Worried about my grandparents.
August 13, 2009 7:24 PM Subscribe
My grandparents are getting to the age where they need some professional assistance, but they're very resistant to the idea of leaving their home or hiring anyone. How can we convince them that this is an appropriate step at this point in their lives?
So, my grandfather is 86 and my grandmother is 83. They live together in a 2-story dwelling, with the bedroom on the second floor (although they recently installed a chair lift). My grandfather has some arthritis and bad joints and whatnot, but still gets about ok, and even still consults for his old company a few times a week. My grandmother has had more health problems recently; her kidneys are shot and she needs dialysis several times per week. She has fallen at least five times in recent years - one time was a head-over-heels tumble down a full flight of stairs, other times my grandfather has come home to find her on the floor unable to get up. Miraculously, she has never had more than bruises from any of these falls. Mentally, my grandfather is still very "with it", but my grandmother wavers a bit - she can still hold her own in a bridge game, but sometimes seems very confused. My grandmother is also diabetic, and now with her kidney trouble, both her sugar and her salt intake need to be managed. It's possible that dietary issues are causing these confused states, but it's also possible that she's developing some kind of senile dementia.
The consensus in my family is that my grandparents, for the sake of their own health, should be living in some sort of retirement/assisted living village/home where the maintenance will be taken care of for them and there will be ready access to medical care and/or moves to a higher tier of assistance if needed. My grandfather has enough in savings for money not to be of issue. On a recent visit, my mother and my grandfather toured the local retirement village (individual cottages with attached garages), yet my grandparents both remain resistant to the idea of moving. It's possible that they will change their minds, but the rest of my family fears that my grandmother might have a more serious fall in the mean time.
My grandfather has always had strong independent and frugal streaks, and he objects to hiring anyone to do a job that he feels he can do himself - including taking care of my grandmother. I'm posting this question because it feels (to me and other family members) like nobody in my family will be able to convince him to take the right steps, and I'm wondering if others out there have been in a similar situation and might offer some advice.
So, my grandfather is 86 and my grandmother is 83. They live together in a 2-story dwelling, with the bedroom on the second floor (although they recently installed a chair lift). My grandfather has some arthritis and bad joints and whatnot, but still gets about ok, and even still consults for his old company a few times a week. My grandmother has had more health problems recently; her kidneys are shot and she needs dialysis several times per week. She has fallen at least five times in recent years - one time was a head-over-heels tumble down a full flight of stairs, other times my grandfather has come home to find her on the floor unable to get up. Miraculously, she has never had more than bruises from any of these falls. Mentally, my grandfather is still very "with it", but my grandmother wavers a bit - she can still hold her own in a bridge game, but sometimes seems very confused. My grandmother is also diabetic, and now with her kidney trouble, both her sugar and her salt intake need to be managed. It's possible that dietary issues are causing these confused states, but it's also possible that she's developing some kind of senile dementia.
The consensus in my family is that my grandparents, for the sake of their own health, should be living in some sort of retirement/assisted living village/home where the maintenance will be taken care of for them and there will be ready access to medical care and/or moves to a higher tier of assistance if needed. My grandfather has enough in savings for money not to be of issue. On a recent visit, my mother and my grandfather toured the local retirement village (individual cottages with attached garages), yet my grandparents both remain resistant to the idea of moving. It's possible that they will change their minds, but the rest of my family fears that my grandmother might have a more serious fall in the mean time.
My grandfather has always had strong independent and frugal streaks, and he objects to hiring anyone to do a job that he feels he can do himself - including taking care of my grandmother. I'm posting this question because it feels (to me and other family members) like nobody in my family will be able to convince him to take the right steps, and I'm wondering if others out there have been in a similar situation and might offer some advice.
When my grandparents started reaching a similar state, we talked to each of them individually about getting some additional help...for the other. They were both independent, private, self-reliant people who didn't want to admit they weren't 100% capable of taking care of themselves and who would never, never, never have considered moving out of their house. But they were willing to do things for each other that they wouldn't have done for themselves, and so
my grandfather was willing to have a nurse come a few times a week to help her, and she was OK with someone coming to help him.
We talked to the nurse separately as well to make sure she understood, and she was wonderful about making sure each of them felt it was a favor to the other. The arrangement made it possible for them to stay in their house until they died.
posted by picopebbles at 7:57 PM on August 13, 2009 [14 favorites]
my grandfather was willing to have a nurse come a few times a week to help her, and she was OK with someone coming to help him.
We talked to the nurse separately as well to make sure she understood, and she was wonderful about making sure each of them felt it was a favor to the other. The arrangement made it possible for them to stay in their house until they died.
posted by picopebbles at 7:57 PM on August 13, 2009 [14 favorites]
Cat Pie Hurts has made very good points.
With my in-laws, who are not quite where your grandparents are at but getting there, we "treated" them to a major, professional house clean-up after my FIL's bout with a severe illness about six months ago; and they were so thrilled that they're considering it again - but we suggested they do it on a smaller, more frequent basis, which is what's really needed. I do what I can when I visit, like getting them caught up on laundry. A diagnosis of COPD means that my MIL has legitimate reasons not to do certain things any more - she and my FIL just needed to hear it from a doctor (I find that my parents, as well as my in-laws, come from a generation where the Doctor's word is law, and they don't question him); and with my FIL's diabetes worsening, that means we may get in a company like Seniors for Seniors to help with the cat litters and checking the items in the fridge for food safety and other stuff that they're not keeping up on. They too are independent and frugal - but when it first a gift; then that it's their own idea, that it's a luxury they can easily afford and that they've earned; and they have the doctor's strong recommendaton to take it easier and to avoid certain tasks for their health's maintenance - they're coming around to it. With the right help, there's no reason for your grandparents to stay in their home, it's just that you're probably not the ones to suggest it to them.
posted by peagood at 8:00 PM on August 13, 2009
With my in-laws, who are not quite where your grandparents are at but getting there, we "treated" them to a major, professional house clean-up after my FIL's bout with a severe illness about six months ago; and they were so thrilled that they're considering it again - but we suggested they do it on a smaller, more frequent basis, which is what's really needed. I do what I can when I visit, like getting them caught up on laundry. A diagnosis of COPD means that my MIL has legitimate reasons not to do certain things any more - she and my FIL just needed to hear it from a doctor (I find that my parents, as well as my in-laws, come from a generation where the Doctor's word is law, and they don't question him); and with my FIL's diabetes worsening, that means we may get in a company like Seniors for Seniors to help with the cat litters and checking the items in the fridge for food safety and other stuff that they're not keeping up on. They too are independent and frugal - but when it first a gift; then that it's their own idea, that it's a luxury they can easily afford and that they've earned; and they have the doctor's strong recommendaton to take it easier and to avoid certain tasks for their health's maintenance - they're coming around to it. With the right help, there's no reason for your grandparents to stay in their home, it's just that you're probably not the ones to suggest it to them.
posted by peagood at 8:00 PM on August 13, 2009
My elderly grandfather lived with his wife, my step-grandmother, until she died, caring for her together with her grown children (who lived nearby) and a nurse who came to their house daily. It was actually great for him to have that help because it let him get out of the house for an hour or so everyday instead of having to constantly watch over his wife. It actually increased his sense of freedom.
So, I don't really have a strategy for you to use to persuade your grandfather now, but if your grandmother's health worsens and his workload in caring for her increases, you might be able to frame it in terms of just giving him a break now and then rather than "You are incapable of caring for yourself and your wife."
posted by Meg_Murry at 8:05 PM on August 13, 2009 [1 favorite]
So, I don't really have a strategy for you to use to persuade your grandfather now, but if your grandmother's health worsens and his workload in caring for her increases, you might be able to frame it in terms of just giving him a break now and then rather than "You are incapable of caring for yourself and your wife."
posted by Meg_Murry at 8:05 PM on August 13, 2009 [1 favorite]
I don't know how to convince them. All I know is that my uncle (86) and aunt (84) were recently convinced by their kids to move into an assisted living facility after being badgered about it for at least two years. And they LOVE IT. They are more active, they've made friends, their kids visit more often (the facility is more convenient than their house, which is out in the middle of nowhere), they have help with the cleaning and the cooking, etc. Oh, and they could keep their dogs! They go to cook-outs on the weekends and attend baseball games on the group bus that drops them off at their front door. Last thing I heard they were going to a casino with their neighbors to get their sinnin' on.
Do your grandparents have friends in assisted living that they could talk to? I'd keep taking them to see more places. Hopefully it'll click.
posted by BitterOldPunk at 8:33 PM on August 13, 2009 [1 favorite]
Do your grandparents have friends in assisted living that they could talk to? I'd keep taking them to see more places. Hopefully it'll click.
posted by BitterOldPunk at 8:33 PM on August 13, 2009 [1 favorite]
My parents lived in their home for close to 45 years. The house they lived in had plenty of stairs. Seniors and stairs are not a good mix. When they got to the ages of seventy or so, I tried to convince them to go into a retirement home, or something similar. I thought if there was one person they would have listened to, it would be me. My parents and I were very close. Everything would have been at their fingertips. They would have had a nurse on call, no house maintenance, daily housekeeping, plenty to do, etc, etc. My Dad was pretty against it for all kinds of ( so called) reasons. I think it was just his independence that he thought he'd be giving up. I ended up talking to a social worker about it ( thinking she could help me to get them to move) and I remember her last words about it very well. She said that at that age they have every right to choose how, as well as where, they want to live their final years. If they didn't want to leave their home for whatever reasons, whether valid or not ( to anyone else) , thats THEIR decision. As long as they know the risks. And she was right. You can inform them all you want, but they are the ones who make that choice. If you've done all you can to explain to them your viewpoint, then theres nothing left you can do. I still thought they ( my parents) should have moved, but they had the right to make that choice for themselves. They stayed there for about 14 more years before my Mom had a stroke and while in the hospital, my Dad developed pneumonia. They both ended up in a nursing home.
Your one line says a lot about how they feel, "leaving their home". Thats what they'd be doing. It may be a house or building to others, but its their home.
And what Cat Pie Hurts says. She has some very good points. Its definitely NOT a "crap" answer. Especially the frugality part. No one has walked in another persons shoes.
I wish you and your grandparents all the best from someone who's been there. I understand how your feeling though. It isn't a good feeling. But you can feel at ease about what you've tried to do. Its their choice not ours.
posted by Taurid at 11:14 PM on August 13, 2009
Your one line says a lot about how they feel, "leaving their home". Thats what they'd be doing. It may be a house or building to others, but its their home.
And what Cat Pie Hurts says. She has some very good points. Its definitely NOT a "crap" answer. Especially the frugality part. No one has walked in another persons shoes.
I wish you and your grandparents all the best from someone who's been there. I understand how your feeling though. It isn't a good feeling. But you can feel at ease about what you've tried to do. Its their choice not ours.
posted by Taurid at 11:14 PM on August 13, 2009
Best answer: Been there, done that, but it was not easy, and I was only able to persuade my parents to move to a retirement community when it was almost too late to help my mother. My father now acknowledges (of course) that he should have done it a lot sooner than they actually did (along the lines of what BitterOldPunk says about his aunt and uncle). What helped was that the place they moved to is 10 minutes from their longtime home, so they basically were able to remain in the same community they had lived in for 40 years. Also, my sister lives extremely close by. What ultimately persuaded them was that my father himself came to the realization that he could not take care of the house or the both of them properly anymore, once my mother herself became more disabled.
The thing is, that even when they did move to the retirement facility, they were living fairly independently there, so when things deteriorated more with my mother, my sister and I still had to armtwist my father to notify those in charge that he needed more help with her. He was still trying to do too much to care for her by himself, even though it was beyond his capacity at that point to do so (for example, he could not physically lift her by himself, and she needed that kind of help to get up and get clean.)
My point is, please don't think that getting them to a retirement community is the solution to all the problems, and the only way to persuade them really is if you can get them to persuade themselves - i.e. acknowledge that they need a bit of additional help that is beyond their own ability to cope. This last is by far the hardest part. You are dealing with the generation that grew up with the Depression, WWII, Korea, etc.. They are usually frugal, independent, proud, and reluctant to accept help.
Some version of what picopebbles did might perhaps work with your grandparents.
Sorry not to have better advice. I do know how difficult it is.
posted by gudrun at 12:57 AM on August 14, 2009
The thing is, that even when they did move to the retirement facility, they were living fairly independently there, so when things deteriorated more with my mother, my sister and I still had to armtwist my father to notify those in charge that he needed more help with her. He was still trying to do too much to care for her by himself, even though it was beyond his capacity at that point to do so (for example, he could not physically lift her by himself, and she needed that kind of help to get up and get clean.)
My point is, please don't think that getting them to a retirement community is the solution to all the problems, and the only way to persuade them really is if you can get them to persuade themselves - i.e. acknowledge that they need a bit of additional help that is beyond their own ability to cope. This last is by far the hardest part. You are dealing with the generation that grew up with the Depression, WWII, Korea, etc.. They are usually frugal, independent, proud, and reluctant to accept help.
Some version of what picopebbles did might perhaps work with your grandparents.
Sorry not to have better advice. I do know how difficult it is.
posted by gudrun at 12:57 AM on August 14, 2009
My grandparents were also very resistant to the idea of getting anyone to help with anything domestic or personal. That changed, very slowly and gradually. They started off getting someone to help with some decorating and gardening work that neither of them was strong enough to do any more, then, with advice from their community matron, found someone to come in a couple of times a week to help with shopping and laundry and a bit of cleaning. As with comments above, they didn't like the idea of having paid help, seeing it as a luxury they didn't need, but it was still better than having a 'carer' to come in. I'm fairly sure they both saw it more as being a help for the other one, each of them claiming to be perfectly capable of coping on their own.
A few years later, my grandfather fell ill and eventually died at home, supported by Macmillan and Marie Curie nurses as well as an agency care assistant and that same person who'd started off doing a bit of cleaning. My grandmother's health was also deteriorating, but she was also able to remain at home until shortly before her death even though she had to have people come in to help get her up, make her lunch - still that same woman who was just going to help with the laundry - and help her back to bed.
The community matron played a major part in making all of this possible, especially as my grandparents lived a long way from the rest of their family. I don't know if there will be anything in any way equivalent where your family are, but if they have someone to help and deal with different healthcare providers and agencies, they may well be able to remain, safely, as they wish, in their own home. Good luck.
posted by Lebannen at 9:20 AM on August 14, 2009
A few years later, my grandfather fell ill and eventually died at home, supported by Macmillan and Marie Curie nurses as well as an agency care assistant and that same person who'd started off doing a bit of cleaning. My grandmother's health was also deteriorating, but she was also able to remain at home until shortly before her death even though she had to have people come in to help get her up, make her lunch - still that same woman who was just going to help with the laundry - and help her back to bed.
The community matron played a major part in making all of this possible, especially as my grandparents lived a long way from the rest of their family. I don't know if there will be anything in any way equivalent where your family are, but if they have someone to help and deal with different healthcare providers and agencies, they may well be able to remain, safely, as they wish, in their own home. Good luck.
posted by Lebannen at 9:20 AM on August 14, 2009
A big change is much harder to swallow than a series of small ones.
Also, there is actually a lot to be said for keeping folks in their own home as long as possible. I firmly believe that my grandfather lived many years longer in his own home than he would have in even the nicest assisted living community.
Talk with their doctor or a local senior center about what kind of in-home help is available for them first. This might include daily nurses visits, home-health aides (that would remain for several hours, rather than simply for an hour or so), or other assistance. Also, see if your grandparents are amenable to finding ways to change the existing patterns in their own home -- for instance, is there a den that could be converted into a downstairs bedroom if needed? Do they need a handicapped-accessible downstairs bathroom installed? Even significant structural changes to their existing home might be less expensive than assisted living in the long run. Also, devises that can summon help if a person falls may seem silly, but can be a real lifesaver.
In my own case, my grandfather sometimes seemed slightly confused when in his own home; however, once he was removed from that environment (he was in a nursing home for two weeks recovering from surgery - he was fully mobile and not bedridden at all) his "confusion" became markedly worse and he became very agitated (and, I think, frightened) even when family members and familiar objects were with him.
Having them live in their own home might be a little harder for everyone, but there are a ton of in-home resources available for folks like your grandparents, with the aim of keeping them in their own home for as long as possible. Its my personal, honest opinion that if you can find ways to keep them happy and relatively safe in their own home, in the long run everyone will be happier with that option. Then, if the situation changes, they will see moving as another point on a continuum, rather than a big abrupt disruption to their lives.
posted by anastasiav at 11:01 AM on August 14, 2009
Also, there is actually a lot to be said for keeping folks in their own home as long as possible. I firmly believe that my grandfather lived many years longer in his own home than he would have in even the nicest assisted living community.
Talk with their doctor or a local senior center about what kind of in-home help is available for them first. This might include daily nurses visits, home-health aides (that would remain for several hours, rather than simply for an hour or so), or other assistance. Also, see if your grandparents are amenable to finding ways to change the existing patterns in their own home -- for instance, is there a den that could be converted into a downstairs bedroom if needed? Do they need a handicapped-accessible downstairs bathroom installed? Even significant structural changes to their existing home might be less expensive than assisted living in the long run. Also, devises that can summon help if a person falls may seem silly, but can be a real lifesaver.
In my own case, my grandfather sometimes seemed slightly confused when in his own home; however, once he was removed from that environment (he was in a nursing home for two weeks recovering from surgery - he was fully mobile and not bedridden at all) his "confusion" became markedly worse and he became very agitated (and, I think, frightened) even when family members and familiar objects were with him.
Having them live in their own home might be a little harder for everyone, but there are a ton of in-home resources available for folks like your grandparents, with the aim of keeping them in their own home for as long as possible. Its my personal, honest opinion that if you can find ways to keep them happy and relatively safe in their own home, in the long run everyone will be happier with that option. Then, if the situation changes, they will see moving as another point on a continuum, rather than a big abrupt disruption to their lives.
posted by anastasiav at 11:01 AM on August 14, 2009
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My grandfather lived with and took care of his senile wife until he passed away at 94. My mother, a geriatric nurse, convinced him to have an aide come by 3 days a weeks to help out, but she never would have considered putting him in an assisted care facility; the loss of freedom would have killed him much sooner.
Also, regarding frugality: your grandfather grew up in a time when frugality wasn't just a way of life, it meant survival. please don't begrudge him that and try to approach necessary expense in a compassionate way. I can't give you a good example of the right way, but I know the wrong way is saying, "you've got lots of money, it won't kill you to spend it".
So, you may not be able to convince him on your own, and it may very well take a bad incident to push him in the safer direction, but don't force anything on him.
posted by Cat Pie Hurts at 7:45 PM on August 13, 2009 [5 favorites]