care for elderly mother

In addition to the book Being Mortal, I’d also suggest viewing this TED talk:

BJ Miller: What Really Matters at the End of Life

The speaker is a doctor who works in hospice care and had a near-death experience of his own that cost him an arm and both legs. His perspective at first seems mostly relevant to those who have been diagnosed with terminal illness, but I think it may also be of use in understanding the position of people in their final few years of life (rather than just their final few months).

Who put it there, I wonder?

(I remember, around the time my brothers and I were going through puberty, finding a pamphlet called “A Doctor Talks to 12- to 14-Year Olds” lying around the house in various spots. To be candid, I was the one with the reputation of picking up and reading any printed matter within reach, so they could have meant it just for me.)

Will “the fire department” even respond to a call like this?

Where I live we have a volunteer fire department. I can’t imagine them firing up the horn to call volunteers in for a situation like this.

My father made a similar mistake. By the time he’s sure it’s necessary it’ll be too late. They need to make the decision not only while they still can decide but also while they can still have control of the process.

Agreed. A good independent or assisted living facility can prolong the years of declining but still desirable quality of life. The stress & strain of coping with the now-overwhelming demands of living alone at home can cost them years of good living.

OTOH, a crappy but expensive facility can cost them their sanity, their dignity, and their money.

This is definitely a choice that’s ideally made carefully and deliberately a few years before it’s nice-to-have, much less need-to-have.

A recent health scare for my mom convinced my dad to visit several independent-living places in their area with her - but now that she’s (mostly) recovered, he’s again expressing reluctance to actually make the move. One of the big concerns we have is that if they reach a crisis point where they suddenly need assistance, a space might not be available at their first-choice facility for several months.

:confused: Are you suggesting they put that book out on their coffee table for me to discover and read? Anything’s possible I suppose, but that’s a level of subterfuge that seems unlikely for them. More likely that my mom is reading it based on a recommendation from someone else (possibly my sister).

That was my original idea. But you know your mother better than I do. If she’s been reading it on her own and just happened to leave it there, it might be a good opening for you to bring it up in conversation (after you’ve read it, of course).

Will the fire department respond?

ABSOLUTELY. Patient assist is one of the most common calls for emergency departments.

Officially they will tell you they want you to call because it gives them the opportunity to assess the situation and perhaps even ask the person to go to the hospital if needed.

Would they prefer not to have to do it? Sure.

Will they come if you call? Hell yes.

What will likely happen is if the caller becomes a frequent flier they will get social services involved to get the person some assistance.

My parents are in their mid eighties and are still independent and in their home. We know of a number of steps before they will have to move into assisted living including in home visits and senior transport when my mom can no longer drive.

All of these options are far less expensive than moving out of their home.

Because they are not home, and they cost a freakin’ mint. If you only need ADL care, it’s not really worth it. I’d prefer to have a daily medical assistant come in to help with those tasks.

If you need any medical help at all, too many of those places take away your autonomy in the name of “safety”. Residents can’t prepare their own food (they might eat an Oreo, god forbid). They can’t wear high heels. They can’t have pets (DEAL-BREAKER). They can’t drive. They can’t have alcohol.

Nope. Not interested. Perhaps if it’s one of the newer elder care communities being developed to treat older people as people, not patients, as discussed in Dr. Atul Gawande’s book Being Mortal (which others have suggested). Otherwise, I’ll go kicking and screaming.

Green Elf, I wonder if your mother has considered what calling 911 in the case of her toileting issues would really entail?

Not just what others have said in that if she calls more than a couple times they may get social services in there to assess her situation, but the immediate consequences of having giant men break into her house. Obviously she won’t be greeting them and letting them in the front door, which means it will be broken. And then there will be a bunch of large strange men in her house, one of whom will have to lose a game of rock-paper-scissors, to basically reach one hand out and pull her up. It’s kind of ridiculous.

She needs hand rails installed, like yesterday.

There are certainly services that you can call for help, but they’ll probably just call the fire department for you. Think of “I’ve fallen and I can’t get up”. My MIL wore a pendant for such a service for a bit, as she indeed had some problems with falling and my FIL is deaf as a post so didn’t hear her calls for help.

OK, I was still curious about how this would be handled by the local small town VFD, so I asked a guy who is a volunteer fire dude.

Here, a call to the VFD for assistance getting off the toilet would be turfed to the local ambulance service. If the paramedics couldn’t gain entry due to locked doors, the police would be called to deal with busting down the door.

The ambulance call would be billed to the caller, whose insurance may or may not cover the charge.

ETA: The local Volunteer Fire Department used to have their own medical response unit (like a big ambulance) but they sold it due to financial problems.