What to do about your aging parents in their final years

Taiwan Parenting
1

I just got back from visiting my folks. They’re both 80 yrs old, still very capable of thinking and speaking coherently and getting around, but it’s clear they’re aging rapidly. At age 80 the passage of 1 year is like the passage of 5 or 10 years at age 20.

There’s no denying it, they will gradually become less capable of performing everyday tasks, driving to the grocery store or the doctor, handling housework, laundry and gardening, they will increasingly forget to turn off appliances, risk increasingly serious car accidents, perhaps fall and break a bone, resulting in very long recovery period, etc. And eventually they may end up sitting there nodding off and peeing in their pants, waiting for someone to come help them out. None of that quite holds true yet, but I (and I think they) are aware that it’s likely to be transition of geometric progression, with things increasingly deteriorating and falling apart. . . until death. That’s just the reality of human existence.

One of my grandmothers was a tough old bat who lived to 90. The other 3 grandfolks passed away in their 70’s, so I expect that in 5 years my parents will no longer be capable of living in their big, beautiful house, gardening in their backyard, and driving about living their fairly normal independent lives. Perhaps in 2 or 3 years that might not be possible. Maybe in just 1 to 2 years.

So, I asked my dad if he’s thought about alternatives once they’re no longer able to drive about and take care of themselves. He knows that day will come; they’ve got lots of friends in their 80’s and 90’s who require constant care and who are dying off one after another.

Apparently he discussed various senior facilities with my mom a while back, but they haven’t followed through, so I think my brothers and I need to start doing some preliminary research and present them with options for discussion. They won’t pack up and move to Taiwan at age 80, so that’s out. Nor does either of my brothers seem to have the ability to take them on. So I think there are basically two options: (a) hire cooks/housekeepers/grocery shoppers/caretakers to live in their nice house with them (perhaps part time at first but maybe fulltime eventually, or (b) move into a senior facility. Regarding the latter, I started researching and apparently there are two kinds: “independent living” facilities and “assisted living” facilities.

I expect it must me heart-wrenching to accept the move into either, because it’s an admission that I’m a deteriorating old geezer working my way towards death, can no longer care for myself, and I’ll move into this place for the few final years as I waste away until I die. True, there’s bingo and yoga classes, but you’re holed up with a bunch of other geezers waiting to die. At least that’s my initial impression.

Some such places, like this one, look very nice, with golf course, swimming pool, hiking trails, etc., but that place must be affordable only for retired stockbrokers and CEOS and not most normal people.

rossmoor.com/about/about-rossmoor/1-homes

Anyway, I’m just thinking aloud, as I’m only starting to consider the reality and the possibilities. What are your thoughts/experiences in this area?

2

I left Taiwan primarily for this reason. My parents are now 81 and 82 and with my father just diagnosed with cancer, I am now doing the driving back and forth to chemo and other things like that. They still live – so far – in their own house and do things for themselves. But things would be very difficult were I still in Taiwan.

3

I left Taiwan for this reason.
The problem with nursing homes - it almost seems as if the staff is just taking minimal care of the people and waiting for them to die. The statistics show that a lot of people die within the first year of moving into a nursing home, and after seeing the one my mom finally moved into, I’m not surprised.
Assisted living facilities can be fine, but most people in them are still fairly functional. Once someone gets sicker or weaker, they’ll have to go to a nursing home.
For me, the best option would be to hire help so people can stay in their own home as long as possible. My mom hated living in the nursing home and always wanted to come back home. She was bored out of her mind, even though she didn’t do much at home either. But still, it’s your home, so naturally you feel more comfortable there.

4

I am moving back to Canada in Sept. just for the fact that my Dad, though strong at 76, is in his twilight years. I want him to spend some time with his grandkids, for me and him to supplement some of our own difficult past, and in general, just to have some good times.

Both my parents would die rather than live their life out in an institution. I agree, as we’re all of Norse-Scot descent, and we want to die in our own home, with our bootstraps on. I help them with expenses explicitly for that end.
MT, if no other option, go with the housekeeper over the facility. Remember the ageless adage about quality of life, and above all, that of dignity.

5

Good topic, MT.

My parents are already thinking ahead about what to do in the future. I will likely move to Austin, in the central part of Texas, after I leave Taiwan. My folks now live in near the most southern part of Texas, about 300 miles away from Austin. When I move to the US, my parents are considering moving and living in a condo or apartment near Austin so that they can be nearer my family, and more than likely so we can look after them better. It’s still years away, so we haven’t talked seriously about it. By the time I’m ready to move back to the US, my father will be around 78 and my mom around 72, so this will definitely be something we consider greatly.

One of my biggest fears is that their health will deteriorate before I even leave Taiwan, which would make it all the tougher.

6

Of course that’s true in part because most people probably delay the financial and emotional/psychological expense of giving up ones normal life/house and moving into a generic old folks home as long as possible, so by that point they’re closer to death. But I’m sure the other reason’s true too – that folks get seriously depressed upon making that move and may just give up and die, because they recognize that facility is pretty much designed for counting down the days to death.

Yea, I only just started googling the subject and thinking about it and was struck with the blunt realization of how sad it must be to move out of ones house into a place like that – even a good one – so I think you’re right and I’ll have to start looking into that. I guess one transitions into such services. They already have a cleaning lady every week or two. Eventually have to hire people to deliver groceries, etc., take them to doctor appointments, clean house more regularly, and then perhaps regular (even live-in) nursing assistance eventually.

So far none of that seems to be needed, but we all worrry about them still driving and eventually we’ll have to put an end to that, which should be a huge, decisive, humbling moment. Not quite sure how/when we’ll decide that day has come and lay down the law. Moreover, my mom can probably drive for another year or two longer than my dad. We probably ought to take away his keys now, but it ain’t easy. I had him drive me around a little so I could see how he did and he didn’t crash, but. . . . Hopefully we won’t take away driving privileges due to a bad crash, but will do so before that happens.

7

My folks just reached the 80 milestone. Last year it was decided that keeping up the house and property was more of a charade than anything else – considering all they did was write checks to the laborers who actually did the cooking, cleaning, yardwork, etc – and so we moved them into a retirement community. This is in the greater metro Phoenix area, where such communities are a dime a dozen. We found one owned and operated by the Hyatt Corp., which is considerably more upscale than my surviving sibling was comfortable with (seeing as how it would eat into her inheritance) but I prevailed. There was a waiting list and numerous hoops to jump through (financial, medical, and logistical) but we got them in sooner than later.

The community is structured thusly: independent living, assisted living, live-in care, and finally hospice. All care is adjusted according to the needs of the residents. My folks are able-bodied (although frequently forgetful) and live independently in the community. When it gets to the point, for instance, where they are not able of doing their laundry, they move up the to the next tier: assisted living. And so on.

It took the folks a few weeks to adjust to the change of lifestyle but now they love it. Having spent some time there myself, I must admit that it’s a brilliant set-up. Even though they are living independently, there is an army of professionals on staff to help them with whatever they may need. One day the old man was complaining about a phantom moldy smell coming from an A/C vent. A call was made to maintenance and 15 minutes later, a guy was out at the townhouse checking and changing every vent in the joint. And so on.

I know a lot of parents are stubborn and say they would rather rot in hell than enter some sort of institutionalized living but when you get to that age, it’s mostly bluster and pride. Both my parents were against the idea from the get-go. But as I said, now that they’re in there, they think it’s fucking genius and always complain that they didn’t move in five years ago. It isn’t cheap by any means, but I feel good about it, they feel good about it, and God forbid anything happens to them, I know I won’t have to catch the next flight to PHX. Meanwhile, the sibling routinely sends me spreadsheets detailing the amount of money this is costing her (in future “earnings”). The bottom line is, they are safe and sound and I can sleep at night.

8

Don’t put your parents in a home. They brought you up, changed your diapers, and spent time teaching you right from wrong. In Chinese culture, when people laud success, they usually heap praise on that succcessful person’s parents for doing such a good job.

If they are well enough, leave them alone. Once they start to deteriorate, that’s when you have to consider your options. If your brothers and sisters aren’t stepping up to the plate, you should then consider moving back.

I’m not sure where I will be in five years. We moved back to America for our kids’ education and to be close to my retired parents, but as you amass some experience in various sectors, some interesting options present themselves.

If the opportunity for me to be an expat in my field arises and the price is right, I’d jump at such a position. But family is family. If something ever happened to my parents or they were growing senile fast, I’d take a year leave of absence, unpaid leave, whatever, to make sure I was there during critical times and for an extended period of time. If I didn’t, I’d probably regret it the rest of my life.

Putting them in an old folks home is just so impersonal and it’s a quick fix easy way out.

9

When it’s my turn, I’m just going to go for a long walk in the Candian woods in the wintertime…

10

And then leave your parents there and run away?

11

[quote=“Chewycorns”]Don’t put your parents in a home. They brought you up, changed your diapers, and spent time teaching you right from wrong. In Chinese culture, when people laud success, they usually heap praise on that succcessful person’s parents for doing such a good job.

If they are well enough, leave them alone. Once they start to deteriorate, that’s when you have to consider your options. If your brothers and sisters aren’t stepping up to the plate, you should then consider moving back.

I’m not sure where I will be in five years. We moved back to America for our kids’ education and to be close to my retired parents, but as you amass some experience in various sectors, some interesting options present themselves.

If the opportunity for me to be an expat in my field arises and the price is right, I’d jump at such a position. But family is family. If something ever happened to my parents or they were growing senile fast, I’d take a year leave of absence, unpaid leave, whatever, to make sure I was there during critical times and for an extended period of time. If I didn’t, I’d probably regret it the rest of my life.

Putting them in an old folks home is just so impersonal and it’s a quick fix easy way out.[/quote]

I concur with your sentiments about family, however, certain parents don’t want the kids to put their lives on hold to take care of them. Let’s face it, I didn’t ask them to bring me into this world. In fact, I did them the favor of coming out of the womb healthy and happy. They way they see it (my parents – not all parents, I’m sure) I am their responsibility until the day they die. Not the other way around.

As far as it being impersonal to put them in a home, well, that’s a hard one to argue against. Perhaps it marks a difference between Western and Eastern family values. When you move out of the house at 18, never to return, the idea of adult babysitting is very hard to reconcile.

12

Two fuckin words, baby.

Ice

Floe

13

I left Taiwan 5 years ago to go home and help my dad take care of my mother after she had a stroke. 10 days later he fell down the basement stairs, breaking his back and smashing his head, which caused serious brain damage. I’ve been looking after one or both of them since then. My mother died in July. I’m glad I was able to be here for her last years, but looking after my father is very difficult. Emotionally it has taken a toll, and it has harmed my health, I’m sure.

My mother had to move into a nursing home close to 3 years ago - because she had become just too difficult to look after. My sister and I were hoping to be able to have her come home, but it never happened. The nursing home was horrible, but in Canada you don’t really have a choice - you go where they send you, which is the first available bed. In the States if you have money you can maybe find a good place, but here money or not is not the issue. Mother liked the nurses and workers at the home, but there was nothing to do there, and almost all the other residents were completely gaga. The worst thing was that the staff really seemed to just be waiting for the residents to die - two times someone should have phoned for an ambulance for my mom, but they didn’t. They didn’t even phone us. We visited, and saw she needed emergency care, and phoned the ambulance ourselves. We visited her a lot. Most of the residents, though, had no visitors, so what would have happened to them in an emergency? I’m guessing they just would have died.

Another problem, specific to my situation - I’m glad I moved home to be with my mom, but the fact remains that it has caused problems. I’m married to a foreigner, but the Canadian government won’t let him come to Canada. So what do I do? I stayed in Canada to look after my parents, but that means I can’t live with my husband. Now that my mom is dead, what do I do? It’s so hard to know what to do - stay here and care for my dad, or go abroad to live with my husband. If I leave, what do we do with my father?

14

My old man is quite adamant. If he’s the one left, he’ll go out for an early morning wild goose flight and accidentally step on his shotgun while crossing a fence. I firmly believe him, too.

15

The idea that you’ll take a year (or a few years) off to take care of a parent is admirable. But what if your parent has a slow decline, and it’s over a decade of them just holding on? How many years will you put your life on hold to stay beside a parent that can’t recall your name?

I’ve got a lot of respect for those that are working hard in hospice care. I also appreciate what sandman’s dad is saying; I feel the same way. But by the time your Alzheimer’s has progressed to the level where quality of life is gone, the family has already taken the guns away, or you’ve forgotten where you put the shells.

Edit to add: I hope my children never have to care for me 24/7. If I can no longer eat, sit up, deal with my own diapers or make any sense of the world, I wanna go. I’m guessing with the huge numbers of aging people and the prevalance of Alzheimer’s, the Kevorkians of the world will have end-of-life “care” down to a science by the time I’m ready to go.

Perhaps it will be a simple 3 question quiz that will determine when they pull the plug/give you the gas.

What is your wife’s name?
Who are your children?
What is your name?

Two right is passing.

16

true. bababa :notworthy:

true

Several years ago I first started thinking maybe I should move back to help them out, but I didnt. Instead I call them every weekend and visit twice a year (though sometimes I’d rather use that vacation time to go elsewhere, but I visit them instead because I figure their time is limited and both they and my daughter cherish time together.) So I believe so far I’ve made the right choice, not sacrificing my career and life here to relocate and care for them. However, I’ve been thinking further lately and maybe if I could land a good job in the Bay Area I would move my family back in a year or so instead of the 5-10 years that I had planned on. They’re still getting around ok at age 80, so the first year or so shouldn’t require too much sacrifice on my part – just checking in on them occassionally and helping with heavy chores on the odd weekend. But as their inevitable declines ensue, I guess I’d be hiring more helpers to assist them and checking up on the helpers, which also wouldn’t mean 100% devotion/sacrifice on my part. And, it would be nice being back in beautiful California again, I suppose, and enjoying thier beautiful house.

So, I agree completely with your point, but perhaps it needn’t mean total sacrifice. Of course, that assumes I can find good employment back there, doing the kind of work i wish to do, which in this economy seems highly unlikely. For now that seems to be the biggest hitch.

17

My mother fought fiercly not to be put into any kind of home. My “family” is so fractured anyway, that she was able to hold us off for a long time like this, even though we knew she really did not need to be living alone any longer, because my brother and I are distant–both emotionally and geographically from one another.

However, once we got her into an assisted living place, she LOVED it! She didn’t have to cook, didn’t have to do laundry–didn’t have to do anything at all. But then on Christmas day that year she had a stroke and her kidneys also failed completely. She had to be moved to a nursing home when she was released from the hospital. Though she’s gotten better, she’s never gotten better enough to go back to assisted living. One reason for this is the nursing home atmosphere itself. It’s depressing and she hates it.

She lost controle of her bowles with the stroke, but has it back now. However, she continues to use diapers because that is easier for the nursing home staff than gettting to her in time to help her toilet. That part really angers me. As for my mom, I don’t think it bothers her a bit any more. She couldn’t help it at first, and just got used to it, I guess. But it bothers me a lot that it doesn’t bother her.

My brother almost never visits her and he lives very near. I lived very far and visited twice a year at an expense that was quite great fro me because I am not welcome to stay with my brother, so have to have hotels. This also meant visits were much shorter than they needed to be. But when I was there, I took her out as much as I could manage. When doing that, she has to be signed in and out–so I know that he really was there only the two days she told me about. The staff told me that they’d never seen him and didn’t even realize that she had kids.

Now, I’m here and it’s frustraiting because, due to the time change, I can’t even talk to her much. She’s usually in bed by seven her time–I’m 14 hours ahead of her here. I used to talk on the phone to her almost every day.

Ours is a sad, sad situation. But it is what it is. Those of you with parents in their seventies and eighties, especially if they’re still able to get around and have their minds–you are really blessed.

18

[quote=“the chief”]Two fuckin words, baby.

Ice

Floe[/quote]

That’s why there’s no word in Eskimo for ‘Bournemouth’.

19

Interesting topc…
My mother is not too old (76), but she’s decided on her own to make the move into a sort of graduated assisted living apartment complex.
At one end of the community are independent apartments, at the other are apartments with 24 hour care.

Personally I find the idea of moving into even the independent area very hard to swallow, but I think she’s made the right call for a several reasons:

  1. Going early while she is still fit and healthy and has all her marbles means she’s actually able to deal with the move.

  2. She is single, and has just recently retired, so actually she is really excited about the chance to meet new people and make friends who live in the same building as her.

  3. As noted above the idea of sending your folks to an institution is pretty hard to take, but seriously, I don’t think many choices in the last 10-15 years of life are easy, or pleasant. The old idea of cold and mean institutions has given way to places (though driven by the market) that actually do try and provide a high standard of living.

Woah, I didn’t think I’d ever be defending old people’s homes, but here I am ; )

Anyway, I’m only fresh to Taiwan, but as someone who has traveled a lot and is not sure where I’ll end up, I think about this a lot.

20

Taiwan, of course, would be a much better place to get old and die. Everything’s so close and convenient. You could take the elevator downstairs and push a little shopping cart to the Welcomme store, walk to the local noodle shop for dinner, walk to the hospital to stock up on pills, walk to the park to play checkers with your old pals. Then, when you get older you can hire an indonesian or filipina lady to take care of you and push you to the park in your wheelchair and park you beside some other geezer in a wheelchair, to stare at the trees and drool, till finally the end came. No need to drive to the store, drive to the doctor, drive everywhere, or hole up all alone (except for your very high priced caretakers) in a big closed off house. Won’t work for my parents, because it’s too late to move to Taiwan for the first time at age 80. But maybe when my time comes. . .