Tips for helping elderly parents face reality?

[Pl242]

My MIL has rapidly declined over the past few years. Mostly a decline in mobility but we’re also concerned about possible cognitive decline too.

Things are getting worse but they can’t seem to see it and make changes to accommodate/mitigate it.

There have been a few incidents which we hoped would act as a wake up call. But so far all that seems to happen is that they talk about making changes then go back to muddling through.

We’re worried that if nothing changes then something really awful will happen such as a bad fall down the stairs etc.

But we don’t know how best to help them face up to the reality of the situation and to do so in a way that may encourage them to make much needed changes, but comes from them wanting to do that vs being browbeaten into it by the family.

Any advice?

Get an assessment by social services, and have a Memory check at the GP.

Maybe not the advice you want but let them fail their way. Don’t brow beat but quietly and efficiently add little things like that are future proofing. Like a key safe, or declutter busy walk ways, or take away rugs they trip over….

Really important to get things like power of attorney in place….also could a friend help persuade them? But they do have the right to make poor( or no) decisions….

Keep pointing out things that could “make it easier to live independently for longer”. Suggest they might need it for the future rather than they’re incapable now, the only reason to get it now is so it’s already in place should they need it. Talk about making life easier, don’t suggest that they can’t manage. Don’t pick up the pieces when things go wrong, let them feel the consequences.

Don’t talk to them in a way that suggests you think they aren’t capable.

Talking as an elderly parent here, not as a daughter! (I’m both)

Thanks. It’s just so hard knowing what to do. Hypothetically (cough) if your MIL had fallen down the stairs in the middle of the night and had a lucky escape, could you really hold your tongue when they say it’s all fine now because they’re leaving the landing light on overnight?

Why was your MIL heading downstairs in the night?

Also, what would you like the outcome to be?

Sorry, badly worded. What are you trying to prevent and what do you think should happen to do this?

She wasn’t heading downstairs. Had been to the toilet upstairs and fell on way back to bedroom, also upstairs (the stairs aren’t on her direct route back so no one quite knows how she came to be at top of stairs and what made her fall).

I don’t think the house is fit for purpose to what she needs. IMO they should move or at the very least seriously modify their set up somehow.

trying to prevent her having a serious fall in their house that will have significant consequences for her and risk her already poor mobility getting even worse/more serious/permanent.

does that make sense?

Totally get the worrying and I don't think you're wrong necessarily, but moving from a longstanding house when you're already declining cognitively is quite likely to make her more unhappy and confused.

It is also true that in a way she is making a choice - to have perhaps a shorter life in a place she would rather be, to take that risk.

I'd agree with seeing if she will agree to a memory assessment by the GP.

My dm was getting doddery, in her 80s but adamant that she didn't want people interfering.

We did it gradually. There was a bus strike and she wanted to go to the supermarket so I arranged a local lady taxi driver to collect her, take her shopping and bring her home. Once she's done it once, I told her the taxi would come every week and she didn't argue.

The same with gardening, dm had a cold one week so I arranged a 'temporary' gardener to do an hour's tidy-up. Then it was easy to move once a week.

Eventually she had gardener, Farm Foods delivery, visiting chiropodist, alarm button pendant, and cleaner. But she lived in a bungalow - no stairs.

I'd take it slowly, and pitch it as helping with individual issues to start with.

My DM's latest unrealistic expectation (she sounds similar in physical & cognitive ability to your DM, OP) is for me to take her on holiday to Italy. We only went to Morrison's for an hour this afternoon & that was exhausting, so I think a trip to Italy would be a killer - for me at any rate.

I went for the "I know you're not going to like me saying this, but have you thought about moving into a retirement flat." Then gave a couple of examples (I think the idea of moving can seem insurmountable when there are already mobility issues, the thought of finding somewhere, logistics etc so figured giving concrete suggestions might help).

So, I've mentioned it, indicated we would help, suggested it was better to seriously consider it before it was too late and then changed topic. I hope the ideas take root, there was no immediate shut down, which I took as a positive. Who knows!

What changes do you want her to make?

Sorry, see that it both your PIL, not just MIL.

Get OT from council to assess her home and provide adaptations, E.g. rails/handles around the house, step and handle for shower, high toilet seat, rise and recline chair etc. all provided free of charge.
Sign her up to Careline which does come with a cost

I have had this battle with my DM. She saw the possibility of a stair lift depressing and a visible sign of ageing. The wake up call was seeing how her own aunt (3years older) become housebound and worse confined to her bedroom because she didn’t have a stair lift. Thankfully both ladies have a stairlift now.

took mum to see a beautiful new build bungalow. But she said she couldn’t walk to the local parade of shops , 8 minutes away. Now she regrets not looking at solutions.

if she had a mobility scooter she could have gone to the shops its a flat walk.

current house can’t have a scooter because the driveway is too steep.

DM has had a spare bedroom decorated (because it needed it) with the view of being presentable should she decide to move. And in the meantime she is pleased her spare bedroom is looking fresh.

it’s difficult, parents can age suddenly. Its a matter of telling them they are today as mobile as they will ever be but that might change and no harm in future proofing.

Thank you for all the replies. Some conversations have been had between them and my DH since the most recent fall.

The main issue is that my MIL doesn’t want to make changes as (in her own words) “that would be like giving up and saying I’m disabled”.

We all completely understand what she’s saying and fully sympathise. She’s been having physio etc and hoping her mobility will improve. But we all think it is unlikely to and possibly the best realistic hope is that it doesn’t get worse.

So whilst we (me/DH, his DB/SIL) think there has to be change to prevent further accidents and to open up her life, ie she could get out and about more if she would be open to using a wheelchair, she would rather not do any of that because in her mind it equates to “giving up”. Even though this means that her life remains much smaller and her risk of further falls and injury remains high.

we think my fil is more persuadable to our view but doesn’t want to push her and feels overwhelmed by what making change would practically entail.

so unless she has a change of view we feel powerless to help improve things/prevent further accidents.

my DH has handled these delicate conversations really well imo. He strongly wants to protect her/them to change but he also worries that this belief (delusion) that things aren’t so bad/will improve is keeping her going and if we help/make her face reality then it might just completely depress her.

It’s all very sad and tough.

The main issue is that my MIL doesn’t want to make changes as (in her own words) “that would be like giving up and saying I’m disabled”.

IMO the Queen could have helped people a lot by being seen in a wheelchair and being more open about the modifications to her life that were undoubtedly made in the last years. A huge missed opportunity.

I agree with trying to implement small changes gradually, encouraging independence, so focusing on the positive aspects rather than the negative potentials.

That said, if she has capacity you cannot force her. Its hard because she'll be way more depressed if she ends up breaking a hip which then involves months of rehab and pain

I think the government has to change the attitude to ageing in this country. I LOVE the suggestion that the Queen could have been seen in a wheel chair, or using a stair Lift - what an amazing thing that would have been! There should be a campaign promoting AgeTech and mobility support. Perhaps a national design competition to make ageing products more desirable.

I have realised very quickly that my parents will not listen to me when it comes to possible downsizing or future-proofing the house. Firstly it has to be their decision anyway. All I can do is have conversations that skirt the issues and hope they pick up on what they could do to stay safe. I'm thinking of talking to their friends to see if they can make suggestions.

Frustratingly, there is so much cool new tech that could help them. I have thought that, as me and my brothers have always been the ones to help with tech issues, that might be the place to focus as they are comfortable with us being in charge in that area.

I also think that making it a bit of the lesser of two evils choice might help - Would you rather go into a care-home, or make the changes so you can stay at home?

Anyway, know that you are not alone, you are doing a great job, and it's their decisions and their responsibility.

afutureathome.com

@AgeinPlace such a sensible post. It would have helped my parents so much to accept that they'd had a great and active life but sh£t happens to everyone and there's no shame in it. I'm quite sure their lives were shortened and made more miserable by their inability to accept they needed help.

Let's have an Age-Positive campaign to get the conversations going.

We've done it with mental health, and to a lesser extent disability. What is ageing if not a combination of both after (hopefully) a life well lived?

Thanks for the replies. Totally agree with age positive campaign. Might be too late for my inlaws however. Another fall, now in hospital with a fractured pelvis. People keep saying maybe this will be a wake up call. I have been hoping that with the last five falls so I’m not feeling as hopeful. It’s beyond frustrating.

The main issue is that my MIL doesn’t want to make changes as (in her own words) “that would be like giving up and saying I’m disabled”.

Hi OP - I can sympathise with your DM because it needs a big mental switch and it's bringing home to her that she's getting older and frailer. I'm 69 and I went from being someone taking no medication at all to taking both BP tablets and oral chemo, and when you've a view of yourself as healthy/coping with daily life/whatever it's a big mental adjustment to a reality that's not very welcome.

The most important thing you can do it make sure you have power of attorney. Both for health and money. It is a lot of paperwork but it has to be in place before anything happens. Like an insurance policy.

Point out that it would allow you to pay the bills if either parent was in hospital or to help out with life admin.

Aside from that, all you can do is try to make the right decision easier.

@MrsDanversGlidesAgain i completely sympathise. I really do. But it’s got to the point that she is constantly putting herself in danger of something she won’t recover from. There has to be a tipping point when you have, for your own sake and that of all your loved ones, who are worried out of their minds as well as picking up the pieces (in all senses), that you try and make the best of your situation, however unwelcome the reality of that might be?