care for elderly mother

My mother is in her mid-70’s and told me last night that she almost called me on my cellphone to request help getting up from the toilet. She lives in her own home and avoids getting any help from professionals. I’m male and would rather not view her when she’s less than fully clothed, plus she’ll probably need help wiping in a few years. What is the job title for people that take care of these kind of things and where do I find one? She says she’ll call the fire department for assistance if I’m unavailable.

The person who actually provides this type of care for the elderly is a home health aide. To find one, you probably want to start by looking up elder services in your area and contacting the government department that can assist you in assessing your mother’s needs.

I often wonder at the rationale of the elderly who need assistance, but insist on staying in their home. If I manage to live so long, I’m heading to an assisted living facility.

SpoilerVirgin has the answer. It wouldn’t hurt to have a professional help assess things. Current solutions could be as simple as installing rails and hand-holds in places she needs help pulling herself up. There are raised toilet seats that can be installed. Maybe a weekly visit to help clean, and in that way she can be assessed, could carry her for the next few years.

The rationale is lack of money. Those places can quickly drain a person of all his assets.

In my area, there are several different titles for related but subtly different assistance in the home.

Home health nurse: this is an RN or LPN who comes in once or a few times a week for about an hour at a time. We help people with wound dressings, IVs, sometimes feeding tubes and ostomies, education about their diagnosis and understanding their medications. Our assistance is meant to be intermittent and of finite duration. Medicare will pay for our services if the person is homebound (their medical condition creates a considerable and taxing effort for them to leave the home) and has a skilled nursing need.

CNA/Certified Nurse Assistant: this is a person who comes in a few times a week for an hour or so at a time to assist with bathing, dressing, feeding and some light housework like changing bedsheets. Medicare will pay for this for only as long as the person also has a need for a nurse or a physical, speech or occupational therapist.

Homemaker: if a person has low income, the Department of Aging will evaluate them for eligibility for homemaker services paid through state funds. Homemakers are responsible for cleaning, cooking, laundry, and some errands, like grocery shopping.

Private duty nurse: this is an RN or LPN that spends many hours or even lives in the home with a person. I don’t know of any insurance plans that cover private duty nursing. These are paid for by the patient or their families. Their duties are similar to the home health nurse, but for people who need a nurse around for more than a short visit.

Caregiver: this is an unlicensed person, also paid for by the patient or their family, who spends many hours or even lives in the home with a person. Their duties are those of a a homemaker and a CNA combined. They’ll assist with bathing, cooking, eating, cleaning, errands, etc.

Home health nurses and CNAs can be found by asking her doctor for a referral for home health services. Homemakers can be found (in my area, at least) by contacting the Department of Aging. Private duty nurses and caregivers are generally found by word of mouth or by directly answering advertisements on job boards or Craigslist type services.

Is there anyone besides the fire department to call if she can’t get up from the toilet on her own? I don’t think she’d agree to having live-in care. Do any caregivers work on an on-call, moment’s notice, basis?

Possibly? As caregivers are usually hired directly by the patient or family, you can try to negotiate whatever works for all of you.

But I think compensation is going to be tricky for that one. You’re essentially asking someone to be on call at all hours, which means they can’t take another job, but don’t know how often, if ever, they’ll be called to work.

Does she have a neighbor nearby she can call for help? If she only needs it once in a while, that might be a better solution.

Does your mom have a raised toilet seat and sturdy grab bars installed in the bathroom? Might want to start there. It won’t solve the problem forever, but it might be what she needs now while you figure out your next step.

She doesn’t have any neighbors that she could call for bathroom assistance. She does have a raised toilet seat and grab bars in the bathtub stall. Maybe she could get those installed by the toilet as well.

That’s an excellent idea. If there’s no space for them near the toilet, you might consider a raised toilet set with built in handles. http://www.arthritissupplies.com/bath-safe-raised-toilet-seat-with-arms.html

(There are actually lots and lots of aids and devices on that website that might be helpful to her.)

That’s the kind of stuff you can get her for Birthdays, Mothers Day, Xmas gifts.

After all, what else can you get for gifts at her age? She probably has all the ‘stuff’ she needs by now. And many older people (like my Mother) are quite reluctant to get such things for themselves – it’s admitting they need help, and a loss of their independence. But they’ll use these aids if they are there, to avoid disappointing their kids. And often discover they are quite helpful, even if they won’t admit that.

Lack of money

Loss of control

Fear of strangers

If dementia is setting in, people in new/strange surroundings can be disorienting.

That’s just off the top of my head, I’m sure there are other reasons.

I dont have any advice to offer
Both my parents are a similar age and divorced and single
I fear for their future somewhat of course…

Reflecting our past several years with my MIL, the person I’d want to call is Dr. Kevorkian.

It just gets better and better from here on GreenElf!

Money is one potential issue, but even when it’s not, there are others.

My elderly parents are getting to a point where it would be appropriate to move into an independent-living facility, but my dad is resisting. They live in a big, nice house with a view of the mountains, all of which will go away when they finally do decide to move. They could afford the nicest retirement community in their area, but even that doesn’t have what their home has.

It’s also a difficult move to undo. My dad understands that it will be a one-way transition; they will sell their house and probably most of their possessions, so he doesn’t want to make the move until he’s absolutely sure it’s necessary.

And then there’s the stubbornness of old folks. People whose minds and bodies have decayed to the point of needing assistance often have compromised decision-making abilities and an increased propensity for cognitive distortion.

Finally, it’s a symbolic acknowledgement of their own mortality. To move into a place because it offers assistance (even if it’s just with laundry and meals) is an admission that your ability to be independent is fading; moving into an independent- or assisted-living facility may feel like putting one foot in the grave. For folks who have already fully accepted that they’re going to die some time in the next few years, this isn’t so difficult; for folks who have not, it’s a tough pill to swallow.

Mike Tyson famously said “everyone has a plan until they get punched in the mouth:” it all seems to clear and easy when we’re watching from the sidelines, but if you’re actually in the fight, you start to understand why things go down the way they do. When we’re young, we like to imagine that we won’t behave like so many elderly people seem to; but when we finally to get to be their age, their seemingly irrational behaviors may seem a lot more rational to us.

This may be a very bad thing to do.
(Disclaimer:I am talking out my ass here, and do not know the laws in your area.)

If you call the fire dept, you are inviting a government agency to disrupt your life.

One call may be okay–I don’t know. But repeated calls to assist a person on the toilet are not what the fire dept is designed to do. They will notify the local health authorities/social workers, or whoever is responsible in your local government.

And those people have a lot of power to disrupt your life. I think they can simply declare, after a single home visit, that in their professional view, the resident is incapacitated and incapable of liviing independently.
This has–I think–the same legal authority as a court order , in which, say, the social workers remove a child from an abusive home.
They can basically give themselves guardianship over your mother, and force her to move to whichever old-age facility they choose.

Again- read my disclaimer before you panic.
But I faced a similiar situation with my family., and was present when a social worker basically warned us to hire a full-time caretaker, or else the government would intervene and require the person to move out of the house.
(It was, by the way, a legitimate concern, which is why we invited the social worker. )

Well said Machine Elf.

My 86 year old mother broke her hip last summer. Had to have two surgeries on it. Ended up for 2 months in a nice skilled nursing home. I picked it out of three that the hospital recommended. I’ve also looked into about half a dozen more.

She absolutely hated it.

She is now back home. She has all the apparatus for her bathroom so she currently needs no help there. Monthly, she has a cleaning woman come by. The grocery store delivers food. She has an emergency pendent that she has on her 24x7.

I live 100 miles away and visit twice a month. And all that is peanuts compared to what it would cost to put her in assisted living. Not even comparable.

Not sure I agree. With what we’re going through with my MIL, we’ve clearly told our kids that we NEVER want to put them in a similar situation. 2 of the 3 have agreed to help us die before that happens.

One doesn’t HAVE to get unreasonable and selfish as one ages. And one doesn’t have to ignore the declining quality of one’s life.

Also - when I used to fight, a lot of our training involved taking hits. You can learn how you react.

Being Mortal by Atul Gawande is required reading in these cases.

There are old folks’ homes, and there are old folks’ homes, and there are huge differerences between them.

But ignoring the problem isn’t going to make it go away. You and your parents will get older, and the odds are help will be needed.

This book was on my parents’ coffee table when I visited them a few weeks ago. I read a few pages, and remember thinking I’d like to read more. Thanks for the reminder.

I hope your, and my, judgment remains this clear when we are 85.

Sure, but even a well-trained fighter doesn’t react to a punch as well as an inexperienced spectator thinks he should. Which was kind of my point: young people are the inexperienced spectators of the elderly - we haven’t yet been punched in the face by old age - and we would do well to temper our exasperation with a bit of compassion.