AGING PARENTS

when I was small my mom was POA for her mother, who had non-Alzheimer's senile dementia and must have been a mighty challenge to deal with. It was many years before the phone in her room was taken away and until then my mom would regularly have frustrating phone calls with her that ended in shouting, which was naturally upsetting and confusing to small-me. Thinking about it now as a young adult and my folks on the edge of retirement makes me anxious sometimes. I don't know what they might need in 10 or 20 or 30 years, or if they have advance directives, or anything.

I highly recommend "5 Wishes" for advance directive planning:

http://www.agingwithdignity.org/five-wishes.php

It's actually pretty cheesy in places, but has the advantages of 1) being very straightforward and accessible and 2) recognized and honored as a legal document across most states (so you don't necessarily have to do a state-specific directive) and 3) no lawyer required

The palliative care team at my hospital uses it and it is pretty much the "go to" document for hospitals and hospices. I'm doing one myself.

this is relevant to the discussion, tangentially:

http://loudwire.com/megadeth-dave-mustaine-help-find-missing-mother-in-law/

http://www.nbcnews.com/nightly-news/glen-campbells-battle-alzheimers-last-recorded-song-n220031

there should maybe be a 'fuck dementia/alzheimer's' thread. it is a terrible, terrifying thing.

The fact that Alzheimer's is a thing that is happening to ppl every day irl is utterly intolerable to me, one hates to scale dissimilar horrors but I abhor it even more than C.

Not to start some sort of suffering Olympics, but Alzheimer's takes the gold for absolute worst fucking disease.

like i've said before we're dealing with my wife's mom going through it, she's towards the end of stage 6. she seems to be where glen campbell is at, recognizing people and able to have happy moments, but also on the cusp of going into a care facility. she's had these plateaus that last for months and months, then there's a sudden decline, then another plateau. so much of it is being aware that another decline is inevitable, but knowing just when it will occur is impossible. w/r/t my previous story a few weeks ago, my wife was at her parents' house for a week while her dad was in the hospital and they've had caregivers for most of that time since. it's just devastating stuff, going over there and seeing how bad it is.

My mother's 90th birthday was on November 1. The hospice folks (she's on hospice now) brought in a big cake and had a party. She loved it. Her current med combination is working out well and her dementia state has advanced along to whatever counts as Stage Five Acceptance.

Meanwhile, we hit the wall at 18 tons of crap hauled out of the house. There were dishes in the crawlspace, under all the sinks, everywhere... the woman who's handling the estate sale (my life in the the hoarder estate sale voyeur underground deserves another post) has seen all the obsessions: dolls, penguins, radios, but apparently my mom earns the "I've never seen so many dishes before!"award.

The sale is happening this Wednesday, Thursday, & Friday. Here's what's left.

I hope it's to some extent gratifying that after all of this heartache your mom was able to enjoy a birthday party and you've unearthed enough of value from the home to have an extravaganza.

Best of luck and congrats on all the progress ET.

Good luck with the sale! It's encouraging to hear how much you've accomplished.

I should never click on those things because it's always "Wow, I had that toy airplane! Is that a Snoopy sno-cone maker? Here, let me get my billfold…"

Yes, I see a Cathrineholm bowl in there and a lot of the kind of stuff my grandma left to my mother that's now considered sentimental family loot.

Basically we'll be right over.

I like knowing that many of those items are going to go on to be much-loved by other folks. I'm glad your mom is feeling better and had a great birthday. You are a great person and I really admire your grace and humor and humanity in dealing with this most difficult of situations. I hope I can be half as good with my dad as things progress.

Sounds like you're getting to a (relatively) good place - really happy to hear

sending good thoughts your way Elvis

same, i am sincerely in awe of the enormous task you took on and of how gracious and respectful and loving you have been throughout. and i'm glad your mom had a nice birthday.

ILX gets first dibs on whatever's left from the sale. The only catch is that you have to come here to get it. I take Square.

Dishes and bowls are a hard sell in the current estate sale market. Read as much sociology into this as you want, but it's difficult to liquidate those kinds of family inheritance. Sterling silver is only worth the melt value. Dishes, china, etc. that aren't microwaveable just aren't desirable except for other folks of that generation. OTOH, I've been told that a lot of dish patterns are desirable in China and that it's relatively common for liquidators to buy up all the dishes from a sale, repeat until one container unit is filled, and then ship it off across the Pacific. 2014 economy: go figure.

I recognize at least two china patterns. I don't know if it's worth seeing if Replacements Ltd would buy anything.

"Ooh, it's a special family dinner taking place in our house? Liao, make sure we set out the fine California."

Er, is a joke my granddad would have made, that silly guy.

aaargh

four hospital trips in two weeks for my father in law, he refuses to cooperate in any way when he's back at home, won't take meds, won't eat, but is of sound mind and lies to everybody so they can't do anything just yet.

L is near Hudson NY on FMLA time (Family Medical Leave Act) and it is slammed w/snow as well, she has been driving him back and forth from the Albany hospitals in hellish road conditions while he yells at her.

her dad doesn't want her there. everybody (family, medical folks) is telling her that it's time to let go.

what is up with these WW2 guys who just fuck with/abuse everybody and treat serious issues like they are jokes, it's like they live inside their own personal mythology.

she's been reading "Being Mortal" and I guess it helps, a little, in the abstract sense.

I wish I had gone with her now, we didn't think it was gonna turn out this badly when she first left.

aaand now he's in the ICU

sometimes people just want to die

I guess

i'm sorry. that sounds really rough.
this thread totally freaks me out but i am trying to steel myself for the future so i read it anyway

yeah that's what's going on xp

he's been clear with her that he wants to die at home if possible, has signed over power of attorney, no heroic measures, all that good stuff. so at least the paperwork is in order, there's a will and a trust, all that.

I just wish he could ease up on her a bit

Have you talked with hospital's palliative care team? ICU docs can be dicks about not a palliative consult unless you demand it. Hospice is good at helping with family dynamics stuff. You can ask for the hospital social worker for referrals.

I'm so sorry you're both having to deal with this, her up close and you long distance. Being Mortal doesn't address cantankerousness enough or how to deal with people you care for behaving badly toward you. I get reminded of the nasty old racist lady trying to kick her morphine addiction in To Kill a Morningside whenever I hear my MIL let fly. Not that it helps.

will forward to L, she's the one there right now, thanks xp

thanks Jaq

the VA hospital person dryly described him as "fiercely independent"

her dad doesn't want her there. everybody (family, medical folks) is telling her that it's time to let go.

This is not advice nor bear any reflection on your situation.

But those two sentences describe the very similar situation I watched my dad go through with his mother. He would drive back and forth 300 miles roundtrip to take her to the doctor, to go through her bills, to get her groceries, etc. Sounds very noble except that you have to keep in mind that he has four siblings who also lived in the same city as my grandmother, including a son who lived with her.

He said it was his duty, that he had to, that the other siblings wouldn't or couldn't handle running errands or have the know-how to wrangle a head nurse to get grandma her medication. He was also an overweight diabetic in his late 50s, doing all of this driving through the worst stretch of I-40 in America. Once, he told me on the side, something had happened and his car spun around in a 360 before he stopped in the median.

Sometimes, I'd go over there by myself to visit. Grandma would tell me how she didn't know why my Dad did all that. She'd complain about how angry he'd get at her. She appreciated it, she told me, but it seemed like too much to her at times.

I'm not doing any of that. I love my parents, but no.

thanks pp

I should clarify here that my wife is an RN and works in a hospital, so she is familiar with the systems in general.

and although she does have some of that overachiever/wounded healer stuff going on (by her own admission), I know she wouldn't hang on as long as your dad did in that case.

an interesting side note here is that the family uber-Republicans she argues with on FB have stepped up the most, helped the most, given the best advice, and generally just been awesome and supportive.

if he makes it out of the hospital this time, there is a small army of assorted cousins and uncles who will be checking in on him, they are the ones who are telling her it is OK to let go.

diagnosis is bacterial endocarditis

they think they caught it early enough that antibiotics will take care of it

but their next level is, like, bowel removal and open heart surgery, for an 84-yo guy who has emphysema, is medically/legally "frail" (I did not know this was a thing), and weighs 115 lbs. utter Western medicine head-up-its-ass insanity.

quincie, L says thank you and she is ready to demand palliative care if necessary. if her dad demands the surgery, she may break out the big guns and have a mental health evaluation (which he will almost certainly fail, right now he is also "confused" in the medical sense) so that she can nix the extreme heroic measures.

aargh.

so sorry sleeve, please can you give l. my kindest and best wishes.

thanks estela

antibiotics appear to have done the trick. from L:

At the hospital waiting to talk to a doctor. He is better and plans are being made for transfer to a rehab place for IV meds and physical therapy! He's agreeing. I have a few more things to tie up but think I will be able to swing a ticket for Wednesday. Much of what may be needed of me could be done by phone and fax...

(she's stayed about ten days longer than her initial plan was for)

Phew, sleeve, that's so rough. I hope she has the chance for some self-care when she gets back home.

I think my mom is showing early signs of dementia but she denies it and won't get a screening. :(

xp thanx carl.

self-care and pampering are definitely on the agenda :)

this whole situation plays in to a lot of the old Italian patriarchal expectations - that the women of the family drop everything and devote their lives to the men when duty calls. L doesn't play that game and never has, fortunately she only had to argue her case with one relative (a woman). I know in orbit and others have written eloquently about this in ILX before, the expectation of total self-sacrifice.

Frobisher, is there a will, advance medical directives, that sort of stuff? it's a tough subject but having some of that in place definitely makes it easier down the road, speaking from experience.

Not to link dump, but I saw this story on NPR about a residential care home that has phased out anti-psychotics for dementia. This approach seems like it has some common ground with certain approaches to child rearing or cat ownership. Like, our kid loves to open a specific desk drawer and pull out the checkbook. Rather than try to stop her (she's one, so it's not like reasoning is an option here), we just took the checks out of the cover, and also put a toy she likes in the drawer, so now she can open it and pull things out until her heart's content. Or giving the cat something acceptable to scratch next to the chair we don't want her to scratch (thank you Jackson Galaxy). Basically adapting the environment to the people living in it instead of adapting the people to the environment.

Anyway, here's the story - http://www.npr.org/blogs/health/2014/12/09/368539057/this-nursing-home-calms-troubling-behavior-without-risky-drugs.

I saw that story and the harsh truth is that long-term care facilities that are for-profit are not willing to pay for the staff necessary to create individualized therapy plans that are not strictly medical (the one in the story above is non-profit). I worked part-time at a place that wouldn't even pay for an extra nursing aide in the evenings to help get people to bed--even though we were able to show that falls among residents decreased when one extra aide was on shift.

Yeah somebody brought that up in the comments. It's monstrous.

Being rich is nowhere more useful than when it comes to elder care. The place I'd choose for my father is 12 grand a month.

Twelve. Grand. Per. Month.

jfc

O_o

It's nice but it ain't the Ritz, y'know? Medicare does not cover long term care, and the nicer places don't take Medicaid, which you'd have to get really fucking poor to qualify for anyway.

I am going to manage my own dottage (lol no kids) by moving to Finland and/or Taiwan, where they take good care of old people on the cheap.

Or the Netherlands where I can just smoke a nice joint before being euthanized in a dignified manner.

Holy shit that's insane. TWELVE THOUSAND DOLLARS? What the fuck is wrong with this country.

Or the Netherlands where I can just smoke a nice joint before being euthanized in a dignified manner.

By the time the Baby Boomer cohort goes through old age, I expect someone to create real-world suicide booths.