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Dad is 80 and Mom is 85. She was diagnosed with Alzheimer’s about 6 months ago, she is in need of a hip replacement, but won’t undergo surgery because she’s too afraid with her diagnosis of Pulmonary Fibrosis from a year ago. She is on oxygen 24/7.  She is in “excruciating pain” daily and therefore doesn’t move from her chair, except to use the bathroom and return to bed a few times during the day. Also, she is going blind quickly, with her recent diagnosis of Macular Degeneration and a stroke in one eye, too. Sometimes she remembers her medication, sometimes not. My Dad says “I told her to take it and she must have forgot!” “She won’t listen to me.” He is not attentive to her completely. He is also forgetful, a severe diabetic, and dealing with a not-so-successful knee replacement from a year ago. He keeps his head above water, just enough to care for himself, for the most part. How do my siblings and I help my Mom without insulting my Dad, his care is not sufficient. I feel like my hands are tied and it’s horrible to just sit back and watch this unfold. Yes some of us visit them while in Florida, but that doesn’t help for their daily needs.

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They are ready for at least an AL. Your Mom may even be ready for Hospice. You no longer have to have a diagnosis of dying in six months. They would help keep her comfortable . Call the Office of Aging near them. They will evaluate the situation.
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These guys are not going to make it at home. Insulting your dad is a minor issue at this point. I just went through getting my parents in care after frequent falls mom was having and my dads dementia increasing.  It was just in the nick of time.

Is there family near? You need boots on the ground soon.
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Your mom needs more care. Your dad needs more care. Someone needs to visit and arrange for a needs sssessment which can usually be arranged through their local Area Agency on Aging.
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So, this is helpful, however, both my parents are “just fine!” How do we convince them they need help?
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You don’t. You can’t. You have to work around the dementia.

My parents were just fine too. Mom bleeding all over from a fall and Dad driving around trying to find the hospital mom was taken to.

Once I got mom placed assisted living, I took Dad over to have lunch with her. He’s living there with her now “Until mom gets better”.

They are not leaving. It was tough and we’ll have some bumps but it’s was past time.

You’re there now with your guys I think.
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What Windy said. You get a needs assessment, at least in part, to know what someone ELSE thinks mom and dad needs right now. For some folks, hearing from a "professional" trumps what their "kid" thinks. Not often, but sometimes.

It also puts the elders on someone else's radar. And it make you feel like you're doing something.

Believe me, that last is NOT to be ignored. I think otherwise, the guilt when the big "something" happens is kind of overwhelming.
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Listen to Barb, and Windy.
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Patty, let me share a story with you. My aunt and uncle (he with dementia, she with CHF, but no cognitive issues) lived alone in a big isolated house, refused all care, accepted my cousin bringing in groceries and cleaning their house (cousin with 4 kids of her own, blind MIL living at her home, managing finances for 4 other elders, in her late 60s).

Aunt falls one day, can't bear weight. Uncle drags her around the house for 3 days on a throw rug ( I never asked about the bathroom aspect of this, didn't want to know). Cousin shows up with groceries and aunt says (from the throw rug) "every thing is fine. No don't call anyone, we're just fine". 911 is called. Uncle attacks EMS workers who removed aunt.

Aunt has hip surgery, rehabs well for 3 months. INSISTS on returning home to her husband.

24/7 caregivers were brought in at this point (Aunt and Uncle were seriously rich, thank G-d,) and although uncle fired the caregivers every other day, they knew to stay, I think they hid out in the carport until he was calm.

You can't make this stuff up. Interestingly, my aunt passed first of her heart issues; uncle lived in memory care and then a VA nursing home for about a year after she died. Happy as a clam, once they got him on the right meds.

Please don't feel bad that you can't fix this problem. I apparently had one of the very few cooperative demented elderly moms for which I will be ever grateful.
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Patty, check your message board.
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We did basically the same as Windyridge....Mom had a UTI, had to go into rehab after hospitalization as she was so weak, we finally took Dad to rehab as "Mom needed him with her" (he has pretty advanced Alzheimer's and could not be by himself...plus we discovered bedbugs in their home, so the agency would not send caregivers), then moved them into assisted living from there (we were still dealing w/cleaning out bedbugs, so used that as excuse) Mom was actually relieved in most ways...Dad was getting incontinent and they were 89 and 91...and Dad keeps asking my sister and I to take him home, which breaks our hearts, but we tell him he IS home...he is in his "retirement home" and that works as well as possible...most of the time he is content. It is very hard...we didn't have to use the aging council, but is a good idea, too!
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My father was the same way with my Mom. In fact, he was mean and cruel to her. So I had to protect her. It was sad.
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All the above advice is valuable. Read it, reread it, and act on it. Hospice is a great resource. Follow the recommendations that have been made about it.
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At the very least they need a morning and evening nurse or aide, maybe 3 hrs each shift.
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Time for Assisted Living or maybe even a Memory Home.

If they won't listen - call the "authorities" to check on them as they cannot live that way.

Better to be embarrassed asking for assistance than to later deal with charges of neglect.

And yes, I am sorry to hear about your situation. It's very sad how so many truly elderly are barely surviving.
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If your mom was diagnosed with Alzheimer's, she probably needs to be in a facility. You mentioned your parents go to Florida during winter. Hopefully your dad didn't leave without her, leaving her to fend for herself when she may not even be capable. It sounds like he may need some help of his own but if he left for Florida without her, then he needs his head examined and he needs to be baker acted for evaluation. No one should be neglecting a needy family member. It's one thing to reach out for help when you're dealing with someone with dementia or Alzheimer's but another to totally neglect or even abandon that person who needs help
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Regarding the Florida "snowbirds", do they have a local doctor who can certify the need for Home Health services? Also, if someone has that much pain sitting in a chair she may have a fracture, not just arthritis. I suggest you get her to an ER for an Xray.
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I echo what Bigsister said. Call EMS in Florida and have them take your mom to the ER. It would be best if one of their kids could go down an sort through all this. But, for the immediate term, your mom needs an x-ray. The hospital will probably send her to a nursing home ("rehab") afterward. Now is the time to research facilities in Florida and in their home area to determine where your mom will ultimately stay. It sounds like your dad needs assistance as well, at least home care. If he were to enter the same facility, they have the legal right to room together. Facilities have double rooms for just this purpose. Good luck.
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Do your parents have LTC insurance? You can tell him that if he doesn't use it, he looses it. And to use it, they should consider in home care or a move to a facility. Many of the facilities in my area of Florida are "age in place" types, where they can stay until they pass. I have also found the FL facilities are more reasonably priced that the ones in my mother's home state, by about half!

You can also tell him that if something were to happen, YOU could be liable for neglect and go to jail (a bit of a while lie, but I use it with mom all the time).

It sounds like this is also the time to have the tough talk about paperwork, is there someone that has medical and financial POA assigned, living will, pre-need guardianship, last will, and the person named to take care of their remains?

Good luck, wishing you strength to make those tough decisions and have those hard conversations.
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To those of you recommending hospice: Unless criteria have changed very recently, an individual must still be determined (by a physician) to have a prognosis of six months or less to live. Since predicting life expectancy is not an exact science, there will always be some people who will exceed the six months. However, on initial evaluation/acceptance into the program, the six-month or less estimate should be documented.
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Their medical insurance probably has Case Managers/Social Workers that work with the doctors to determine what need they have with their ADLs (activities of daily living). Once that is determined the Case Manager looks at their finances to best determine how to meet those needs. Check with their medical insurance to see if they have resources.
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They really need to be in an AL. I cannot see how they're even managing. Good grief!
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There is a saying that we are our own worse enemies. So true with the aged who just want to keep their independence. But....life for them is not safe any longer and a Social Worker would be able to help assess the situation and offer advice. Seems to me, tho, that someone needs to get POA for each of them, not only to keep them safe, but "viable" until the end comes. Good luck with your journey....it will not be easy.
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As long your parents don't ask for help, stay out of it.
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I would hope you could contact an agency and just hire someone to spend several afternoons a week with your Mom. To help her cook, as an excuse to get in there. Something like that. Thinking you need to initiate it though - they won't. It's unfair to her, she's in pain, that can't be ok. God speed. ( Tell her it is unfair to you, to refuse help, without which your life is miserable worrying about her? )
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It is most likely worse than you know - they are showboating for the family - this means they make much of good parts & ignore the bad - they can hold it together for some time but when you or other family members leave they go back to real normal -

They need more help than they realize - I'll bet they are doing minimum in cleaning - how often do they change sheets?, kitchen & bathroom towels?, clean out fridge? - if you can go through fridge & find expired, dried up or moldy items then they are in danger of food poisoning - this is especially true of those frugal people who will scrape off mold then eat what is left -

Does any of this sound familiar? - many of us have had these issues - so what if your dad is unhappy with the intervention - try for a united sibling front as that will show how worried you are then they can't undo all by getting another family member to be on their 'side' - there are no sides in this but keeping your mom & dad safe & as well as can be expected -

Try to get them to be near as many of the siblings as possible so that they have regular visitors when they get into AL - as they get older there will be more issues to solve -

Make sure their paperwork is in order while you're at it even if you state that you looked at your own wills & found them really out of date so are updating now & discount if mom & dad do it too [everyone loves a bargain]
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Seewell: I strongly disagree. An elder is not likely to ask for help.
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