Aging Parent Filter: how do your folks get food and transportation?
February 28, 2014 2:08 PM   Subscribe

People with aging parents (not newly retired, but also not ready for home care/retirement home): how are your parents getting food and transportation?

My husband and I are having a debate on taking care of elderly parents, and we're now wondering about the general state of how the elderly are getting by on their own who still have some degree of independence. For those of you with aging parents who are at the stage where they've been independent for a while, but are now slowing down (but aren't ready to let go of their independence)...

1. How are they getting their food? (Do they cook still? Does someone cooks for them? If so, who? Do they get food delivered? If so, by who?)

2. How are they getting around? (Are they still driving? What if you don't want them to drive? Are they using a service? If so, who and how do they contact them?)

Background on your parents' age/basic health status would be helpful.
posted by cranberryskies to Human Relations (21 answers total) 19 users marked this as a favorite
1. How are they getting their food? (Do they cook still? Does someone cooks for them? If so, who? Do they get food delivered? If so, by who?)

2. How are they getting around? (Are they still driving? What if you don't want them to drive? Are they using a service? If so, who and how do they contact them?)

My 88-year-old grandmother has a companion caregiver who goes grocery shopping with her and cooks for her. The companion caregiver comes in 2-3 days per week, for pretty much the whole day (6-8 hours) each time. She also takes her to appointments (medical and for things like the hairdresser), helps her in other daily living type ways, keeps track of paperwork and helps my grandma keep on top of it, lets us know if anything is amiss, and is in general an absolute godsend. We used to do all the shopping/transporting/etc ourselves, but it was extremely hard on relationships and things were always falling through the cracks. Of course, we still cook for her and send over food and stuff, but in a normal "family members caring for each other" way and not in as much of a caregiver way. If there's an emergency, like we all get snowed in, one of us will order takeout for her over the phone. The companion caregiver service is expensive, but less expensive than assisted living (we use Home Instead).

My grandma refused to stop driving until she got into a horrifying accident that nearly killed her and laid her up in the hospital and then rehab for months (luckily, it was right in front of us so we got her help immediately and nobody else was hurt). Her car was totaled, and we simply refused to help her get another.

She's in great health for her age, but she's still 88, so she has some issues with mobility (should use a cane but usually doesn't, not that stable on her feet, has trouble getting up from a seated position, etc) and she does suffer from some age-related dementia. She spends time alone in her apartment doing regular stuff like watching TV and puttering around, talking on the phone, etc. My mom calls to check on her on days when her caregiver isn't going to be there, and at least one of us will visit to take her out or have her over for dinner every week.

She's been able to stay in her own apartment, which she's lived in for about fifteen years or so at this point, and will be living there for the foreseeable. It's a very workable arrangement in terms of the workload for the family, she's safe and healthy, and she's in good spirits.
posted by rue72 at 2:37 PM on February 28, 2014

My mother went into an independent living situation (she is responsible for everything but they provide an apartment, which she furnishes, and meals) a year ago last October. Up until then, she was living in her own home, cooking for herself, and doing some driving (surface streets that she knew well). She was 76 when she moved into the independent living situation.

What precipitated the move was a medical crisis: she had a cough she couldn't shake and was overmedicated--common in older folks who react more strongly to medication--which resulted in her going to the ER. After that it was clear she couldn't stay home any longer and we found her a place, which she and I had been thinking about. But even before she got sick, she was having some trouble with cooking for herself and driving. She did not consider a home health aide of any kind or senior activities. I am about 2 1/2 hours by car from where she was living, so I could check in but not track her daily activities. She seemed fine from that distance until the crisis--but I trusted her on that and I was wrong. Mom was a widow; my dad died in 1987 and she did not remarry.

My great-aunt is 83 and still lives at home, and refuses to consider a different living situation. She gets by with the help of neighbors and a daily home health aide. I believe the health aide cooks for her; I know she's not allowed to cook (they unhooked the over after an accident in the kitchen). Errands are run by the friendly neighbors after the car was taken away from her because she lost her license. (She is four hours away from me and I have no way to get her into living situation closer to me. She'd probably curl up and die if I did, as she's very attached to her home.)

My husband's aunt is in her early 90s and in the last 18 months she and her 96-year old husband, who were living in his house, hit a health crisis. She is now in a care home with fairly serious Alzheimer's and he also needs to go into a daily care situation of some sort as far as I can tell. The situation was maintained as long as it was by dint of one of his children, who cooked, drove/ran errands for them, and administered medical care (she's a nurse in her day job). The effort of maintaining the daily care of two elderly people was very hard on this relative and there were a lot of family discussions about how to ease the burden before a medical crisis blew the situation up.

For all three of them, the biggest problem is deteriorating mental acuity. My mother and great aunt are in decent shape for their age physically, with most ailments under control; my husband's aunt is also diabetic with poor control, and has other difficulties, most of which are due to advanced age.
posted by immlass at 2:42 PM on February 28, 2014

My father is 80 and in great health. He does it all for himself, and lives alone. At some point here in AskMe, someone mentioned that they solved the independence vs. can't drive situation by hiring a taxi for their elder -- taxi service whenever they want it, in a pre-paid sort of arrangement. I can't find that comment, but I still remember it and hope to do something similar for my father if he is ever in a non-driving position.
posted by Houstonian at 3:00 PM on February 28, 2014

Found it! The whole thread might interest you, but I've linked directly to the comment about a taxi service.
posted by Houstonian at 3:03 PM on February 28, 2014 [1 favorite]

I can answer in regards to my grandfather who was generally in good physical health relative to his age (meaning plenty of the smaller old age issues) and good mental health. He lived independently until he passed away in his 90s.

The best thing for my grandfather as he got into his 80s was helping him move to a place that was very easy walking distance to shops, services and public transport (a couple of blocks). He could do small runs of grocery shopping or pick up some take-out or take his cat over to the vet without getting in a car. I think the interaction with other people and getting some exercise was good for him. He was still able to cook his own meals, although as he got a bit older, I think he got more convenience meals. I have a feeling we might have got him to try out "meals on wheels" when he got run down, which is the meal delivery service for senior citizens in our area, but he hated the food. The local government provided a free or discounted housecleaning service.

Family members would take him out for heavier grocery shopping runs, particularly as he got less capable of driving (it took longer than we would have liked for him to be ready to stop driving, but keeping the car in the family seemed to help). A senior citizens group would pick him up in a mini-bus sometimes to go on outings. He'd sometimes take taxis; as a senior citizen and veteran, he had a discount card for taxis.
posted by AnnaRat at 3:04 PM on February 28, 2014 [1 favorite]

There are organizations springing up around the country that help aging folks to remain in their homes by offering volunteer help with shopping, rides, house and yard work, etc. The model is membership-based with service provided by volunteers. Brian Williams did a story about his in-laws and their experiences with a 'Village'. The organization that I'm involved with in Seattle is called NEST. The granddaddy of them all is Beacon Hill Village in Boston. There's are a few in San Francisco too. Google 'aging in place - your city) Check them out and perhaps there's one near your folks. The financial aspects work very well for the services provided and the other benefits of connecting with community are fantastic. Big topic.
posted by lois1950 at 3:18 PM on February 28, 2014 [2 favorites]

Back in the '70s, my maternal grandmother stayed in her longtime home; all shopping, cleaning, and care was taken care of by the family: the old-fashioned version of aging, I suppose you could call it, with everything except when she was actually hospitalized handled by the extended family.

My paternal grandfather died in the mid- '80s; he'd slowed down some but was still in his home when he died. Grandmom moved into a retirement home not too long after that (her choice), then a nursing home as her health slowly failed: she did not want to be cared for in a family-member's home, she preferred a professional-care situation.

As my parents got elderly, my mother choose to stop driving altogether, and my father gradually restricted himself to driving in daylight only, and tried to avoid heavy traffic. I took over the vast majority of their shopping; they had a cleaning service take care of the interior and a yard service for outside. Like my maternal grandmother, they both stayed in their home to the end.
posted by easily confused at 4:06 PM on February 28, 2014

This depends on your city, but I can give you experience for Chicago:

1) DRS (Department of Rehabilition Services) offers in-home care based on an assessment. They help with things like laundry, cleaning house and sometimes even transportation to and from medical appointments. Sometimes they cook, other times they don't. Services vary based on exact needs.

2) Meals on Wheels. This is Also through DRS, and basically it is pre-cooked frozen meals with the elderly and disabled in mind. All it requires is to pop them in the microwave or oven. They have a good bit of varity but the people I know who use it generally supplement with something. In addition watching out for particular dietary restrictions is important at first to make sure they get it right.

3)Paratransit. In addition to Chicago's public transit they offer paratransit for individuals who have difficulty making it to the train. These services cost approx 3 dollars a ride each way and will go pretty much anywhere in the city with 24 hours notice. The wait-times can be frustrating (in terms of when you will be picked up and dropped off again). But it does its job and keeps people independent.

4) Medicar is the same service as paratransit but just for medical appointments. People on medicaid and medicare(I think) can use it. Very useful.

Chicago also has Senior Services Area Agency on Aging, which is the city helping organize services for individuals as well. They also help with some benefits, like medicare, medicaid and state specific benefits.

Many many social service agencies exist to help navigate this process.. Many provide so many services, from case management to adult day-care to simple writing groups! Ask around. Also, if you are from a particular ethnic community, there may be something catered specifically to your community. Here there is specifically the Japanese Senior Services for example. They will serve everyone, but do have some extra understanding of cultural components you may not find everywhere.
posted by AlexiaSky at 4:49 PM on February 28, 2014 [1 favorite]

I help my wife's mother with these types of items.... I utilize a medical transport service and a shopping service
posted by HuronBob at 6:11 PM on February 28, 2014

I sat on the board of a small non-profit that organized volunteers to look after the needs of the elderly. Volunteer activities included driving elderly folks to doctor appoinments, shopping, assisting with banking, and just providing regular companionship. Our community is one of the only places in Canada to get no snow in winter, so many retirees move here from back East, leaving family support networks behind. They need help.

Most of meager funding for the non-profit ($70K a year, less than an FTE) came from the local health authority and gaming grants.

Non-profits like ours were an integral part of the social safety net in our community, and were counted on to a certain extent by the health authority and the ministry responsible for seniors to help provide services - the gap between independence and relying on (ugh) a social worker (the next step is becoming a ward of the state and being placed in care).

So really some seniors rely on the kindness of strangers.

My own grandmother, who died a few years ago at age 95, chose to remain in her home, in a community relatively far away from my parents.

She also relied on a broad web of friends and contacts to help out. However, the final few years of her life were spent in the shadow of the 2007/08 financial crisis, when many people around her had lost their life savings.

She become a target of acquaintances seeking pocket money ($20 to go to the store for food) or even to become a beneficiary in her will (we had people actually try to take over her bank account).

For about a year my parents would make weekly 7-hour round trips to see to her affairs, and move forward the process of getting her into a home.

The challenge of course are parent-child dynamics, which in some ways never change, and my grandmother's resistance to my parents' efforts to help and protect her.

I think more than feeding a lot of attention must be paid to end of life decisions such as powers of attorney. It can become an extremely dangerous situation if the State determines the aged parent can longer make judgements on their own and no longer has the ability to sign a power of attorney etc with family members acting, like my parents, in good faith.

Besides the grifters, that was the greatest peril - that the social workers would take over, thereby giving the State a big chunk of my grandmother's net worth as essentially payment for taking care of her.

It worked out for my grandmother and my parents, but it was no sure thing.

So be proactive.
posted by KokuRyu at 6:20 PM on February 28, 2014

The best thing my Mom did was to sell the big old house, which meant getting rid of 35 years' accumulation of stuff, saving us untold headaches, so if you have parents who are aging, encourage them to downsize. Mom went to Independent Living, then lived with my sister, a nurse, for her last 6 months.
posted by theora55 at 7:53 PM on February 28, 2014 [1 favorite]

As far as meals, most people gradually become less able to safely cook. My grandmother's pathway was living completely independently --> senior retirement home (which had excursions to stores, but many/most were still driving, no meals provided) --> senior apartment with kitchenette but no stove after she had an apartment fire with stove left on (no driving at this point, 1-2 meals daily in cafeteria) --> nursing home.

Resources for food and transportation vary by needs and geographical area. In Tucson, we often refer our patients for home health after hospital discharge, and include a social worker visit to assist with program enrollment. A lot of our elderly residents living independently but unable to drive qualify for low-cost public transportation to and from medical appointments, and for bus passes for the rest.

A lot of municipalities fund organizations to assist the aged on the community. Ours is Pima Council on Aging, and they provide all kinds of services for people who qualify. They'll pay caregivers for 4-8 hours a week, whose job it is to help with bathing, cleaning, and sometimes cooking a light meal. I've also used them to help get patients' air conditioners repaired in the middle of the summer so they can go home safely, and they've even bought one patient a new refrigerator after his died. They also run our Meals on Wheels program.
posted by honeybee413 at 8:24 PM on February 28, 2014

The building I live in has 150 apartments - all 1 bdrm - for seniors over the age of 62. There are a few couples living here, but most are singles, men and women about half and half. Half the apartments are HUD subsidized and the others are market rate - all include full utilities. We have a coin-operated laundry, a small library and computer room, a free table, a gorgeous patio where one of the residents feeds the birds and everyone is welcome to add a trinket to the garden if they wish, and a grand rec room with big-screen TV, pool table, full kitchen, movie library. There's weekly Bingo, the downtown library comes once a month bringing books to check out, there are weekly BBQs, pot lucks, and some great music (we have two excellent singers living here who perform weekly), wine and cheese parties, etc and more etc. We also have a Social Service Director who is always available to help people make connections and locate resources when problems come up - she works the miracles that keep people from getting lost in paperwork, for one thing. We also have visiting nurses - nursing students who come weekly to do blood pressures, answer questions, help with foot care, etc.

Each apartment is an independent rental - they're unfurnished, very nice, but they're for independent living - there are no people to assist with ADLs and no meals are served here. Every year your apartment is inspected officially, and other times unobtrusively, like when they come in to check and renew the fire extinguishers, etc. Each time we're given 48 hours notice before they come in - unless, of course, there's an emergency.

There is no pressure at all to take part in the activities in the rec room; you can be as reclusive or as social as you wish. There are 15 floors, two elevators, and a secure entrance. The residents here keep an eye on each other. There are lots of mother hens who like to watch over the flock and its rare, though it does happen, that a person will fall or die in their apartment and it will take a day or two for it to become known. Most of us are hanging on by our bloody fingernails to keep from ending up in a nursing home - we value our independence and we cling to it. We also realize that it's overall a losing battle and that, little by little, we need more help.

There are several women and one man who are licensed caregivers who work for some residents; their hours and duties vary. Some are paid by the state, some are not. I have a lady who comes in every two weeks and does all my laundry, changes my bed, vacuums, dusts, cleans my kitchen and bathroom floor and bathtub. I pay her myself, but she does all that for $30 a go. And she's a doll - a friend - besides. I do my own cooking, though sometimes I let the dishes go and she'll do them for me. I still like to cook and eat, but again, that varies from person to person. Overall, the people here care about each other, even when there's some bickering and grumbling. When someone goes to the hospital, or worse, the place is subdued for awhile.

Our building is in the heart of downtown Spokane - not a big city, but a decent one. The city bus terminal with connections to all lines is five blocks away. Right in front of our building is a bus stop for three major lines. And our bus service operates a transit van for the disabled which transports anyone who signs up - and, of course, there are taxis.

We're allowed to have small pets here and most everyone has either a little dog or a couple of cats or a couple of birds. There are people going in and out all day taking their dogs for a walk. We're also allowed to have scooters and power chairs, but they must be parked inside your own apartment, not in the halls (fire regulations). The use of power wheelchairs is going to become more and more common and a new place like this should make some sort of niche parking or a room on each floor for parking or something similar - it's been a bit of a problem for some folks here.

I can't think, for the life of me, of a better arrangement for someone who's old and has physical problems and some doddering around behavior but who still has enough life within that he/she doesn't need or deserve full-time nursing care. If a person had a grand enough income that he could afford NICE assisted-living, that's one thing, but if the only assisted living he could afford is a glorified nursing home, please consider a place like this instead. I hope I get to stay here until I'm literally no longer aware of where I am, but then ... that's just what I hope, you know.

This isn't about my parents, but maybe it will have some information that will help you.
posted by aryma at 10:29 PM on February 28, 2014 [4 favorites]

Forgot to add that grocery stores do deliver up to $200 worth of groceries for $9 for seniors, and there are at least two pharmacies that deliver meds for no charge (other than a tip). There is a specific bus at the bus station that is called the Medical Shuttle; it runs every 20 minutes and covers the area with the most concentrated medical facilities. Bus passes can be purchased, or each ride is 75 cents for seniors or those on disability - and all buses have wheelchair access.

I think that covers it ... whew.
posted by aryma at 10:35 PM on February 28, 2014 [1 favorite]

I encounter a LOT of old people at work and need to know their living circumstances to know if they are safe at home. I would say that generally people who are elderly but in amazing shape are cooking for themselves and just maybe getting grocery delivery, people who are elderly but in good shape are maybe cooking sometimes but they are either getting meals at their assisted living facility or getting Meals on Wheels or similar at home, or some live with family and eat with the family. People who are elderly but are not in good shape are either on their own and hardly eating/nutritionally deficient/on the verge of some kind of medical issue that will prompt them to go into an extended care facility, or getting meals in their extended care facility (assisted living, rehab, or nursing home), or are lucky enough to either be cared for by family or have family who can afford an in home caregiver for them. I have seen a small minority of decrepit and extremely old, poor physical condition but mentally sharp people who have been able to stay in their own independent homes because they are able to afford to have aides with them 24/7.

Transportation I'm not so sure about because most of the folks I see are either being driven by themselves, family/friend, or ambulance, but I assume to less urgent destinations they use different means.
posted by treehorn+bunny at 11:22 PM on February 28, 2014

My grandfather is just 87. He lives in a rural area and still drives his own car.

He has someone come in most days who helps him round the house. He was offered meals on wheels but says they aren't appetising so most days his home help brings him a portion of dinner. He eats out with friends or extended family on Sundays.

He also has access to a respite care and day centre. He goes there at least weekly, and they coordinate his medical care.

Extended family (nieces and nephews) keep an eye on him. His grandchildren live in a different country.
posted by plonkee at 12:47 AM on March 1, 2014

My father is 86. He lives independently, still drives, still works, cooks for himself. We see him a couple times a week. I wish he wasn't driving at this point and he's getting a bit frailer, more wobbly but still very engaged and capable. He has a cleaning service and occasionally will hire someone to help with outside chores like leaf raking but insists on snow-blowing himself. Since we live in SE Michigan this is more than a little crazy but he is immovable on that issue.

My in-laws followed a path mentioned by many - they lived in an independent apartment in a senior living community with the main meal in a dining room. After my FIL died my MIL moved into assisted living first there, then near us because she was almost blind from macular degeneration and very deaf so living alone was really not an option at that point. She bounced back and forth between assisted living and nursing home a couple times the last 2 years of her life. She was 92 when she died.
posted by leslies at 6:32 AM on March 1, 2014 [1 favorite]

My dad is approaching 80 and my mom is in her mid-seventies. They live in the house they built ~12 years ago and they both still drive. My dad works part-time at a bowling alley and they both are on leagues there. They each cook at home, though my mom does all of the grocery shopping. They're considering putting the house on the market to move closer to me (I have half siblings but am my parents only child together) so as they age things will be a little easier for me to take care of (they live a four-hour drive from me now).

On the other hand, my mother-in-law is the same age as my dad and her health and mobility are a real concern for us. She's in the process of selling her home (it's under contract) and once that is done, she will be moving into my brother-in-law's house. In about a year or less, they both will be moving closer to us, too. I'm pretty sure she's not driving much right now and has a much younger friend who helps her with shopping trips and cleaning the house. She still cooks but she tends to make large amounts so she's only really cooking once or twice a week.

There are wonderful assisted living facilities in my city that we will be looking at for all three parents.
posted by cooker girl at 6:40 AM on March 1, 2014 [1 favorite]

I still have two grandmothers. One is 88, and recently moved into a retirement facility, and gave up her car about six months after that. Before that, she was living on her own and cooking for herself and driving herself. She would only drive during the day, and would rely on friends or family if she needed to go somewhere at night. At her new place, we're encouraging her to use the discounted taxis for seniors, as well as the van provided by the facility, though she insists on reminding us that she can always rent a zipcar. She now eats two meals (breakfast and lunch) a day in the cafeteria, and generally doesn't eat much for dinner-- just nuts or other snacks that she gets at Trader Joe's.

My other grandmother is older, and lives in an apartment in the same building as my father. He and his wife see her almost every day- they pop down for a drink in the evening just to chat and see how she's doing- and his sister sees her probably once a week or so. She also has in-home care providers who come 4-5 days a week to clean and cook and chat with her. She gave up her car a few years ago, and has recently gotten a mobility scooter, which has made life much easier and happier for her. She's now able to take herself downtown to the grocery store and pick up small amounts of groceries if she needs to, and she uses it to get to church as well. Before the scooter, she was pretty much home-bound because her hips are very bad, but now she's out and about on a regular basis (when it's not polar vortex time). I can't recommend the scooter highly enough; it has really changed her life. Her in-home care providers cook substantial amounts of food when they come and leave it for her to reheat whenever she wants a meal. They will also sit and eat with her sometimes, but I don't know if that's standard or just something she has asked them to do. She does cook for herself sometimes, but in a pretty limited way- I think mostly because she relishes not having to!
posted by dizziest at 8:40 AM on March 1, 2014 [1 favorite]

I'll second and third the mobility scooter. I spent two years indoors almost all the time before I got my scooter and the depression and sense of uselessness was overwhelming at times. The scooter has made life worth living again - it's honestly just that important.
posted by aryma at 3:37 PM on March 1, 2014 [1 favorite]

My friend is a driver for an elderly lady.
posted by St. Alia of the Bunnies at 11:24 AM on March 2, 2014

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