We are fortunate. Our elders have all made their wishes known about end of life care at least to some degree. It’s actually in writing, which helps make it easier to cope with a painful reality for all concerned. That hasn’t meant that it was easy to do. Very few want to admit that death is a possibility let alone discuss it.
I don’t want to go: That has been universal. None of our elders want to go into a facility if it can be helped. It’s just not home and it isn’t like having personal space. Right now there is freedom of movement of a sort. If they want to go for a car ride, the only difficulty is getting them into a car. In a facility they would probably have to be checked out and back in. A nurse may say that they aren’t strong enough or they just took medication that could make them fall asleep.
Set conditions early: All of our elders have been told that there are conditions that would make staying at home impossible. Finances and health aside the biggest condition is physical. If one of them hits someone it’s game over. There’s no choice. We can’t take the risk.
Discuss early: This isn’t the same as setting conditions. It’s more complicated and it does involve finances, health and the ability of a family member to care for them. When it is impossible to provide safe care…safe for both the elders and the caregivers…options are limited. If a reverse mortgage is involved, a set limit has to be in place to make sure there are enough funds to pay for assisted living or other services of that sort.
Make it legal: Get it in writing. In fact, if you can, get a lawyer to write it and spell out conditions. Have it notarized. If it’s in writing it will be a lot easier to do what needs to be done. The elders can’t argue with a document they signed…much.
Adult Protective Services: Elder abuse is on the rise. Just like child abuse it’s a crime. Also just like children have child protective services, adults have adult protective services. If they feel one of our elders is being neglected or that we are not following doctor’s orders they have teeth and will bite. I know because a neighbor’s son is running into difficulties from this source.
If an elder’s doctor requires 24/7/365 awake care you have two choices. One is in home care. It’s medically ideal and financially draining. Look for the cost to be in five digits each month. The other is some sort of assisted living. An elder with dementia will have to go into a memory care sort of place. If you don’t provide, APS could remove the elder from your care and put them into whatever facility they wish…and you still get to foot the bill.
This information is important for your elders. It’s also important for us. Eventually we will be the elder and we need to do what’s necessary to make sure we will have the kind of care we want and need.