Chapter 2: Weighing the Options

She wants to stay in her house.  Her preference was made clear from the time she was widowed.  She does not want to move.  But can we keep her safe and keep her well cared for in her house?

I cannot begin a discussion on options for providing care for an elderly family member without discussing the topic of elder abuse.  Per the National Center on Elder Abuse, Bureau of Justice Statistics, 5,961,568 elderly persons were abused in 2010.  That’s 9.5% of the elderly population that year.  Fifty-eight percent (58%) of these cases involved neglect – the main problem we were trying to solve.  Twelve percent involved financial exploitation – a problem we were keen to prevent.  Mom needed what little money she had to pay for her care for the rest of her life.  We didn’t want to provide any unwanted opportunity for anyone – no matter how well meaning – to shatter her financial integrity.

Family discussions on providing better care for Mom revolved around three major options.

Option 1:  Find a family member or a college couple to move in and care for Mom. 

Pros:  Free rent in exchange for care would be the least expensive option.  Mom would be able to stay in her house.

Cons:  The person/people in question would likely not be professional caregivers.  And as much as we would hope to be able to screen a potential care giver, the opportunity for this type of caregiver to commit a form of elder abuse is quite high.

Option 2:  Pay a professional caregiver

Pros:  The person or company providing the care would be trained and licensed.  There would be a legal recourse if elder abuse were detected.

Cons:  It’s very expensive.  Caregivers charge an hourly rate; rates are higher if 24-hour care is needed.

Option 3:  Assisted Living

Pros:  24 hour professional care in a setting where she would not be alone.   We were surprised to learn that the assisted living facilities we researched were actually less expensive than paying a professional caregiver in her home.

Cons:  She would have to leave her home.

After the family meeting to discuss the options, and after all our research was done, we discussed the options – including the pros and cons – with Mom directly.  We decided together than she would consider assisted living.

Chapter 1: It's Our Turn

I wrote last week’s post, Prologue, to set the stage for this series on caregiving.  Suffice it to say that it is not fiction.

Per Caregiving in the U.S., The National Alliance for Caregiving and AARP 2009, “As our parents age, it’s likely a matter of when, not if, they will need our help.  Nearly 44 million Americans — 1 in 5 adults — are family caregivers for a relative or friend over age 50.” 

It’s our turn.  Dad died in August, leaving Mom alone in their big house.   In the few short months since Dad passed, we have watched as the Parkinson’s symptoms have caused her to lose mobility and feel almost constant pain.  While the informed sources on the Internet tell me that pain is not a classic symptom of Parkinson’s, most go on to say that most Parkinson’s patients do in fact have pain.

These sources also tell me that dementia and depression are symptoms.  We have observed evidence of forgetfulness.  She doesn't remember if she’s taken her pills.  She wakes in the night and becomes disoriented. 

And as for depression, well, I can’t even begin to comprehend the losses she’s suffered in so short a time.  Her husband of over 50 years.  Her mobility.  Her short-term memory.  Her independence.  Who wouldn't be depressed?  Who wouldn't be sad? And who wouldn't, at times, be angry?

Mostly, she is alone.  The regular visitors that came bearing food, gifts, and a shoulder to cry on stopped coming.  She can no longer drive, so she depends on others to transport her – but she really doesn't want to go anywhere.  She no longer feels up to going to church.  She no longer wants to go out to lunch.  She can no longer read, and operating the TV remote has become too complicated for her.  So she spends hours each day alone with her thoughts.

She seems to perk up when she has visitors.  Although she complains that food no longer tastes good to her, she will always sit down and eat something if it is prepared for her and someone else sits down and shares the meal with her.

It is clear to us that she needs more care than family visits can provide.  And she needs it sooner rather than later.  We have some decisions to make.

Prologue

She is frail.  Far more so than when last I saw her.  Was it really only two weeks ago?  Can she really be going downhill this quickly?

I take her arm and walk her to the car.  She weighs so little now that even I can support her easily.  She leans on me as I open the car door.  She sits awkwardly, unsure of how to adjust herself so she is facing forward on the seat.  My husband reaches in from the other side and pulls her toward him. 

It takes both of us to secure her seat belt.  He holds the strap across her body while I fumble for the clasp where the buckle end goes.  Finally we are all situated and back out of her driveway.

She is silent most of the trip.  I can only imagine what she is thinking.  Our destination is two hours from her home of more than 30 years.  We are meeting her youngest daughter, who has made appointments for her to visit two assisted living facilities.

She agreed to this visit last week.  In her more lucid moments she knows that she can no longer live alone.  But the loss of her independence must be unbearable to her.  For as long as I have known her, she has been physically strong, mentally alert, and the proud matriarch of her family.  So much loss – in so short a time.  Her heart must be breaking.

                “I’m as nervous as I can possibly be,” she finally admits.

We emphasize the positive.  You’ll be so much closer to family.  There will always be someone there with you.  They take care of everything.  They’ll make sure you get your medicine on time.  You won’t need to cook.  You won’t need to clean.   She says nothing more.

She is anxious to get out of the car when we finally reach the meeting place.  We are parked around the corner from the door to the convenience store.  We get her walker out of the trunk.

“Let’s walk inside and use the restroom,” I suggest.

She looks at the door and then looks at me.  “It’s too far to walk.”  I help her get back into the car and drag her walker to the front door while my husband drives her over.

Her daughter is there.  We go inside together.  We settle her into yet another vehicle for the second leg of this road trip.  We kiss her goodbye and assure her we’ll see her later that day. 

I turn away, hoping she didn’t catch the tears coming to my eyes.