Thinking ahead... any tips

[mysparkleismissing]

Evening all

My parents are in their mid-late 80s and live about 35 miles from me. Im the youngest of 4 and the closest by a fair few hours driving

They're in reasonable health just old age really

We have LPA for both elements and parents and their wills are recently updated. We know they wont want to go into a home and some brief funeral plans (d refuses to talk about his wishes)

D drives, M can but hasn't for years - M does all the finances D knows nothing!

Are there any thoughts or tips of things they/we should consider as they age.

One thing I would just take a note of for yourself is their wish to stay at home and for you to realise that is not always possible or the right thing to do so don’t promise you will do that. There are plenty of posts on here with people being run ragged because an elderly parent refuses to leave their home and their parents having crisis after crisis.
Would be worth looking into public transport options available. If not are there community transport services that will take them shopping, drs, hospitals etc.
also consider how your either will manage finances / cooking / cleaning etc. if they’re left on their own. Will they be able / willing to pay for help with housework or meals on wheels?
Find out where all their important documents are kept such as birth certificates, insurance policies, banks / building societies etc.
make sure you know which gp they are registered with.

It's hard isnt it! Would your Mum be able to get a taxi or a bus on her own if required? Perhaps you could suggest that she give one or both a try and your Dad too as he may not always be able to drive. Find a local reliable taxi company and give them the number and a give them a bus timetable. Can they use a mobile phone, a tablet or a laptop? If so, teach them how to do an online food shop. Set up online accounts for their utilities, insurances etc and online banking. Make sure that you have all of their private pension details, bank accounts, ISA's, life insurance details etc this will make things easier in the future. Find out when things like home insurance, car tax, insurance, MOT etc are due for renewal and make a note. Offer to help at renewal times as you may be able to save them quite a bit (older people can be very loyal to the same company). Ask permission to have a look at their bank statements, PIL had several insurances for appliances which they had not had for years and also keep an eye on direct debits to charities which they may have forgotten about and unknown direct debits/withdrawls which could be scams. PIL also had massive monthly bills to Sky which we reduced. As for care homes, none of us want our parents in a home if they are able to stay healthy and safe at home, however it became obvious that my PIL became unable to keep themselves safe and well despite carers visits x 4 a day and we had to put them in a home. It was not a pleasant conversation, but they were together and well cared for. Do try and have the end of life conversation, their wishes and complete an advance decision and statement for each of them online. Make sure that you have a record of their Nat Ins No etc. Find out what their medication is and what it is for (if they have medication) and keep your notes up to date. Consider suggesting that medication is delivered by the pharmacy if needed and is in dosette boxes. All of the above will help and make things a little easier for you in the future.

LPA for health does not give you total control, a doctor can still over ride you. So if the are certain of certain things they don’t want like a DNR/treatment for certain illnesses then you need to get an Advanced directive/decision written and signed by them before their faculties go. I was overruled by a doctor which caused my parent to have six months bedridden before they passed. Not what they would have wanted. We all think an LPA is enough but it’s not

They say they want to stay at home, but it can be lonely being home alone, old and frail, waiting for brief confusing visits from carers who are virtual strangers. A good care home can be a much better experience. My mum has made a good friend at hers and they have all their meals together! So don't rule it out.

Are they living in a property that is suitable long term for them i.e on one level or with the facilities to allow downstairs living? My parents downsized in their mid seventies to a very sensible 2 bedroomed flat, short walk from shops, lift to all floors etc. This enabled them to clear through all their things, sell or give away everything they no longer needed and they also gave their 4 kids a nice sum of money each to pay off some mortgage. Their wills are sorted plus POA,plus advanced directives and funerals planned/ plot purchased in cemetery.
But I think the most important thing is that they are living somewhere sensible for advancing age so they can remain as independent as possible and not get marooned in hospital unable to be discharged home because they can't do stairs etc. A downstairs bathroom with walk in shower is always useful.

Start getting D used to the idea that at some point in the next few years he will probably have to give up driving.

Do they both have passports ? It's increasingly difficult to do anything such as open a new bank account without valid photo ID so make sure they continue to renew them even if they have no intention of going abroad.

If D really takes no interest in their finances, then M at least needs to document things so that someone could pick things up if M is incapacitated - e.g. who is the house insurance with, when is it due ? What are their customer account numbers for the various utilities and how are they paid ?

It’s great that you are planning ahead to be prepared for whatever happens. It’s good to manage your own expectations that when things start to go downhill there is seldom any appetite from the elderly people to accept changes in what you consider to be ‘time’. It usually takes some crisis to precipitate each change, including if necessary more support that can be provided at home.

You know they don't want to go into a home... so try to find out what they would want to happen, and work out who would look after them, if they get dementia, or a long term disabling disease.

I say this not to be grim but because my grandparents live far from the rest of the family and said they didn't want to move closer. Then they both got dementia so now my mum and her brother are having a total nightmare taking it in turns to provide them round the clock care in their own home, so having to put their own lives on hold.

If my grandparents had moved closer to my mum/uncle before the dementia it would have been much easier, but now with dementia it's too late to move them.

I agree with the comments about care home. My DM always said the same but after many falls and hospital admissions there was no other option for her. In the last two years she's thrived! She has three healthy meals a day, has excellent care and a range of activities are on offer (even though she doesn't join in) It's also meant I and the rest of the family can rest easy knowing she is safe and well cared for and our weekly visits are more meaningful rather than just getting jobs done.

Agree with others, get your mum to document all the key things about the home/finances.

When my dad died I felt awful that mum could not drive, but in reality she was probably too frail to be able to drive even if she had passed her test. We sold the car, and she was able to stop car insurance etc. So that money could go towards taxis etc.

We have also initiated my F-I-L sending a family email every day to let us know all is well. There are also people in his village who could pop over quickly if there were an emergency.

These could be people like a gardener or cleaner who are paid helpers, or voluntary people like friends from church etc. If your parents have such people in their lives then having contact details, mobile number etc for them is very useful.

I hate to bring in dementia, as others say, dementia is awful. And could mean that they then cannot stay in their own home, and a home is really the best option. A person with full dementia cannot easily be looked after by just one other person at home - they might really need round the clock care. They might wander off etc. So, please do not promise they can stay in their own home whatever happens as it may not be possible.

My mum had dementia and was in a home which she helped to choose.

My mother-in-law now has dementia and is also in a home.

Good idea for a thread

Although they are older, it sounds like health/independence wise your DP are in a similar position to mine 5-10 years ago. With the benefit of hindsight my list would be:

• Think carefully and realistically about what you would be willing and able to do for them if/when their needs increase. Discuss this with siblings too- if you live closer would siblings agree to do things that can be done remotely if needed (eg managing bills/insurances etc). Then speak to your parents about how they would plan to manage any additional help they need, and how this could be funded. I appreciate this might not be possible in all families (my own included!)
• If their current home is not ideal for an older couple, encourage them to consider a move whilst they still have the health and energy. If you would intend to do a lot of 'hands on' care or frequent visits if needed consider whether any move should be to somewhere that would make this more convenient for you.
• Make sure whoever would be dealing with finances/admin if your DM can't knows how to access everything and where important documents are. Ideally get that person involved in making/checking a filing system for everything important. Some organisations will allow customers to nominate another person who is authorised to deal with their account (Mum's insurance company did this) which can make things quicker and easier even if you have LPA.
• If they aren't already, encourage your parents to get used to online supermarket shopping, prescriptions and other delivery services. If they have their own accounts for these things, ask if you can have access details in case they want you to help. If they struggle with the internet, consider arranging occasional deliveries for them so they can see how it works. Even if they don't need them all the time right now this will make it far easier if they are not able to get out and could be managed remotely so no need for someone to drive for hours to take things to them.
• Speak to them about whether they might want you or a sibling to be able to discuss their health with their GP (eg if they are unwell and might want you to call for test results etc). If they might, encourage them to give formal consent for this now. H&W LPA won't authorise this in most circumstances and it can be difficult to try to get the paperwork signed when they are unwell.
• Try to get them to discuss WHY they won't want to go in to a home, and the circumstances when it might be better for them (eg serious medical needs, dementia etc). Obviously they can't demand that family care for them at home if they ever need more than visiting carers could do but if you can have an open discussion about this it could help prevent family arguments and unrealistic expectations if/when things hit a crisis point.
• Try to get them to discuss end of life wishes in detail. My DM has always been adamant that she wants all and any available life extending treatment right to the end. We never really discussed what that might mean. She now has dementia and so we can't really discuss it (she doesn't fully understand it and finds any mention of the end of life very distressing). I have LPA and I suspect that I will be face and ethical dilemma and/or family arguments if she gets to the stage where she has very little quality of life and I am asked to make decisions about treatment/resuscitation etc. I can see circumstances where my view of what's kindest to her does not match her blanket statement that she wants all available treatments and I think some family members are likely to try to make things difficult for me if I make what they consider to be the wrong decision.

Yes, I was going to say this too. My mum has dementia and never in our wildest dreams would we have imagined a care home would be ok for her, (very feisty, passionate and independent woman!) but maybe due to the stage at which she had to move there, she was accepting and actually thrived from the attention and sociable side of it, instead of it just being her and my Dad in a quiet house. She also has a friend there. The staff are brilliant.

I always say this to people as it surprised all of us.

That's really interesting. My DM is adamant she doesn't want to go in to a care home but also doesn't want visiting carers because she wants someone around during the night, someone to eat dinner with/watch TV with in the evenings and these should be familiar people, not a different person each time (which she says is her experience of visiting carers). I keep thinking 'That sounds just like a small care home!'

It's not always possible to keep them in their home. Are they prepared to make sure their house is suitable? Stairs are a big issue, are doorways wide enough, bathrooms suitable for use with a carer, all trip hazards removed etc, etc? Will they consider moving if the house is unsuitable or not adaptable?

When we originally discussed care at home, there were two provisos which would mean staying at home would not be possible. The first was that it became unsafe for either or both of us, the second was if the level of care needed became too great.

Unfortunately we met both of those criteria just before Christmas. I've just had to move my elderly parent to residential care. Neither of us is thrilled with this, but when you are responsible for their welfare, sometimes their needs override their wants. It's hard, but they need to be aware of this.

Very good post !!