Friday, June 19, 2009

Brother wants to move mom in

As I expected, I got "the call" from my brother the other day. He wants to move my mom into his home. I must be painfully honest here, this brother and I have rarely got on well. While his initial intent is probably good, he has a way of trying to weasel things to his benefit and it usually turns out poorly for all involved. He is trying to be sensitive to our past and began this discussion with a voice mail: "I want to have a nice friendly conversation...." I dreaded returning his call but it turned out well. We agreed to discuss the idea and I told him it's my responsibility to play devil's advocate and look out for what's best for mom.

I had considered this scenario - Mom living with them - but it only lasted a few minutes then I dismissed it as unwise. I know just what my brother is feeling, we don't get along because we are very much alike in some respects. We both want to help family, we both want to make Mom's money last as long as possible; we both feel a sense of obligation to try and make her last years as happy as possible. That said, there are practical considerations that we must consider.

  • First is the amount of help Mom needs. I don't think my brother realizes just how much mom CAN'T do for herself anymore. Holding normal spoons and forks is hard given her weakened hands and failing dexterity. He is not the one who would help Mom; the burden would fall completely on his wife. Mom also has no chronic problems like diabetes or heart disease that would speed her passing. Aside from arthritis, her heart, kidneys, liver, digestion, etc.. are all good. She could live another 5 years or more. That's a long time to help someone who needs so much.
  • Second are personalities involved. My brother will not be the primary care taker; his wife will be the one who helps Mom. My sister in law and mom probably could not get along under the same roof. Mom is very intelligent and logical; she has years of experience doing many things and she wants to be involved. She also doesn't understand that others need to feel that their methods are meaningful too. I just know Mom would end up criticizing sister in law and it would sound insulting. Feelings would be hurt, anger would result and then resentments would build.
  • Third is money. Brother suggested that his wife (sister in law) quit her part time job and Mom pay them the same amount each month to live with them. Seems easy enough but they fail to consider that sister in law can leave work and stress then come home to relax. If Mom lives with them it's a 24-7 commitment. Brother and family are also not the best at budgeting; I know that soon they'd be asking mom to "help" round out their finances with extra money. They would not intend to take advantage but it always seems that something goes unpaid - the electric bill, the phone bill, the water - it's inevitable that they'd look to Mom for help and that's not acceptable. She's avoided helping too much thus far but living there would mean greater pressure and resentments on both sides. She doesn't help, they resent her and her prescence. If she does shell out more cash; she resents them and feels used.
  • Fourth is respite care for Mom. Brother has diabetes; sister in law has problems with knees and feet. They also babysit their 2 year old grand daughter. I live in another state so could not easily get there for emergencies and stay without advance planning. There is no one to stay with mom if they need a break for more than a few hours. They deserve some vacation time. Who would do this? How long could they go without a break? What if one of them has a medical emergency ? Their kids will want to be with their parent not staying with grandma.
  • Fifth are the conditions of their home. They live in a small place that is elevated by steep steps. Mom could not get in or out without a lot of help. Neither brother or sister in law can carry Mom; special ramps or something are required. There are no bars in their bathroom or shower. Door ways and halls are not wide enough for a wheelchair and remodeling is not practical. I feel the home is cramped for two people, a third with special needs would be so cramped as to cause great stress and inconvenience.
We have not had this conversation yet but these are the topics I will bring up. In the end, as Mom's Power of Attorney, I will probably say no but I will have a civil discussion. I know it's more about preserving the relationship with my brother and sister in law (for his kids more than anything else...). My brother is generous to think about moving Mom into his home but he and his wife deserve to think of themselves. I think the amount of work, emotion and patience required would cause too much stress for them. It's best that they conserve their energy for kids, grandkids, themselves and grandparents. They can visit Mom and take her out with the family instead of provide 24-7 care for her.

Signs your parent needs "adjustment"

Two main objectives to keeping your Elders at home are enabling them to do as much for themselves as possible and ensuring their safety. Often they will make minor adjustments for themselves to help get things done but we kids and grand kids we also need to OBSERVE and ACT to enable their day to day activities and be safe.

Be patient and prepare to do things like this often or RE-do them often. I see things during every visit that I can change for Mom to help her do things more easily. As she grows weaker, we often address the same problem again and again. When she began to have trouble doing laundry, we got front loading washer & dryer. Six months later stairs were becoming difficult and were impossible with an arm load of clothes, so we did a minor remodel and moved the new machines from basement to the kitchen. Three months after that we had to install a shelf to create storage for the laundry soap and softener at arm height so she didn't have to reach up or bend down to get at it. Within a few more months, she could barely lift wet items from the washer to dryer but she kept at it one garment at a time. She wanted to do it for herself so we enabled that through a lot of work and effort on our part. Remember if you care about your parent, Aunt, uncle or friend, you will help them to help themselves.

Here's a list of things that we did at Mom's that enabled her to do for herself and be safe. Be sure to read later posts with aging in place tags for more ideas:

  • Opening cans of food :
    moderate difficulty: get an electric can opener
    more difficultly: buy foods with flip top lids
  • Soda cans or bottles: Get Open Sesame - a multi-tool for cans and bottles. It works on flip top soda cans, twist off caps and has a magnet for storage on the fridge.
  • Opening jars:
    moderate difficulty: use rubber gloves, one to hold the jar and one to grip the top
    more difficulty: use under the counter mounted devices; these grip the lid while the user turns the jar, using rubber gloves to grip the jar is best. I don't have a specific name or source for these; I've found them in catalogs, dollar stores - I saw them in all kinds of places when I didn't mean to buy one and ordered one online when we did need it.
  • Stairs: often going down is more dangerous than going up - my Mom seemed to have equilibrium problems when looking DOWN and decending at the same time. Ensure that railings are tight and strong enough to hold up under a lot of use and a lot of weight. Can you install railings on BOTH sides of the stairway? Consider a ramp for short rises like from the back door to the yard. The most sure fire safe thing: get your Elder on one level - eating, relaxing, sleeping, bathroom and laundry. There are also more spendy solutions like the lift chairs that ride up and down on a railing; I've seen this only once and it was quite an expensive solution. I'd prefer to sacrifice a formal dining room or living room to get my Mom on one floor.
  • Medications and pills: This is one of the touchier issues with elderly folks. Often Elders underestimate the importance of keeping up with medications for a variety of reasons. This is another key issue to consider whether an Elder can no longer live alone.

    moderate difficulty: make a schedule by time and put it on the fridge, get a pill box labeled by days of the week or even morning, noon and evening. Fill it for them weekly.
    more difficulty: Call them with a reminder or hire an aid to visit regularily and remind them to take their meds. Sometimes aides cannot give meds due to liability but they can check the pill box and the schedule and "help your Elder remember" with gentle words. This person should also report back to the family if the Elder refuses, the pills in the box don't coincide with the schedule or other issues crop up
That's all for now, look for more installments as time permits.