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Our parents live on about $1200 a month and pay almost half of that in health care premiums. They live in a remote desert town with minimal healthcare services. Our father is 89 and still driving when he probably shouldn't be. They are stubborn and won't take advice. We can't afford anywhere else for them to live and we can no longer always provide the transportation and help they need. They make bad decisions and cause more problems for themselves.

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Sounds to me like a situation begging earnest prayer...And in addition, get with their local, state or even federal agencies for advice, as well as an elder care attorney. (local agencies would include social services type folk.)

Grace + peace,

Bob
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I think this is more common than most of us realize. They do have a right to live their lives the way they want to, even if it causes anxiety for their families.

Perhaps the best you can do is to help put in place systems that will protect them to the extent possible.

For the car breakdowns, such as flat tires, etc., get AAA or some other road service. To stop them from driving, first locate alternate transportation services before you can any action that would leave them stranded at home.

Upgrade their house to prevent falls, install exterior motion lights, security sensors, a lock box outside for emergency personnel, alert the local fire and police departments, ask if periodic wellness checks can be made, arrange for meals on wheels, etc.

Honestly, even if they lived next door to you, with all the precautions available, there still could be that one moment when something happens that changes everything.

I've spent hours agonizing over how to protect my father and am still battling with the concept that there's a limited amount I can do. You could even get in-facility care in assisted or independent living and one moment of inattentiveness could cause a fall that could change their lives.

The difficulty in caring is acknowledging and accepting (easier said than done) that these are high risk situations and there's a limited amount we can do to protect our loved ones.

I'm not saying give up or just accept their situation - but rather do as much as you can think of to protect them, recognizing their independence and refusal to accept change to a safer living environment.
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I lost my grandmother yesterday from injuries she sustained from being run over by her own vechile Dec 16. She suffered a devastating injuries to her legs and ensured 4 weeks of pure agony. We brought her home at her request with me serving as her primary caregiver for her last days. This was a horrific accident. I have worked in long term care for +20 years and have seen many thing in this population but never in my mind could a projected anything like this. It leaves me asking questions? What could have been done? Why? I am angry that the medical personnel in her life, her primary care physician's did a report that to the department of transportation as she was undergoing treatment for dementia for several years. Our families questioned her ability to drive and of course came under fire from both her my grandfather when we did so . I've seen this population become very bitter about losing their independence about driving but killing Themselves or someone else is certainly the worst case scenario. Our family is devastated. I find myself searching for ways to reach other people, communicate what happened to us in hopes of preventing this from occurring to others in the future. There are not enough agencies to help people who can't drive . It's something I'm going to look into . What can I do now? Although her journey is over mine continues w a message from
Her. This doesn't need to be your family. Speak to them, be up front. Hope that they can reason. If not speak to primary care physician. Call Your driving agency, report it. The worst thing is to do nothing!
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Maybe they just want to be left alone to die on their own instead of drag it out? That is what I'd want
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When I run across this dilemma (which is often!), I try to remember what these folks have lived through over the years. Born in 1926? That means they endured WW II on the home front, followed by the rebuilding of the American economy. This is the tail end of those known as The Greatest Generation. They have always made it through with a “pull yourself up by the boot straps” mentality. The end result is that at the tender age of eighty-nine, they are highly unlikely to see the error of their ways and start cooperating. Failure to recognize and accept this fact of life only results in a great deal of frustration and aggravation for all involved.

The good news is that there are steps you can take. The business of unsafe driving is the most pressing as the consequences of an error can be dire. You can research online the policies for drivers' licenses in their state. More and more states are responding to this dilemma with a process to report an unsafe driver without identifying the reporter. The state sends the elder a letter simply requiring them to report to the Dept. of Motor Vehicles for a standard driving test. The letter states the testing is mandatory with suspension of license for failure to appear.

No doubt there will be grumbling or worse, but you can play dumb and sympathize with what an inconvenience it is. A driving test will either clear him as safe or confirm your fears with a subsequent revocation of his license.

As to keeping an eye out, the others who have responded have great ideas. All you can do is alert the local "boots on the ground" about your fears and provide your contact information. Neighbors, clergy, physicians and the Dept. of Social Services can receive this heads up.

Families facing obstinacy in an elder often can only wait for a difficult event to break through the determination to remain independent. It may take a broken hip, a loss of a driver’s license, a disconnection of the electricity for an unpaid invoice to crack open a door to accepting help. Waiting is the hardest thing to do, but laws to protect the individual's right to make their own bad choices are tight.

Do what you can and pray for it not to take too great a fiasco to get through to them. Good luck and God bless!
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unfortunately it's not an option for things to stay the same. eventually they will need intervention. as my mother did when she lived in Florida and I lived in New York, suffering demential & living alone. it was the same as if she lived in the wilderness. i brought her up to New York to live with me under false pretenses ~ a 'vacation' ~ & she eventually needed hospitalization & placement in a nursing home. & so she is in a nursing home an hour from me. sooner or later your hand will be forced, as mine was. don't wait until something horrible happens.
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Your description of your parent's behavior in the subsequent post is quite alarming. It sure sounds like there is something wrong with your dad's driving. Multiple accidents like that raise my suspicions. Plus, the other behavior of how he acts when he's sick.....very concerning. I think I would focus on that first, since it could really hurt them and other people or worse. I'd contact his doctor and share my concern and ask him to help or contact his state's DMV and ask for guidance to get his license.

Then, I would try to stay with them for 24 hrs, to see just how bad things are in the house. Are they really caring for themselves.

Why such a high insurance premium? I've never heard of someone paying those high prices.
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Ok. They are not independent, really, and they are not safe. You could ask for a DMV evaluation or a specialized OT evaluation and see if that will get Dad off the road. I'm sorry for him and for you, but he needs to be off the road. With $1200 a month income between the two of them, they need a cheaper health plan and they will qualify for Medicaid or PPACA-based care, unless they have assets beyond house and car you don't know about. They need help understanding this and navigating the system, that's for sure. Remote and rural may be a bad fit for them, unless there is a local Area Agency on Aging that can fill the gap. Realize too that Dad is not necessarily going to be "independent until I die" but sort of semi-independent until something bad enough happens that he can't be anymore. If your best efforts - getting POA, maybe even APS or guardianship though it may not be that bad "yet" fail and the bad thing does happen, it will not be your fault. Ia55cagirl is right about things too...so hey, welcome to the hit-your-head-on-the-wall club. Hope we can cushion the blows a little here.
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My mom was pretty far gone, getting lost driving was the last straw. She took a fall in her house one day and in all the hub bub of people getting her up, examined, etc. I ran around and took all the car keys off key rings I could find. I knew where the extra keys were hidden, too. She called me up a time or two asking if I had any spare car key, but that was really all, guess I was lucky! I had her nephew move her car to his house and we sold it for cash....Now, I have heard of people selling a parent's car and using the money to set up an account with a local taxi service. The same driver would come as often as possible, take them to the dollar store, grocery shopping, to church. It sounds a bit expensive to me, but this didn't go on forever as their conditions (physical and cognitive) declined, and it seemed to work out well from what I'd read.
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Having health insurance in addition to the VA is something my brother does for my Dad only because he might like a second opinion. Technically the VA does it all, and nothing more should be needed. They might be wasting what little money they have on that extra health insurance policy. the VA even provides cheap prescriptions. And a law passed recently that says you don't have to drive that far to a VA, they must come to you.
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