Adult children making decisions affecting their elderly parents talk about experiencing the difficulty, the guilt, the stress and, when they find help along the way, relief.
The best bet, say social workers, nurses and other professional caregivers in Greene County, is to talk with parents about their wishes concerning living arrangements, advance directives and finances long before their parents are no longer able to do so.
“I’ve seen so many people who haven’t had those discussions and are having to make tough decisions,” says Beverly Mentzer, director of nursing at Regency Place Nursing and Rehabilitation Center in Jefferson. Decisions can be as varied as whether to continue life support or whether to have a no-resuscitation order if a parent is found and his or her heart has stopped, to taking over the checkbook or taking away the car keys.
Circumstances of every situation differ, but they often carry the same themes when adult children retell their experiences with parents.
Molle Schmidt, social work designee at Regency Park, vividly pinpoints one of the main experiences with her mother-in-law, the late Madonna Schmidt, that triggered the need to step in with assistance. The family found Madonna with the oven on for heat because she forgot how to heat the house.
The family also had to take over the checkbook after discovering she was handing out $20 tips instead of $2 tips, and she didn’t realize it, Molle says.
Now she is also going through evaluating what needs her mother, Verla Anderson, might have.
“Just this week she agreed to have us help with her checkbook, and she is willing to give up her car,” Molle says.
The best scenario is for people to begin talking about finances, where they want to live, and whether they need extra help in the home, says Mentzer.
But even with advance discussions, adult children need to keep their eyes open for signs their parents are slipping, she says. There may be frequent falls, for example. But there may be more subtle signs such as Mom or Dad looking more disheveled when they used to be particular about their appearance. It might be dishes piling up in the sink, the house being messy, or bills going unpaid.
“Everyone wants to stay at home as long as possible, but we are also seeing Medicare not paying for the people who do in-home care to stay for more than an hour or so,” Toni Lindberg, director of marketing for the nursing and rehab center, says.
They used to let them help out for longer periods of time, she says. Now people are home for longer periods by themselves. Because of that, some of those people end up having to come into the home before they might have had to otherwise, she says.
Beverly shared her own experience with her parents. Her father was taking care of her mother when he fell and broke his shoulder. He was the one fixing the meals, cleaning the house, and more.
“We had to place both because he couldn’t take care of her and himself,” she says. After several months, they were able to move back to an independent living situation.
“I am one of five girls and three of us are nurses, and we couldn’t coordinate the care. We tried, but it was just too much,” Beverly says. Her parents weren’t happy about leaving their home and were very resistant to the idea of being in another place, even for the short-term.
Moving out of a home is a major life decision, says Randy Downey, Regency administrator. He added, however, that people are bringing their loved ones to very different nursing homes than the one his own mother was in before she died in the 1970s.
“My mother had cancer, and she was in a nursing home, but it was horrible. I’m surprised I became a nursing home administrator after what we went through with her. She was only 42 when she died,” Downey says.
His experience was seeing people over-medicated and restrained in their wheel chairs without any activities. That isn’t the nursing homes of today, he says. Even though nursing homes have changed a great deal since the 1970s, people are still fearful of bringing their parents to a home, he says.
Often, after the person has been in the rehab/nursing center, their health improves, he says.
Marcy Barlage of Jefferson didn’t want her husband to leave their home and live in Regency, but after a stay there to recuperate from health issues and then going back home, he decided he needed to be at Regency.
“I didn’t like it at first,” Marcy says. “But since he has been here almost two years, I realize it was the right thing to do.”
Marcy and Roy, both 87, retired about the same time and have been together post-retirement for many years. It was a huge adjustment for her when Roy moved into the home.
She says she and her husband have worked at making sure their affairs are in order so their children will not have to make those choices for them. The choices have included buying their own burial stones and more.
“I didn’t want the children to have to deal with it,” she says. The couple recently celebrated their 41st wedding anniversary. Their marriage was a second one for both. She brought two children to the marriage, and he brought six.
All the children agreed having Roy move into Regency was the best option. They supported their father’s decision.
“His children were very good about it. They could see that he needed to be in the home,” Marcy says.
Marcy comes to Regency to visit Roy every day, unless the weather is bad, she says.
While Marcy and Roy made their own tough decisions, often the first people who have contact with a family dealing with aging parents are Greene County Public Health and/or long-term or short-term care provided through Greene County Hospital.
Becky Wolf, Greene County public health director, and Katie Heldt, chief nurse executive at Greene County Medical Center, usually see elderly parents who need help when they end up in the hospital with major medical issues or broken bones from a fall.
Wolf noted they often hear adult children say they have told their parents they would never put them in a nursing home. That is not very realistic, she added.
“You can’t always follow through with what you promised your parents,” Wolf says.
It also is important to include all family members in the discussion.
“It helps if all the family members are on the same page,” she says. “That isn’t always an easy thing to accomplish.”
Adult children need to think about what could potentially happen if they don’t move their parents, or get extra help for them to stay in their own home. If there was a fire, could the parent get out of the house? If they fell, could they call for help?
Greene County Public Health Services offers in-home personal care and homemaking care for bathing and cleaning the house. Physical therapy is also available in-home, as well as nursing services. How often a nurse visits depends on each situation. Sometimes it is once a month, sometimes once a week.
The nurses visiting at-home patients set up meds, check blood pressure, can dress wounds and monitor other medical issues. Often, having a nurse come in on a regular basis reduces the number of doctor visits, but if needed, the nurse can also set up appointments with the doctor.
Often, the continuum of care will take elderly people through being able to stay longer in their own home and then eventually into a facility.
Dementia and memory problems are additional issues. Often, people who are beginning to have memory problems work very hard to put on a good show, Katie says. Picking up on the memory problems is much more difficult for adult children who live far away and don’t see their parent every day.
“No one wants a parent to go to a nursing homes, but if they aren’t safe, then it is time to consider other alternatives,” Katie says.
Wolf added, “To be able to walk away and know that your parent is being taken care of is a relief.”