If you have elderly parents, the time will come when you need to have THE conversation. Hopefully, you will have it when your parents are vibrant, energetic, and possess all their faculties.
Your parents can tell you their plans and hopes for the future, and you can tell them how you will be able to help them when they need your help. They will show you their finances and let you know vital details, such as where their safe deposit box is, who their attorney is, who their doctors are, and whether they have a will or a revocable trust.
Perhaps they will have you sit in when they discuss their wishes with their attorney. Maybe they will have prepared a list of their possessions and whom they would like to inherit them. They may add your name to their safe deposit box and give you keys to the house.
But sometimes, end-of-life planning and decisions just are not made. Parents may think that they have plenty of time to make those decisions. They may understand that their children have responsibilities involving full-time work or child-rearing, and they may hesitate to add additional burdens to their already full plates.
Or sometimes, a medical problem, such as dementia or Alzheimer’s, may arise too quickly to allow for pre-planning.
And sometimes parents just do not want their children to get into their business. In that case, children need to have a plan to deal with parents who refuse their help.
How To Begin
If you have parents who need help but won’t accept it, you need to see if you can get to the root of the problem. Talk to them to find out why they won’t take help. Try to determine if they are refusing all help or if they are just adamant about refusing some help. Many different types of help may be offered.
Types of Help
Try to discover why your parent has not contacted a physician about any medical problems. Are they frightened about what the diagnosis might be? Afraid that dementia or Alzheimer’s might be diagnosed? Worried that a caregiver might be needed? Concerned that a possible hospitalization would leave a spouse without essential care?
Having a gentle conversation to discover a parent’s fears and explaining how you would be able to help might encourage a parent to seek medical treatment. For instance, you might be able to discover that back pain is keeping a parent homebound. Arranging for chiropractic treatment or a gentle exercise regimen at a local senior citizens’ center may solve the problem and give the bonus of socialization with others who can become part of their social circle.
Some elderly parents relish their independence above all else. They have heard stories from friends and acquaintances about children who put their parents in a care facility and who never visit. They don’t want that to happen to them. They may have worked hard all their lives and may own a home, have some stocks or bonds, and have a small pension. They may be self-sufficient now, but if they need to go into a senior community, assisted living, or a nursing home, they may not be able to cover all the expenses.
Assuring parents that you are there to help and going over all the different alternatives to paying for care may help. A Senior Advisor could help reassure them by taking them on tours of local independent or assisted living facilities, going over the costs, and showing how you could help with costs. If parents have a financial advisor, ask if you can meet with the advisor and them to go over how their finances could stretch over a variety of different scenarios for their care in the future.
Some older people have become somewhat insulated. They might enjoy their home, their own company, and a select group of friends and church members, but their social circle grows smaller as their friends grow older and less able to help. If they have realized that they have needs that they cannot meet, they may have fears about caregivers. They may have heard stories about caregiver abuse or caregiver theft, so they don’t want strangers in their homes. But caregivers may have become necessary.
This is a good time for you and your siblings to get together to see how you might help. Perhaps more frequent visits from all of you may be the answer. You could set up a schedule so that your parents would have someone visiting often enough to take them to doctor’s appointments, prepare meals for the freezer, do housekeeping chores, hire a lawn care company, and pay bills.
If that is not possible, you could thoroughly investigate the caregiving opportunities available in your parents’ location. You could present the information to your parents, emphasizing that you and your siblings would be visiting to check on things. You could suggest that cameras could be set up in the main living areas of your parent’s home so that you and your siblings could watch for caregiver problems or any problems when the caregiver was not there.
Perhaps your parents just need some help with meal preparation. This problem can be solved in a variety of ways. If your parents are still mobile, you and your siblings could give them gift cards to their favorite restaurants. Perhaps their church has a weekly meal and get-together. You could ask their pastor about securing a ride for them to attend, and you could pay for the meal and perhaps make a small contribution to the church as a thank you.
If their need is greater, Meals on Wheels delivers meals directly to the home, and the delivery people will often stop to chat, providing some social activity. Some communities have chefs who will prepare a week’s worth of food for a set fee. You and your siblings could visit often and cook meals for the freezer, attaching instructions that a parent or caregiver could follow. You could ensure that your parents have a good supply of supplemental drinks, like Ensure, that will give them the protein, vitamins, and minerals they may need.
Call your parents often to ask what they had for breakfast, lunch, and supper. They may get in the habit of eating the same things repeatedly. They may need supplementation with fruits and vegetables. There are online sites, such as Harry and David, that will send fruit boxes through the mail. And some restaurants will deliver fresh salads for a minimal fee. You could tell your parents to watch for a special delivery of fruit or supper one day, which will encourage them to get up, get dressed, and look forward to something special that day.
Your parents may not be able to continue with home upkeep. Parents with arthritis or back problems can no longer bend to mop or vacuum. It may be challenging to carry laundry baskets to the washing machine or change the sheets on the bed. It may be impossible to pull weeds from the flower bed or do the mowing, edging, and hedge trimming to keep the home looking fresh. It may be difficult for parents to move from the first-floor living area to the second-floor bedroom area of their home.
Keeping the lines of communication open with parents is essential. If you hear a parent lamenting that the house isn’t looking tidy, ask if you can investigate cleaning services. Check on lawn services that are available in the area. If your parents are church members, contact the pastor. Many churches have elder care programs in which members care for lawns, run errands, prepare meals for the freezer, provide rides to doctor’s visits, or provide companionship.
While many parents do not want their business told to others or do not want to feel like a charity case, they might accept help if they understand that they can make a small financial contribution to a favorite church project they support or have supported in the past. Or perhaps your mother can knit or crochet, and the church has a project providing prayer shawls to people who need them. Or maybe your church needs someone who can call people who are homebound, and your parent is an excellent conversationalist who would enjoy doing that. Anything that gets your parent more involved in a social group would be good.
Some parents are just lonely. Having someone to talk to or visit with would bring them out of their depression. If parents are mobile, encourage them to attend church or attend programs at senior citizen centers or churches (such as grief support groups for parents who have lost spouses). They can go to concerts (send them some tickets), go to the movies (send them some tickets), go out to eat with friends (send them some gift cards), go on short trips or visit museums (send them some information and offer to go along with them when you visit).
Encouraging them to volunteer will give them a reason to forget their concerns for some time. If a parent is good at woodworking, they could build desks for children in the community. If a parent is a wonderful baker, they could provide cakes for the church’s bake sale.
Volunteering to help others often lifts loneliness and depression and gives a parent a reason to get up and out of the house each day. There are many volunteer positions in hospitals, nursing homes, and schools. Perhaps a parent could read books to children at the local library or volunteer to shelve books or work at the book sale. Perhaps your parent would enjoy fostering a cat or dog. There would be no long-term commitment, but the companionship would be rewarding.
The Hard Part
Suppose that, while your parents were healthy, you were added to their medical paperwork, and you were made their power of attorney and health care proxy for medical care. Your parents informed you of their finances. They drew up a will and revocable trust with you as the successor trustee. You and your parents have made sure all these advance directives exist, and you know where they are.
But these things don’t always happen. Many times, people don’t have a durable or financial power of attorney. A sudden accident, a frightening diagnosis, or a sudden slide into dementia or Alzheimer’s may take away the opportunity to work together. It may hasten feelings of fear, anxiety, distrust, suspicion, or anger.
If your parent requires care but refuses care, there may well be nothing you can do. Parents who have isolated themselves and live in hoarding situations have a right to do so. You can encourage, advise, and plead, but they may refuse all of your attempts to help. The best you can do in that situation is try to stay in contact without seeming like a threat. You can contact an advisor or a physician for help. You can contact neighbors and friends of your parents to see if they could monitor the situation. The situation is bound to get worse over time. If the situation becomes hazardous, the health department can be contacted to make sure the situation will not precipitate a fire or other dangerous situation.
If a parent refuses, you are responsible for stepping in. If you have a power of attorney and it has been invoked, you can exercise it immediately to have a parent admitted to the hospital, assisted living, memory care, or a nursing home. If you do not have a power of attorney, you should contact an attorney to see what rights you must intervene. Courts may appoint you as your parent’s guardian to arrange for the care.
You are not alone in wanting the best situation for your parent or loved one. Reach out to Oasis Senior Advisors or your physician and start to identify what plans may be most appropriate for your family.