How do you help an aging parent who insists they don't need or want your help?

I had a similar situation with my mother in law several years ago. She kept firing the home health aides we hired and would not admit that she needed help because of her diabetes, macular degeneration and COPD. After several ambulance trips to the hospital (she would panic and call 911), the hospital social worker told us to find a new living arrangement for her because she was no longer safe in her home. The social worker told her that Medicare would not pay for repeated ambulance trips and ER visits. I don't know if this was true or not, but it convinced her to leave her home. We placed her in assisted living where she lived the last 17 months of her life.

So, although it is hard to watch family members suffer and go downhill, sometimes you are forced to wait until something happens and an outsider gets involved. You could try talking to your in-laws health care providers to see if they will help, but most are reluctant to get involved. Of course, if things get really bad and you fear for their safety, you can call adult protective services to investigate.

Do you know why your father in law has reacted badly to the care-giver? Is it a particular individual he's taken against, or has an agency tried a number of different people without success?

Not wanting help and needing help are too different sides of the same coin, they point in the direction of needing protection from themselves, I would report them and say you are afraid for them.

I'm in a similar situation with my own father and would like to follow this and hear what people suggest. Are they making finical mistakes ? Do they have a DPOA done yet ?

You need to get their doctors involved, then the court system because they are not going to have help unless they are forced. It will take a serious health crisis before they will comply.

Ten years ago my mother went to see a PCP because she was not feeling very well. That doctor bluntly told her that she was old in her age and she just had to live with what was ailing her. How rude. Doctors take an oath that they are to be "kind" to their patients. From that moment on I have always taken my mother for her doctor appointments. My mother is now 84 years of age.

Please note that as of last November 2013 I just went through the same experience with my mother that you are now facing with your parent(s). For about the past 10 years she has been having a mini blackout. This time my mother had the "Big One". I phoned 911 and EMS took my mother to the hospital. I learned a long time ago that when you need immediate medical help for a loved one and they need to go to the hospital, you need to phone 911. Otherwise, if you yourself take the person to the hospital you will be waiting hours for the patient to be helped. This time as soon as EMS delivered my mother to the hospital, she was immediately seen by doctors. Her blood pressure was 150/100 and 200/200 is classified as instant death. These doctors had my mother to start taking all kinds of tests in the hospital. It took the doctors 2 days to stabilize her blood pressure. The very next test she received was an MRI. It was not explained to us everything that was involved for a person to take this test. The only question mother and I were asked, "Is your mother claustrophobic?" We replied, “She is not Claustrophobic.”. We were not told that mother would be placed inside a cylinder for this test. We were not told that she could have received a sedative to help keep her calm during this test. After my mother took this test, she was returned to her room. My mother was as white as a sheet, her body was ice cold, and the doctors had to immediately start working with her to get her vital signs back to being somewhat normal. You talk about being mad and upset with doctors, nurses, and hospitals.

While my mother was still in the hospital, the admitting doctor phoned me. Keep in mind that the admitting doctor hadn't received all the final results from the tests my mother had received in the hospital. He classified my mother as having 80% blockage in her brain and that she has a left clogged artery in her neck. This admitting doctor didn't make any other suggestions for her medical situation except that she needed to be moved to a Nursing Home. I couldn't understand why surgery couldn't be performed at that time to remove the blockage in her left artery. It was later explained to me by another doctor that due to my mother having 80% blockage in her brain, her already having severe dementia, clearing the blockage in her left neck artery could cause her to die or she could stand a chance of living as a vegetable for the rest of her life.

This admitting doctor who called me on my phone and gave me his findings wanted to know right then and there our decision in what we were going to do to take care of my mother. I phoned her insurance company, CIGNA Health Spring, and explained the situation to them. They said that if I could find a Care Giver Service who accepts their insurance, they would pay 8Hrs or less per day and 32Hrs or less per week. I must have phoned about 30 Care Giver Services and found no help. Because insurance companies are very bad about not paying for Care Giver Services, these companies do not want to work with insurance companies. I was finally able to find a Care Giver Service that was happy to receive my mother's medical insurance. They only provide her 1Hr of care 2 days a week. I feel fortunate to have received this limited help. I was told by the Care Giver Service that mother will only receive this help for (6) weeks. I was informed that (2) weeks before the Care Giver Service time expires, I must present a letter to her PCP requesting that this service be extended. I must continue this procedure on permanent basis until the insurance company says it can no longer extend the service. At that time you can submit a letter to your parent(s) PCP stating that you need a 24Hr. Reference Nurse (Medical Home Health Care Giver) to help assist your parent(s) in controlling their medications and taking their vital signs. If your parent(s) medical health insurance denies any further help, a Care Giver at Care.Com would need to be hired to work for these needed hours.

For 2 months after my mother returned home from recently being in the hospital (November 13-15, 2013), I took care of my mother every day and made sure she was safe, read her vital signs, made her meals, assisted her with taking a bath, and gave her the daily medications, etc.. All of a sudden one morning I arrived at her apartment and she bluntly told me, "You are not my mother and I no longer need your help." This upset me so much that all I could do was tell her, "Mother you do need my help. I told her that I love her very much. I told her that if she didn't do what I needed her to do, she had no choice but to be moved to a Nursing Home." I then left her apartment. I did not wish to fuss with her and feel sadder than what I already felt. It was suggested to me that I do one of the following: 1) I could either contact Adult Protection Services and have them talk to her; or 2) we could make arrangements to hire a Care Giver to take care of her; or 3) we would have my mother moved a Nursing Home. My mother has it written in her “Living Will” that she does not want to be moved to a Nursing Home. Note that Adult Protection Services can schedule an appointment to meet together with you and your parents to tell each of you in a kind way what your parent(s) can and can't do. Please note that if you phone the Adult Protection Services and something bad happens to them, you could possibly be held liable for the incident because it is then classified as "Elderly Abuse".

Three years ago we hired a Health Care Whisperer for my mother. This is a wonderful person who has stood right by our side in respect to my mother seeing doctors and going to the hospital. She has helped us in every medical way that you can possibly think of in respect to taking care of my mother. She suggested to me that I search Care.Com on the Internet. My husband also found this information for me at the same time. Since my mother would not allow me to keep taking care of her because I am her daughter, and since she does not want to be moved to a Nursing Home, I finally found a Care Giver at an Internet source named Care.Com to take care of my mother. Please note that Care.Com exist throughout the United States. When you visit the site, select "Special Needs Provider" and enter the rest of the required information. You will find wonderful Care Givers who can help take care of your parent(s) for $10.00-$15.00 per hour. One important thing to remember in hiring a Care Giver is that they work for you not you for them. Tell the Care Giver exactly your parent(s) health care situation and what you need them to do. Explain to them any difficulties your parent(s) may be going through. You can find retired RNs who can work with difficult cases. Please note that your parent(s) may tell the Care Giver one day that they don't need them anymore and ask them to leave. You need to explain to your parent(s) that if they don't do what you need them to do, and they don't allow the Care Giver to return and take care of them, they will have no choice but to be moved to a Nursing Home. Hopefully your parent(s) have named you their POA so that you can withdraw money from their banking accounts so you can take care of them. All you need to do is tell them that you will contact their PCP and tell them that you are not being cooperative and their PCP will immediately have them moved to a Nursing Home. They are going to tell you that you that you and their PCP can’t do this to them. Yes, your parent(s) PCP has the right to make this decision for their safety and health. If your parents don’t have money saved to help them in this situation, there are Government agencies that can help them. Please note that in order for your parent(s) to receive this kind of help, they may not be allowed to have any more than $2K-$5K in their name. You may also need to contact Medicare for further assistance. This is going to be a long journey for you and your parent(s) but you must help them to the best of your ability.

Please note I have been the POA in my mother's “Living Will” for the past 10 years. I have learned that a POA does not have the immediate legal right to move a loved one to a Nursing Home for their safety and health. A designated POA only has the right to follow what is written in the “Living Will” and this may only be for a limited amount of time. I learned quickly that you must issue a letter to your parent(s) PCP stating that they are (incompetent) and can no longer make safety or health decisions for their own care. You must also state that due to this decision you are now classifying yourself as their Medical Power of Attorney (MPOA). You do not have to do this procedure through a legal attorney which will cost you money. It is hard for all of us to see our elderly parents going through the last of their living years. It breaks our hearts to see our parent(s) suffer in any way. It is sad to say but they do become the children and we do become the caring and loving parent.

This has been a very long answer to your question. Since I have just been through this experience and journey in helping to take care of my mother, and since I have learned some very valuable information in helping me to take care of her, I feel I need to share my information with you. I hope my information has helped you. I hope my information will also help other family members who are going through the same health care problems involving parent(s). There is hope and help for you and your parent(s). Please help and love your parents because you will only have them one time in your life. Please be proud of your parents and all the things they have accomplished throughout their life. My prayers are with you and your family.

If anyone reading this letter has more information that you would like to share with me that I should know about, your help will be greatly appreciated.
January 6, 2014
Eva Lynn Denise P., MPOA, Daughter

I'd like to hear other's responses here as well. My father and his wife refuse help, although she is mainly able to handle most of their issues at this time. Despite all the melodrama that goes along with it. I am not in much of a position to help them - currently unemployed and living rent free in a friend's home, and I need to take care of my own needs first. Any ideas would be appreciated. Thanks.

I am going through similar events with my 93 yr old dad. He lives alone in a 2 story home and still drives. He's relatively healthy but has a pacemaker and is on several medications. He pays his own bills, goes to the store and exists on store made tuna and chicken salad. Always a bowl of cereal, cup of coffee ( he buys in the deli the day before and heats in the microwave ) and a donut or piece of pie for dessert. His hygiene isn't the greatest but I do know that he washes himself every day. Since his job involved a suit and tie every day, he wears a suit and die every day. I have POA. I called his doctor noting his hygiene and my fear that he's still driving. The doc was very kind and had dad come in for a complete checkup. Blood work and all, and also the generic dementia test. He passed all with flying colors. I sat him down and explained about his hygiene. I did it in the nicest possible way, but I was told he was fine, he washes every day. Yes, but your clothes are not washed often enough. Oh yes they are. Dead end there. Then I suggested that he add my name to his banking accounts in case something should happen and I need to pay his bills. Well, that's not going to happen. I also suggested that instead of driving over 30 min down a busy road to visit his grandson at his office ( the grandson never calls or comes to visit his grandfather, yet this is the man who put him through college ) to visit for 5 minutes then leave, just drive around town to do the things he needs to do. That isn't happening either. I suggested that he sell the car and I will take him to do what he needs to be done. Not only does he drive his car, but my mom had a 66 Mustang that he takes out every other week because you can't let it just sit in the garage, He refuses to sell that car as well. He also has macular degeneration. I've talked to some police officers that I know well and I also went to motor vehicles. What can I do? Nothing until he has an accident or is issued a summons for something. Frustrating? Yes! But on the other hand I'm thankful that he's as good as he is for 93.

Depends on how "with it" they are mentally. When you first start realizing that your memory is getting worse, you can go into denial, or you could panic and be afraid that your independence is going to be taken away from you, so you try to hide it. If it's possible to reason with them at all, you could try explaining that you want them to be able to stay in their own home as long as possible, but that you want them safe too. If they can't remember to take meds, or might possibly take them 2 or 3 times in one day because they can't remember if they took them before, they could cause great harm to themselves. If they are beyond reasoning, you could notify APS (Adult Protective Services) for suggestions of what to do. I don't know if this agency is in every state, but I'm sure every state has an agency similar. Sometimes 'threatening' to call them if they don't let you help them to be safe is all they need to comply with your help, but with some people that could cause a big divide between you and them, so you'd have to use your own judgement about that.

I had these same issues with my Dad and am now having them with Mom, who is living home alone with mild dementia. What worked for my Dad, when it was obvious they needed in home help and supervision because Dad was missing his meds, couldn't fill his weekly pill box correctly and was spending an hour to try to do it right, refused to allow Mom to help him and more.... We had gotten to the point where police were called out a couple times due to them fighting and him yelling in summer when doors and windows were opened and neighbors could hear.....On advice of our eldercare attorney and case manager, I explained to my Dad that we needed to 'try for a month' a helper coming to the house part time, mainly to 'help Mom' with cleaning because she had fractured her back and was using a walker. He was willing to do that for her...but HE didn't need help! She did her best to undermine the plan insisting in front of him that she didn't need help and we didn't need to waste their money. This was despite her constantly saying she couldn't handle him and she wanted help...(which then and even now...to her...means I should travel from 5 hours away and come stay with them and fix things....) I explained the helper would really be for him, but that she needed to play the game so we could get the helper in the house. Still, she refused. So finally, what I did was point out that by having police come, they were in danger of adult protective services getting called in and the home inspected and them being told that APS would decide whether they could stay in the home or needed caregivers, and all the choices were out of our control then. I said that 'the lawyer' (who was a loved authority with my Dad at the time!) said, that if WE got a caregiver coming in even for 4 hrs a day several days per week, then if APS got called, they would be OK because 'we all had a plan in place to assure things were OK in the home'....that by having our own home health agency involved APS would stay out of it. (which is true!). So I went back to the 'let's just try it for a month and if you don't like the person or having strangers coming to help out, we can discuss it again' Well, Dad was agreeable to a month of 'trying this' because the lawyer said it was a good idea. Our caregiver was very experienced with dementia and elderly clients that at the end of a month, she and Dad were great friends. She managed to show him things she was doing to 'help Mom' despite Mom not wanting any help....Mom was very unfriendly to her, so she bonded with Dad in terms of listening to him complain about his situation and she was gradually able to do things for Mom as she saw Mom struggling with something. At the end of a month, it never came up from any of them to stop her service. After 6 months, we had to place Dad in memory care, and Lisa, our caregiver spent another 6 months helping Mom...and they became very good friends by bonding over the issue of Dad having to leave....and getting him set up, visiting him and her doing things for Mom that Dad would have done etc. Finally, when Lisa had a health issue and needed some time off....Mom decided if she didn't have Lisa coming, she was OK and didn't want anyone else coming. BUT....her life there alone is getting progressively harder now that it's been six months with no one coming to help and her gradually getting worse with her dementia.....that even though, physically she is back to normal, she's not coping well with remembering and following through on doing things she intends, some more concerns about her driving just in her neighborhood etc. that we're getting to the point where I'm going to have these issues with her again. But, to summarize....if you can somehow get an agreement to 'try it for a month'....and you have someone really good with the elderly....I'll bet your Dad will be so appreciative of this helper by the end of a month, that he'll be OK with continuing it. That way....he has some control...being as he's only agreeing to a 'trial' period. There will be a couple weeks of mainly just 'visiting' (assessment and bonding time) and offering "Could I help with this or that?" before it would be getting to more hands on...like 'Today is shower day' or 'I'm putting out clean clothes for you today.....do you want to choose this or that option...' The elderly needs to slowly come to needing help with showers, skin care, toileting etc. THAT is really giving up lots of personal control to a stranger.... I hope this idea would work for you as it did for me!

Lucysmom501 - Regarding your father driving. I understand your concern. Check with your state's dept. of motor vehicles, the licensing dept. They may have a reporting system in place which allows concerned citizens to report individuals who probably shouldn't be driving any longer. The state then takes over and usually requires the person to pass a driving test the next time their license comes due.
We didn't have to do this because my parents believed their doctor, whom they trusted, when he suggested they not drive. But it's a good option to have.

CatTreeKids.............thanks so much for your response about checking with our state's DMV..........as of right now, there is nothing in place to have a person tested when their license comes due. I explained that it's my dad and while he's had no accidents or tickets, he's still 93. My only option is to ask him to voluntarily go into the local DMV office and ask to be retested. That would be an eye exam and a driving exam. I know he will refuse. When I asked why there is nothing in place to retest an older driver, I was told that it's age discrimination. They completely understood my situation but the only thing that can be done is a voluntary retesting, unless he were to be issued a summons or be at fault in an accident.

Same rules here in AZ, unless a doctor reports, I think. We do have private agencies that will do testing, but even if doctor orders it, the cost is $500. I am considering for my Mom as neurologist suggested it. But as far as DMV....only when there is an accident or a citation. My dad had a little fender bender at a red light, and he came home from that one and simply said, " It's time for me to quit driving". He didn't ever drive again, but as his dementia progressed, he threatened to when angry......and now that he's in a facility, we listen to stories about how he was out all day driving here or there and doing this or that kind of work, or traveling cross country on a trip. It appears that driving was an important part of his life! He often believes he's staying in a nice hotel with good food, while he is traveling and wants to know how Mom found him there and then tells her SHE shouldn't be on the road driving like that....as he would be home exactly when he told her he would be!! Interesting stories.... If they aren't about him thinking he's still involved in the ARMY and WWII...then he's been out on the road doing something. I had to go to DMV, by the way, and have his licensed suspended in order to take his name off the car insurances. That lowered the rates for Mom, since it was Dad who had had several fender benders the last few years, and not her. It does bother me a lot that they do not require a driving test at a certain age, because fender benders are one thing, but what if they hit and kill a child or something?? It's not just THEM getting hurt that we all have to be worried about. My parents do have a very high liability on their vehicle...but that still doesn't make up for them hurting someone else.

I would love to know the answer to this one. I will be reading the replies carefully. Both of my parents are in different stages of Alzheimer's and they cannot accept they need help. They have recently allowed me and my husband to come in weekly to sort their meds, but other than that I am just getting push back. No other siblings will step up though they admit our parents need help, so I am on my own here. Right now I am helping when they let, but I know this will only last for so long before they have to move into assisted living if they don't let me in more...Very frustrating...

At 53, I've had some health issues lately and am reaching out to friends for assistance. The last thing I want to do is worry my sons who are biochemists and live in Miami. So I think I understand your parents despite the short-term memory loss and other handicaps.

Their "fronting" is probably b/c they don't want to burden you and your siblings. But they might accept help from outsiders. I'd say help them indirectly, through elder care agencies.

If they still refuse, dog 'em. Tell them you're going to help whether they like it or not.

It can be very difficult, especially if the parent is very hostile, and there are no others to help. My parent does not like my help or outside help - I have saved her life twice. Not much one can do but try to check in as often as possible and pray.

Anyone who is still struggling with a parent who continues to drive when they shouldn't, needs to know about what happened in my town last week. An 88 year old women was backing out of a parking stall in a grocery store parking lot when she suddenly accelerated and ran over and killed a women walking behind her. It is speculated that she was backing out slowly, saw the other women and intended to brake, but pushed the gas instead. A similar thing happened to my grandfather when he was in his late 80's. He was backing down a sloped driveway, thinking he had his foot on the brake, but when he reached the bottom and pushed what he thought was the brake, he zoomed in reverse diagonally across the street. Fortunately, all he hit was a fire hydrant, which stopped his car. Of course this could happen to anyone at any age, but stiff joints, reduced sensitivity and slower reflexes (to move the foot when they realize what is happening), make it more likely in the elderly.

Don't all drivers need to go every four years?
If not, shouldn't that be the requirement?
You do not have to say because you are old,
it should just because you are a driver...
failing to renew your license would be one way...

Iwentanon...I spoke with the Motor Vehicle office of my state only yesterday. There is no requirement that anyone take a test to renew their drivers license. They call it age discrimination if they require an older driver to be retested. Unless the person is deemed incompetent or will agree to be retested there is nothing that can be done.

akdaughter, Living in an area where there is a large senior citizen population, I see this happen on a regular basis. Unfortunately in my state there is nothing that can be done to retest an older driver, or any driver for that fact. Once they've been the cause of an accident or they've received a citation for some reason, the police officer than state that they can't drive until they're retested, but only in those circumstances.

Age Discrimination? You can't get a drivers license until you reach a certain age! Are we discriminating now for those ages 0-16 (-/+)? Try going to the DMV with a five year old to get them a license and they will lock you up. Take a 95 year old and if they pass the eye test off they go with a renewed license even if the oldster has advanced stages of dementia. I live in a self reporting state where you can apply online. I wonder how many newly blind individuals are renewing their licenses online?

Debralee, the law states that an individual can apply for a license to drive at 16 1/2, with a state certified drivers education course. At age 17, per law, they can obtain a license to drive a motor vehicle providing they pass the written, eye and drivers test. Unfortunately the law does not allow to retest anyone at any age unless they are deemed incompetent, as with dementia, or a doctor gives a medical reason for them not to drive. Do I agree? Absolutely not! But until the law is changed, there is nothing that can be done to keep older drivers off of the road. And yes, now in my state you can now apply online to renew your license. Frustrating? Of course it is, but until the law is changed, older drivers will still be able to legally drive.

The driving thing is a tough issue. My experience with my dad: He has had a stroke so his memory is very poor also his concentration. He has been lucky for quite a while. First he totaled his car tailgating, the women stopped to turn left and he swerved into a telephone pole. Ironically his insurance paid him what he paid for the car plus good driver bonus. Ya, I laughter at that one, so much i called to ask. Didn't really get anywhere with that. Next accident was very minor but he was so medicated ( taking wrong medications), the officer wrote him up for medical public menice. Or something like that. And his license was suspended, so he had to pass a compatience test to get it reinstated. I set him up with a driving school to freshen up and get tested, but he kept driving and got caught driving while suspended. At this point I began to think he maybe shouldn't be driving after meeting with the officer and getting his side of the story. Dad got a court date, but in the mean time he got really sick and had congestive heart failure which put him in the hospital. I had to move in with him. I hired a lawyer told him the story and that I would be driving my dad and he would not be behind the wheel again. I also talked with his insurance company who explained that once his license was revoked the insurance and plate would be canceled. I explained that to my dad and he turned the cars over to me. It's hard but you really have to wait till thing go bad and hope they aren't catastrophic. Then you can try to help.