Elder Care Part 3

The saga continues with my father in law's condition and care.

Yesterday, he was moved into a nursing home. It has been two weeks since the massive stroke that has left the right side of his body paralyzed and 25% of his brain affected.

My husband had to go to County Court to obtain a guardianship over his dad. Without a Power of Attorney, Medical POA, directive or living will, someone has to take legal control. My husband feels very strange to suddenly be responsible for all decisions affecting his father. I empathize completely. How sad the day you become responsible for your parent.

We are lucky though. When this first happened, there were no beds in the closest nursing home. We were told the nearest one open was an hour away. But one opened up and it's a pretty nice place. They keep the grounds and interior clean, attractive. The rooms are spacious. You do have to watch out for the old ladies in wheel chairs who drive with their feet. They can knock you over before you know it. It may be a form of bump cars or visitor bingo for all I know. Actually, I had a good feeling about it. I saw another gent I knew. He is a professional musician, a pianist, quite good. He was playing for the crowd. He's there too for rehab. His wife is hopeful.

Elder Care Part 2

So it begins...

My father-in-law had a massive stroke Wednesday night. My mother-in-law found him the next morning lying near his bed. He must have been getting ready for bed when he collapsed. The time frame between the incident and the ambulance arrival was too long to administer the medicine they give stroke victims to minimize damage. That has to occur within 2-3 hours of the stroke. As such, he's in ICU. His CT shows damage to 25% of his brain. His right side appears to be paralyzed. For the past 48 hours he's been in and out of consciousness.

My 83 year old mother-in-law cannot take care of him if he survives nor can my husband and I. He will require skilled nursing round the clock. We will look to Medicare or Medicaid for assistance. With an uncertain prognosis, we have to prepare for any eventuality..

If he lives, he will be put in a private, nearby nursing home for the first 120 days. After that, we are told Medicaid kicks in and he'll be moved to a state run facility at least an hour or more from here. We know that scenario. It's the same everywhere. If you're lucky, the facility is clean and decent. The help is always questionable. There are many dedicated people who work in this field. There are also many not vetted and uncaring as well. I think of the many issues, the bedsores, the neglect, the cleanliness or lack thereof. It's depressing. Of course, if he rallies and can be rehabilitated, that's another scenario in itself.

If he dies, his 90 year old brother wants him buried in the family plot in Kentucky. We'll have to have him transported. Having been through this with my dad in '07, I know what caskets, preparation for the deceased, funeral services and transportation cost. My father wanted to be buried in a military cemetery several hundred miles from where he lived. His plot was paid for by the government thanks to his military service. Still, when it was all said and done, we spent almost $5000 for a modest casket, embalming and preparation for an open casket, services and transportation.

I haven't looked in to transportation to Kentucky but I know it will be sizable. The death industry is not cheap. It's a business. Many of these places manipulate the emotions of the surviving family. Just picking out a casket was an incredible experience. I did it online as I was 3000 miles away and had to make a decision before I got out there. Luckily, I did a good job with my brother's help. I think the more modest one we chose was at least $1200.00. It was perfectly nice but not fancy. I think the cheapest one was $400-$500 but I never saw it. We actually got a discount on the whole procedure. Weird.

My brother and I were in synch on pretty much everything. There was no family discord, only cooperation, and boy did that help. When siblings or remaining family members disagree, legal wranglings can occur, particularly if there is no medical power of attorney and durable power of attorney. Those are two of the most important documents to get from each member of the family. Something to show the hospital with regard to the wishes of the patient as well as who is the designated LEGAL decision maker in these matters. A living will also covers these things.

In the end, someone has to make the hard decisions.

Post Script: My husband just called from the hospital. His father opened his eyes and recognized him and seemed to understand his son when he was told "I love you." My husband's relief in getting to speak to and be understood by his father was palpable. I am so grateful.

P.S. #2: I started this train of thought in April with my post Elder Care.

Elder Care

My husband is struggling with the question of what to do about his parents. They are in their eighties, living alone in a large house on several acres of land. They live on social security and a bit of savings and their health is precarious. His suggestion for the past year has been to get a reverse mortgage and use the money to live and stop worrying. His mother refuses to do so The Keeper colescottphotos.com

and this is at the crux of his frustration and fear.

Without going into details, he has a strained relationship with his folks. He has been a very good son, providing hard work, financial advice and emotional support. They are not easy people; too self involved most of their lives. There is no money. They spent it all years ago. His sister hasn't seen them in over a decade. But he has been there for them and now the decline is in full swing and he does not know what to do.

His mother claims she wants to bequeath the house to he and his sister; a nice gesture but not practical or realistic. Sadly, he cannot talk with her about it because she stubbornly refuses or claims she's too weak to discuss. We have talked about moving in with them but I just don't see me doing it. I think it would destroy our marriage.

I feel sorry for my husband because I understand the responsibility and sense of obligation he feels. I went through it with my father in his last years He was so stubborn. It was unbelievable!!!! Dad had money and he wisely gave my brother and I a series of powers of attorney to oversee it if he could not. But he was still a handful. Being 3000 miles away did not help. The year he turned 92, while he was still in fine shape, I found a beautiful level care facility of independent bungalows on an old estate with nine acres of trees. Dad refused to leave his home. He fired every home helper. He drove til he was 95 and my brother took away his keys. He ate little, refusing to spend money at the grocery. At 96, the cantankerous behaviour ceased. He was depressed and too feeble to resist. I was finally able to implement a routine. His last 18 mos were spent with 24/7 care by two loving sisters. He had good food to eat, lots of outings, his daily walk and was clean and happy. It cost $70k annually to take care of him at home but I had power of attorney and I felt it was money well spent.

My in laws have no such savings or hopes of this lifestyle. They refuse to give us power of attorney or any legal oversight. Without that, I am not sure what will happen. Everyone faces this. Few of us have the luxury to hire care for family members. If parents knew what a burden they place on us by refusing to give up control, would they still do it?