How long to let an elderly loved one be independent?

So...

This is a topic that has, or will soon, hit us all.

Right now, my wife's mom is at the borderline between functionally and non-functionally independent. Her siblings, who are much more functional, say let her live her life in her home undisturbed... My wife and I... who can see her day-to day and can see her slipping, question that laissez faire mindset and wonder if we are enabling a lifestyle that might end up killing her.

My question, I suppose... is at what point are we negligent in our permissiveness? In our agreeableness. In our willingness to allow her to live in the home she's known for 30 years and come to know as her own?

At what point are we negligent in allowing her to maintain what has become an illusion of independence? An illusion that could end up killing her at any time? The truth is, we are just waiting for her to do something... to find herself in a situation... that we should have prevented by requiring her to move into a facility that ostensibly would protect her from these situations.

This is a shitty situation to find yourself in. Made worse by the knowledge that your loved one will forever remember you by the decisions that you make in the moments that they are least capable of judging for
themselves.

 

If there is family in town there is no question.... Let her live there if she wants... When my Grandmother passed at 94 7 years ago we were in the same situation with my Grandfather... He lived by himself for 7 years until last October... He passed away getting his mail 6 days from being 102.... The key is checking on them with phone calls daily as well as a visit 2 or 3 times a week... I would go visit with him for weeks and I regret not doing it 30 years ago... Have respect for their decisions and support them until their final day... I hope your situation works out...

 

If it's against her wishes, that may speed up her demise anyhow so I wouldn't use that argument.

Bottom line, does she have her wits? If the answer is yes, let her be. If she has trouble walking, then get her a walker and encourage it's use and hell, threaten assisted living if she doesn't! Put her safety up front and center....meaning her being too pigheaded in NOT using her walker.

My mom was adamant, she wanted to live on her own for many yrs. It wasn't til she turned 88yrs old that her feelings had begun to change and thus a decision was made to move her into my sisters place since she didn't want to leave NJ with me. I had begun installing a kitchenette when she fell ill, to the exact weekend we had planned to move her in, instead she had to go to the hospital. She passed a few days later.....that was almost one yr ago this week, miss you much momma.

All we can do as children is make their lives as comfortable as possible.

 

I agree completely. I watched it happen to my FIL when they moved him and my MIL into an assisted living facility.
He was sort of okay with that, but then they took his car away too, without even discussing it with him.
After that, he just faded away physically and was dead in a few months.
My MIL, who is deep into Alzheimer's and the reason they had to go into assisted living in the first place is still there, healthy as a horse with no idea what's going on.

 

Have you looked into a PCA? Then she can remain in her home and have a caregiver help her with basic tasks like cooking and cleaning.

 

Two years after my father died, my mother sold the house and paid to have a large garage converted to an apartment at my sister's house. It allowed her to live independently yet have help right there when needed and allowed my sister to keep an eye on her, which wasn't tough since they were always very close (mom's first girl after two boys).
It worked out great and she lived out her life there.
She could also have pets, which is a big thing for older people.
Pets are great company.

 

Being honest with yourself, is it because it’s best for her or best for you?

 

It's not just one side or the other....There has to be a compromise. My sisters (who live in Ca and NJ) weren't able to deal with my Mom's condition so it fell to me. I'm not complaining, I've been the primary responsible person for over a decade. When it comes to serious issues I consult my sisters, my Mom (when she's up to it) and I decide the best course of action. And yes, my convenience too. If I listened to just my Mom's wishes I'd be living in the home with her...
PS...Why is this dungeon material? It's real life stuff.

 

Longevity for longevities sake is not a good thing. A lot depends on how important to her independence is, your ability to help both time and financial if needed. Life is not perfect so you have to do the best with what is available. Sounds like you are already on the right track to doing the best by thinking on it and discussing it. I would recommend a fall detector if she does not have one. My mom does and it is a great thing for her confidence and well being.

On a side note my grand father died of cancer years ago. He would get where he was doing very bad and they would take him to the hospital and put him in an o2 tent. After a couple of days he would get back to feeling better and check himself out. They had a cow about it so he asked 'if I stay in will that cure me' the answer was of course not but you might live a month or two longer. He told them he would call them when he needed them. Died at home and I can guarantee his last days were better by his judgement by a lot.

Good luck and she is blessed that she has people that care and are attempting to do the best. Just remember that.

 

As always with these types of scenarios there is no standard answer. In the end it all comes down to quantity of life Vs. Quality of life and a full spectrum in between. There is not a right or wrong solution.

My own personal experience and feelings are quality over quantity.

Good luck and good on you for getting involved. Not an easy task one way or the other.

 

We're going through exactly this with my grandmother right now, except she is adamant that she will not go to a nursing home under any circumstances. We have all talked to her about it and she can apparently not imagine any scenario in which she should leave her house. Even though when she falls (not if) she can't get up by herself.

Unfortunately, without doctor's orders she cannot be forced into a nursing home even though she cannot live by herself. Naturally, when we took her to the doctor for an evaluation, he said he didn't see any reason why she couldn't stay at home, as long as someone else is there with her. None of her children, grandchildren, or even great grandchildren were pleased with his assessment.

Not gonna lie, after dealing with this for the past few years, including her health getting worse, losing strength, dementia setting in, etc, we're all tired of her shit. We want to be respectful, but every single one of us is more annoyed by her pig-headed insistence on staying in her house with each passing day.

 

Mike, that's excellent! My mom's last few years were worked out about the same way. We moved her to a modular home on my sister's property right next door so she had her privacy yet was close enough that my sister checked on mom several times per day. It was great.

 

As you get older, you stat thinking about such things. Most people, myself included, don't want to be a burden. Some people want to be cared for. My mom was the former. Sometimes her not wanting to be trouble (staying alone, not complaining, etc.) ended up resulting in problems that were significantly worse than they would have been if dealt with earlier. The answers are as varied as the lives we lead.

 

She has been in a walker, but she still falls some

This is pretty much where we're at. Her doctor ""suggested"" that she go to assisted living, but did not ""order"" it.

She absolutely will not hear of it, will not discuss it, and gets very upset even at the mention of it, screaming that we're trying to "take her home away from her". There is no such thing as a logical, measured conversation with her on any subject anymore. Any suggestion that we bring up is met with suspicion and resistance. She won't even let us buy a lift chair to help her get up & down in the living room. We've gone through 4 or 5 walkers in the last 3 months for various complaints... I'm fixing to put the latest iteration together as I watch football this afternoon... I'm sure there'll be something wrong with it, too, though. I realize that I sound like a selfish prick typing this, but we are absolutely at our wits end. I love the old warbird, and I only want what's best for her, but I can only swallow & suppress just so much resentment when I see her reduce my wife to tears several times a week. It really makes me hope that I die before I get old!!

The paramedics have to come help her up every time she falls, (count is about 5 right now, 2 in one week recently) I'm curious/concerned that they might possibly initiate some sort of investigation on us for not placing her in a home... I'm not sure if that is done, or can be done, but at some point I can certainly see them getting tired of rolling to her house every few days to pick her up off the floor.

She has a caretaker agency that sends a girl to stay with her a few days a week, run errands, take her to appointments, light housekeeping, etc.

I fear that in the end, we're just going to have to pack her up one day and take her to an assisted living facility... and tell her this is the way it's going to be. She'll scream and cry, and pitch a fit... and as others have said, it may well destroy her will to live... but the alternative is that someday she'll fall and bleed out before help can arrive. If she hits her head when she falls it's very likely, given her a-fib meds, that she'll stroke out.

I don't guess that there really is a good answer. At this point, I'm really just struggling to figure out which answer is the least bad.

 

Another thing to keep in mind...many of the meds used to manage health issues are seriously strong. Some, not all, of the mental changes are, IMHO, drug induced.

 

When it came to dealing with the question of whether or not to move them into a facility, my FIL was his own worst enemy.
He wanted to stay in his home, but he couldn't take care of my MIL by himself, so his kids tried various arrangements of people coming in to help and he'd tell them he didn't need them or find some reason he didn't want them there.
The night the police found my MIL walking down a road almost a mile from her house at 2 AM in her pajamas in 20-degree weather his fate was sealed.
Old people can be very exasperating, but we have to remember that children are also very exasperating and they stuck with you when you weren't easy to deal with. Maybe not perfectly, but they did it.

 

Much truth to this^^^. If an elderly person needs surgery with anethesia be very wary. That stuff can put them over the edge permanently.....

 

This^

After my father died (2005), I started having occasional discussions with my mother about having her make a plan for what comes next. She was having issues that were progressive, and which would eventually make it impossible for her to drive. She knew this, but was in denial.

Headstrong does not even begin to describe my mom's personality. She would not hear of any suggestions of alternatives.

I decided to use her desire to control her own life to help her see that she needed to make these choices/plans, or eventually a crisis will come, and someone else will make the choices for her. I pointed out to her that I believed she would be very angry and unhappy with whatever choice anyone else would make, no matter how well intentioned and loving they were trying to be. She agreed she did not want anyone else making choices for her.

The message that she needed to make these choices, or someone eventually would be forced to make these choices for her when she was incapacitated finally got through to her.

She then asked for help to investigate facilities that would provide Continuum of Care starting with independent living, and when needed, assisted living along with providing progressive care as she would need it. Her first choice of facility was unaffordable, but eventually with the help of all three of her kids, she found some alternatives that were affordable and high quality.

The choice was made, the entry fee paid, and the actual move was deferred until Mom decided it was time to go. That process took about 2.5 years.

One day, she hit a curb while driving in the rain and destroyed the two right side wheels and tires (and other stuff in the front end). She gave up driving and moved within three weeks of that incident.

 

Absolutely.
My mom would not call for help when falling or having other issues unless she could not get up and clean up herself. When she eventually did end up in the hospital after the catastrophic fall, they discovered three broken vertebrae in her back. She had been taking way too much tylenol and complaining about back pain for a while, but refused to go have it x-rayed.

Auminer - You are in a position that is very uncomfortable. Lead with love and concern for her.