Trying to convince your aging parents to get with the program

You belong in a senior home, Dr. Jones

Boomers, when facing their mortality

I’m mad at my parents. They raised me to be a good, rule-following oldest daughter, so it’s incredibly frustrating when you’re that type of person and the people you care about are not.

Case in point: My mom told me she took a spill down the basement stairs not long ago. She’s fine (as far as I know), but when I say, “Have you thought about the next place you might live that isn’t full of dangerous stairs? So we can start this process before it’s an emergency?” Her reaction isn’t: “You’re right, good point,” but more like ¯\_(ツ)_/¯.

No plans! No thinking ahead. No research. Not even an iota of a preference. We’ll figure it out when the time comes. MUST BE NICE TO LIVE THAT WAY!

I know a lot of you out there are in this spot, or will be soon. In fact, a witch wrote in recently with her own eldercare scenario:

My stepdad is in very poor health and needs more care than my (also aging!) mom can give him, and my siblings and I agreed that it would be best if they moved closer to one/some of us. But if my stepdad goes into VA assisted living, where does my mom live? How do we make sure she isn’t more socially isolated in a new place than she is already? how do I make sure I don’t end up doing *all* the driving and communicating and coordinating, if my stepsister who’s also in the area flakes?

I’d love the advice and perspective of witches who’ve navigated the challenge of how to help aging parents and making decisions about moving them closer to you.

I threw this query out to other witches as well as readers of Sari Botton’s

Oldster Magazine

to hear what type of advice they might have. Below are some of the very empathetic, helpful (edited) responses from people who have been there. Nobody has hacked the issue of what magical words can get your parents to think about the next step, but there might be a few tiny pieces of advice or commiseration in here for you:

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The fact that you and your siblings are somewhat agreed that something needs to be done is a huge start. Hopefully your parents are also agreed. Now you all need to sit down and hash out the following:

1. Would they prefer to stay in their home or move to a care facility of some kind? Note that you and/or your siblings may have to overrule the stay-at-home option if there isn’t a specific plan to care for them there.

2. Unfortunately, the most important: how much money do they have? Do they, by any chance, have long-term care insurance? Elder care is criminally expensive and overlooked in this country, so the more money they have, the more options.

3. How much are all of you willing/able to do? Can someone go there for a few hours every day? Is someone willing/able to have your mom live with them? Are they sure? Are they really, really sure? If so, which room would Mom live? Etc. Be realistic based on your job/family responsibilities/relationship with your parents. No judgment at all.

You need to get as specific as possible with your parents. How much are they willing to spend? What do they absolutely need in a long-term living option, if that’s what they choose? (For example, my mom was adamant that she have her own separate townhouse-type thing. She did not want people living above or below her. Fortunately she was able to afford it.) And of course this also depends on the specific kind of care they may need.

Depending on your family, it may be better to meet with your siblings first to hash out No. 3 at the very least, with some guesses as to 1 and 2, before sitting down with your parents. It’ll also, ideally, let you go in with a united front, which, again, is important if your parents are resistant to the plan.

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I’m a volunteer resident advocate in a nursing home. Many, many, many people overestimate their ability to continue to live at home. And many of their families overestimate their ability to care for their loved ones at home. No one ever wants to go to a nursing home, with good reason, but there are a couple of criteria that would make moving to a nursing home a requirement:

• If it requires 2 people to move them safely; related, if they need assistance with the activities of daily living (ADL) - eating, mobility, toileting (probably the biggest one)... If they can’t afford to pay an aide out of pocket to assist them at home, they’re pretty much out of luck.

• Dementia, obviously - it’s possible, with love and patience, to care for a dementia patient at home, but sometimes it just ceases to be safe for many reasons. That said, if a nursing home promises "dementia care," I’m calling bullshit on that one. Many dementia patients benefit from intensive daily therapy, but I can pretty much guarantee that they are parked in the day room for most of the day.

• If your loved one is prone to bedsores, that’s a really serious issue that requires nursing. Of course, people develop bedsores in nursing homes, but they are very hard to treat at home.

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Start having those conversations about the living situation sooner rather than later. Better for them to go to independent living too soon rather than too late. Because my parents delayed it too long, the move was chaotic, stressful, and became an emergency.

Many older folks can qualify for PT through Medicare, which is an important benefit. Keeping them strong and stable improves their quality of life and can mean the difference between an independent living facility, assisted living, and a nursing home.

If they have long-term care insurance, start the process to use it as soon as their health declines. It’s long and arduous, but can really help with costs especially if they need to go to a nursing home.

If you have siblings, strengthen those bonds and start having the hard conversations well before your parents decline. Navigating medical systems, care facilities, making hard decisions and taking care of your parents is a lot; sibling stress just compounds all of that.

Finally, don’t forget to take care of yourself! You’ll need those financial, emotional, physical and mental reserves to support them through this.

Even though it’s been heartbreaking and exhausting, I’m honored to walk my parents home and would do it again.

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I’m glad that I got some of the (it’s many!) Powers of Attorney handled early. A few years ago, my mom was in the early stages of dementia associated with Mild Cognitive Impairment. I was in real “fix it” mode, and my dad was... moving more slowly. When my aunt’s husband had a bike accident that left him in a coma, I used that as a ‘window of opportunity’ to say, “We better get our forms together, right?” I printed out a bunch of do-at-home stuff, but my dad took it as enough of a nudge to have it all properly handled with an attorney.

This has already paid off - our street has no parking after 6PM. Once their car got towed, it turned out I needed a Power of Attorney to retrieve their car. Bam! Easy! All to say, a witch might be able to say, “Hey, this isn’t about YOU, per say, but look what happened to Rosalie. Let’s just sign all this stuff now, shall we?” A huge dementia-related resource for us has been the work of Teepa Snow, an occupational therapist in Canada. She has a ton of videos, podcasts, etc that give you actionable (short!) tips. Her deal/space/beneficent empire is Positive Approach to Care. She offers a F R E E (no upsell) consult with one of her PAC consultants for anyone. My Dad and I did this together. It was really useful because then I could Reading-Rainbow it: “You don’t have to take my word for it!” If you wanted to see more of those consultants, the rate was very reasonable ($25 or $50 for 30 min).

I’ve also tried out a few caregiver support groups. It’s weird, but even if you don’t talk to yourself, it’s helpful. People there also tend to know (and tell you straight up) what good/beware-of resources are available locally. I’d like my dad to work with a ‘geriatric care manager’ to work on the next (living arrangement) steps. He’s not opposed per se, he’s just slow.

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Luckily — no, seriously, luckily — my mother fractured her pelvis when she was on the verge of moving into an apartment in my neighborhood, where I would have been a 24-7 health concierge. Once in the continuing care community, she realized it was right for her, but only then. So I guess part of the answer is to set your boundaries now, whatever they are, financial or time. As in: “I love you both, but this is what I have to contribute to your care, and that’s why we have to figure this out now.” I was at once lucky/unlucky enough that my mother’s care fell to me, as my sister’s was already in a memory care unit as a result of Parkinson’s, so I’m not sure how to make siblings do their share. But I do know that you just have to be almost defiantly blunt.

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Know what you are capable of, for whatever reason, and be clear. The complicating issue that we are now seeing with my in-laws is that they are also adults, and at the end of the day, unless you have a POA, they get to decide the next steps. (I doubt my stubborn mother would have listened had we ever gotten to have A Talk).

I WILL advise to do all the paperwork related to worst-case as soon as you can, while it’s a “just in case.” The one gift my mother gave us as a life-long legal secretary was that she had Powers of Attorney for health, finances, etc, all set and signed with backup plans in the event of her first choice being unable to act. Those meant we had fewer hoops to jump through when we had to act quickly when she got sick suddenly. My sibling sucks so I have no advice there.

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My parents both went very quickly downhill fairly young (70-72), my mother with COPD that became lung cancer compounded by absolutely overwhelming anxiety, and my father with Parkinson’s that he medicated with alcohol until he had a stroke and needed full-time care. He ended up in a nursing home via Medicaid; meanwhile, my mother moved to a fancy assisted living just half a mile away, paid for by her rich college roommate.

Dementia made my dad charming and affable; my mother’s anxiety and hostility made her impossible to deal with. It was two extremes of eldercare for two years, until they both died. I think we need more community solutions to eldercare that improve nursing home options. People shouldn’t feel terrible if they can’t provide at-home care to their parents; the American idealization of “independence” really makes no sense in this context. We all need assistance to live!

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My sister has been my mother’s live-in caretaker for ten years now. We both thought Mom would die eight years ago. Surprise surprise. I don’t mean to sound callous, but my mom is a handful and refused to move into a retirement home (“I hate old people.” Her words.) Plus, my sister thought they’d kick her out anyway since she can often be ...difficult. Four years back, Sis moved my mom with her across the country. And then I moved further away, too, so I don’t get out West to help often. Oh, the guilt and powerlessness. But Mom is finally in a nursing home now, and my sister visits her 3x a week. I ask my sister, “Can I help? Should I come out? Don’t you want a break?” It’s always, “Don’t bother,” which I both love and hate. So, I’m no help, but my sister could write a book.

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I am recovering from a decade of caretaking my elderly parents. I didn’t do it well — but I did the best I could. What I would change looking back:

1) Make friends with their doctor. I found that the things I needed my parents to make decisions on, they refused until it was an emergency. But, whenever the doc said it, they shrugged and said OK. This would’ve helped with the ending of driving, the moving out of a 2-story house, and getting a helper for food and laundry.

2) I would have the convos around all of this waaaaaaay before it happened. My parents were so stubborn and so deep in their denial.

3) I’d get an agreement with siblings. It will change. But just having a talk about who does what helps.

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I’m 60, with a 63-year-old spouse. In the last 5 years we’ve lost all four of our parents (ranging in age from 89-98). Both sets (married) moved into assisted living facilities. I have many thoughts! The corporatization of senior care is a problem. I found an inconsistency of caregiving and management in both facilities. Having sound legal advice when embarking on the move to a care facility is invaluable. The hands-on people are almost always compassionate and stretched way too thin. The pandemic made an already difficult situation into a tragedy beyond imagination. My mother ended her days in a private, family-owned nursing home in my town. If you can find such a place, move heaven and earth to get your loved one there at the very end (if that level of care is needed)

What I learned: take care of your health and all your faculties (mind, sight, hearing, as well as locomotion), understand what makes your life worth living, and try hard to have someone on the outside watching over your care. There really are no easy choices. Having money is helpful, and my heart goes out to anyone who is going through this process under any circumstances, much less a financially challenged one. Despite the difficult circumstances of almost all of their final days, they lived long and full lives, and our memories focus on the happy and meaningful times we shared. Our kids got to have a front row seat to this process. Now I get texts about strength training and puzzles, lol.

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You can read more of the replies to Sari’s Oldster post on this topic, including from some seniors who have already relocated, here.

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End credits

I hope this issue of Evil Witches (a newsletter for people who happen to be mothers) might be helpful to you or someone you know. If you feel that way, maybe it will convince you to become a paid subscriber if you’re not already. I went to a newsletter dinner party thing this week and feel newly empowered to say out loud instead of just hinting at it:

I would love some new paid subscribers! There, I said it. How embarrassing.

By subscribing, you show your support for this long-term newsletter, and you get paid subscriber extras. And it’s just fun to be a part of the kind of chats and whatnot that are just for you. Plus, I have a sort of intimate call for witchy stories coming in the next subscriber issue, if that will tempt you into joining us.

Some nice things people have said to me about Evil Witches include:

• “Just made me laugh and was a delight to read.”

• “Oh my goodness, this was the most validating newsletter!”

• “This might be the single best parenting related thing I’ve read in a long time” (that was about this issue in particular, about young adults looking back at their techy childhoods, to be clear)

The archives live here, by the way. I promise we cover topics aside from being in the sandwich generation, but a few other times I’ve addressed this topic can be found here, here and here. Man, I can’t wait to reach the era where I am not worried about everyone and can just fuck shit up for a little bit before I move into my own senior living home.

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One witchy thing