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In 5 weeks our lives have changed radically. First my mom, 84, was hospitalized for 2 weeks because she'd stopped eating; she was diagnosed with failure to thrive. A week later my father, 86, who was vibrant and active, fell and was taken to the hospital where they found he had 20 percent heart function and a dangerously large abdominal aortic aneurysm. After emergency surgeries he was in the ICU for 3 weeks; he died last week after 2 days in hospice.

Now my mom is home and my sister and I are faced with taking care of her and settling my father's affairs. We're in shock and exhausted. My sister is talking about giving up her life in LA to live in NYC with my mom. I'm a freelancer and must go back to work, as I've been unable to work steadily for the past month. Where do we start?

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I am so sorry for your loss. It is so difficult to grieve for one parent and care for the other simultanously.

It sounds like you and your sister are a united front - are there other siblings? or other family members who can help? Be very honest and clear about what you are willing and able to do for your mother. It won't help if you are guided by emotions only. Some questions: with some rehabilitation would your mother be able to live independently? with some occasional help? or will she need full time care? If one of you is planning on sharing the her home, are you ready to become a full time caregiver? (this is alternately a rewarding and taxing venture...there are also financial/legal issues to deal with; i.e., will the live-in occupant be compensated? if so, a contract needs to be drawn up) what is you mother's financial situation? is she able to afford assisted living or a nursing home? private in-home care?

Talk to your mother...find out what her expectations are and how she wishes to live out her elderhood. This one is hard...but try to be as "objective" as you can...as if you were talking to a client. Emotions seem to cloud our judgments at times.

My first piece of advice is to gather as much information as possible: her medical records, financial records, etc. If these have not been prepared already I would suggest the creation of the following documents: will, living trust (and "fund" the trust with any assets that you want protected from probate), Power of Attorney (one each for both medical and financial), and a DNR directive. (it seems like a lot of paperwork, but it will save you so much time and energy down the road...many of these forms are available on the internet and each state has its own filing requirements, etc.)

Lastly, you need to research all the types of assisted care that you are considering. (Medicare pays for very little in-home care...mostly after a hospital stay...it sounds like your mother was just released...did the hospital staff talked to you about an aide, etc? It is limited care, but it helps.) There are some in-home senior care companies - they mostly offer non-medical assistance. My mother has someone come in once every few weeks. It gives me a "breather."

I suppose the main thing to do for now is assessment: financial, living arrangements, and emotional.

Please come back here too...I have found so much good advice and support from my fellow caregivers.

Good luck
Lilli
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Lilli offers some sound advice. I've been dealing with a very similar situation in the past couple of years so I'll share these points:
- First, be VERY honest about what you can and can't do. I love my mom dearly and we are very close but I CANNOT be a good, loving daughter and live with her.
- Your sister is noble to consider moving to help mom but given mom's health it's not wise; Sister could be giving up a lot for a time that might be quite short. How much long term financial damage will Sister do if she gives up a career, health benefits,etc? Can she use Family and Medical Leave for 12 weeks, do the very same thing and still go back to job and her life? I did it once 12 years ago when my Dad was ill and I'm still paying for it. My parents live in a rural area where the current economy is BAD. If I move to Mom's town, I'll never get a job paying what I make now; there will certainly be no benefits and I need health insurance. I could never contribute as much to my retirement accounts - meaning I'll be LESS well off in retirement than my mom - something she would not want. I have no local network of friends/colleagues to help find work and if I use my savings I won't have the money to return to my previous location/job/network.
- As a freelancer you need time, space and isolation to work at home, you probably will not get that if you live with her. I've tried this and it's NOT possible, there's always something to do and my Mom wanted to "visit" - usually me listening to her reminisce which made me nuts since I heard it all over and over.
- Contact your local Area Agency on Aging or an Elder Care attorney; they might have ideas, knowledge of state laws concerning financial assistance with long term care and names of credible resources for in-home care and other similar services.
- DO NOT take or pay yourself anything, cash, checks or physical items - until you understand state law on medicaide and look back periods. If an adult gives away or sells any assets like money, land, stocks, bonds, etc.. - for several years before needing help, they may be denied benefits!!

Good luck! I know this is a trying and difficult time but just try ensure your mom feels loved. If she ends up in a nursing home or assisted living facility be sure to visit often; the staff know you'll be around, watching and listening and will take better care of your mom. It's sad but it's true..
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To Kayepeannyc so sorry for your loss. I had a similair situation last year, Dad was Moms main caregiver for awhile but he began declining with emphysema. Mom had a stroke 3 years prior and needs help walking, toileting, meals. My sis up North was sickly, Dad died in April, sis died in May, leaving mom alone in the house with a big dog. I lived the down the street and the out of state family asked "What are You going to do?" I abandoned my home and now live there with Mom, have to, but still have belongings in both places. I also work full time weekends so its tough. I have no life of my own, can go out 2-3 hrs at a time, unless I have a caregiver or my fiance to sit with her. ..which means we rarely go out together. See if hospice in your state is an option, some states do have Adult Failure to Thrive as a hospice Dx. The can get u and your sister some respite, volunteers, CNA's to assist. If not, see what medicare or medicaid offers. Her physician may be able to assit. Keep in mind, many physicians are not up on the hospice criteria so if Dr says no, inquire yourself to be sure.
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My Dad passed away four months ago, and I am the only sibling in the same town as her. His loss has devistated all of us. I have one brother living in Nebraska, whom can't doing anything wrong, while on the other hand I am trying to work full time and do everything possible to help her. She interupts me while I am talking, argues with everything I say, even such little things as the tempurature outside, she has no respect for me what so ever. I have alway been the one to take care of everything and I am at my witts end. We are only four months into this and I can not imagine spending the rest of my future being treated like this.
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My father passed three weeks ago, and my only sibling, a brother, passed one year and a half earlier. My mom is 84, I live overseas, and am now facing a crisis. I got a 12-week unpaid leave in order to assist my mother, and don't know exactly what to do next. Leaving her alone in the house is out of question. However, if I live with her, I would have to leave my job overseas. I thought of taking her with me, but I am absolutely sure she would not adapt. What should I do? I live in the US and my mom, in Brazil.
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God bless you, and I hope you can find the extra streng, meditate I am a prision Guard and have leave workbto teke care of my only paraent and became the caregiver at the house as my back never give up orher aaing in my traing the will to aurvive I try ao hard to live by that but I learn very painfull way that doen'nt apply to everybody make aure the siet was proper watch augar level highblood preasuee and all the mwdication in conbination of the chimo with will destroy people and iwas meking sure wverything was going fine but than you have the soctors the some are care less or what ever the case dont care and then patient had enough but i wasn't ready to let go and turn out bad form loved one and now me the guilt it's unberable and felt the i fail now the my parent passaway and I blame for mot guiding better the de's and me ao i have search for my sanity and at times it get's better but those flash backs ate a killer i wish the best and the god protect you .
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