My father in law had a stroke recently. He has lost his short term memory. He doesn't remember to take his medications and apparently has had difficulty with that for some time. He is also diabetic and his daily nutrition needs are not being met. Unfortunately my mother in law is not much better off than he is. They are insisting they are fine and don't need any help from their children. We are trying to keep them stay in their home as long as possible and have tried to hire a care giver to stay with them during the day to fix meals and administer their medications. My father in law has become hostile and combative. What do we do?
Please note that as of last November 2013 I just went through the same experience with my mother that you are now facing with your parent(s). For about the past 10 years she has been having a mini blackout. This time my mother had the "Big One". I phoned 911 and EMS took my mother to the hospital. I learned a long time ago that when you need immediate medical help for a loved one and they need to go to the hospital, you need to phone 911. Otherwise, if you yourself take the person to the hospital you will be waiting hours for the patient to be helped. This time as soon as EMS delivered my mother to the hospital, she was immediately seen by doctors. Her blood pressure was 150/100 and 200/200 is classified as instant death. These doctors had my mother to start taking all kinds of tests in the hospital. It took the doctors 2 days to stabilize her blood pressure. The very next test she received was an MRI. It was not explained to us everything that was involved for a person to take this test. The only question mother and I were asked, "Is your mother claustrophobic?" We replied, “She is not Claustrophobic.”. We were not told that mother would be placed inside a cylinder for this test. We were not told that she could have received a sedative to help keep her calm during this test. After my mother took this test, she was returned to her room. My mother was as white as a sheet, her body was ice cold, and the doctors had to immediately start working with her to get her vital signs back to being somewhat normal. You talk about being mad and upset with doctors, nurses, and hospitals.
While my mother was still in the hospital, the admitting doctor phoned me. Keep in mind that the admitting doctor hadn't received all the final results from the tests my mother had received in the hospital. He classified my mother as having 80% blockage in her brain and that she has a left clogged artery in her neck. This admitting doctor didn't make any other suggestions for her medical situation except that she needed to be moved to a Nursing Home. I couldn't understand why surgery couldn't be performed at that time to remove the blockage in her left artery. It was later explained to me by another doctor that due to my mother having 80% blockage in her brain, her already having severe dementia, clearing the blockage in her left neck artery could cause her to die or she could stand a chance of living as a vegetable for the rest of her life.
This admitting doctor who called me on my phone and gave me his findings wanted to know right then and there our decision in what we were going to do to take care of my mother. I phoned her insurance company, CIGNA Health Spring, and explained the situation to them. They said that if I could find a Care Giver Service who accepts their insurance, they would pay 8Hrs or less per day and 32Hrs or less per week. I must have phoned about 30 Care Giver Services and found no help. Because insurance companies are very bad about not paying for Care Giver Services, these companies do not want to work with insurance companies. I was finally able to find a Care Giver Service that was happy to receive my mother's medical insurance. They only provide her 1Hr of care 2 days a week. I feel fortunate to have received this limited help. I was told by the Care Giver Service that mother will only receive this help for (6) weeks. I was informed that (2) weeks before the Care Giver Service time expires, I must present a letter to her PCP requesting that this service be extended. I must continue this procedure on permanent basis until the insurance company says it can no longer extend the service. At that time you can submit a letter to your parent(s) PCP stating that you need a 24Hr. Reference Nurse (Medical Home Health Care Giver) to help assist your parent(s) in controlling their medications and taking their vital signs. If your parent(s) medical health insurance denies any further help, a Care Giver at Care.Com would need to be hired to work for these needed hours.
For 2 months after my mother returned home from recently being in the hospital (November 13-15, 2013), I took care of my mother every day and made sure she was safe, read her vital signs, made her meals, assisted her with taking a bath, and gave her the daily medications, etc.. All of a sudden one morning I arrived at her apartment and she bluntly told me, "You are not my mother and I no longer need your help." This upset me so much that all I could do was tell her, "Mother you do need my help. I told her that I love her very much. I told her that if she didn't do what I needed her to do, she had no choice but to be moved to a Nursing Home." I then left her apartment. I did not wish to fuss with her and feel sadder than what I already felt. It was suggested to me that I do one of the following: 1) I could either contact Adult Protection Services and have them talk to her; or 2) we could make arrangements to hire a Care Giver to take care of her; or 3) we would have my mother moved a Nursing Home. My mother has it written in her “Living Will” that she does not want to be moved to a Nursing Home. Note that Adult Protection Services can schedule an appointment to meet together with you and your parents to tell each of you in a kind way what your parent(s) can and can't do. Please note that if you phone the Adult Protection Services and something bad happens to them, you could possibly be held liable for the incident because it is then classified as "Elderly Abuse".
Three years ago we hired a Health Care Whisperer for my mother. This is a wonderful person who has stood right by our side in respect to my mother seeing doctors and going to the hospital. She has helped us in every medical way that you can possibly think of in respect to taking care of my mother. She suggested to me that I search Care.Com on the Internet. My husband also found this information for me at the same time. Since my mother would not allow me to keep taking care of her because I am her daughter, and since she does not want to be moved to a Nursing Home, I finally found a Care Giver at an Internet source named Care.Com to take care of my mother. Please note that Care.Com exist throughout the United States. When you visit the site, select "Special Needs Provider" and enter the rest of the required information. You will find wonderful Care Givers who can help take care of your parent(s) for $10.00-$15.00 per hour. One important thing to remember in hiring a Care Giver is that they work for you not you for them. Tell the Care Giver exactly your parent(s) health care situation and what you need them to do. Explain to them any difficulties your parent(s) may be going through. You can find retired RNs who can work with difficult cases. Please note that your parent(s) may tell the Care Giver one day that they don't need them anymore and ask them to leave. You need to explain to your parent(s) that if they don't do what you need them to do, and they don't allow the Care Giver to return and take care of them, they will have no choice but to be moved to a Nursing Home. Hopefully your parent(s) have named you their POA so that you can withdraw money from their banking accounts so you can take care of them. All you need to do is tell them that you will contact their PCP and tell them that you are not being cooperative and their PCP will immediately have them moved to a Nursing Home. They are going to tell you that you that you and their PCP can’t do this to them. Yes, your parent(s) PCP has the right to make this decision for their safety and health. If your parents don’t have money saved to help them in this situation, there are Government agencies that can help them. Please note that in order for your parent(s) to receive this kind of help, they may not be allowed to have any more than $2K-$5K in their name. You may also need to contact Medicare for further assistance. This is going to be a long journey for you and your parent(s) but you must help them to the best of your ability.
Please note I have been the POA in my mother's “Living Will” for the past 10 years. I have learned that a POA does not have the immediate legal right to move a loved one to a Nursing Home for their safety and health. A designated POA only has the right to follow what is written in the “Living Will” and this may only be for a limited amount of time. I learned quickly that you must issue a letter to your parent(s) PCP stating that they are (incompetent) and can no longer make safety or health decisions for their own care. You must also state that due to this decision you are now classifying yourself as their Medical Power of Attorney (MPOA). You do not have to do this procedure through a legal attorney which will cost you money. It is hard for all of us to see our elderly parents going through the last of their living years. It breaks our hearts to see our parent(s) suffer in any way. It is sad to say but they do become the children and we do become the caring and loving parent.
This has been a very long answer to your question. Since I have just been through this experience and journey in helping to take care of my mother, and since I have learned some very valuable information in helping me to take care of her, I feel I need to share my information with you. I hope my information has helped you. I hope my information will also help other family members who are going through the same health care problems involving parent(s). There is hope and help for you and your parent(s). Please help and love your parents because you will only have them one time in your life. Please be proud of your parents and all the things they have accomplished throughout their life. My prayers are with you and your family.
If anyone reading this letter has more information that you would like to share with me that I should know about, your help will be greatly appreciated.
January 6, 2014
Eva Lynn Denise P., MPOA, Daughter
So, although it is hard to watch family members suffer and go downhill, sometimes you are forced to wait until something happens and an outsider gets involved. You could try talking to your in-laws health care providers to see if they will help, but most are reluctant to get involved. Of course, if things get really bad and you fear for their safety, you can call adult protective services to investigate.
Their "fronting" is probably b/c they don't want to burden you and your siblings. But they might accept help from outsiders. I'd say help them indirectly, through elder care agencies.
If they still refuse, dog 'em. Tell them you're going to help whether they like it or not.
We didn't have to do this because my parents believed their doctor, whom they trusted, when he suggested they not drive. But it's a good option to have.
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