How can my wife help her aging parents? (long)

I struggled to make a decision on where to put this post. It’s sort of MPSIMS-y, but ultimately I want opinions on what other Dopers would do in a similar situation.

Here’s the gist of the problem:

Toward the end of 2007, my father-in-law (FIL) began having problems with his eyes, and ultimately, after being diagnosed with a malignant tumor in his sinus that started on the olfactory nerve and eventually grew into and destroyed his optic nerve where it joins from both eyes at the base, he lost his sight.

His treatment consisted of very strong radiation directly on his face as well as chemotherapy, which was hard for (at the time of diagnosis) an 82 year old man to bear. He was not able to finish his radiation treatments, but did complete his chemo, but not without various prolonged hospital stays because of treatment complications.

He’s 83 now, and other than the tumor (still there because surgery was not an option, although it’s “dead”), he’s relatively healthy, but he can’t see.

In 2005, my mother-in-law (MIL) was having some shortness of breath and, after some tests, was determined to have blockages in her arteries. She had quadruple bypass surgery (no heart attack) to “fix” the problem. Last Sunday, minutes before we arrived for a visit, my MIL fell in her bedroom, lacerated her face and broke her shoulder (she’s 77). The ER docs put her in a bodywrap type shoulder sling after diagnosing a humeral fracture. My wife is taking her to an ortho doc today for further instructions.

The alarming part of this situation is that my FIL couldn’t dial the phone because he can’t see. My MIL couldn’t see to dial the numbers because she lost and broke her glasses when she fell and was not able to get off the ground. They ended up dialing the operator who connected them with a neighbor who came up the street and called my wife’s cell. (Don’t ask why they didn’t call EMS from the start :rolleyes:; that’s part of the problem.) Luckily we had already planned a visit and were only a few minutes away when the fall occurred. We called EMS when we arrived and were able to survey the situation.

Anyway, since my FIL lost his sight, my wife has made the 2 hour trip every weekend to help with grocery shopping, bills, some house work, etc. It is difficult for either my wife or me to provide any assistance until the weekend because we both work and we have 4 children age 7 and younger. In January of this year she was able to reduce the trip to every other weekend.

However, since the fall, my MIL only has use of one arm/hand, and is not able to perform basic tasks of daily living, e.g., dressing (herself or my FIL), using the bathroom easily, showering, preparing food. She also had been helping my FIL with his medicines and glucose monitoring, which he has trouble doing himself because of the loss of sight. My MIL is overweight, clumsy and has little strength, so normal locomotion was already a problem (the reason she fell in the first place).

When my FIL first lost his sight, we asked them to think about moving closer to us or even moving into an assisted living care environment. My MIL would move right now, but my FIL refuses. He has “things to do” and can take care of himself.

I’ll let you ponder that.

So, for a year and a half we’ve strongly suggested they move closer to us, but he refuses. My wife is an only child, so there is no one else to help them (or us). Thankfully, his neighbors have been able to give some respite, but we can’t and don’t expect them to shoulder any long term responsibility. Neither my FIL nor my MIL have given my wife any power of attorney, which makes it difficult with bills and medical decisions.

Because of the fall, neither of them are getting proper care. My MIL has hardly eaten because she doesn’t want to poop. She hasn’t bathed all week. She hasn’t changed any of her clothing. She can’t brush her teeth (I don’t know why…she only needs one hand.) The time has come that they need assistance. Truly, they’ve needed assistance since he lost his sight.

But my FIL refuses even to discuss it.

<SCREAM>

My wife and I have come to the decision that we think it’s time we need to “force” them to move. There is a very fine line between respecting their wishes and making sure they get adequate care. Although this inability hopefully is temporary (4-6 weeks), they can’t live even those 6 weeks without assistance. Hopefully the ortho doc will allow home health care after today’s visit. If my MIL had to go in the hospital for any reason, my FIL couldn’t stay alone (although he’ll argue that he can).

As an aside, we think my FIL is suffering from mild depression due to his loss of sight. Although he’s been told several times by various specialists that he will never regain his sight, he continues to make comments such as, “When I can see I’m gonna [insert whatever].” He also mentions ending his life if he can’t see. We don’t think he would actually do it, but he’s mentioned it more and more, lately, so it’s a little unnerving.

We need some advice on how to begin talks with the court in order to get power of attorney and how to find resources for support. We have looked on the web and have found a few leads, but surely some of you have had a similar experience or know of a similar situation.

We are losing our minds.

You should talk to Social Services for their area. Ask them what they can do with the current situation. They can’t solve the problem, but they could possibly reduce it right now.

Is making them move closer going to really help? Sounds like it would put more burden on your wife to be their caretaker - “oh they live so close now, I can just take care of them.” With two jobs and 4 young kids between you, it doesn’t seem prudent to take on the extra responsibility.

IMHO your money would probably do more service to the situation than your time. Money as in “hire a home nurse.” Now, I’m definitely not suggesting that money can solve all your problems and you can hire someone to take over your wife having to care at all…but I hope you get my gist. I hope it works out for you all, too.

What a crappy situation. I second the idea of social services. Also, look up “elderly services” in your area. Most places have a hotline to help you sort things out. I agree with the last poster about you guys taking on too much. Is it time for assisted living, a nursing home, or as she suggested, a paid caregiver? Your parents insurance might or might not cover these. Have you talked to their doctors?

Do you have an Area Agency on Aging, or State Department of Aging in your area? They might be able to provide some guidance and assistance.

At a minimum, your parents are probably eligible for a home-health aide to come in a few times a week to help out with some of the activities of daily living, including the medication organization. My mom was a home care nurse for many years, and she would often arrange for such services, especially when someone experienced a health crisis. This service is often covered by health insurance. This could help ease your wife’s burden and give you some piece of mind, knowing that someone else was visiting their home and checking on things. It might also help if they get advice from a third party, like the office of aging. I know in many cases parents are resistant to taking their children’s advice, but sometimes will accept help and advice from others, including professionals.

Best of luck to you… I know that the role reversal can be very difficult on everyone involved.

Google “Lighthouse for the Blind” and see if there are any of these organizations near you - they provide help for the blind and visually impaired, and I’m sure they’ve dealt with cases like your FIL before. I know he’s in denial so that may be tough, but maybe they can spin it like “this will help you in the meantime then” if he won’t face facts. I know they’ll at least know of financial aid resources that may apply to their case.

There are legal implications for your wife. If things continue to deteriorate, she could land out being charged with elder abuse through no fault of her own. Talk about rock and a hard place. Best wishes to both of you as you struggle with this.

We want them closer, even if they are in assisted living because visiting would be easier and if there was a severe emergency, it’s hard to make arrangements for the kids or work with them being 2 hours away.

If they were closer to us, necessary emergency arrangements would be easier. It sounds selfish, I know.

We’ve thought about this, too, and have been documenting times we’ve asked them to move or asked them to think about getting in-home care.

It’s just a tough situation.

I figure I’ve got a only a few years before I’m writing this exact same OP.
I’m thinking that for me, the way to get to my dad will be to make it sound like it’s all about making life easier for Mom.

Dad, have you noticed that Mom is having problems getting dressed and undresses? What do you think about moving someplace with staff that can help out?

Dad, I’m worried that it is to hard for Mom to take care of the house. Do you think that moving into a smaller place would help? Someplace nearby so we can help with around the house?

Dad, is Mom eating? Does someone need to help keep track of that?

Is there any chance that FIL’s reluctance to move has to do with being familiar with where he is now? Being blind, the idea of not knowing where the sofa ends, or where the spoons are might be scary.

No, it doesn’t.

if you can go with them to the doctor, sometimes they can arrange home care help. it was the only way i could get my mother to agree to it.

of course i had to mention it to the doctor when she was out of the room. he was able to say, i’m going to have a nurse and home care person stop by and check on your legs to be sure they are healing right, and that you are getting the things done that you need to.

he made it sound like it is something they do for everyone not just “hard headed old coots”.

some people have difficulties accepting that they just can’t do what they were able to and it takes a very long time for them to admit it. sounds like your fil is in this phase.

My grandparents moved into a independent living place after my grandmother went blind (macular degeneration), and this was super scary for her. It helped that they were bringing their own furniture, so that it was still the same sofa that she knew how long it was, but I know it was tough.

In my state, a power of attorney does not usually require going to Court. The person wishing to grant a POA must contact the lawyer, demonstrate competence to grant such a power, and then instruct the attorney on what authority they wish to give, and who they wish to have the POA. After the power is executed, it may have to be filed of record somewhere, and copies may need to be provided to banks, doctors, etc. The parents may also wish to consider a “Living Will”, sometimes called a Durable Power of Attorney for Healthcare, or a Advance Healthcare Directive to express their wishes regarding medical care when/if they become unable to make such decisions for themselves.

Another option would be a guardianship/conservatorship–this does require going to court, and if involuntary, may require medical testimony on the issue of competency. The Court may require the Guardian/Conservator to post a bond and file an annual (or more frequent) accounting of the ward’s estate.

Your local Legal Services (sometimes called Legal Aid) program may be able to assist or at least provide advice on how such things work in your jurisdiction.

Oakminster, normally, POA works the same way in our state (Georgia). However, FIL and MIL right now are not willing to grant POA to my wife. Technically they are mentally competent, but they are not able to manage to care for themselves and, frankly, are a danger to themselves in their current condition. So, we are under the impression that we’d have to go to a probate court to plead our case in order to acquire POA so that we can manage their medical (and financial) care. Otherwise, unless they agree to any care plans, it’s all moot.

I feel for you and your wife. Very tough situation. Lots of great advice so far and there’s lots more you could use - I’ll only make one suggestion for now.

We call it “the buttton” . There are services that will provide your in-laws with a device they wear around their neck. They can press the button on it any time and it will contact emergency services. I won’t go into details because I can’t remember them but would be glad to look stuff up it would help. My Mom was having problems and just refused to move out of her house. One compromise was that she get “the button” and keep it active. It at least brings me some peace of mind.

Nah doesn’t sound selfish at all. You gotta do what works for everyone! Just remember that you and your wife can’t do it all, whether they live next door or in the next state.

I’ll second this, but make sure you get the bill. Otherwise, one or the other of your parents could cancel the service if they decide they don’t “need” it anymore.

That said, it definitely sounds like your parents need to have some in-home help, even if it’s just a visiting aide that comes over to check on them. Whatever you do, you need to make sure you can communicate with the aide, that the aide will communicate with you, and that there’s some coordination with your parents’ doctor’s office to make sure all orders and instructions about medications and treatments are correct and being followed.

Finally, you may want to hook them up with Meals on Wheels to make sure they eat. The volunteer will also look in on them and offer some companionship.

Robin

Get them on the list at the nicest place near you, like yesterday. Do this first.

Talk to their doctor’s, call and express your concerns to the receptionist and ask the Dr to call you. They should know the next, fastest thing to do, to get them into assisted living or full care, as you choose.

From there it’s all straightening out their affairs, which sounds like it could be complicated as they are unprepared and will likely be caring a grudge when told they are moving - like it or not!

You will be in my thoughts, this is a very difficult challenge you’re facing.