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Questions tagged with 'elderly' at Ask MetaFilter.

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    Around 1999-2001 (maybe earlier or later) my grandfather ordered a "PC". It wasn't a computer in the traditional sense, but basically an Internet terminal. If my memory serves me right it had a monitor with handful of colors and a keyboard and mouse. All the insides must have been behind the monitor. I remember the interface was similar to AOL where everything was funneled through a homescreen and that is where you checked your mail and got your weather and stock information. Going to other websites looked terrible and it seemed like the browser had a hard time formatting anything that wasn't a proprietary website. It was awful. And pricey. The idea was that you paid a the company a monthly fee that covered the dial-up and the "computer" only cost $99 bucks.

    This is something that would have been advertised in the Wall Street Journal or AARP around 15/16 years ago. I could have sworn the name was "Web.0" or something terribly Y2K like that.

    Does anyone remember anything like this?

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    My family has a summer house with a steep, poorly lit stairway to the basement. The top exits into the kitchen. There is a door that is normally kept closed at the top, and guests other than children rarely need to go down these stairs. So, what's the problem? Recently, a family friend with a similar setup had their elderly friend tumble down such stairs (presumably confusing it with the bathroom), and were badly injured and had to be rushed to the hospital. We have lots of elderly friends/family/neighbors that regularly come over. So... ...what solution would you suggest to prevent elderly guests with poor vision/balance/sense of direction from accidentally falling down these stairs?

    I know a simple lock will not work, because other guests will inevitably find it a nuisance and leave it unlocked, defeating its purpose.

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    I'm travelling to help an elderly relative (in pain, sciatica, on pain meds) who is 83 and fuzzing mentally. She has been pretty good with computers for years, but is having trouble maintaining her PC. I thought an iPhone would be easier but she hasn't taken to it. So I'm looking for some kind of ultra simple phone (few features, big buttons, I doubt she'll text), and a replacement computer. She was ripped off by one of those flashing warnings that said "Your PC is infected with spyware!"; the assholes took several hundreds of dollars to "fix" it.

    My first thought is ChromeBook, I know phishing is still an issue but updating operating systems, Flash, antivirus software etc. is just not going to happen. Making it web based will allow us to help her with files remotely.

    But that's a guess, and changing from Windows will be confusing to her which is also bad. Any advice would be much appreciated.

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    At the end of the week I'll be staying overnight at the home of someone who is clearly exhibiting some early dementia symptoms. I've been incredibly lucky that no one in my family has ever had to deal with this before firsthand and I just want some tips so I don't accidentally be a jerk. My grandmother, who usually lives flying distance away from me, is visiting her hometown and staying with a very dear lifelong friend (we'll call her Vera) this week somewhere a reasonable driving distance away. It's been probably 5-7 years since my grandma has last seen Vera in person, and apparently she's suffered some cognitive decline since then that she's been hiding from my grandma. (This has been a complete surprise. They've been emailing, facebooking, and talking on the phone about the visit (Vera invited my grandma to stay with her in her home) and when my grandma showed up at her door Vera said, "it's so nice to see you! Where are you staying while you're in town?") I spoke on the phone with Gram yesterday morning while Vera was at church (so Gram could speak freely) and apparently Vera is "really struggling," repeating things a lot, asking the same things over and over, has to write checklists for herself for basic things like putting on clothes before leaving the house and bathing daily...it's not a great scene.

    Anyway, Vera has graciously invited me and my dog to stay overnight with her in a few days so I can spend some time with my grandma, and I want to make sure it's as un-stressful as possible for her while I'm there.

    I'm not exactly the most patient and charitable person, but I can make it work for two days.

    What do I need to know? What do I need to be careful about? I know she's embarrassed by this (hiding it from one of her best friends), so are there tips for gently handling the awkward moments?

    Also, is there anything I can do for her or bring to her house that would make her life a small bit easier after I leave? I know I'm only going to be staying overnight, but if you have something like "my grandfather has dementia and lives alone, this One Weird Trick made it a lot easier for him to ___" I want to hear about it! Vera has been a very good friend to my grandma since they were in their 30s and I know my grandma feels helpless and sad right now. Even a small gesture would do a lot of good.

    If it matters, Vera is 90 and still physically mobile/capable.

    Assume I am competent enough to be a good houseguest in general (i.e. be respectful of the house, clean up after myself, practice good dog guest management, etc) and a good houseguest to the elderly (I already intend to spend my two days there lifting heavy things, reaching high shelves, and doing helpful chores). I am looking for advice specific to this situation re: Vera's cognitive decline. Thanks!

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    What device or electronic setup would enable an elderly, non-tech-savvy person to straightforwardly view photos and videos with a minimum of fuss? Difficulty: no wifi, no 4G, no DVD player, no ongoing tech-support access, nursing-home setting with mild theft issues. This is for someone who has mail delivery but no online access at all, so I was ideally hoping I could find a setup that'd allow simple, reliable and non-buggy playback of video files pre-saved on some sort of pluggable media that could be mailed (SD cards? cheapie thumb drives?). You'd think that e-picture frames with video capability would be A Thing, but the few I've seen seem to get terrible reviews for reliability and user-friendliness. The user has played computer games in the past (c. Win 98 era) and could probably handle simple menu navigation or icon selection, but would absolutely not be up to recognizing or fixing any issues that might arise.

    Complicating matters still farther, this would be used in a sometimes-unsupervised institutional setting where there have been occasional reports of theft, so it'd be best if this could be done with either secondhand or conspicuously-inexpensive new tech. (As a side-note, if anyone has ideas for deterring such theft, or for securing belongings in these settings, I'd love to hear them!) On the bright side, premium picture and sound quality aren't necessarily a priority, as long as everything can be viewed. Thanks in advance, Metafilter!

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    An elderly relative of mine is retiring within the next few years. Help me find a therapist/counselor to help them through this transition. I'm looking up therapists/counselors/planners/life coaches on their behalf, but most of the retirement counseling services I'm finding via Google seem to be focused exclusively on financial issues and most of the therapists seem to be focused exclusively on emotional support.

    While my relative could definitely use some help with the complexities of financial planning in retirement, what they really need is someone to talk to about the life transition, particularly suggestions for things to do to keep themself busy in retirement (volunteering, social activities, etc.).

    I'm not even sure what search terms to use. Bonus points if you can help me find people located specifically in or around Indianapolis, though I may expand my search to Chicago if I can't find anyone in Indy. Ordinary therapist price range is fine, nothing exorbitant but no need for sliding scale/discount either.

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    Unfortunately my grandmother (85) suffered a stroke which left her left arm and leg paralyzed and required that she be in a nursing home. Although she initially could still walk, she now spends most of her day in bed. I would like to try to get her to sit in a wheelchair. The nursing home, however, is against this for reasons I'm not sure make sense. What can I do? After my grandmother had her stroke 10 years ago, she could walk (or more accurately, hop) with the help of a cane. Around 4 years ago, however, she developed a contracture in her left leg which meant she could no longer safely walk. She then settled for sitting on the side of her bed, or in a chair, or on a wheelchair which the staff pushed around.

    About a year ago, she decided she wanted to spend most of her time in bed (I suspect due to depression). Although we told the staff to put her in the wheelchair on a daily basis, this didn’t end up happening because my grandmother protested whenever the staff tried. To complicate matters, my grandmother doesn’t speak English, and so the staff were unable to communicate with her (so I think kind of gave up in frustration). I don’t speak her language either, so was unable to explain to her the importance of sitting up. The staff giving up and not telling me, combined with me moving away, meant that she was allowed to stay in bed most of the day. The staff did manage to get her in a water chair/tub chair, which is basically this institutional recliner with wheels, for several hours a day. She also got some sitting exercise when she would sit up in bed as the staff used a hoist/lifter to transport her to the toilet.

    I recently decided to try to help my grandmother get more mobile. My original hope was to get her a one armed drive wheelchair she could propel herself. The nursing home management, however, was really against this on the grounds that she may hit other residents (I’m not sure about the risk there, but I let it go for the time being). I then proposed that my grandmother simply sit in a wheelchair in her room. It turns out she is still able to sit on the side of her bed and in a wheelchair. On several different days, we have sat her in a transport chair for 1-2 hours at a time. She has good posture, and seemed secure. I thought, great, she can sit in a wheelchair at least for a couple hours a day to start. However, the nursing home administrator said no, she can't sit in a wheelchair/transport chair at all if I'm not there. They are saying that in order to sit in a wheelchair, she needs to be supervised (e.g. by the family, at group exercise or at dinner). Their argument is that she could slip out of the wheelchair and injure herself. There are several reasons why I am not sure of this point:

    1) She appears extremely stable while sitting with good posture. Her foot is firmly on the footrest to stop her from sliding forward. She has even started to doze off while in the wheelchair while we were there and was still stable with no signs of slipping. We had an occupational therapist (OT) assess her, and he said that she looked fine. All of the nurses on duty haven’t batted an eyelid when I asked to put her in the wheelchair. When I asked the nurses if it there was a risk she would fall out, they said no (when our risk-adverse nursing home administrator talked to them, they changed their tune).

    2) She was able to sit in the wheelchair unsupervised before, and there appears to be no significant physical deterioration.

    3) Almost every other resident is sitting in a chair/wheelchair unsupervised. Some of them have terrible posture, are slouching, and appear to be much more of a fall risk than my grandmother. It appears inconsistent for the administration to say no here.

    Although we could kind of acquiesce and tell my grandmother she can only sit in the chair during dinner, she would much prefer to be able to sit in the chair in her room while she does her everyday tasks.

    I asked the OT about what to do, but he wasn’t entirely clear. On the one hand, he said there were really no great risk of her sitting in a chair, but on the other hand, he said due to her age (85), he couldn’t officially recommend that she is left unsupervised. He did seem rather uncertain about this, and we have had different physical therapist/OT's in the past who have given very contradictory advice. So, I would like to continue to consider the wheelchair issue.

    The nursing home is suggesting that she just sit in the recliner/water chair in the reclined position (therefore reducing the risk of her falling forward). However, as I understand it, most of the health benefits of sitting are achieved by actually sitting up straight. Also, my grandmother doesn’t like the water chair, and complains of neck pain while sitting in it.

    I suppose my question is should I just let it go and give up? To the reasonable observer, there is no evidence that she is going to fall out of the wheelchair. In fact, if she hadn’t had her hiatus where she chose to stay in bed, I don’t think anyone would’ve questioned whether she could sit in a wheelchair. The nursing home is quite risk-averse, probably for liability reasons, but I feel sometimes this can go too far.

    However, in the interests of safety, I wonder if there any common risks to the elderly sitting in wheelchairs in the locked position indoors, or in chairs in general? I know that the safest option is to keep her in bed all day, but if the risk of her sitting in a wheelchair is reasonable, I think that’s something that we should do.

    I will try to assuage the nursing home's fears by having a long trial period, but I wonder if at the end of the day, everything looks fine, can we insist that they help her sit in the chair? Or is it up to them?

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    My parents are in their early 80's. The time has come for them to sell their house and move to an assisted living type environment. This needs to happen sooner than later. If you have gone through this process what do you wish you had known before you started visiting places? What questions do we ask? What type of financial set-ups have you encountered? I understand there are residential facilities within some living facilities that are small houses where can utilize the services of a more staffed environment and then as my parents needs progress they can move to a more care driven environment. Have you encountered this type of set-up? What accreditations do we need to look for? Is there a place to check for "reviews"?

    My mom was an active women until a year ago when she broke her hip. Her health has declined. Her dementia has progressed to a point that she can no longer be left alone. My father is in his 80's and is healthy, but that could change. They currently live in a large house with about an acre of land. This is to much for my father to take care of. Also, it is two stories with only a bathroom on the second floor. Adding a bathroom to the first floor and moving my parents to the first floor is not an option.

    Please understand the ONLY option is to move them to some sort of assisted living facility. The question I have is...what do I need to know to do this effectively and protect them for the rest of their lives.


    This is in the Maryland area outside of Washington, DC if it makes a difference.

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    My relatives are coming to visit the big apple and I would be chaperoning them around on a site-seeing tour. The problem is that they are elderly (are retired), from another culture & country (India), a group of 5 and there is a very young baby ( couple of months old) traveling with them. This makes using subways, or taking long walks or using bicycles a difficult proposition. What would be the best way to give them a good NYC experience? They would be here for 1 day on Sunday and would like something that can be wrapped up by 8 or 9 PM.

    I was thinking of one of those open top, double decker, get on-get off bus tours and would love to get to get your feedback and recommendations on various bus companies advertising out there.

    If you feel there are other better options, feel free to recommend. Thanks.

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    My 90-year-old aunt was just admitted to a nursing home, and they aren't set up to have landlines in individual rooms. For patients to have phones in their rooms, relatives need to provide cell phones. My aunt has some dementia. She still enjoys talking on the phone (and most of us live hundreds of miles away, so it's important), but she really is incapable of learning anything new. When I talk to her, she often won't remember something I said just five minutes before. More below. Every time I talk to her on the nursing home's phone, she gets confused and has to ask them how to use it and what to do when the conversation's over, so she needs a phone that looks and acts like a traditional phone. I don't think she'd be capable of using something like the Jitterbug, which I know is marketed to elderly people. I've heard that some elderly people can't process the Jitterbug's ring as a phone ringing - so I doubt she'd be able to. I have searched and found some phones that look good, but have been discontinued. I found this one on Amazon (http://www.amazon.com/Wireless-GSM-Desktop-Phone-Gadgets%C2%AE/dp/B00MWJS6HQ/ref=sr_1_2?ie=UTF8&qid=1448478717&sr=8-2&keywords=desk+phone+sim+card), but it doesn't have very good reviews. So I thought I'd ask here if anyone knows of any other options or has experience with the phone I found. Thank you!

    0 0

    My 80-year-old mother has been declining mentally in recent months. Recently she's been making some very poor decisions for herself, both financially and medically. I am her only child, I live with her, and I need to find some way(s) to get her to make better decisions, or to make them for her. My mother is 80 years old. I'm her only child and have been living with her for the past 2 years, since shortly before my father died.

    She was always very intelligent (PhD in Biology, ran her own lab, taught Anatomy & Physiology at the local college for many years), competent, and independent. She hates feeling dependent on or beholden to people.

    However, her mental faculties are not as sharp as they once were. She realizes this at least some of the time, and has made unprompted comments about not thinking as well as she used to.

    For a while now, I've felt she wasn't making the best decisions for herself, but I didn't feel it was to the point where I needed to step in. But based on a few incidents recently, I now feel we're at that point.

    The scariest one is that she became ill on Wednesday morning but would not seek medical care. She was coughing up blood-tinged mucus, had the shakes, and was running a fever. She has COPD and uses oxygen 12 hours a day, so symptoms that affect her breathing are especially concerning.

    I cancelled my plans for the day and tried to drag her to the doctor's to no avail. So instead, I spent the day caring for her since she couldn't do anything for herself. For the last several days, she'd been supposedly feeling better (I'm unsure whether she said this because she was actually feeling better or to get me off her case) and then worse, but still running a fever, sounding terribly wheezy, and just generally worrying the crap out of me. I finally told her today that if she didn't go to the emergency clinic, I would spend the entire day by her chair nagging her about it relentlessly.

    She finally went this morning, was diagnosed with pneumonia, and given instructions to go to the ER if she felt even slightly worse. She seems significantly better already, thankfully.

    I am so upset about this incident, by the idea that she endangered her life needlessly by refusing to seek care, by how helpless I felt watching her do this, and because I had to modify my own life significantly to respond to this, a fact she does not acknowledge.

    Less scary, but also concerning, are some purchases she's made lately, for big ticket items, most recently a refrigerator. The previous refrigerator worked fine, but she bought an expensive new one with the idea that it would improve the resale value of the house. I asked whether she's researched how much one would get back in resale value for this particular purchase, and she hadn't. And more importantly, it's putting the cart before the horse; we have tons of other things to do to prep the house for sale, if it will even be possible to sell anytime soon (nothing for sale on our street is moving). There is still most of a lifetime's worth of stuff packed into the house, which we (mostly me) are slooowly selling/donating/trashing. This process is made slower than it needs to be because she over-values some of the stuff.

    She's also failed to pay some bills, perhaps more than I realize. I found out about one because I happened to be home when she wasn't when a recorded "pay your bill or else get cut off" phone call came in. I was also shocked recently to see the cable bill on her desk and see how much she is paying for it still. We'd talked months ago about her getting the extra outlets taken off that are never used (she's paying for 5 but only ever watches TV in two spots). I just assumed she'd done so.

    After a friend suggested it, I tried to have a conversation with my mother tonight about my having durable power of attorney for her medical decisions (I didn't even bring up financial issues at this time). Long story short, she doesn't want to. She seemed to willfully misunderstand the bottom line, waving me away by saying "you could always call an ambulance" as if that settles the issue. But I can't predict what situations might arise in the future, not all of which can be solved by calling an ambulance. And I want to have a document in place that allows me to step in and make decisions, not just when some doctors deem her incompetent but as needed.

    I'm unsure what to do at this point. I could try having the conversation about power of attorney again, though I'm not sure how to get her to really even hear what I'm saying. I could try getting some legal entity to declare her incompetent, though I'm not sure she really is. She seems to be occupying a grey area right now.

    Any advice either from a legal or personal perspective would be welcome.

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    Some close, older relatives make terrible financial decisions, and are unwilling to stop. My wife and I are liable to wind up financially responsible for them when the money runs out in a few years. How can we wash our hands of this situation (or can we)? The husband and wife are in their early 70s. (For privacy's sake, I'm omitting how we're related to them.) They're deeply in debt, become more deeply in debt every month, have no money saved for retirement, and have all but abandoned the rental properties that were to serve as their source of retirement income (the ones that they rent out, they rent out to the idiot children of friends, who trash the properties and pay almost nothing in rent). It appears that this is just how they've managed their finances for decades now. Complicating things, they are hoarders. In all other regards, we have a close and friendly relationship.

    My wife and I have tried to help them get their act together, in response to their regular complaints about how they really wish they could retire, but our 40-year age difference yields only patronizing responses (basically, "nah, we don't need your help, kids!") Any solution that we propose—seeing a financial planner, seeing a therapist, spending less, selling off depreciating assets, us buying their rental houses—is shot down. In short, they don't want to solve this problem. But we've seen their household finances, and they're headed for financial collapse.

    Under family norms, it will be incumbent upon me and my wife to provide for these relatives when their money runs out. This strikes us as totally unfair—if they would just get their act together now, as we're trying to help them to do, they could remain independent indefinitely. And while it's true that we are not legally responsible for them, we'll have no less of a moral obligation.

    Is there any way that we can wash our hands of this situation, so that when the time comes, we can say, with a clear conscience, "you're on your own"? Or is the obligation to family so great that, no matter what we say or do in advance, we're on the hook to provide for them?

    0 0

    I have an old dog. She does not appear to be in any obvious pain, but I wonder if I should keep her on a maintenance med just because of her age. My 65-pound Rhodi-ridgeback-mix rescue is about 15 years old now. She seems to have a slight occasional limp, but other than that nothing that indicates chronic pain. She is increasingly reluctant to come outside with me every time I go, and she takes longer getting to her feet in non-emergency situations, but I am 52 myself and I like my Aleves when I need them, so I wonder if maybe at her age I should put her on a maintenance dose of something? I hate to think that she might be always suffering from some random pain that could easily be relieved.

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    After some prolonged time with dear old dad in the car recently, I noticed he constantly makes weird little sounds and vocalizations when things are quiet. I don't think he has any idea he's doing this. What gives? They sound like a pretty steady stream of the following:

    * Quiet Throat clearing
    * Mmming
    * Loud verbalized swallowing
    * A quiet "uh" stutter, like he's about to speak
    * Vocalizing small sounds while breathing
    * Lip smacking

    It's basically like whatever he's doing with his throat, he's making vocalizations outloud to go along with it. It's like the "tennis grunt" but instead of happening every time he swings a racket, he's making tiny noises every time he swallows or moves his mouth or breathes.

    Or you know how some people can choose to over-vocalize a sneeze? It's like he's doing that with every micromovement in his upper respiratory tract.

    I find it super distracting, annoying, and to be honest, a little bit gross.

    But you know, he's my dad, so I want to be sympathetic. It doesn't sound uniform enough to be a tic. He's a smoker and sometimes coughs a lot in the morning. He's fine in conversation and doesn't seem to have hearing problems, but maybe he doesn't hear himself doing this weirdness and doesn't realize it??

    What the heck could this be?

    0 0

    My elderly mom is experiencing a delusion that seems to be rapidly worsening. I am her only family and live 8 hours away. She will not see a doctor. What should I do? She has been in decline since my dad died 19 years ago after a 10 year cascade of illnesses. I tried to intercede as our house took on rescue cats and one severely traumatized incontinent dog, with the end result being a personal breakdown that resulted in the loss of my career. After that point, I had to remove myself from the situation for my own sanity. My infrequent visits to my childhood home show our house in disrepair. Her wedding dress was covered in cat fur and scratches from kneading. Things were covered in cat urine. The house smells. Cat vomit unnoticed in a corner. Cat fur in a sandwich she made for me.

    My mom has always been extremely determined and stubborn. When my dad was diagnosed with COPD and emphysema and I developed asthma, she refused to get rid of our cats under our doctor's orders. My asthma severely affected my life until I went away to college. My first visit back resulted in an emergency room visit. My mom doesn't believe that I have any allergy to the cats and that my asthma comes from dust.
    When I was a senior in high school, my father's cancer became terminal. My dad was catatonic in a hospital bed in our living room with home palliative care visiting intermittently. My mom did not want to tell her employer about his illness because she didn't want to become emotional at work and went to her job. When I called myself in to my high school attendance office saying that I had to miss school to stay with him, I received a call back from the dean saying that I would not be able to return due to missing so much school that year. My father died that night and I was ultimately allowed to return and graduate, but barely. (Odd aside -- my mother had dropped out of high school her senior year because her own father died.)

    Her anxiety is extreme. She hasn't traveled out of the city in 20 years. She will not come to my city to meet her grandchild. I have offered and she just simply says she can't. She will not see doctors. She will see dentists and all eye doctors, particularly because her vision has been an ongoing issue. She has had eye surgery and is facing vision loss nonetheless. Repair and delivery men are allowed in the house but none of our neighbors are. Her life centers around going to our public library, where she has an extensive queue of reserved books and art films, going to Whole Foods (she's vegetarian now), getting the five cats' health maintained, and watching two movies a day. She listens to NPR all day and follows world news closely. She presents as 100% sharp.

    The delusion she is experiencing began a few years ago. Her computer got a virus and she kept having issues with it. On my advice she got an iPad, which also had issues. She connected strange phone calls to these computer issues and cancelled her land line (cutting her off from our family outside the country entirely). She then went through a succession of cell phones, changing numbers constantly and angry when the companies wouldn't understand how to fix it. She cancelled the Internet and got rid of the computer and iPad because of "the hacker." My mom is very intelligent but has always struggled with understanding computers and Internet and cell phones. She began to only charge the cell phones at the public library (where she also uses the Internet) because of a belief that charging it at home opened it up to hacking. My attempts to clarify these misunderstandings have failed.

    The virus or whatever happened to her computer somehow connected to a light she saw in our neighbor's window. She confronted him and he somehow politely clarified that he did not know what she meant, and she decided he was not The Guy. The focus then moved to our other neighbor, who told her "F*** off" when she confronted him and told him to leave her phone alone. That incident happened about a year ago.

    Saturday she called me, happy that she had finally figured out how The Guy was "accessing" the phone. She said she saw a pulse of light come from his house into our microwave. She went to the library, wikipedia'd microwaves, and found the entry for electromagnetic interference. She said that she had unplugged the microwave and would no longer be using it. Yesterday she called from a burner phone and said that The Guy had now gotten into the DVD player and radio and that she had gone to a home security shop, where they advised her to contact a private detective and write a cease and desist letter to The Guy. She was near tears and saying all she could do was listen to a tiny radio in our kitchen. It's possible the light pulse she saw was a result of her vision issues. She told me I can call the landline, but don't mention the burner phone's existence.

    Right now I have been overwhelmed in my own life with a new baby, postpartum depression, and news of my half sister outside the country being diagnosed with brain cancer. We are just barely keeping our little household running. I don't know what to do. Everyone I have asked about dementia symptoms had their extended family deal with it. I have spoken to many doctors over the years about this and none have had any helpful ideas -- one even said, "why don't you have the rug removed?" when I told him about the ongoing urine damage from the animals.

    There remains one neighbor I trust. I have also identified the neighbor she believes to be doing this, a twentysomething political filmmaker activist. I am out of ideas and beyond exhausted by this. I've got nothing. What is happening here? What is she suffering from and what on earth do I do?

    0 0

    Elder care for an aunt with schizophrenia. Help me stay sane! My 75 year old aunt (let's call her Alice)who has had paranoid schizophrenia since she was 27, fell three weeks ago and broke her dominant arm (right humerus). Alice lives alone in a subsidized elderly/disabled complex in a city right outside of Boston where she has lived for the past 25 years. Her husband, who was also mentally ill, functioned at a much higher capacity than Alice and took care of all the household needs until his death 15 years ago. Since then, Alice has struggled immensely with self-care, household chores, bill payment, etc. After the fall, many issues with her safety and competency have come sharply into focus and I fear that she is no longer safe and/or capable of living independently.

    The past three weeks have been extremely challenging for me as her primary caretaker. Alice is my mother's sister -- my mother is away in Florida until April, so it has just been me, my husband, and my uncle (who is 80 years old) helping Alice. Mainly it has been me.

    Alice has a caseworker through an agency contracted through the Massachusetts Dept of Mental Health. It has been a struggle to parse out exactly what her caseworker helps Alice with besides acting as her representative payee. The agency receives her SSDI and then pays her rent, utilities, and medical bills. Alice gets a check for $75 each Monday and Thursday for personal spending, which she very quickly depletes on her most beloved items: Cigarettes, coffee, donuts, lottery tickets. She smokes three packs a day, so when her pocket is full she will get Parliaments, when she is running low on money she'll buy $2 cigarillos from the smoke shop. At any rate, this leaves her with very little money to buy food besides her $100 monthly food stamps. Alice borrows money from people, trades food items for money, gets food from the food bank, or begs a family member to take her grocery shopping. When I questioned the caseworker about how Alice's money is handled, she said that she has been trying for years to get an accounting from Alice about how she spends her money. I wondered out loud if $50-$75 a week could be given to Alice in a grocery gift card, along with $10 per week to go on her laundry card. The answer was yes, they could do that, but so far this has not happened.

    When I questioned the caseworker about what services they were providing Alice I was told "symptom management and medication management." The caseworker then revealed that Alice decided 18 months ago that she didn't need her antipsychotic medication anymore, so she stopped taking it (Prolixin injection .75 ml every 2 weeks.) Even though Alice had given permission for her caseworker to share concerns with my mother and I, this information had not been made available to us.

    When Alice fell she was taken to a Boston hospital. She was refusing to get her arm x-rayed and only agreed to it after her caseworker arrived and was able to convince Alice to get the xray. Alice was discharged home without any homecare services. I called the caseworker the day after the fall to ask for Alice's discharge papers and instructions. After 8 days and three phone calls the caseworker finally returned my call.

    Alice was already involved with Elder Services so I called them and asked for a nurse to come out to assess her for a home health aide. The nurse came out after about a week and saw that Alice's hand was very purple and swollen and suggested I take her to the ER. I did take her (this time to a different hospital) , and though it turned out to be normal swelling and discoloring, the very lovely and concerned Nurse case manager quickly put in place RN, PT, OT, Psych Nurse, and HHA services for Alice at home. The hospital wanted to admit her for three days per Medicare regs, and then send her to a rehab to recover. Alice flipped out at this suggestion, insisting that she can take care of herself. She can't, of course, so the last three weeks have been a nightmare of trying to arrange services, prepare for the future, and manage my own job and family. I am burnt.

    From the time of the fall to Alice's 2nd hospital visit Alice was calling daily, several times a day, for various things - groceries, help taking a shower, help getting dressed, various necessities - underwear, toilet paper, cleaning supplies, etc. Every time I went to her apartment she was completely naked because she had trouble getting dressed with the broken arm. At one point I arrived and the homemaker, who happens to be male, was in the kitchen doing dishes as she's sitting on the couch buck naked. He has since been replaced with a different homemaker. I have keys to her apartment and found her completely zonked on the couch with a half-burned cigarette in hand. At that point I decided to make a Protective Services report for self-neglect. The case was screened in and Alice agreed to allow the Protective Services worker to speak to me, her doctor, her caseworker, and her Home Healthcare agency. The case is still being investigated and I'm not sure what the outcome will be. There is definitely cause for concern with her ability to care for herself, and she is putting others at risk when she falls asleep smoking.

    At this point I've done the following:

    -Gotten medical equipment ordered through Elder Services (handheld shower, raised toilet seat, grab bars)
    -Applied for a handicap placard for Alice due to her difficulty walking with a cane in her left hand and her broken right arm.
    -Gotten Alice back on the Prolixin shot with trickery, bribes, and the help of her PCP.
    -Applied for a MassHealth frail elder waiver (she's like 50 bucks over the standard MassHealth limit with an income of $1,100 per month). The waiver would get Alice up to 24 hour care at home should she need it. However, there's about a one month wait for the application to be processed, and then another wait for services to start.
    -Gotten Alice's HHA services increased to 3 times a week.
    -Gotten Alice to accept home delivered meals
    -Gotten Alice to agree to pre-packaged medication in blister packs. Limited success with this as she thinks someone is trying to poison her.
    -Gotten her doctor to request a reasonable accommodation for new carpeting in her apartment.
    -Requested heavy chore services (her apartment is beyond filthy.)
    -Researched different living arrangements for the future.

    So what's my question here?

    Even with all the extra services that could be set in place once the MassHealth frail elder waiver is approved, I fear that Alice is not safe at home and not competent enough to make a reasonable decision. Her doctor, her psych RN, and I all think that she can't live alone anymore. Alice disagrees and immediately goes to Code Red whenever we mention a different living situtation. She has deep paranoia about being hospitalized against her will, for good reason, and her delusions are mainly about people trying to hurt her. Even with medication her delusions are there, she's just less agitated.

    She can't afford Assisted Living and there are very few placements for those on MassHealth/Medicaid. I don't think Assisted Living offers enough support for her at this stage anyways and I don't know if her behaviors would be tolerated. Her psych RN suggested looking into congregate housing or a Rest Home/Level IV Nursing home. Both sound like good options for her - she'd have her own bedroom but there would be a shared bathroom and kitchen, and supervision 24/7.

    If Protective Services deems her incapable of making her own decisions, I would consider stepping up as her guardian. I want her to be safe, for others around her to be safe, and for her to be happy with where she lives.

    Is there anything more that I have not considered here for housing options? Any recommendations for resources on anything related to the scenario above? I could move on my own to ask the court to appoint a guardian, but this would be very contentious and I'd most likely alienate Alice.

    Despite all of her challenges, Alice is very funny, clever, generous, and can be very sweet. She can also be very aggressive and extremely volatile - she's never been violent towards anyone, but she gives scathing tongue lashings to many people while we are out in public. People usually understand from her appearance and general disorganized/nonsensical speech that she's mentally ill, but still, it's difficult.

    Any advice or suggestions for this woman I love so dearly would be greatly appreciated. Thanks!

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    My elderly mom is a hoarder. What should I do? This is a long story, but I'll keep it as short as I can. My mom is in her mid-70s, retired, and a hoarder. I lived in a different state from her for many years, and didn't realize how bad the house was until I moved back to my home state recently. The house was full of garbage, insects, rats, and other creatures. The water had been physically disconnected many months earlier, when a flood occurred due to broken pipes. The bathroom was completely destroyed. Ultimately, a friend and I filled a dumpster half the size of the house with garbage, and then I hired workers to replace the bathroom entirely (it was sinking through the floor), as well as the shower, the basement stairs, the kitchen sink, nearly every water pipe, and I don't even know what all else. We cleaned out the bugs and removed the wild fauna. This whole adventure took about five months and cost ten thousand dollars.

    Through it all, my mom mostly sat around and watched TV. She sometimes "helped" by showing me what garbage I could pick up. She continued to throw garbage on the floor. Yogurt cartons, empty bottles, her incontinence pads. I made sure there was a garbage can in every room. Sometimes she used them. Sometimes not. Mostly not.

    We're at a point now where things are really strained. I got family members to give me money for a lot of this, but they rightly feel they've given enough. Most never gave anything, but have a lot of opinions anyway. My mom, who was largely passive while we did the work to restore her water, seemed to bounce back once she had the basic amentities of early twentieth century life restored. Then she started to be just really openly shitty to me. A lot. Putdowns, irritation at my presence, strewing her used incontinence pads all over the floor when she knows I'm coming over to get the garbage out, and screaming when I suggest the house still needs more work.

    Which it does. Her house needs more repair. Desperately. She was to obtain a grant for elderly homeowners, but remains incapable of filling out the paperwork, and will not allow me to do it. And the house itself is still full of junk. Even after we took out a giant dumpster of garbage, there's still mountains of "good" things we were not allowed to throw away. Boxes full of hundreds of pounds of filthy dishes that have been soiled a year or more, and that she insisted had to be kept. Dozens of garbage bags full of "good" dirty clothes that I can tell (holes have been chewed into them) are probably full of rat shit, and may have rats living in them right now. Other stuff. It's foul.

    And I am out of energy. I grew up in the house, and wanted to see it restored so that she could have a nice place to live. But I also just grew up in it, and it breaks my heart to see it treated so badly. I don't know what to do. I am certain that, left to her own devices, she will turn the house into the cesspool it was a few months ago. I am equally certain that I cannot spend the rest of my life cleaning up after her. She owns the house. I think that eventually the authorities will remove her from it if it does revert to form; the neighborhood is being "revitalized," and the rich hipsters moving in are unlikely to want to share their trendy home with my mom's trash palace. For me, it feels like every choice is a different kind of lose. I'm very frustrated. Suggestions are welcome.

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    Growing up, my family was squarely middle class. But that didn’t make it easy. My father was an alcoholic with a vicious temper. He was incredibly emotionally abusive, and on occasion, he was physically abusive. Think “The Great Santini”, minus the military elements. And minus the supportive mother. My mother – whom my father abused just as much as he did us – put up with every inch of it. What’s more, she basically took it out on us children, keeping herself cold and distant while never once acknowledging his faults. Now they’re dying, and man, are the guilt trips heavy. It was a miracle that none of us ended up dead or in jail. Seriously, it got very close to that at times. My father unsuccessfully attempted suicide, and one of us nearly killed my mother, literally. All of us children developed issues with drug and alcohol abuse at an early age.

    My siblings and I all left home as soon as possible. We all moved thousands of miles away. And since then, we’ve all managed to put together successful lives, although I’ve never had a desire to have children. Luckily, I managed to find a wife who also had no desire for children, and we’ve been happily married for 20+ years.

    But that’s more a testament to my wife’s patience than my ability to heal or reconcile. I fully admit that I have an intense fear of emotional intimacy, and I still have a deep reservoir of rage and anger at my core. My wife, who clearly deserves better than me, has put up with my inability to provide her with emotional support.

    Now my parents are in their 80s, and their health is failing. They’ve mellowed over the years, but they are still highly manipulative and incurably dysfunctional. My father actually abandoned my mother while she was in the hospital in another state undergoing serious heart surgery.

    But they’re both expecting me and my siblings to swoop in and start taking care of them now. We are fighting each other not to do it. None of us can stand to be around them for more than two or three days. The last sibling to try to visit them ended up leaving in a rage after a day and a half.

    But we are the target of endless guilt trips now. “Your mother is dying, and if you don’t come take care of her, you will regret it,” my father keeps saying. My mother, for her part, has guilt trips of her own to lay on us.

    I want someone to tell me I’m not an evil person for wanting to stay out of it. My father, ever the Christian, is begging me to forgive and forget. And while I acknowledge the value of forgiveness, I’m not sure being a Christian requires me to submit myself to ongoing abuse and manipulation.

    My wife, while she is extremely understanding, came from a comparatively idyllic family, and she doesn’t quite get it. She sees my parents as they are now, not as they were when I was a child, so she’s a lot more sympathetic to their current plight. She wants me to go take care of them now.

    Can someone who’s experienced this kind of situation offer me some thoughts or advice?

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    What can a woman living in a nursing home in the state of New York do with her pension income so that she is not in a constant state of qualifying for financial aid / not qualifying for financial aid? I'm asking for a friend so I don't really have all the facts at hand but the basic question is that a woman in the state of New York is living in a nursing home but receives a pension so that when the pension earnings accumulate to 14, 000 the woman's family is notified and they have to take her off the financial aid that is paying her nursing home bills. (I think it is Medicaid?)

    Apparently the problem could be solved if she just spent the money but she doesn't need anything.

    We understand that she could own a home and a car and still get Medicaid but that seems too complicated right now. Can you even pay a mortgage with your pension and still qualify for Medicaid?

    We also understand she can not "gift" any of the pension money to her grandkids. But could she open a college savings fund with the pension money?

    The reason I am asking is because the family has to do tons of paperwork every year when this happens and they are worn out. They have to do all the re-applying to Medicaid every year because of this.

    What do other people do in this situation? The staff at the nursing home have hinted at some solutions but I think they can't out-right tell the family what to do because it would be financial or legal advice. Not sure.

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  • 06/27/16--10:36: Friendships with the elderly
  • Are you friends with someone a lot older or younger than you? I did some volunteer work at a senior center and there is an elderly lady, 92, who I am starting to recognize is interested in being friends. Though it happens rarely, I have been friends with much older folks before and think I will set up a time to have tea with her. A part of me feels awkward about this and I don't know why.

    I never met my grandparents and am not close to any family members. This has made me wonder about other people's experiences. What have you gotten out of spending time with someone significantly older -- or younger -- who is not related to you?

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