WWYD. Agening parent dilemma

[cressetmama]

Please give opinions... MIL is 86, widowed, solvent, becoming frail both physically (scoliosis) and mentally (a touch absent-minded, not really dementia) but lives 300 miles away, at the other end of the country. Moving closer is not an option as DH has a business locally, DC are in school, etc. Me: SATM, so flexible. DSIL is difficult (very complex story) but located nearby to DMIL, and reluctant to lose the frequent financial help that is on offer every time she bleats.

We would like to move DMIL to a nice warden assisted block of flats in a pleasant market town near us, where everything would be within walking or mobility scooter range; however, the matron thinks she might be too old to settle. Where she is, she still has a few friends locally, plays bridge and drives (close your eyes please). Money is to be considered, but not a serious problem. DH would like to see more of her during what are likely to be the last few years, and I am happy to do whatever is necessary.

If she can't remember where she's going then you don't know she's going to stay within 5 miles of home. Nor can you rely on the fact that people will make allowances for her.

cresset I hope I don't sound unsympathetic - I've been through this and it's been nothing short of a nightmare, with lots of hurt feelings all round.

I was the wicked witch of the west for a long time after getting my mum off the road, but all of her neighbours were mightily relieved - it was just a matter of time before someone got hurt.

That's the plan for this week Daffs. I so hope she likes it; the stress on DH is worrying me. I just fear that she is getting locked into a circle of thoughts, on, off, on, off. We have been having this conversation for over a year.

It sounds like your DMIL is still quite capable of living independently, but you and your DH are looking to rush to the next step out of good intentions around guilt and obligation - getting her sorted somewhere safe sooner rather than later? Whose needs are being met if you and DH get your way right now? This is all about timing - she might be fine where she is for another 5 years or an escalation in a health problem could end the current set up in days.

Do the research with her exploring options.

Can she stay in her home and community with family and friends close by for as long as possible. Can you arrange a rota of carers, family friends etc?

If she is being resistant and you have real concerns about her ability to live independently ask her GP for an independent living assessment - then it is a professional decision.

I am concerned about the driving - with all due respect your DH is not qualified to make the judgement that she is fine to drive and this is at odds with his assessment that at the same time she is not able to live independently? Again this should be assessed by professionals who will make the call if she poses a risk to herself or others.

I have been in this situation and all I can say is that you need to have all options researched and approach it as a long game a series of "nudges" whilst watchful waiting. Good luck.

I've missed some posts as they have come in but thank you to everyone who has taken time to read this thread. Not sure there is a RIGHT answer to my question but I'm keen to hear new ideas. I'd just like a resolution that doesn't mean DP is driving to visit his mum for 14 hours a week every week, on top of running his business which is often demanding.

Been there, done that, bought the Tshirt! My own mum is now safely and comfortably ensconced in an assisted living facility close by. We waited a little too long and it was a pretty traumatic time, too long to go into here!

It's never too early to make plans, even if she doesn't want to move today. The time will come, probably sooner than you realize, when it will be more convenient for all involved for her to be closer to you. And as her memory 'goes' the time may come when she isn't able or willing to make these decisions on her own. Dementia can make even the most kind and even-tempered person angry and suspicious. This is what happened with my mum, and we were just lucky that we were able to find a very nice place for her that had an immediate opening.

We were very lucky with my mum, she 'self limited' her driving to the grocery, church, and the doctor's, all within 3 miles of her home and never drove after dark. BUT the day we found out that 1-she'd gotten disoriented on the way to her doctor's office and 2- she'd been 'giving people (strangers) lifts' we knew it was time for her to stop. We were lucky that she agreed and voluntarily gave us her car keys. And that my brother was retired, and that I retired soon afterwards. Once they stop driving, the demand on their children's time driving them to and fro to doctor's, shopping, church, Sunday drives etc is unbelievable, especially if you are still working.

I wish you much luck. Dealing with aging parents is difficult, at best.

It takes him 7 hours each way? Is train an option- or plane?

I'm not being unsympathetic either but need to ask if this is about his and your 'guilt'- maybe realising late in life that you never did enough before- and over reacting now? Surely a fortnightly or monthly visit is ok? My own elderly parents are a similar distance and I try to go every 2- 3 months, as I'm working and staying for 1 night is too tiring, which they are happy with as I have siblings closer - like your DH.

I go back to what I said before which is your DH out to ask her GP for an assessment at the Memory Clinic (dementia care and diagnosis) and an assessment re. driving. Once you know those outcomes that may take 6 months on the NHS then you can all reassess.

I think you have to appreciate that moving house at 86 is a huge step and the other option is a team of carers who visit her plus local taxis if she can't drive. An assisted care flat may not be enough if she does have dementia and you could set all of that up then have to sell in a year or so if she has dementia that is progressing quickly.

You need a medical assessment before you can make changes.

Guilt does not enter into this; distance and declining health are the issues. If there were a better transport option, we would use it. We live at opposite sides of the country and there is no obvious direct link. We don't visit every week yet; sorry if that seemed misleading, but in the next 10 days, DH will drive up and back, bringing MiL back with him, if she feels well enough to sit in the car for about six hours; she will stay about a week (of which I am guessing three days will be spent in bed, based on the last two visits since Christmas) and then will need to be taken home, a second 700 mile round trip. There was a suggestion that DSiL would visit for the second weekend and take MiL back; meeting half way would help, but we aren't hearing helpful noises!

If you move her to sheltered housing near you - then are you just creating he same problem for her friends and family at home as you DH has now ie they will then have to make a 700 mile return trip?

What is the issue with carers coming into her home or sheltered housing near her home where her local friends and family can support?

I think you might be jumping the gun with regards to her needs and maybe some interim steps (eg building up carers at home) would be useful right now and the assess how she deteriorates over time?

What does she get out of moving a 700 mile round trip from her friends and family? Maybe just build in more overnight visits - maybe treating yourselves to lunch/hotel stay to ease the stress?

Is your MIL asking to visit and undergo the journey? Or does your DH feel he 'has' to? It may well reach the stage soon where the journey is too much; my parents are older and can't contemplate a journey of 5 hrs .
If she is happy at home and has friends, why is she being brought to you so often? ( every 10 days??). Or is this not the case?
I get the sense that - this is based on your first post- that this is being driven by a 'time's running out' idea from your DH rather than your MIL saying she wants more contact or a change in living circumstances.

If this is not the case, then your DH needs to talk to his sister and tell her in a no-discussion way that she should share the driving of their mum to you.

But why a visit every 10 days anyway? I love my parents to bits but due to distance, my work and their inability to travel, we are all happy with a visit from me every couple of months. It doesn't sound as if your MIL is lonely or short of things to do. Aren't you putting yourselves under pressure when it's not necessary?

I watched PIL go through this at the end of GFIL's life, and it is not easy. Part of the problem is that we don't plan for ageing very well, and that ageing is for many people not a smooth and linear process. Things suddenly happen - medication goes wrong, an accident is had, something deteriorates and all of a sudden, huge decisions have to be taken about accommodation because older arrangements are suddenly not suitable. While the potential negative effects of a move shouldn't be underplayed, I think many families ultimately know that some change in living arrangements is going to be necessary. Facing this head-on is helpful. Otherwise, the inevitable move can end up happening at the worst point - when the person is ill, vulnerable, needs a community around them, and is in bad shape for decision-making.

One thing I learned from watching PIL is that it is much, much better and easier if things can be planned in advance, and if the person at the centre of it all can make positive decisions for themselves. However, I also saw how difficult it was for older people to accept the narrowing of their physical and mental abilities and to budget for it getting worse (and I completely understand this, who wants to think about it?) Not everyone is very rational about saying 'Actually I can't do this or that task anymore' - in my GFIL's case, he swore blind he could live independently when he absolutely clearly and obviously couldn't.

For this reason, I do think staged retirement housing where people can move from independent living to residential care are a pretty ideal solution if funds are available for them. It allows that psychological and physical freedom to continue for as long as possible, but with flexibility for the future.

I wish that there were advisors who were also counsellors who could be visited as a family in order to outline the options and facilitate decision-making.

Thanks Holly! I was beginning to feel like some kind of manipulative dominatrix.

No, not at all. I think it's really, really hard and every situation is so different that there is no one-size-fits-all solution. A lot of people have the kind of mentality of 'we'll deal with it when we are forced to do so' but my experience has been that this can lead to disaster.

Holly is 100% spot on! People really do bury their heads in the sand when it comes to aging and living arrangements. My own parents had outlined what they wanted 'when the time came'. But when the time came that Mum could not continue living at home, dementia had started to make her paranoid and suspicious, and she felt that she felt we were 'drugging her' and 'stealing her money'. It was horrible.

I think that our generation is really hard-hit with this, more than previous generations. Years ago families had more ability to have an aging parent move in, more children lived closer to aging parents, families were larger so the care responsibilities were more spread around, and (brutally but truly) aging parents died younger, many of them before the ravages of dementia really took hold. I also think that 'living independently' wasn't as big a 'thing' to our grandparents generation, they expected and tolerated 'help' from their children. Help that is sometimes now thought of as 'interference' by the elderly relative.

I was very lucky that my parents lived nearby and that I had a brother who was able to move in with Mum after Dad died, but after awhile, even that no longer worked. I cannot imagine the nightmare of 'long distance' care such as the OP and her DH are trying to deal with.

cresset, you are NOT being cruel. You are being wise. If SiL cannot be 100% depended upon to be the primary carer for your MiL, then she needs to live nearer you.

I don't know much about the practical arrangements but I do know, from friends who live in one, that there are care complexes - villages, almost - with apartments that address various needs. eg my friends are ancient but the wife is as sprightly as ever, whereas the husband is going downhill fast, both mentally and physically. They have an apartment in one part of the (palatial!!) complex but will no doubt move to another part when the husband's needs are greater. All under one roof, as it were.

Amazing communities, too. I wouldn't mind living there! (I'm serious!) I appreciate my friend's 'village' isn't cheap but isn't it a model that is used throughout care/living complexes for older people?

(apologies I'm using the wrong terms though)

My friends moved there at the start of signs of trouble with the husband's health, so they were ready and settled should things (inevitably) get worse for him.

A lot 'easier' when it's a couple, though.

DH's grandma was 250miles away in the house she had lived in her whole married life. She is now in a warden assisted flat. It took a few years to persuade her to move.

She had loads of friends but they started to get ill, die or move closer to their children. In any event, noone ever visited at weekends, she often went Fri-Mon without speaking to anyone.

In the warden assisted place now she spends loads of time in the lounge and has a busy social life, local churches organise monthly lunches and trips.

She rents her flat, round here there are so many flats on the market people often struggle to sell them and choose to rent. Definitely worth considering, it's much less hassle and it meant the house didn't have to be sold before she moved.

The move has been talked about, in general terms, for a couple of years now and until last summer the decision was that DMiL would prefer to stay put; then she changed her mind, and said she would like to be closer to DP and her grandchildren. But now, she hardly remembers what she has said, done or asked between phone calls and forgets appointments and arrangements constantly.

The warden assisted place we are going to show her next week (and a couple of others for comparison) has an active programme of National Trust visits, theatre and concert outings etc. As well as the onsite warden, it is the base for a team of carers who will do as little or as much as required, and we shall be 20 minutes away so able to dash round as needed. The doctor's surgery and pharmacy are next door, and the town (which she knows reasonably well from visiting us for 20-some years) centre starts about 100 metres from her door.

With 20/20 hindsight, it would have been better for the move to have happened while DFiL was still around; we just hope that we haven't left it too late!

to everyone for their thoughts, advice and comments. We shall see how things proceed. First the apartment has to appeal!

Please God!

Let us know how it goes op

I think it sounds an ideal situation. She'll have things to keep her busy, you'll all be nearby, and I'm sure she'll make new friends.

Honestly, if she likes the place (or another suitable one) I think you'd do best to 'strike whilst the iron is hot'. Would she have the ability to move before her home is sold? That was the one saving grace with our mother, that we could move her in before she changed her mind. Granted, she was much further gone with dementia that your MiL appears to be so in some ways it was easier to convince her. There was some upset afterwards but she calmed down soon and has been happy there since.

Best of luck to you all.

I don't think the elderly are being difficult with their dithering, I think they actually can't make decisions.

My DM asked me what flowers she should get planted in her tiny front garden (now that she was too old to plant it herself) --- after 70 odd years of doing her own garden, I was gobsmacked - sadly she just couldn't make up her mind for herself, it was making her worried and anxious trying to decide!!

So I would tell your DMIL this arrangement (in the new flats) is what is best for her and what you have decided. And only if she is severely distressed at the thought of this let her stay where she is. If everyone is really upbeat and positive I would think she will go along with it. Any change will unsettle her but she can't go on as she is.

Decisions do get harder with age, as I have seen close up with this. But DM who is as robust as people of 80 can be, now gets stressed by tiny things that she would once have taken in her stride. Older people just need a bit more help, and considerable patience!