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I have read interest in the BFC forum in an elder care thread a few times and I could use a resource for this information also. I searched and I couldn't find one anywhere else. Many of us have elderly and aging parents we are caring for now or did so in the past. Some of us are retiring or well into their retirement and may have first-hand information to contribute. Come here to request advice, offer advice, recount a cool story you heard, or just rant about your family and the system. The target is here is that anyone can find information for any level of involvement:
Definitions
Other threads around SA: To begin this OP, I am relying on government websites and well-known organizations to avoid any incorrect or misleading information. US Government Sources
Non-Profit Help
For-Profit Help
Healthcare Medicare - https://en.wikipedia.org/wiki/Medicare_(United_States) - One of the most important aspects of elder care in the US: getting their health needs paid. Part A
Medicaid - Needs expanding https://www.medicaid.gov/medicaid/eligibility/seniors-medicare-and-medicaid-enrollees/index.html Tricare - Needs expanding https://tricare.mil/ Private Insurance Common Health Issues - None are exclusive to the elderly but they do present problems unique to the elderly
Debits and Credits Income
Spending - The headaches this causes, wow. Some stuff to look out for:
States and Territories Alabama
Alaska https://health.alaska.gov/acoa/Pages/default.aspx Arizona https://des.az.gov/services/older-adults Arkansas https://humanservices.arkansas.gov/divisions-shared-services/aging-adult-behavioral-health-services/area-agencies-on-aging/ California Colorado
Connecticut https://portal.ct.gov/AgingandDisability Delaware https://dhss.delaware.gov/dhss/dsaapd/index.html Florida https://elderaffairs.org/ Georgia https://aging.georgia.gov/ Hawaii https://health.hawaii.gov/eoa/ Idaho https://aging.idaho.gov/ Illinois https://ilaging.illinois.gov/ Indiana https://www.in.gov/fssa/da/index.html Iowa https://hhs.iowa.gov/programs/programs-and-services/aging-services Kansas https://kdads.ks.gov/ Kentucky https://www.chfs.ky.gov/agencies/dail/Pages/default.aspx Louisiana https://ldh.la.gov/index.cfm/subhome/12/n/7 Maine https://www.maine.gov/dhhs/oads Maryland
Massachusetts https://www.mass.gov/orgs/executive-office-of-elder-affairs Michigan https://www.michigan.gov/mdhhs/adult-child-serv/adults-and-seniors/behavioral-and-physical-health-and-aging-services/aging-services Minnesota https://mn.gov/dhs/partners-and-providers/program-overviews/aging/ Mississippi https://www.mdhs.ms.gov/aging/ Missouri https://health.mo.gov/seniors/aaa/ Montana https://dphhs.mt.gov/SLTC/aging/ Nebraska https://dhhs.ne.gov/Pages/Aging.aspx Nevada https://adsd.nv.gov/Programs/ADSD_Programs/ New Hampshire https://www.dhhs.nh.gov/programs-services/adult-aging-care New Jersey https://www.nj.gov/humanservices/doas/ New Mexico https://aging.nm.gov/ New York https://aging.ny.gov/ North Carolina https://www.ncdhhs.gov/divisions/division-aging North Dakota https://www.hhs.nd.gov/adults-and-aging/services Ohio https://aging.ohio.gov/find-services Oklahoma https://oklahoma.gov/odmhsas/treatment/adult-family-treatment-services/aging-services.html Oregon https://www.oregon.gov/odhs/aging-disability-services/Pages/default.aspx Pennsylvania https://www.aging.pa.gov/Pages/default.aspx Rhode Island https://oha.ri.gov/ South Carolina https://aging.sc.gov/ South Dakota https://dhs.sd.gov/en Tennessee
Texas https://www.hhs.texas.gov/services/aging Utah https://daas.utah.gov/ Vermont https://asd.vermont.gov/services/aaa-oaa-services Virginia https://www.vda.virginia.gov/ Washington https://www.dshs.wa.gov/altsa West Virginia http://www.wvseniorservices.gov/ Wisconsin
Wyoming
Washington DC https://dc.gov/service/dc-aging-and-disability-resource-centers-locations American Samoa - Can't find anything official Puerto Rico - Can't find anything official Guam - Can't find anything official US Virgin Islands - Can't find anything official Legal / Estate Planning Fiduciary - a fiduciary is a person who owes a duty of care and trust to another and must act primarily for the benefit of the other in a particular activity. https://www.irs.gov/retirement-plans/retirement-plan-fiduciary-responsibilities Wills and Trusts Wills and Trusts info from the IRS. Trust Primer from the IRS. Primer for Power of Attorney from the CFBP. More details here in baddog's post Long-term Care Insurance You’ll get better information in the Insurance Questions thread but here’s what I’ve heard: Difficult to make claims either by slow processing or limited options for assistance. https://www.medicare.gov/what-medicare-covers/what-part-a-covers/how-can-i-pay-for-nursing-home-care
Scam Prevention Very important. Any time I read something about the elderly being scammed I send it to my parents. https://consumer.ftc.gov/consumer-alerts/2021/10/keeping-older-adults-safe-scams https://www.washingtonpost.com/opinions/2023/02/08/elderly-scams-protections-targets-finances/ https://www.ncoa.org/article/top-5-financial-scams-targeting-older-adults/ Security and Safety Security issues exist for the elderly too. This may be certain locks to keep persons with dementia in their home or it may be keeping people away from the home. Discuss this with them to see what they're willing to do. Safety concerns weighs heavily on the elderly and their caretakers. Some things to consider:
Cleaning Another thing that can cause a lot of headaches. In some cases our parents may have a lot of stuff, and things hidden inside of that stuff. And it may need to leave their home in a hurry if they suddenly lose their independence. Someone needs to be aware of this. abravemoose fucked around with this message at 23:40 on Apr 27, 2024 |
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Apr 2, 2024 23:56
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thank you for putting effort into a new thread on a very important topic. pinned for visibility!
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Apr 3, 2024 14:16
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This is awesome thanks for doing it! You have some great stuff here. I've been working on a draft on the same topic, but it's such a hard thing to write about, I had a really hard time with it. Let me dump a few things here, maybe you can incorporate a few into the OP. There is a thread in E/N for venting about how awful the situation can get. Links: 1. Power of Attorney: https://www.sos.state.co.us/pubs/info_center/laws/Title15/powerOfAttorney.pdf This is colorado's, but every state should look somewhat similar. Most states seem to recognize each others, so you shouldn't need to get multiple notarized. You can see there is space to "ease" into things, and only check off what they feel comfortable signing over. Obtaining a Power of Attorney for your parents is probably the single biggest thing to make taking care of them easier. Every time you try to act on behalf of your parents, almost immediately you will be asked if you have power of attorney. Financial institutions won't even discuss the situation in the vaguest terms unless you have a power of attorney. Once you get one, doing everything becomes so much easier (although it does take several days or more to have it approved at each place). And this isn't *just* for taking care of their bank or brokerage, you need a POA to do things like get them on a better phone plan (my folks were still paying a dime a minute for "long distance"), cable, internet, adjust their insurance, etc etc without having to try to conference them in and navigate them through the identify verification process. Even before you take over paying the bills, a big thing that you can do once you have POA is to get warnings on the bank accounts and credit cards to ensure that they aren't falling victim to scams. Doing your best to keep them from falling victim to elder abuse is a huge part of taking care of them. Although a lot of end of life stuff these days feels like institutionalized elder abuse. Eventually try to wean them off of credit cards and bouncing checks (old people love checks). Getting them a debit card on an account with a low balance would be perfect. 2. Medical Power of Attorney: https://www.senioranswers.org/legal/advance-directives/medical/mdpoa/ I never had to use this, but can see where it might be really critical. Better to have it than not, although the discussion to get it done can be painful. 3. Living Will: https://www.findlaw.com/state/colorado-law/colorado-living-wills-laws.html Even more uncomfortable for some people. Can see where situations can get really bad if you don't have one. 4. Regular old will: Also very important to update the good ol' normal will, and ensure there is only one "latest and greatest" copy floating around, and everyone knows where it is. We have an estate planning thread here if you have any questions about what that looks like. Some people want it to be a big secret what's in the will, including my own parents. But it turned out to be pretty cut and dry equal shares, and the only pain in the rear end was actually dividing things up that didn't divide equally. But it's going to be less drama if you can hash things out *before* that time comes, and ensure that everything is set up to avoid probate and get settled cleanly. Beneficiaries on accounts that aren't overriding the will's intentions, transfer on death, etc. 5. Long term care insurance: https://www.medicare.gov/what-medicare-covers/what-part-a-covers/how-can-i-pay-for-nursing-home-care Insanely expensive, but I have seen some companies offer what seemed to be a subsidized plan for their employees. Or at least better than what you could buy on your own. It obviously depends on the area, but even a middling nursing home in a low cost of living state can run 10K+/month. If you think a nursing home will likely be in the future, it's going to be worth consider this insurance. Although most plans feel more like a form of prepayment (like dental plans), rather than actual insurance. Long term care insurance is much cheaper the younger you buy it, but people don't want to consider it until it seems inevitable. I've known people who have managed to find good home nurses to come by for a few hours a day, maybe multiple times a day as an alternative to a nursing home. This can be cheaper, and of course everyone wants to stay in their own home as long as possible. But at some point it becomes basically like running your own health care company. Other potentially important topics. Everything works better if you can actually have discussion about it *before* it becomes an emergency: 1. Trying to convince your parents to move into a manageable space as they get older, instead of a huge house out in the woods. And moving to be near the people who are likely to take care of them. 2. Splitting up responsibilities between siblings/grandchildren in a manageable way. 3. Getting their important stuff delivered by mail/switching mailing address to your address/switching their important email correspondence to an email that you have access to. And weaning them off email and it's potential for scams altogether. Post office reliability hasn't been great lately, so getting any of their subscriptions moved to an email you have access to might be better than snail mail. Their main email is probably just a cesspit of shittery, so would be good to set up a new clean account for the important stuff. 4. Huge issue - getting them to stop driving when it become dangerous (good luck with this one!)
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Apr 3, 2024 14:31
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Just a bit on my personal experience, I really wish I'd taken over more of the finances earlier. Getting parents to agree to it would have been difficult, signing over that power of attorney to your kid is I'm sure incredibly emotionally difficult. I chipped at it piecemeal, "let me take care of the phone and cable, ok let me handle the insurance now....". But it was a pain to do even that without a POA in place. I can speak to tricare a bit. I'm glad they had it, most bills did *eventually* get paid. But the department of defense has outsourced prescriptions to Express Scripts. I suppose it might work ok if you are getting prescriptions mailed directly from *them*. But when the nursing home is running things through the pharmacy that they use for everyone else, the wheels just come completely off. Nursing home wants things filled in monthly amounts (along with everyone else they are taking care of), Express Scripts really wants you to get 3 months or more at a time, otherwise they charge you 3x (or more) the standard copay amount. There was also often a 30 day vs 31 days in the month thing, where we would get charged 2 copays. Or not getting the "preferred" version and being charged an insane amount for the alternative, etc. So what should have been almost 100% covered from tricare, or absolutely free if they were still able to go get it filled at the base, started costing thousands a month. I was able to get a lot of that argued down, but it was just a neverending thing, unfortunately. I think a lot of people are just on autopay these days - please pay attention to those bills!
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Apr 3, 2024 16:41
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What a great thread. I've been through a lot with the last few years of my mom's life (she passed away in December) - she had Parkinsons disease, and was mostly cared for by her husband, my stepfather; and, a sequence of in-home care staff, ramping up to 3 part time staffers collectively doing 6 hours a day 7 days a week in-home, and then finally 2 months in the memory care wing of a nursing home. It was all horrendously stressful and difficult and heartbreaking, and there were a lot of disagreements within the family about what was best to do, what my stepdad could handle, and how to pay for it. Before that, my sister's husband suffered from multiple sclerosis and survived living at home for 15+ years before he finally passed away about two years ago, and he had in-home care for most of his last 10 years. AMA about any of that. One resource worth linking is care.com, which is an online marketplace for finding caretakers to direct hire. When you hire an in-home caretaker you can go through a service, or directly hire, and both choices have major drawbacks. Services cost more, typically; they may send someone inexperienced or unsuitable on any given day if they're having staffing trouble or may just not have anyone; and they often have hour minimums (as in, you must get a person for at least 4 hours for any shift). Direct hire you can negotiate cost directly with a caretaker, but they need time off so you might need 2 or more in order to have full coverage. You are now an employer so you will have to handle poo poo like employer taxes, issuing 1099s or doing employee stuff. If someone doesn't work out you have to fire them, and with three different employees my stepdad had them just stop showing up eventually which is very frustrating. If your elderly patient needs medical services, including giving medication, service providers will insist that you need a qualified nurse, which costs far more and is much less available. If you direct hire you can negotiate specific services; for my mom, my stepdad had all her pills sorted and labeled and in their little sorting trays, and my mom knew what her pills where and how to take them, so his direct hires generally had no problem with doing her pills and even the services kind of looked the other way for that level of thing since she had no other invasive "nurse" type things needing done. But in my brother in law's case, he needed a catheter, wound cleaning, and other services like that, so his caretaker had to have medical qualifications. He was paid for by the state (CA) too, because of the level of disability of my BIL, but wound up arranging to do a lot more work than what the state actually paid for. Another thing this thread should discuss is living trusts. All of my parent's significant assets are in a trust, I will be the trustee when my stepdad passes, and the trust specifies the benificiaries (the inheritors) and how the money should get divided up. This will make everything far, far easier on me than if he only had a will. Setting up a trust costs two or three thousand dollars, but it is very worth it and there are a lot of misconceptions elders might have. They may worry that they're losing control of their money (they are not), that it's a trick that lets someone take their money (it isn't), that they'll pay more in taxes (they won't), or that their kids are trying to screw them (well, they might be, but it's far easier for kids to screw their parents by challenging a will after they're dead than it is for them to screw with a trust, because the attorney setting up the trust literally will not do anything without the living trustee - that's the old folks - requesting it independently and without interference). There are several forms of trust but the most usual for estate planning is the revokable living trust. An irrevocable trust may also be a good idea for folks who need to sequester away assets in order to qualify for public assistance, but that is a different kettle of fish and should probably be discussed separately.
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Apr 3, 2024 17:10
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Baddog posted:This is awesome thanks for doing it! You have some great stuff here. I've been working on a draft on the same topic, but it's such a hard thing to write about, I had a really hard time with it. Let me dump a few things here, maybe you can incorporate a few into the OP. Thanks, I will add things to the OP as discussion develops and at the very least link to effort posts in any subsequent pages. Thanks for this addition. Leperflesh posted:I've been through a lot with the last few years of my mom's life (she passed away in December) - she had Parkinsons disease, and was mostly cared for by her husband, my stepfather; and, a sequence of in-home care staff, ramping up to 3 part time staffers collectively doing 6 hours a day 7 days a week in-home, and then finally 2 months in the memory care wing of a nursing home. It was all horrendously stressful and difficult and heartbreaking, and there were a lot of disagreements within the family about what was best to do, what my stepdad could handle, and how to pay for it. Before that, my sister's husband suffered from multiple sclerosis and survived living at home for 15+ years before he finally passed away about two years ago, and he had in-home care for most of his last 10 years. My dad also has Parkinsons, diagnosed at least six years ago. So far he's mostly limited by mobility and still there mentally at least, when medicated. I bought him a soft helmet to wear around the house (my mom is there too.) When I asked him if he ever wore his hard bicycle helmet at a time he had a fall, he said no. Soft is better than nothing and he now wears it all the time. Some things I hope to learn is more resources for people dealing with dementia, diabetes, incontinence, and so many other issues that care takers must get involved in. At my work place there is a Care Givers Support Group which is where I learned some of the information in the OP. If your workplace is large enough you may already have one, ask around.
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Apr 3, 2024 17:53
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Dealing with incontinence was a massive, massive issue for my mom. You could say she had "potty issues". A small bladder, a constant need to pee, and an absolute terror of wetting herself, probably due to some childhood trauma. So the last four or five years of her life were dominated by a demand every 60 minutes or so to be taken to the bathroom, and she needed assistance to do that. She started intentionally dehydrating herself, especially at night, to try to reduce her need to pee, and that plus some of her meds led to chronic constipation. Sorry to get gross here but we found out she was dealing with constipation by sticking her finger up her butt. She insisted a nurse told her to do that. Probably that never happened. We had to have consultations, she had to have clear instructions, and we had to fight with her a lot about the goddamn potty issues. This one specific thing was the biggest factor in her needing continuous in-home care: either my stepdad was doing it, or my sister during the 6 months she lived at my sister's house, or a caretaker. If your elder can be adjusted to wearing a diaper it's so, so much better. Of course then there's the cleaning issue, and if they have mobility issues (they will eventually with Parkinsons) that has its own challenges. But at least it means you can leave them alone in a room for an hour, maybe. The mobility stuff is a big challenge too. The helmet is great, my mom never wore one, she fell a lot but her injuries were always to her hips. She was mobile with a walker - with assistance - until the very end, although she was increasingly in a wheelchair the last year. There's a bunch of different walkers, we tried several designs before she settled on one that she could squeeze to collapse partially but still use, which helped with getting through doorways and stuff like that. We also had to do stuff like change flooring, adjust the height of her bed, and constantly rearrange pillows and towels and stuff on the backs of chairs, to help her be comfortable. She had a lot of pain, bad hips, very low weight, and generally that was a big challenge too. From a planning perspective I'd say reach out to your local alzheimers & parkinsons groups. Not just for the patient but especially for the caretaker. The local groups pool resources and share info and my stepdad found them very good. Like when he needed to find a new neurologist, when he needed someone to build a ramp (that never happened but he was at least looking into it), and just to have someone going through the same poo poo as him to talk to. Another thing to consider is the wellbeing of the primary caretaker. Look up "respite care," it's super important to be able to drop off the patient for a day or a week or even three weeks, to give the caretaker a significant break. Of course it's potentially quite expensive, but being a full-time caretaker for a loved one for years will absolutely destroy you if you don't get breaks.
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Apr 3, 2024 18:08
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I updated the OP with some of the resources posted here and added Colorado-specific links to that state's information.
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Apr 4, 2024 00:02
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Just want to say that this is a fabulous OP. Thank you, abravemoose.
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Apr 4, 2024 19:43
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Great stuff. At present I'm mostly concerned with change management with my folks. My parents have been pretty proactive and have shifted their assets to a trust and have worked through most of the financial aspects. They are both in generally good health and are either side of 75 and they have a financially comfortable retirement. The problem that I have is that they live in a very rural place and in a house that requires a significant amount of manual labor to keep up. They are installing heat pumps so that they will no longer be dependent on wood for heat, which is good both for selling the place and for them staying in it. I worry that in short to mid term the house will become nonviable for them very suddenly, and they will be too slow to react to it. I've tried to get them to game plan a bit more, and they are at least taking some concrete steps with the heat pumps, but since they are in fine health the planning hasn't advanced much beyond that right now. That's fine - but that will likely change fast. Any thoughts on approaching this in a productive way?
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Apr 4, 2024 19:55
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I wound up hiring a cleaner to go to my stepmom's place twice a month. In oklahoma that's not very expensive, I'm paying something less than $200/mo, they send two people for a couple hours every other tuesday. We're trying to get up to the point where we could get my wife's parents to accept an arrangement like that. Her dad is in his late 70s, still very active, but has a pacemaker due to the ablasions not fixing his issues. Her stepmom has some form of dementia that has stabilized now she's at home again, but can only get worse over time. One big issue is that we have no idea how much money they have. Her dad has never been the kind to share that kind of information, but they're on medi-cal, cut a lot of corners budgetwise, and are generally behaving like they have not very much money, although they do have too much money to qualify for free in-home assistance. The killer part? They own a house with an acre of oak treed (sloped, mostly) land in the very south edge of the bay area, closer to monterey than san francisco but still it's a pretty lovely area and I bet their home is worth $900k despite a big and ever-growing maintenance deficit. But selling that house to access the money might mean plunging her stepmom into much worse dementia - she was way worse in the rehab facility after she broke her hip, and got quite noticeably better after being home for a couple of weeks. So they love their home and really I'm sure don't want to leave it. There's still options to access the equity to pay for stuff but my wife hasn't even broached topics like "have you done any estate planning whatsoever" or "how much money do you actually have," nevermind "have you considered selling your home that you increasingly can't keep up with anyway?" So yeah it's a tough conversation to have and I think you have to try to find a way to position it that's not giving the impression you're just trying to assess your inheritance. "Mom and dad I want to help you figure out a way to keep your place up, can we talk about your finances and what your options are" might work?
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Apr 4, 2024 20:52
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Thanks for the feedback. I hope someone will find some actionable content here. Updated the OP a bit and added some things like common health problems a few more sections, and a little more information for Maryland. It'll take a while to get all the states+DC+territories. I have an anecdote to share about security. Last year someone came to their door at 1am banging and shouting. My mom came down and someone outside was yelling that they 'have your kid and he's hurt.' This is weird because I'm 40 and my brother is not too far behind. We both have our own careers and health insurance. She could see down the road that there was an unfamiliar car/van parked on the street. She also can't see the person outside. They kept banging on the door and yelling, it was probably at most five minutes but it must have felt like an agonizingly long time. She called the police and told the person outside who promptly left. Why target them? I have some suspicions but that's another related post. A small part of me wonders if it was a hard-sell for a security system. Anyway that convinced them to get a security system and monitoring. I helped them install it and fixed the lighting outside. I'm not happy my childhood home has cameras but they do feel safer. Is there any research that these systems are actually effective? They have some features that are good for the elderly like if someone tries to leave and panic buttons if someone is hurt.
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Apr 4, 2024 23:54
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some tips on how to find / how to evaluate assisted living facilities or other long-term care facilities would be useful. an older person can go from fully functional to "can no longer live alone in their home, ever again" very quickly if there's a health emergency.
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Apr 5, 2024 00:14
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pmchem posted:some tips on how to find / how to evaluate assisted living facilities or other long-term care facilities would be useful. an older person can go from fully functional to "can no longer live alone in their home, ever again" very quickly if there's a health emergency. This is a bit of an aside to your question, but based on my grandmother's experience in a memory care facility I'd say that initial evaluations of a facility are really only gonna get you so far. There's often a lot of turnover in the industry, and the quality of a place can vacillate a lot over time depending on the staff. Even well-managed places can have problems keeping good people. When the facility my grandmother was at had a decline in quality, my mother and uncles found that the best thing they could do was to show up to check in on her very frequently. They made sure the people who were working knew them and knew they would be by often, and when issues arose they were sure to point them out.
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Apr 5, 2024 00:59
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KYOON GRIFFEY JR posted:Great stuff. At present I'm mostly concerned with change management with my folks. My parents have been pretty proactive and have shifted their assets to a trust and have worked through most of the financial aspects. They are both in generally good health and are either side of 75 and they have a financially comfortable retirement. The problem that I have is that they live in a very rural place and in a house that requires a significant amount of manual labor to keep up. They are installing heat pumps so that they will no longer be dependent on wood for heat, which is good both for selling the place and for them staying in it. I worry that in short to mid term the house will become nonviable for them very suddenly, and they will be too slow to react to it. I've tried to get them to game plan a bit more, and they are at least taking some concrete steps with the heat pumps, but since they are in fine health the planning hasn't advanced much beyond that right now. That's fine - but that will likely change fast. Any thoughts on approaching this in a productive way? I don't know if it will help at all, but maybe you can share that your friend (me) had parents in a similar situation. And they ran into issues like the ambulance not being able to find where the house was (back a long lane). Driving so far on country roads every day wasn't good, mom got into accidents. Your folks aren't going to want to hear this, but mine ended up basically abandoning large chunks of their huge house, and it just rotted. I really think if they had gotten moved into something in town, a smaller place they could keep a handle on, in a walkable area or at least where they could use the senior shuttle (or an uber), someplace closer to one of the kids.... that it wouldn't have come down to "welp, there really isn't an option now except for a nursing home". But I think people really do get so attached to where they have been for so long (more than 30 years for my folks in that house I think). That's your nest, where you are comfortable. Way too much energy to adapt to something new anymore. We all gotta make that move before it happens to us! Maybe another thing that could help would be pushing the angle that you and your family would *really* like to see them more, but that means they need to move into town, close to you?
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Apr 5, 2024 04:13
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Baddog posted:I don't know if it will help at all, but maybe you can share that your friend (me) had parents in a similar situation. And they ran into issues like the ambulance not being able to find where the house was (back a long lane). Driving so far on country roads every day wasn't good, mom got into accidents. Your folks aren't going to want to hear this, but mine ended up basically abandoning large chunks of their huge house, and it just rotted. Thanks, this is helpful and sort of confirms some of my concerns. For them "moving in to town" is moving to a town of about 12k, where my aunt also lives. There are more services, but not a ton. The moving closer to kids thing is tricky. They've mentioned it, but I am the only kid, and it would involve them moving in to a very HCOL. They could afford it, but it's kind of silly from a financial perspective. I also do not want them living too close to me. We have a good relationship, but it's one that works better at a slight remove, and I find it challenging to manage them. Right now they're a couple hours away. I do not want them closer than an hour.
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Apr 5, 2024 13:05
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pmchem posted:some tips on how to find / how to evaluate assisted living facilities or other long-term care facilities would be useful. an older person can go from fully functional to "can no longer live alone in their home, ever again" very quickly if there's a health emergency. A few years ago my dad's disconnect between "thinks he can do things" and "able to do things" was beginning to drift apart. There were a lot of falls, not consistently taking medicine, mixing medicines in harmful ways, and over estimating his abilities. On his way to a doctor's appointment he was feeling so well he tried to hop up a curb and face planted into the sidewalk. Between 2019-2022 he must have had six stints in skilled nursing facilities to get him straightened out. In my area, the DC suburbs, there are independent and assisted living facilities that also operate short-term skilled nursing facilities that accept Medicare. From this we learned a lot about what kind of care and attitudes these places offer without full commitment of a year-round room. One expensive place that takes a large down payment to get in, plus your monthly rent and service fees was the worst experience we ever had. My dad was left in his room, no exercise outside of a 30 minute therapy session, no socialization, and his medicine was not properly administered. He came back worse than when he went in and motivated to not return. I think where I'm going is that the rehab parts of some assisted living facilities may have different evaluations or word-of-mouth than the curated image of the main AL facility. That may tell you something about their attitude towards residents.
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Apr 6, 2024 15:25
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This has been a bit cathartic to read because a lot of the problems I'm having with my parents are a lot of the same ones listed here. If anyone can figure out how to break the logjam of boomer stubbornness, please, pretty please let me know how you did it. There's almost a complete unwillingness to acknowledge "I am aging and someday I will die." 
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Apr 10, 2024 02:00
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Right now I would settle for a way to wean them off QVC
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Apr 10, 2024 04:08
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i like nice words
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Anne Whateley posted:Right now I would settle for a way to wean them off QVC QVC still better than the alternative: instagram videos, tiktok, and wechat videos that follow some algorithm and show progressively more radical and attention-grabbing content. My mom is now glued to her phone, she walks around the house with videos about "those people" or "what they don't want you to know" and won't go to sleep well past 10, 11, midnight-- just sits on the couch glued to the screen going down conspiracy theory rabbit-holes.
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Apr 10, 2024 15:49
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Oh, my parents do that too, but so far at least that’s been free whereas QVC is $$$$$. Although that may change…my dad’s latest videos have been about “Powerball is rigged, but because I know how it’s rigged, I can teach you how to win it”
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Apr 10, 2024 16:12
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Man QVC is still a thing? I remember when I was a teen 20 years ago my mom bought tons of that stuff and would try to grab all the packages before anyone else and hide them. I was just throwing out some of her stuff last weekend and remembered to go through her purses because she would hide her bills in them. The only thing I found was a flyer for the payday loan site she used. The last few years before she died she would barely move, never go outside, never go to the bathroom or take a shower and spend all her SS checks on door dash, funkos, sun catchers, and whatever other poo poo she would randomly focus on at the time. I would yell at her all the time about it. When my dad got too sick from cancer to work anymore I had to sit down and explain how we could get through it financially but she would have to be more responsible. She died a few days after that so I guess it worked itself out. One thing I learned from my parents dying is that I don't want to go out the way they did just being so stuck and stubborn that you just loving keel over from your bad habits.
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Apr 10, 2024 21:39
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My mother-in-law's hoarding was very much driven by QVC, home shopping network, and - because she is aspirationally a quilter - fabric sites. She got divorced in 2006, moved into a 525 square foot condo with way more stuff than could possibly fit in there so she got a storage unit, and then proceeded to fill her home, that storage unit, her garage, and a second storage unit with stuff she bought that she was totally going to be able to use once her condo was cleaned up enough. We did not know about this, although we had some suspicions about it, until late last year when a water leak in her kitchen forced the issue. It was necessary to clean out everything in order to tear out the kitchen and fix the leak. As we went through all the stuff we found tons of still-sealed boxes of stuff. Exercise equipment, gadgets, a completely new ipad still in its packaging, a completely new kindle still in its packaging, all kinds of stuff. Also cash. Just little wads of cash squirreled away everywhere, I think it worked out to over $2k in mostly small bills and another couple thousand in hundreds. And of course, boxes and boxes and boxes of fabric. We had to throw out and donate a ton of stuff. Thousands of dollars of stuff. Now her freshly remodeled condo is super clean and empty, but she has three storage units (had to get a third to move stuff into when we emptied the place, lol) and it's going to be a lifetime for her to just slowly process through that stuff in an endless hopeless quest to get organized and reduce her living footprint to the size of her actual condo. She's 78. She's not going to live long enough to do it all. We're already seeing signs that make me think she'll need to be in some kind of assisted living within the next 5 years. I'm dreading what to do with all her stuff when that happens. She's going to fight any attempt to get rid of the good stuff. It's all sourced from trauma from her abusive prick of an ex husband, her life-long feeling of helplessness and mistreatment, it's clinging to control in a way that is ironically counterproductive as the pile of stuff actually reduces her real control of her life.
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Apr 11, 2024 17:05
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The hoarding thing is tough. I had a great aunt who was a hoarder, mostly of things like toilet paper, paper towels, food, cleaning supplies, and cigarettes. She also went through world war 2 in Japan so it was kind of understandable. Incredible how much poo poo she crammed in to a 550 square foot one bedroom
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Apr 11, 2024 17:44
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the hoarding was actually not like you see on TV, for my MIL. There was no like rotting garbage. The carpets hadn't been cleaned in a decade, but no dead animals or filth. She was using her bathroom sink as a kitchen sink, but she kept her plate and bowl clean. There was mold in the cabinets from the water leak but otherwise it was just piles of stuff that had become hard to navigate, and then infilled with boxes and clean paper and stuff like that. Some mold growing on the glass of the patio slider because stuff was stacked against it... she was getting to her patio by climbing over its small wall with a little stepladder, lol but yeah very thankfully - but also sorta unfortunately - not one of those situations where everything is tainted with rotten garbage and dead cats and cat piss, where 100% of it goes to the dump. Instead like most of it was recycling, donations, and salvageable belongings. Which will take forever to sift through because even though we got her to get rid of at least 50% of what was crammed into her condo, she kept the other half and there's the three storage units too. Her anxiety and anger is the tough part really. She's not angry with us, she's angry with the world and it makes her irrational about some things. Her condo association closed the local office and only accepts the fees paid online now, and that means she has to give them her email address, and she is furious about that. She likes to pay everything by phone or in person. So she used to pay all her fees a month or two in advance, and now she's past due. She put a fraud alert on her taxes with the IRS (for no reason) so she has to have an annual PIN and she can't find the one for 2023 so she hasn't done her 2022 taxes yet so she can't do her 2023 taxes yet. There's a phone number you call the IRS to get a replacement PIN but of course, it's April, there's a long wait, so she hangs up and is just mad about it. We all have to deal with that poo poo, it is frustrating, but she has no resiliency for dealing with fiddly annoying poo poo. We had to go with her in-person last weekend to an actual Xfinity store to get her signed up for internet and TV (and, sigh, a landline)... she's been on AT&T DSL. DSL! In 2024! She knows exactly what she needs, she was able to tell the guy at the Xfinity store, but just doing it, going there and saying "give me the internets, a TV package, and phone service" was an emotional barrier that she couldn't climb over for 3 months. Elder care can be a lot like that. It's not just elders who need nursing care. Some of it is just like being their emotional support to do all kinds of tasks that they totally can do themselves, but just won't until someone pushes them a bit or goes with them. The sense of being a bit lost and vulnerable in a complicated world full of traps and scams can overwhelm people.
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Apr 11, 2024 18:00
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hey guys im a Neuro/Psych PA (Psych CAQ) who works in inpatient psych and long term care. I'll be heading back to the hospital in a few months but will be keeping a few of the facilities I really like. i know....a lot....about this. If you have any questions about the diseases or the actual process of getting family members into LTCF, feel free to reach out.
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Apr 11, 2024 18:55
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Leperflesh posted:... no resiliency for dealing with fiddly annoying poo poo. I can feel this becoming me, heh. It is so hard to have patience with our own parents, we just aren't used to the dynamic flowing in that direction. But we gotta figure out how to do better with our own kids. On the subject of getting sucked into endless shopping/rabbitholes - our country has so many guardrails for kids, but so few for our old folks. I guess we can use parental controls on our parents as well (lock out that QVC channel), but they figure out how to circumvent it. I'd tear up all the checkbooks I could find, and she'd get her old friend who could still drive to take her to the bank to order more. Looking back on it though, in the grand scheme of things it all ended up being pretty minor. But for awhile I did live in fear that she would write something with a couple extra zeros on it, and I'd have to be in court to try to claw it back so she would still have money for the next years worth of care. Once I got POA though, I moved everything to a new bank she didn't know about, and left the one she was writing checks on with just a bit. Sort of an allowance. The bank still doesn't like bounced checks, but definitely better than the alternative. FizFashizzle posted:hey guys im a Neuro/Psych PA (Psych CAQ) who works in inpatient psych and long term care. I'll be heading back to the hospital in a few months but will be keeping a few of the facilities I really like. i know....a lot....about this. If you have any questions about the diseases or the actual process of getting family members into LTCF, feel free to reach out. Thank you!
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Apr 11, 2024 19:31
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As my mom's Parkinsons got worse, first my stepdad had to clean out her bank account and just leave a bit of money in there monthly after she nearly gave it all away to a scammer, and then eventually we just had to take away her laptop becuase she was just competent enough to log into Wells Fargo but her movements would randomly click things, stuff would pop up that she'd hyperfocus on, and she'd get in trouble. The worst was that she'd keep changing her account passwords every time she'd log in because there was a change password button and she'd mash it, intentionally or not, and think she needed to change it again. Her caretakers would just stand there and watch her do it because they didn't have the computer literacy to understand what she was doing wrong.
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Apr 11, 2024 19:43
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FizFashizzle posted:hey guys im a Neuro/Psych PA (Psych CAQ) who works in inpatient psych and long term care. I'll be heading back to the hospital in a few months but will be keeping a few of the facilities I really like. i know....a lot....about this. If you have any questions about the diseases or the actual process of getting family members into LTCF, feel free to reach out. As in will take questions over PMs or answer questions in the thread? One contribution I want to make in an effort post on getting rid of stuff that's accumulated. My parents aren't hoarders but did inherit furniture and stuff each time my grandparents moved from 2000-2010. That ended up being two apartments and one home as they continually downsized. In addition, my parents were hosting my brother and his ex-wife and former step-kid for a few years in the 2010s into the covid years. Then all that stuff was abandoned when my brother left immediately after the divorce finalized. I think I have removed over 1000 books and I'm not anywhere close to done. One thing that helped was joining a buy nothing facebook group. Yeah, you must be on facebook or use their app. It's also really dependent on your neighborhood line which has some legitimate criticisms. For bulk stuff like boxes of books and old holiday decor it's what ever drop-off charity place is closest. I feel like I'm wasting the time I could spend with my parents' in their final years packing forgotten and ruined holiday decor into bags when I visit. But they could be rendered unable to take care of themselves at any time. As i see it, I need to approach it like it's an emergency even if it isn't, we may have to make the house salable in a hurry. Sometimes I do find interesting items though like my dad's old motorcycle chain and boots.
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Apr 11, 2024 23:13
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Leperflesh posted:She's 78. She's not going to live long enough to do it all. We're already seeing signs that make me think she'll need to be in some kind of assisted living within the next 5 years. I'm dreading what to do with all her stuff when that happens. She's going to fight any attempt to get rid of the good stuff. In the future when she's gone have you considered just letting the storage units be sold off by the storage place? You could make some part time picker very happy. More seriously: When my dad died, he left a house and a condo just packed with stuff. Someone suggested I get in contact with an auction house, and it was a fantastic decision. The way it worked was they sorted *everything*. Personal stuff was returned to me or (with permission) tossed. The rest was put up for auction, with a % of the money from the sale of the properties and contents going to the auction house. Its been a while and I can't remember what cut they took, but I would have let them keep the whole amount just for how much stress and bullshit they dealt with that I didn't have to. You might be saying to yourself "she doesn't have anything nice!" The lady that I dealt with said you would be surprise what people will buy at an auction.
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Apr 12, 2024 22:27
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Oh she definitely has some nice stuff buried away. And like a hundred banker boxes of pieces of fabric. I have not actually put any thought into how to deal with it when she's gone, but my wife and her brother will probably want to go through it to pick out family heirloom type stuff and then we'll sell off or donate the rest. Estate sales are a thing and there's a whole industry set up to help with them.
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Apr 12, 2024 22:33
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Glad this thread exists! Excellent OP. My dad is recently divorced at age 74 and has cognitive/memory issues. He has enough money to comfortably live off of, but he's also obsessed with stock market investing. Feels like a disaster in the making. My sister and I finally got view access to his financial accounts and I'm already finding instances where he subscribed to the same service 4 times concurrently. He insists he's not doing risky investing, he's avoiding margins and options, etc. But all that could change the moment he gets a stupid idea from FOX Business. He's lost tons of money in the past on margins (one of the main reasons he's divorced, to no one's surprise!) Luckily my sister and I can takeover his trust at any moment. Has anyone had to intervene in their parent's finances before? Any advice? smoobles fucked around with this message at 17:12 on Apr 13, 2024 |
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Apr 13, 2024 17:09
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smoobles posted:Glad this thread exists! Excellent OP. There is also a Alzheimer's dementia thread in E/N if you haven't seen it. We were lucky that my husband's mother already had POA set up before we had to take in my father-in-law. We were also lucky that we never had to swoop in and guard him from doing bad things..she had also taken care of that a while back.
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Apr 13, 2024 19:10
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Leperflesh posted:So yeah it's a tough conversation to have and I think you have to try to find a way to position it that's not giving the impression you're just trying to assess your inheritance. "Mom and dad I want to help you figure out a way to keep your place up, can we talk about your finances and what your options are" might work? I went to my job's retirement benefits seminar and learned a lot there, then I used that as a pretext to have that conversation with my parents. My brother is also an actuary who works on some heavy megabuck deals so between the two of us we pitched it as "optimization of your current holdings". They're in pretty good shape and my brother supplied a bullet list of recommendations for them to follow to tighten it up even more. My biggest concern is that dad seems like he wants to get ripped off sometimes; not sure if he feels guilty for being very successful in a really sleepy rural area or what but there have been a couple of times he's let himself get played by former employees for a few hundred bucks at a time. Nothing critical, but as he continues to slip I worry that he's going to do something really high value foolish and leave him and mom hanging. KYOON GRIFFEY JR posted:Thanks, this is helpful and sort of confirms some of my concerns. For them "moving in to town" is moving to a town of about 12k, where my aunt also lives. There are more services, but not a ton. The moving closer to kids thing is tricky. They've mentioned it, but I am the only kid, and it would involve them moving in to a very HCOL. They could afford it, but it's kind of silly from a financial perspective. I also do not want them living too close to me. We have a good relationship, but it's one that works better at a slight remove, and I find it challenging to manage them. Right now they're a couple hours away. I do not want them closer than an hour. My parents live about an hour away from where they grew up and have indicated that they will not leave the area. Okay fine, but I'm 500 miles away and my brother us a few hundred farther and neither of us are in a position to drop everything to be their caretakers like they were for both their sets of parents. Similarly to you, my relationship with them works well when there's some space but I suspect that I will become mega resentful if I have to go to their house five times a week to take care of them. I am not sure how this will resolve.
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Apr 13, 2024 20:56
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I finally googled David Venable and you’re right, he is absolutely the #1 retirement remover my grandma and mom are addicted to, which is impressive given their homophobia. As a queer person idk how to feel. I guess it’s reparations but I would have preferred reparations in my direction??
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Apr 14, 2024 00:31
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abravemoose posted:As in will take questions over PMs or answer questions in the thread? Either. If it's something general I'll answer here, but if someone has something personal I'll answer over DM.
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Apr 15, 2024 01:27
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smoobles posted:Glad this thread exists! Excellent OP. Take over his trust. I had a patient with dementia who lost every cent the family had, over a million dollars, on phone sex operators. Are you the POA? Does he have an official diagnosis from neurology? would he sign over his accounts to you? If you want to force the issue you can legally become the conservator of his estate, but you'll need a lawyer to do that and you'll have to have a judge sign off. sometimes banks will let family put emergencies on his accounts, but I've never figured out how to do that consistently.
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Apr 15, 2024 01:33
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FizFashizzle posted:
We got close to trying to do this, but it seems to be a pretty drat hard thing to get done. I guess it shouldnt be easy! Luckily we got mom talked into giving us POA and she never revoked it, even though she would threaten every now and then, heh. Would like to hear from someone who actually went through the process.
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Apr 15, 2024 01:49
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Baddog posted:Would like to hear from someone who actually went through the process. There are a few ways you can it started. The first is that you need the diagnosis. A primary care provider can do this, but it’s better if a neurologist does it. The bar to clear to take someone’s conservatorship is incredibly high if you don’t have a real obvious reason. Neurologist diagnosis with appropriate imaging and clinical response to medication (donepezil) is one of those things. But you’ll likely never get him to a neurologist. Second is something undeniable happens. Lost in a grocery store and police had to arrive, car crash where he’s evaluated in the ED, something like that. Signing up for something four times isn’t enough. It’s gotta involve professional documentation. If his living situation is bad enough you can get APS involved but it doesn’t sound like this is that case. I’m talking people with poo poo on the walls and dead cats everywhere. You can also wait for him to get a UTI and require hospitalization. I don’t mean to be morbid but it’s only a matter of time. Your best option now is just to have a very serious, honest conversation with him. Don’t be confrontational, don’t try to trip him up, and just express your concerns as directly and calmly as possible. His biggest concerns right now are losing his independence. When you tell him you want to help manage his finances, he’s going to hear you want to take his drivers license and put him in a home. Unfortunately only you and your family know the best way to approach that conversation.
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Apr 15, 2024 12:08
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FizFashizzle posted:Take over his trust. My sister is the next designated trustee after my dad dies/is incapacitated. My sister and I can unilaterally (without a doctor) declare him incapacitated. We've got full view access to his accounts at the moment to look for problems. One question, for those of you who use Fidelity (or similar companies): is there a way to contact Fidelity and permanently remove options/margin loans, things that could wipe him out? I'm a little less concerned about him moving money between companies if my sis and I are keeping an eye on things. I also believe my sister and I can scare him into reducing how much he actively trades so he can have his fun hobby without potentially ruining his life.
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Apr 15, 2024 14:48
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