This is the one question I hear most frequently from baby boomers caring for their aging parents, and I wish there was a “one size fits all” answer for it.

All of our aging parents (or Golden Oldies as I prefer to call them) decline in various ways and at different rates, but here are some guidelines to help you decide if it is time to take steps to move mom and dad out of their long-time home into an assisted living environment.

Physical Safety First

This is the most critical benchmark to apply.  It’s a simple question to ask yourself, “Are he/she/they safe living at home alone?”

Would they know what to do in case of an emergency?  And would they be capable of taking those actions?

If they fell anywhere in their home, do they wear a call button to push for help?  Will they remember to do so, and how to, if they panic?

If they are a married couple, would they hear their spouse calling for help from another room of the house?  Are they strong enough, mentally and physically, to help the other one in an emergency (i.e., a fall)?

If there’s a natural disaster (i.e., earthquake, hurricane, or tornado), would they know what to do during and after to survive if help doesn’t arrive quickly?

Are they a continuing fall risk?

Are They Potential Targets of Scammers?

Would they give out personal information over the telephone to a stranger?  Can they hear well enough on the phone to identify who they’re speaking with?

Would they open their front door to strangers or solicitors?

Are they comfortably in control of their finances and doing their own banking successfully? Are their bills getting paid on time? Have their been any irregularities with their bank accounts or credit cards?

If they use a computer, are they savvy enough to be aware of and avoid online schemes and scammers?

Are they hard of hearing or is their vision declining? These factors could increase their vulnerability.

Warning Signs in their Day to Day Living

In a previous blog post I created a detailed list of things to pay attention to when visiting your parents, whether you live nearby or far away.  You don’t have to pepper them with questions to figure out if they’re doing fine on a day-to-day basis.  Just walk through their home and observe whether these warning signs of decline are evident.  Try your best to really be objective — it’s hard to admit to ourselves when our parents may be declining.

What’s Next?

Based on your honest answers to these questions, if there is any doubt in your mind that your aging parents are no longer secure in their present homes, now is the time to start researching assisted living facilities. It’s best to be proactive rather than reactive on this issue, to avoid having to find a place for them quickly in case of emergency.  Even if they’re not ready to look into alternative living arrangements themselves, as their adult children and caregivers it would be wise to begin touring potential new residences.  You won’t be sorry you did.

Have you been through the process of moving your aging parents?  How did you know it was time for them to make the transition? Please leave your experiences in the Comment section below.  Through your story, you may be helping another family. Thanks!

Related posts:

1. TV Watching and Our Aging Parents – Part 1
2. Holidays with Your Aging Parents: Don’t Miss These Warning Signs
3. Notice Decline in Your Aging Parents? Action Steps — Part 1

This is the final part in our story about how we found the best assisted living facility for 82-year-old Sally to live in.   Please read the background info here, and the reports about our visits to Assisted Living Facilities “A” and “B.”  Below is the outcome of our search . . . .

When we left Assisted Living Facility “B,” I decided to be quiet and see what Sally had to say about the tours we took that day as I drove her back to her friend’s home.

My Thoughts and Assessments

I was wondering if she’d seen enough places? Did she have long enough visits at both facilities to gather enough data to make her decision?

If Sally asked my opinion, I would have recommended Facility “A”  for these reasons:

** Physically, the layout was smaller and easier to learn.

** There was a furnished room available immediately in a prime location with a lovely woman who would welcome her as a roommate.

** The Marketing Director took a lot of time getting to know Sally before we even began our tour. He made me believe the staff truly took an interest in and cared about their residents — it was more than just “filling a vacancy” there.

** The number of residents was slightly less in Facility “A,” and, therefore, the staff could get to know each resident better.

** I liked the suburban feel of the area “A” was located in.

As it turned out, I’m really glad I kept my mouth shut!

Sally’s Decision Was . . . .

Sally knew the next step was for her family in New York to speak with the Administrative Staff of the facility she chose to discuss the finances of her new living quarters, and what the move-in steps were they would need to take.

Before I could even ask, “Sally, which place did you like better?” she said:  ”When you speak with Mark, you tell him I definitely want to move to Facility “B!”  It took her no time to make up her mind!

That really surprised me!  But as I thought it over, it made total sense to me.  Sally could see herself living among the people at Facility “B” because the majority of residents there had her cultural background!  That’s what it really came down to.  The demographics and the type of food they serve clearly outweighed the other factors I was weighing in my mind.

My Take-Aways

I had learned these lessons through my previous caregiving experiences with my own parents, but their importance was re-emphasized during my time spent with Sally:

• To keep an open mind because not everyone has the same perceptions, perspectives and values as me.
• As long as a senior citizen (aka Golden Oldie) can make decisions, allow them to do so (unless it’s a matter of their personal safety).
• We have two ears and one mouth for a reason. It’s often better to remain silent and listen, than to speak too soon.

Post Script

Sally moved into Assisted Living Facility “B” within two weeks.  Her family flew out from NY to purchase furnishings, decorate her half of the Friendship Suite she moved into, and get her settled in.  The other half of her new room would remain vacant until a suitable roommate could be found, but she made new friends there immediately.  Sally is thriving in her new home, and I wish her many more happy and healthy years there!

Have you been on a housing search like Sally and I went on?  What was the outcome? What factors went into the decision to select one Assisted Living facility rather than another for your Golden Oldies?  Please share your story in the Comments section below.

Related posts:

1. A Story about Finding Assisted Living — Part 1
2. A Story About Finding Assisted Living — Part 3
3. A Story About Finding Assisted Living — Part 2

This is the third article in a four-part series about finding an assisted living facility for 82-year-old Sally to live in.  Please read the background info here, and about our visit to Assisted Living Facility “A” here.  Her story continues below . . .

Sally and I were running nearly two hours late for our scheduled tour of Assisted Living Facility “B,” but I called ahead twice to let the staff know we were behind schedule but still coming there. Facility “B” is owned by the same parent company as “A,” but as we approached in my car there were a few differences evident.  While they are situated only about 20 minutes apart in Los Angeles County, the neighborhood around “B” has more of  a “city” feel to it.  The building is larger, high-rise in style, and located on a busier street than Facility “A.”  However, this neighborhood was where Sally had lived for many years, so she is familiar and comfortable with it.  And she has friends who live close by.

Our Welcome

Because there was no street parking available,  I dropped Sally off in front and parked in the underground parking structure.  A staff person met me in the parking lot, and we rendezvoused in the front lobby.  When I made the appointment by phone, the Marketing Director told me she wasn’t working on Saturday, but another Administrative Staff member would gladly give us a tour and answer our questions.  We were greeted by a pretty, young woman who identified herself as Jill, the Activities Director for Facility “B.”  We headed off with Jill for our tour right away.

The Tour

It was obvious that this facility was in the midst of a major remodeling and redecorating project, which the Marketing Director didn’t mention on the phone.  There were half-painted hallways, half-carpeted floors and half-finished rooms throughout the building.  It surprised me that no one prepared us for this “construction-zone” appearance. Jill told us it would be completed in about six weeks.

Facility “B” is home to 100 senior citizens (compared with 70 residents at Facility “A”) so it wasn’t just our impression of it being a larger building from the exterior, it actually is a larger community of people.  The Activities Director took us up to the second floor where the dining room is located, and we saw a large, concrete patio outdoors where residents may eat in nice weather.  They had held a luau on the patio the evening before, and the pretty, tropical decorations were still up.

As we walked around, Sally asked and received answers to the two questions she asked at Facility “A” and were obviously very important to her.  ”B” also offers bus transportation to local doctors and drug stores, and they have Catholic services held there weekly.

I noticed some signs written in Asian characters in the elevator.  I asked Jill about them, and she explained that 85% of their population was Asian.  She also went on to tell Sally and me they served both Western and Eastern food.  Upon hearing this, Sally stopped dead in her tracks, grabbed my arm and said, “My husband was Chinese!”  He had passed away many years ago, but obviously the Asian cultural influence within Facility “B” thrilled her.

Jill showed us a vacant “Friendship Suite” that Sally could move into immediately.  It seemed a little larger than the one in Facility “A,” but it was not furnished.  It did have a balcony which was a nice feature.  As we continued touring, Sally made the remark, “I’ll get lost here.”  While Facility “A” was an easy rectangular, two-story layout built around a central atrium, this building had a more convoluted layout, with various meeting areas on different floors accessible by elevators.

I could see Sally was tiring — using her umbrella more for support now.  We wound up sitting in the Arts and Crafts room.  A staff member brought us some water, and at this point, I asked,  ”Is there space in an existing Friendship Suite for Sally to share?”  Yes, there was one possibility, and Jill introduced us to a resident there named Aurora.  She and Sally immediately started speaking together in Tagalog, their native tongue!  After a brief conversation, Aurora went off to see some friends who just arrived for a visit.  Jill informed us that if Aurora and Sally weren’t a good fit as roommates, they would start a new Friendship Suite for Sally and then find a resident, either a current or new woman, who would then become her roommate.   Jill also informed us there were four Filipino staff members working at Facility “B.”

Getting Down to Details

Unlike our tour at Facility “A,” the Activities Director did not have the  the authority to discuss financial details, nor the specific next move-in steps with us.  She gave Sally a brochure with the required paperwork to be completed prior to moving there.  Jill asked us to call on Monday to speak further with the Marketing Director if Sally wanted to move in there.  While it would have been nice to have someone higher up to speak with then, it had already been a long day and we were both ready to head out.  We had a lot of impressions and input from both residences to mull over.

Decisions, Decisions

OK.  You’ve heard Sally’s story up to this point.  Now it’s your turn to guess the outcome.

Which Assisted Living Facility (“A” or “B”) did Sally choose and why?  What factors do you think weighed most heavily in her decision? Please leave your thoughts in the Comments  section below this post.

In Part 4 of this series, I’ll reveal Sally’s choice.  So stay tuned!

Related posts:

1. A Story about Finding Assisted Living — Part 1
2. A Story About Finding Assisted Living — Part 2

This is the second part in a four-part series.  Please read Part 1 here for background about our story of finding an Assisted Living residence for Sally.

Meeting Sally

On a Saturday morning I met Sally at her friend’s home, where she was living temporarily, and off we went to visit the first of two Assisted Living residences on our list.  It was a few towns away, and we had about a 20 minute drive together. She was outgoing and friendly, and we enjoyed talking about New York, where she and I had both lived previously.

I was pleased to find out that her family’s assessment of her health and mental acuity seemed right on.  Many times family members are in denial about the state their Golden Oldies are in, but as I spent time and spoke with Sally, I could tell they had given me an accurate picture of her condition.  This was important to assess right away, or else the places I had arranged to visit may not have been the best potential living situation for her.

Visiting Assisted Living Facility “A”

The two Assisted Living residences I selected for us to visit are both part of the same overall company, with the same name, but located in different parts of Los Angeles.  To further explain, think about a major hotel chain, such as Hilton, Hyatt or Sheraton Hotels.  They are all owned by the same corporation, yet each individual hotel location has its own look, feel and atmosphere about them.  And while the programs, policies and procedures are all alike at the corporate level, there are still differences from one location to the next.  This holds true for some assisted living housing communities, as well as for major hotel chains.

Assisted Living Facility “A,” while in the city proper, is located in an older neighborhood that feels like a village with large, old trees lining and shading the streets. The building houses 70 residents,  is two-story, and built in a simple rectangular shape, which is easy to navigate and not get lost in.  The center atrium area sports a garden area for residents to walk or sit in on nice days.  The building’s common areas are nicely decorated and we saw many residents sitting and chatting in the lobby area with staff, and what appeared to be other residents and younger family visitors.

Our Welcome

We were greeted warmly by the Marketing Director, Mr.  Tim, and shown into his office.  He spent quite a long time (about an hour) chatting with Sally — asking about her life, what was important to her, and what she was looking for in the place she was moving to.

I introduced myself as a friend of the family, and didn’t tell Mr. Tim I had any eldercare background. I made this decision on the spur of the moment, when I realized I had identified myself only as a family friend during phone conversations up to that point, and could easily become a “secret shopper” and experience the tour from a family member’s perspective — something I hadn’t had the opportunity to do in a long while.

Sally asked two questions that I could tell were very important to her.  One was if there was a Catholic Church nearby that she could attend.  The answer was that they offer Catholic services there, and she didn’t even have to leave the building to attend!  The other question was if they offered transportation to the drug store and her doctor’s appointments.  This was also a requirement the family mentioned to me, and I already knew they did.  I could see by her smiling face that she was pleased with the positive answers to both of her questions.

The Tour

After about an hour of getting to know Sally, Mr. Tim took us on a guided tour of Location “A.” We saw two furnished model apartments, the arts & crafts room, the laundry room (Sally insisted she can and will continue to do her own laundry, even at age 82!), the dining room, other sitting areas, the daily calendar with many activities offered, and the library.

He must have sensed Sally was tiring as we walked around, and asked if we’d like to eat lunch in the dining room, as it was just starting to be served.  Sally jumped at the chance, and I was happy to partake as well.

The dining room was on the first floor and we had our own table.  Mr. Tim also went out of his way to introduce Sally and me to a nearby table of women.  The residents and the dining room staff were very friendly, also answering any other questions we thought of, after Mr. Tim excused himself.  The food was very good and we both really enjoyed the meal and hospitality.

After Lunch — Getting Down to Details

When we went back to Mr. Tim’s office after lunch, he proceeded to tell us about the current openings they had, the move-in fees and monthly rent, which includes all meals, transportation, and  housekeeping.  Sally is able and wants to live independently, and would not need any of the additional  nursing or assisted living options available initially. But it’s reassuring to know these additional services are at her fingertips should she need or want them in the future.

Sally indicated she would be happy to have a roommate in order to save money, and Mr. Tim had just the spot for her.  He led us down the hall to a shared “friendship suite,” and who was living there? Laura, one of the ladies we had met and spoken with during lunch!  The room was large, nicely furnished, with a good-sized closet and bath.  It was available immediately and Sally could move in as soon as she wanted.   Mr. Tim explained it was in a prime location in the building — being on the first floor, and close to the lobby and sitting rooms, the heart of the residence.  This felt like a good match to me, but I didn’t say anything out loud to either him or Sally.  Sally seemed to like and approve of what she saw.

We then went over the next steps that Sally would need to take, including the move-in paperwork to be completed and a physician’s report.  I also let Mr. Tim know her New York family was in charge of Sally’s finances and I would send the rate information to them and they would be in touch with him further.

Moving On

After spending close to three hours there (I had expected about one hour), we thanked Mr. Tim, said our goodbyes and left Location “A” pleased with what we had seen and heard.  Sally’s comment was along the lines of, “The people who live here must be millionaires. I wonder if I can afford it?”

In my mind I thought, “The next place we visit sure has a hard act to follow! ”

In the next post, we continue our hunt for Sally’s new home with a visit to Assisted Living Facility “B”. . . . stay tuned for Part 3 of our story!

Related posts:

1. A Story about Finding Assisted Living — Part 1

One eldercare question I’m asked often is, “How do I find the best assisted living facility for my aging parents?”

I normally go through this process with adult children who are making the decision for their parents.  Recently, I received a different request — please help Sally, an 82-year-young woman with no family living nearby, find an assisted living facility to move into.

I approach the placement process in three steps: (1) researching facilities, (2) visiting or touring them, and (3) deciding upon the one that will be the “best fit” for the Golden Oldies (what I prefer to call senior citizens).  This series of posts will focus on the visits and decision-making process Sally and I went through together to find her a pleasing new home.

Setting the Scene

One day I received a phone call from close friends who live in New York.  Their 82-year-old Aunt Sally had been out of the country visiting family for about a year.  Now she was back and living temporarily with a friend in Los Angeles, but really needed a place to live on her own. Her family knew Sally was declining physically and it wasn’t really safe for her to live independently any longer.  They asked me if I could help them long-distance to find an assisted living facility for her, and I was more than happy to help!

A Little Background

Even before beginning to research places, I asked for details from her family about Sally’s  current physical and mental health, pertinent medical history, and how she was functioning on a list of activities of daily living (bathing, walking, eating, dressing, etc.)

Sally is a Golden Oldie born in the Philippines, who spent most of her life living in New York City and Los Angeles. According to her family’s description, Sally is completely sharp mentally, with no memory loss at all.  Physically she is also in very good condition for 82!  She has some hearing loss, but her biggest challenge is her failing eyesight due to macular degeneration. She can eat, dress, bathe and walk without assistance, although her family feels she is a little unsteady on her feet and may soon benefit from using a cane or walker.

Her family asked me to find a senior community in Los Angeles within Sally’s budget that offers the residents transportation for shopping and doctor’s visits, because Sally doesn’t drive.  She was fine with having a roommate, too. They knew that Sally was capable of, and would insist on, being part of the decision about her new home.

Armed with these basic facts, I began my research based on my experience, online resources and the eldercare consultant organizations and networks I belong to. After coming up with an initially long list of assisted living facilities, I narrowed down the choices to two that fit Sally’s criteria. Then I made a date to meet Sally and take her to tour both possibilities.

The story about our visits to the assisted living facilities and the outcome will be covered in my next few posts.  To be continued . . .

Related posts:

1. How Prepared Are You for the Future?

A reader wrote this comment to a prior post here.  Because her question is a challenge many families face while caring for their “Golden Oldies” (aka aging parents or relatives), I’ve gotten permission to publish it along with my answer below:

. . . I need some advice. I fully believe that pets are beneficial and theraputical for our ‘Golden Oldies’, but what do you do when they can no longer care for their beloved pets due to dimentia and the like? I’m asking this because my grandmother lives for her two dogs. However, she is entering the beginning stages of dimentia and can no longer care for them properly. Family is there daily to help her out, but her house is a mess because she doesn’t feel safe taking them outside. What if you can’t afford pet sitter services, but are tired of cleaning the mess yourself? I’ve thought of trying an easier pet such as fish, but how do you explain why you are taking her dogs away? Help!    ~ Cilla

There are both practical and emotional aspects of your question, Cilla.

Options for the Dogs

An in-depth post with options for rescuing your grandmother’s dogs can be found by clicking this link, but a brief summary of the suggestions are:

• The absolute best option for everyone involved is for a family member, friend or neighbor to adopt her dogs.  By doing so, your grandmother can still visit her pets and/or have them visit her.  It will also give her peace of mind knowing her pets are in good homes with people that love them.

• If the dogs are a specific breed, I would search online (Google.com is your friend) for local animal rescue groups for that breed.  Or ask your veterinarian for a referral. Another alternative is to find a “no kill” animal shelter to take them to. Ask the Humane Society in your area for referrals to rescue groups and appropriate shelters.  Some veterinarians may know of other families who want to adopt pets.

“How do you explain why you are taking her dogs away?”

This is tricky.  And I must preface this advice with the fact that I don’t know exactly how much memory loss your grandmother has, so my advice will have to be my best guess from the brief description you wrote.

I would try taking away one dog at a time.  You can tell her initially the dog’s at the vet for a checkup, and see if she even notices the one dog missing.  Depending on her degree of memory loss, she may not even miss the dog. (A family member should be with her that day or check in frequently by phone to assess her awareness.)  But depending how much she notices the dog’s absence and/or asks about the dog repeatedly later in the day, you can (a) either bring the dog back that evening, or (b) you can delay the return of the dog and tell her the dog will be back from the vet as soon as the checkup is done, because the vet took longer than expected or some such thing.  We call this “ethical fibbing.”  While we aren’t telling the truth to grandma, we’re telling a small white lie so as not to hurt her.  If this first transition goes well,  a week later, I would take the second dog away, repeating the vet “ethical fib” story over again.

Although she is attached to her dogs, her dementia may have advanced to the point where they will be “out of sight, out of mind.”   It may not be necessary to tell her at all that you’ve taken her dogs away, since her memory is already to the point that she’s forgetting to care for them adequately. If you can’t take them away now, as a family I’d come up with a care schedule for the dogs — who will feed, walk, and bathe them on a rotating basis, until such time as they can be removed from her home.  Create a calendar to send to all family members involved so there are no missed days by accident.  Some dementia can be progressive, and unfortunately your grandmother may reach the stage when she won’t be aware of the dog(s) absence.  Sad but a definite possibility.

Don’t make a “big deal” of the reasons for the transition to another home.  You don’t want your grandmother to feel ashamed or guilty that she can’t care for them by herself any longer. It is the disease that is causing her lack of pet care, and it is not something she has any control over.  Please do not make her feel guilty, even as you continue to clean up the mess for the zillionth time.  Bee matter-of-fact about what needs to be done for the dogs, rather than emotional. Use the words, “Grandma, I’m giving the dogs their food and water,” rather than, “Grandma, you forgot to feed the dogs again!!!!”   She will pick up her cues on how to feel about the situation based on how you (or your family) respond to it.  Stay calm and pleasant with Grandma, as hard as that might be at times.

Don’t introduce a new pet to her home, unless you personally are willing to care for it 100%. I like your idea of providing a substitute pet for her dogs, but what I recommend is buying her a gift of two stuffed animals that resemble her dogs (in either color or size) even before you begin the whole removal process.  I’ve seen women with Alzheimer’s disease and dementia happily cuddling stuffed animals and even baby dolls as if they were real.  It’s instinctual bonding, and can quite possibly fulfill your grandmother’s desire to nurture.

“. . . she doesn’t feel safe taking them outside”

This statement raises some red flags for me.

It makes me think, “Is she paranoid?”  If she hasn’t been to her regular doctor for a complete checkup recently, I would do that immediately.  Be sure you let the doctor’s office know when you make the appointment about your grandmother’s memory loss and ask for a comprehensive examination.  He or she may also refer you to a neurologist after their initial examination and diagnosis.

Please be sure to have a family member accompany your grandmother to all of her doctor’s appointments from now on, so you can tell them about her real physical and mental condition, as well as hear what he or she tells your grandmother, because she will likely forget what was said by both parties by the time she gets home.

If your grandmother is having trouble caring for her pets, can she still care for herself? Is she safe living alone?  Is she still driving?  Start a discussion with your family about these questions and come up with an action plan now (even before it is needed) as to where she will live when she can’t live alone any longer.  Thinking ahead, learning about local resources and being prepared for the next step is an essential part of caregiving.

Cilla, she is so very lucky to have a granddaughter who cares so much about her welfare! I hope these ideas help your grandmother, her dogs and your whole family. Thank you for giving me permission to publish your question here for all to learn from.

Have any of you gone through this challenge with your loved ones and their pets?  How did you make the necessary transition with the least amount of resistance by your Golden Oldies? All comments are welcome below.

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Photo Credit:  Creative Commons normanack’s photostream

Related posts:

1. When Aging Parents Can No Longer Care for their Pets
2. TV Watching and Our Aging Parents – Part 2

Today I am introducing a new feature on Tender Loving Eldercare — a readers’ mailbag.  Family caregivers ask me for suggestions and insights into their caregiving challenges. If a question arises for you on your caregiving journey, please feel free to use the contact form above to send me an email.   From time to time I will publish a reader’s question and my response here, so we can all learn from each other.  Please know you are not alone!

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A reader recently sent in this question:

I am asking this question in regards to my mother who is caring for her mother..my grandmother. My grandmother has always treated my mother very mean and has always said very hurtful things to make her cry. Now that she is requiring care my mother is the one that is always there. My mother has a brother who will not have anything to do with his mother. My grandmother has put my mothers brother in her will but left my mother out completely and all insurance policies are also in her brothers name. My mother has taken full responsibility (with help from my sister and I) for her knowing how she feels about her and how it will all end. It hurts her so badly and my mothers health seems to have taken its own toll. My grandmother fights her on everything, then when my mother walks away to gather herself my grandmother will repeatedly call her until she comes back. When she is there she follows her around just to call her names when all she is trying to do is make it possible to help her and keep her in her own home. I want so much for my mother who is 66 to be able to enjoy herself once in a while..i don’t see her smile much. My grandmother isn’t able to do a lot for herself but I would love to make things easier on my mother. My grandmother wont allow anyone in her house or do anything for her but my mother, so what little bit my sister and I can do doesn’t seem to be enough to help my mother. Any suggestions please.

I asked a few follow up questions and this additional info was sent:

Thank you for your response to my message.  My grandmothers physical condition is not that bad. She broke her hip a few years ago and has used that as an excuse to have people waiting on her. I believe that since my grandfathers death 10 years ago that she does get lonely from time to time but at the same note doesn’t want anyone in her home..confusing. I thought she might have Alzheimer’s but there has never been anything that would suggest that so her doctor says. She, in my opinion cannot care for herself.  My family is not in a position to pay for her to have outside care and so that’s why it is tried to do within the family despite her disposition. Yes you may use my question in your blog I hope that if anyone is going through this that things work out for them. It is is hard. Thank you.

First I want to thank you for writing and for caring so very much about your mom and grandmother!  They are very lucky to have you in their lives!  You’re wise to realize the impact caregiving is having on your mom and to try to help in any way you can.

From your description, it sounds like your mom either is (or is close to) having caregiver burnout.  Please call the ElderCare Locator at 1-800-677-1116 and they can refer you to your local Area Agency on Aging.  The agency will tell your mom about programs and services to help her immediately, such as respite programs (so she can get regular breaks), support groups and other community resources (such as adult day centers).  Even if your grandmother won’t allow anyone into the house now to help her, at least your mom will get other types of support to help her in her role as a family caregiver.

If you and your sister continue to help your mom, your grandmother may come to accept over time the routine of you doing more for her.  There are usually special bonds between grandparents and grandchildren, and that may work to your advantage here.  Perhaps if your grandmother allows you to help her more, that will then eventually lead to her willingness to accept other friends, neighbors or relatives willing to help in her home, thus providing more respite for your mom.  This process could take months, beginning with the baby steps of you and your sister pitching in more.  First alongside your mom, and then one day you would show up without your mom because she “has an appointment she couldn’t reschedule” or some reason that allows you and/or your sister to help your grandmother without your mom being there.  Again, think in baby steps — it won’t happen overnight.  It takes a village to be family caregivers, and you can start building that village today.

Your grandmother’s personality sounds very intimidating and difficult to be around, but you write it is not a recent change.  Has your mother spoken privately with your grandmother’s doctor(s) to make sure they have examined her in-depth to rule out any physical reasons for her argumentative nature?  If she hasn’t been to a doctor recently for a checkup, I would definitely start there.  I’ve written about the importance of your mom being both an advocate for your grandmother as well as an “interpreter” at these appointments — for her sake as well as your grandmother’s. While you don’t think your grandmother has Alzheimer’s disease, dementia or other physical ailments could be making her extremely difficult.  It is important your family explore those medical possibilities as well, keeping everyone in the loop on the process and progress made through the doctors appointments.

I’m sure your grandmother is indeed feeling lonely, afraid, resentful, and overly dependent on others for help — just to name a few emotions that go along with aging, especially since her husband is no longer there to be her  companion and soul mate.  She may also be grieving the loss of friends at this stage of life. This is  not offered as an excuse for her mean behavior, but it may be useful for your family to remind themselves of her perspective.  Aging is not an easy process; in fact, it sucks in many cases!  Hopefully, your family’s love and caring will help her have a somewhat more positive outlook over time.  Again, think in baby steps.

Your mom may also have to “bite the bullet” and speak kindly but frankly with her mother about the stress  and sheer exhaustion your mom is experiencing.  Hopefully your grandmother still has enough patience and compassion to listen to her daughter as your mother explains she needs some time for herself because she is physically and mentally drained.  Your mom could point out to your grandmother that if she wants to continue to live in her own home, your mom’s assistance is vital in accomplishing this goal.  And therefore, your mom’s own health and well-being must come first.  You, as her daughter, sense this yourself and I hope your grandmother can understand this, too.  If you and your sister are close with your grandmother, maybe you two can also have one-on-one discussions with her about this, approaching your grandmother with your own valid concerns about your mom’s state of health.

Last but not least, you mention your mom’s brother who “will not have anything to do with his mother.”  It is something I hear all the time from siblings.  It seems there are usually one or two siblings in a family who are very “hands on” as caregivers, and then there are those siblings who are either in denial over the parents’ care needs or just don’t want to be involved.  I’m sure the disappointment your mom feels about her brother’s attitude is upsetting and may be adding to her stress.

Since your uncle has made it clear he doesn’t want to help, at this point I suggest your mom move on and look for other sources of help as given above.  Moving on isn’t easy, but it may be the best step for your mother emotionally.  If she can stop hoping for help from her brother, then she won’t keep being disappointed by his lack of action.  It’s hard to fathom why a child won’t help their aging parents, but unfortunately, it’s common in my experience.

I wish I had a magic wand and could make everything better in just one giant wave.  But since I don’t, I truly hope these suggestions help ease the caregiving situation for your family. Clicking on the blue text links above will take you to other articles on the TLeC blog that may also be of help. Take care and let me know how it’s going.

If you have any resources or suggestions for this reader, please feel free to write them in the Comments section below.  We welcome your input.

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If you or your care recipient are in a crisis, I urge you to call a health care professional immediately for assistance.  TenderLovingEldercare.com and Linda Abbit only provide general insights about general situations.  You should always consult your own lawyer, financial planner, health care professional and other professional advisors for advice specific to your situation.

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Mail bag Photo Credit:  Marcin Wichary under a Creative Commons License

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