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Source: (consider it)
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Thread: Caring for the elderly
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Gwai
Shipmate
# 11076
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Posted
How should we care for the very elderly when they are all there or at least mostly? For instance, if a couple prefers to do something themselves, but it could be more safely done by a loved one or paid caretaker, how should it be handled? I think generally we lean toward keeping our relatives safe, for instance persuading them to go into a home, even if they prefer otherwise. Or if Grandma adores ice cream and seems to live for it, do we have the right to give it to her never or only once a day because the doctor has said it's not good for her?
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A master of men was the Goodly Fere,
A mate of the wind and sea.
If they think they ha’ slain our Goodly Fere
They are fools eternally.
Posts: 11914 | From: Chicago | Registered: Feb 2006
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Jack o' the Green
Shipmate
# 11091
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Posted
In England, this would be sorted out via the 2005 Mental Capacity Act. If someone has capacity regarding a specific decision, they can do anything they want provided it's legal - unwise decisions included.
Posts: 3121 | From: Lancashire, England | Registered: Feb 2006
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Mamacita
Lakefront liberal
# 3659
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Posted
One of the hardest things I ever did was telling my dad that he needed to stop driving. I gave him specific examples of dangerous things he had done, and fortunately he listened to reason. But it was awful taking away that piece of independence.
As to Grandma's ice cream, unless it's giving her gastric distress, I say let her enjoy it.
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Do not be daunted by the enormity of the world’s grief. Do justly, now. Love mercy, now. Walk humbly, now. You are not obligated to complete the work, but neither are you free to abandon it.
Posts: 20761 | From: where the purple line ends | Registered: Dec 2002
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RuthW
liberal "peace first" hankie squeezer
# 13
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Posted
In the last years of his life, my father suffered one loss after another due to the effects of Parkinson's disease and a revised hip replacement that was never right, so I have a lot of understanding of the wish to keep those losses to a minimum. But in the case of doing something like cleaning gutters where there is potential for injury, I'd say the caregiver, or the person who will be the caregiver if/when it becomes necessary, has a strong interest in ruling out such activity. People doing things that are dangerous for them to do are running risks not just for themselves but also for the people who will have to care for them if things go wrong. If an old man suffers a serious injury from a fall, the effects stand a good chance of lasting the rest of his life; the wife, children, or other people who will have to deal with this if it happens have a right to insist that someone else should clean the gutters.
Posts: 24453 | From: La La Land | Registered: Apr 2001
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Tortuf
Ship's fisherman
# 3784
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Posted
If you ask the question in a vacuum you miss out on what happens when people with physical challenges (like some older people) are not encouraged to go to a facility.
Let me preface this by saying that someone who has the capacity to make good choices is entitled to the dignity of their bad choices.
That being said, think about the fully competent couple who have a hard time driving because of sight, reflexes, etc. Think then about that couple not having any relatives near. Then, think about giving $20.00 to a neighbor to go buy milk and eggs and not getting any change back on a small fixed budget. They do not want to go to an assisted living facility.
Then think about the same couple a few months later in an assisted living facility. They have people with whom they can visit and have conversations. They eat three square meals a day and have transportation to go shopping and to church. They are so happy they wonder why they didn't do this before.
Think about the couple where they had enough money and mean that when anyone did try to look at their mental capacity, they got chased off by lawyers. Then look at their house with the black mold and the months and months worth of the same frozen stuff because they keep ordering the same things even though those frozen foods never got fixed. Oh, and don't forget the light fixture in the shower that is hanging by its wires into the shower space.
When they do get to a facility the man was so malnourished that turning him in bed to change him broke his hip and ultimately led to his death.
Am I suggesting that these people should have been forced to go into a facility? No.
As to eating ice cream: Is their DMII advanced enough they have peripheral neuropathy? Is it leading to loss of vision? How about would recovery? I do not think it is a good idea to make a decision like to cream or not to cream in the absence of more information.
Not that any of this is easy.
Posts: 6963 | From: The Venice of the South | Registered: Dec 2002
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Moo
Ship's tough old bird
# 107
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Posted
quote:
Originally posted by Tortuf:
Then think about the same couple a few months later in an assisted living facility. They have people with whom they can visit and have conversations.
Here is the reason I hope and pray I never have to go into an assisted living facility. Some of those nice people whose company you enjoy will have strokes or die. Other people will move in, and you will make friends with them, but you keep wondering how long it will last.
My parents moved into a retirement home with attached nursing home facility. The home was new when they moved in, and it was very pleasant. Then one by one their friends failed or actually died. When I visited my mother, sometimes we would look out the window and see an ambulance. Then we would worry about who it was.
If I become unable to live alone, I hope I will accept the situation gracefully, but it's the last thing I want.
Moo
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Kerygmania host
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See you later, alligator.
Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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RuthW
liberal "peace first" hankie squeezer
# 13
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Posted
quote:
Originally posted by Moo:
My parents moved into a retirement home with attached nursing home facility. The home was new when they moved in, and it was very pleasant. Then one by one their friends failed or actually died. When I visited my mother, sometimes we would look out the window and see an ambulance. Then we would worry about who it was.
Unless elderly people have a lot of friends outside their age bracket, one by one their friends will fail and die no matter where they live. I've heard plenty of elderly people who didn't live in retirement homes say that one of the hard things about old age is watching your contemporaries die off.
Posts: 24453 | From: La La Land | Registered: Apr 2001
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Boogie
Boogie on down!
# 13538
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Posted
quote:
Originally posted by RuthW:
Unless elderly people have a lot of friends outside their age bracket, one by one their friends will fail and die no matter where they live. I've heard plenty of elderly people who didn't live in retirement homes say that one of the hard things about old age is watching your contemporaries die off.
Yes, my Grandma lived with us 'till the day she died and often lamented 'I have no friends left'.
She had lots of friends, family and Church people for company - but no contemporaries at all. It must have been a strange and lonely experience.
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Garden. Room. Walk
Posts: 13030 | From: Boogie Wonderland | Registered: Mar 2008
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L'organist
Shipmate
# 17338
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Posted
Sadly not a problem we really had to face with either of my parents.
My own grandparents, on the other hand, presented various challenges. Two lived with us, at different times, and friends also had live-in grandparents.
At the moment I'm helping an old friend move in with his daughter and her husband - this is to be temporary so that his own home can have a few up-grades done and be decorated before he moves back in. While the workmen are there one of his grandchildren will be living on-site and they will be moving in after their wedding next year.
The young couple will have their own living room and will pay grandpa some rent but this enables them to be close to where they work (London) and also to save for a deposit for their own home - if they don't decide to gradually buy-out the old man.
Prior to this, difficult/dangerous jobs have been eased away from grandpa by getting him to teach the younger generation how to do them: they've acquired practical skills, he feels (and is) useful in passing on knowledge, the jobs get done and everyone is happy.
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Rara temporum felicitate ubi sentire quae velis et quae sentias dicere licet
Posts: 4950 | From: somewhere in England... | Registered: Sep 2012
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Boogie
Boogie on down!
# 13538
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Posted
My Dad died very suddenly, he went from building the decking outside their holiday caravan to hospital and death in two weeks. He died of E-coli caught after a routine, simple op. (He was 86).
My Mum died very, very slowly and had dementia for six years before that. Every decision as to what to do was hard. We started by living with her (the whole family took turns). She didn't know we were there 'till we came in the room she was in - she just thought she had lots of visitors! But, inevitably, we became unable to look after her medically and she went to a wonderful home. She came back to my brother's farm for her final week to die and, once again, we were all there.
Every single case is different. If you are the carer you simply have to play it by ear and take things one day at a time.
Old age comes to us all unless we are unlucky and die young, so we may as well prepare for it and accept it. I'm going to have a budgie to talk to when I can no longer do anything else.
Next week we are scattering Mum's ashes at sea at the same lighthouse we did Dad's. End of an era ![[Frown]](frown.gif)
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Garden. Room. Walk
Posts: 13030 | From: Boogie Wonderland | Registered: Mar 2008
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Moo
Ship's tough old bird
# 107
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Posted
quote:
Originally posted by RuthW:
Unless elderly people have a lot of friends outside their age bracket, one by one their friends will fail and die no matter where they live. I've heard plenty of elderly people who didn't live in retirement homes say that one of the hard things about old age is watching your contemporaries die off.
Most of my friends at church are about fifteen years younger than I; I used to have friends who were fifteen to twenty years older, but they have all died. I don't have any friends who shared my experience of being a child during World War 2.
A home for the elderly is a closed community. You see the same people every day. I see different people when I go to the library, the supermarket, etc., in addition to the friends I meet for lunch, etc.
Moreover, the bit about ambulances arriving to take people away is very disturbing.
I'm not saying I will never go into a home; I am saying that I literally pray it won't be necessary.
Moo
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Kerygmania host
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See you later, alligator.
Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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IconiumBound
Shipmate
# 754
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Posted
Living in a CCRC (Continuing Care Retirement Community) I can understand some of the concerns that posters have expressed. However, I find myself living/dying in this community as enjoyable.
The biggest block to joining a CCRC is the decision that we are here to die. When dementia, disability or death become imminent you are in a company of others to help sustain you; probably far more realistically than family or younger friends.
I have the comfort of knowing my children will not have to go through the torment of worrying about Dad's falls, hospitalization, failure to take medicine etc. I've done that and don't want my children to have their lives so upset by mine.
Posts: 1318 | From: Philadelphia, PA, USA | Registered: Jul 2001
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cliffdweller
Shipmate
# 13338
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Posted
quote:
Originally posted by IconiumBound:
Living in a CCRC (Continuing Care Retirement Community) I can understand some of the concerns that posters have expressed. However, I find myself living/dying in this community as enjoyable.
The biggest block to joining a CCRC is the decision that we are here to die. When dementia, disability or death become imminent you are in a company of others to help sustain you; probably far more realistically than family or younger friends.
I have the comfort of knowing my children will not have to go through the torment of worrying about Dad's falls, hospitalization, failure to take medicine etc. I've done that and don't want my children to have their lives so upset by mine.
I can't find the right emoticon for this, but I am moved by your heart for your kids. May God bless you with the assurance of so much more joy to come.
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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Arabella Purity Winterbottom
Trumpeting hope
# 3434
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Posted
Thank you IconiumBound, you and my mum would get on well, I suspect. I know that I, as the recipient of such thoughtfulness, have been determined to do everything I can to make my mum's life interesting and comfortable.
Attitude definitely plays a huge part in making our lives worth living, at any age. My mum moved herself into a semi-care arrangement several years ago, under her own steam (with me as her navvy). She chose where she wanted to go, decided what she wanted to take with her, and made sure everyone could find her. She is happy, has lots of visitors, still goes to her writing and mah jong groups outside the facility, and often goes out for meals with friends. She's frail, but people look after her because she's a great, positive, person to have around.
My mother-in-law, much frailer, with dementia, had to be placed in a care facility because she was horribly unsafe at home (think fires on the stove unsafe). She didn't want to go, complains daily to my partner, and tells all and sundry she's bored. Like my mum, she still goes to outside groups and meetings, participates in some of the activities at the facility, has loads of visitors and often goes out for meals.
She's unhappy, where my mum is happy. They're both in excellent care facilities. I guess my mum is just much more accepting of her own limitations, so lives up to the line, where mother-in-law refuses to believe hers so thinks she can do things she simply can't then falls, or otherwise hurts herself.
I did like L'Organist's idea of easing dad into being the wise elder teacher of dangerous skills - that's a very dignified way of doing it. While my father-in-law was still alive, I used to have nightmares about him cutting an arm off with his chainsaw - he had nearly removed a thumb earlier this year, and gashed both hands on several occasions. I guess you could applaud his stamina, at 95, but it gave us the heebie jeebies.
In regard to icecream (chocolate, in our experience), quite honestly, if its not going to bring on death tomorrow, or causing your elder discomfort, let them enjoy it.
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Hell is full of the talented and Heaven is full of the energetic. St Jane Frances de Chantal
Posts: 3702 | From: Aotearoa, New Zealand | Registered: Oct 2002
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Tortuf
Ship's fisherman
# 3784
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Posted
My mother lived in assisted living facilities during the last years of her life. My father had died caring for her and her dementia and depression were such that neither my sister, nor I, could take care of her at our homes. We tried. I won't go into the reasons for the failures.
At the facility my mother made several good friends, including a woman who sang backup for Nat King Cole. I got introduced to her every time I visited. Sometimes I got introduced to her if I left the room for a few minutes.
Was it hard on my mother to see her friends die off? Yes. Do not discount or lessen Moo's feelings on the subject.
When she died we asked that a memorial service be held at the facility where she had lived. This was the first time the facility had done such a thing; having tried to divert the residents' attention away from death before.
The memorial service was a grace. What it told the residents was that their lives matter. That their presence should, and would, be honored.
Was it easy? No. I do know that how the latter years of her life passed was better than what would have happened if she had been allowed to stay in her home by herself as she had wished. She would most assuredly have died in bed of starvation, alone and without her family - all of whom lived a good 100 miles away or more.
Posts: 6963 | From: The Venice of the South | Registered: Dec 2002
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Nicodemia
WYSIWYG
# 4756
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Posted
I am old. Like Moo I was a child in the second World War. I would absolutely hate to go into a Home. I cannot be doing with a lot of people round me, much less the thought I should be doing something sociabl e with them. I can easily get "peopled out." I try not to dangerous things but I would far rather cause my own death by falling off the ladder or whatever than linger on in a care home being called "dear" by someone young enough to be my grandchild!
Please give those of us who care deeply for our independence the dignity of making our own decisions as to how we live our lives and approach our deaths.
Posts: 4544 | From: not too far from Manchester, UK | Registered: Jul 2003
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Arabella Purity Winterbottom
Trumpeting hope
# 3434
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Posted
quote:
Originally posted by Gwai:
How should we care for the very elderly when they are all there or at least mostly? For instance, if a couple prefers to do something themselves, but it could be more safely done by a loved one or paid caretaker, how should it be handled?
I've been thinking about this question a lot. My in-laws lived very unsafely for most of the last five years. My MIL has dementia, my FIL was still legally competent, right up until he died recently.
We could only watch as my FIL refused in-home care, continued to use power tools that were too heavy for him, refused to get medical help when he, inevitably, hurt himself, quite badly on several occasions. He kept telling us, with pride, that he was having small heart attacks, but he didn't need the doctor and we weren't to call one. He diagnosed himself with several serious complaints that subsequently turned out to be not so serious (he was a retired surgeon), and wouldn't see a doctor because he knew best. He sacked three family doctors because they suggested he and MIL needed more care.
Our primary concern was my MIL, who desperately needed help to wash, dress and do housework. She wouldn't let any of us so much as wipe down a surface until last year, and the house was horribly grimy. Several times we found her with poo running down her leg that neither of them noticed.
They protected each other with a passion - we didn't realise how bad it was until he got sick with his final illness two months ago. We were visiting every day for the last 18 months, just to try and keep some semblance of order and safety. My partner and her brother took turns to stay over and make sure that they had proper evening meals.
Because my FIL was deemed to be competent there was nothing else we could do, and it nearly killed us to watch MIL's deterioration, which I believe would have been far less had she been having proper medical attention and daily care. When he died, the anger among my partner and her five siblings was way out in front of any grieving. It didn't help that he had alienated everyone but my partner and her youngest brother by being completely obnoxious to them - my partner stuck it out because she had powers of attorney and needed to keep an eye on things even though she couldn't use them, her brother stuck it out because he is very attached to his mother (in a good way).
The irony is that at every turn, both of them kept saying, "We don't want to be a bother/burden..." and yet they kept us all in a constant state of anxiety and roiling anger for nearly three years.
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Hell is full of the talented and Heaven is full of the energetic. St Jane Frances de Chantal
Posts: 3702 | From: Aotearoa, New Zealand | Registered: Oct 2002
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cliffdweller
Shipmate
# 13338
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Posted
from my own experience caring for my mom, first in her home and later in a skilled nursing facility, the problem is that both these two things are true:
quote:
Originally posted by Nicodemia:
Please give those of us who care deeply for our independence the dignity of making our own decisions as to how we live our lives and approach our deaths.
and
quote:
Originally posted by Arabella Purity Winterbottom:
The irony is that at every turn, both of them kept saying, "We don't want to be a bother/burden..." and yet they kept us all in a constant state of anxiety and roiling anger for nearly three years.
Both are true. Those who don't want to be a bother frequently are-- w/o intending to. It is a very very hard row.
What is needed is better options, especially here in the US where in-home care is generally not covered by insurance (yet pricey residential care is), where there is no financial support for relatives who care for loved ones in their homes, where there are few models for accomplishing what Nicodemia is asking for.
It really is heartbreaking.
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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Arabella Purity Winterbottom
Trumpeting hope
# 3434
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Posted
Thanks Cliffdweller, I totally agree. Which is why my partner and I are beginning to think about our later life living situations so that we can manage it with dignity AND without stressing the hell out of whoever is keeping an eye on us (probably our nieces).
NZers are lucky that we do have fairly good access to in-home care.
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Hell is full of the talented and Heaven is full of the energetic. St Jane Frances de Chantal
Posts: 3702 | From: Aotearoa, New Zealand | Registered: Oct 2002
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