it can be accessed if needed. If Mom has an accident, you have all the information needed for entry into the hospital, plus you have a list of medicines that she might need until she is admitted or brought back home. At least where I live, the hospital will use digitized copies, no need to have the actual cards.

2. Make sure you have POLST, POA and Medical POA. Copy of the trust is good too. Get a list of all the doctors and hospitals you would use. Include pharmacies, dentists, hearing aid center, eye care, PT, etc. For instance, my Mom had a preferred orthopedic surgeon. When she was taken to the trauma center, they would not call our preferred orthopedic surgeon, saying that the practice doesn't take new patients. We were not a new patient. To their surprise, he came that night and the next day, she had surgery.

3. Take her to her doctor to get a physical. Check into what kind of vaccines or certifications that would be needed if she needed to put into a AL. In my state, a 2 step TB test is required, with annual renewal. Pneumonia and hepatitis is also highly recommended along with shingles, etc. Some of these vaccines require 2 shots with some time separation between them. I found out that my Mom's previous doctor stopped giving my Mom vaccines like tetanus and pneumonia when she was 92 years old.

4. Start interviewing AL/rehab places and home care facilities. See what facilities are available. How many meals do they cover. Do they check to see if the person actually shows up to eat? Do they do housekeeping or laundry? What is the cost for medication management? Does medication management actually ensure the person takes their medicine or do they just dispense and leave on the table, assuming that the person will take it. What is the minimum length of stay, what is the maximum length of stay. What kind of rehab do they do best? Does the place take her insurance?

5. Finances -- who pays? who has signing authorization should your Mom become unable to make decisions or unable to sign her name?

Yes, this seems like a lot of work. However, once it is done, it is fairly easy to be kept up to date.

More importantly, should another unexpected event happen, you will already have made some decisions so that she can get the best care that you would like. Even though there are 4 of you, having a lot of this stuff written or in a common place, makes it that much easier to deal with the person and the event itself and not be distracted by all the other requirements just so that your Mom can get the care she deserves.
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