Author Topic: Caregiving decision  (Read 2227 times)

daylily

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Caregiving decision
« on: October 18, 2005, 06:41:22 PM »
Hi everybody:

My mother has made it to a rehabilitation hospital.  After her rather horrible treatment by the medical establishment at two hospitals, I can't say enough good things about this place.  Both the care and the communication are wonderful.  When we come to visit, the staff makes a point of seeking us out to tell us how she's doing and what is planned for her.

It is very difficult to say how far my mother will come back.  At this point, she can barely put any weight on her legs.  She was in bed for 32 days, had several seizures and possibly a minor stroke, as well as the initial brain damage from the precipitating event.  While she has made remarkable progress, she is not the same person, and I think it's a pretty safe bet that she will never be that person again.

She will never live in her home again, and this brings up a very difficult issue.  I can't really bear the thought of seeing her live in a nursing home.  She is far too "present" for that.  She will know exactly where she is and why, and I think that may destroy what mental capacity she has left.  There is a strong history of severe dementia in her family, and I don't think it would take too much to push her in that direction.

So that leaves two options, as far as I can see:  high-end assisted living or living with one of her children.  That would be me.  My oldest sister and my brother won't do it, my middle sister can't do it (a variety of reasons, the main one being that her husband is already the invalid-in-residence in that household).  My husband is being absolutely wonderful about this.  He said recently, "You always told me that you wanted to take care of her when she needed you.  Well, she needs you."  We're doing research on ways to make the house more accessible (stair lift, first floor shower, etc.).

High-end assisted living is unbelievably expensive--almost as much as a nursing home, and with no state assistance to pay for it.  I think that financially it would be out of the question.  So that leaves living with me.  I want to do this, and I feel it is the right thing to do if it is possible.  I can't turn my house into a nursing home; I can't afford 24-hour care.  (My mother has almost no assets and a limited income, and my siblings have made it quite clear that they can't contribute very much.)  If my mother recovers to the extent that I can hire an aide for, say, six hours per day, and she will be OK for the rest of the time I'm at work, we might be able to make it work.  Logistically, anyway.

But oh, I'm scared.  I'm afraid that I won't be up to the challenge, that all the issues I've had with my mother will surface again, and I won't be as patient as I need to be.  I'm afraid that my husband's good intentions will crack under the stress of the day-to-day.  I'm afraid that my siblings won't cooperate at all, and so I won't have any time to myself ever again.

But I see this woman who is suffering, and I want her to live with dignity, surrounded by people who love her.  It rained, hard, the other night, and I sat on my bed listening to the rain wash over my roof and through the gutters.  It's a lonely sound, and it made me grateful to be in my own house, in my own bed, with my husband downstairs.  And then I thought of my mother, alone, in a strange place, in a strange bed, with no one to come and tell her that she's safe, that it's just the rain.

I want to bring her home, but I'm so afraid that if I do, I will be signing away my life to her care.

I'd be very grateful for anybody's thoughts or experiences.

daylily

Gail

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Re: Caregiving decision
« Reply #1 on: October 18, 2005, 09:13:00 PM »
Oh Daylily,

What a hard decision.  I don't have any idea what you should do as I'm sure there are lots of different variables to consider.  I know that none of the alternatives are going to be easy.  If you do have her live in your house, you probably will be signing your life over to her care.  I watched my mother care for her mother in law in her home for many years, and she had almost 24 hour help, and it was still all consuming.  (Some of that was the need to manage the caregivers!)  I guess what might help is knowing that if you make a decision and it starts to not work for whatever reason, hopefully, you won't be stuck.  I know some nursing care facilities are decent and some aren't.  Maybe it would help to visit some as you go through the decision making process.

Gail

Plucky

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Re: Caregiving decision
« Reply #2 on: October 19, 2005, 12:33:11 AM »
This is very tough, Daylily.  On the one hand, you know this is the last go round for your mom.  You want to make sure you don't regret your actions.    On the other hand, are you up to giving so much?  and asking those around you to do so?  Does she deserve it?  What is it going to take out of you?
I might face this decision soon.   I hope I will make the right decision.  One thing I will face is my mother's wishes.    So far, she has not wanted to listen to my opinion about anything concerning her welfare.  Will your mother have a say?  Is she clear enough to participate in the decision?  What does your husband think? 
Is there some way you could have her live very near you, like next door, and have a live in person who gets free rent in exchange for certian hours of care?  I have heard of people having this arrangement with maybe 2 or 3 people living in to help out, students or nurses, or maybe student nurses.   The rent of a larger place may be cheaper than an assisted living center.
I agree with Gail that whatever decision should be revisited if it does not work out.

Good luck with this.   Let us know how it goes.
Plucky







miss piggy

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Re: Caregiving decision
« Reply #3 on: October 19, 2005, 01:13:35 AM »
(((Daylily)))

You sound like such a sweet person...it must be really hard to think all this through, even with our nice parents.  My only thought was to ask you if any decision you do make has to be permanent?  Maybe you could try moving her home for a 90 day trial period or something.  I don't know how practical that is, if you have to make major accomodations to your physical environment, etc. 

I feel for you.  My Ndad is getting more frail by the day.  He has one foot in the grave and one foot running to get out.  He wants to die and get it over with  but he's scared, too.  Either case, it isn't living.  It's quite a burden for my mother, but I have her firmly in the driver's seat to make any decisions regarding him.  She wants him off her hands but doesn't want to be the bad guy either.  So they yell at each other constantly between naps.  I hear this is pretty typical but sheesh, I look at my H and hope we can be an exception... :?

Good luck to you, Daylily.  Don't rush yourself.  Write down your thoughts so they don't keep spinning in your head at night.  Take care.
MP

Sela

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Re: Caregiving decision
« Reply #4 on: October 19, 2005, 01:10:17 PM »
Hiya Daylily:

I'm glad to hear that your mother is at least recovering  somewhat and has made remarkable progress!  That's wonderful to hear!

As to your decision...it is so hard eh?  I empathize with you very much and I want to add to what the others have said, although maybe a pitch in another direction,  by saying this:

If you decide not to do this.........it's ok.  You are not a bad daughter or selfish or any other negative thing.  You do indeed have a right to your own life and serenity and it is YOUR obligation to look after you..too.  If you feel you might suffer mentally, emotionally, or physically, as a result of taking this on, it's ok to not do it.  The world will not end and your mother will get care elsewhere.  Life will go on.

I find it specifically generous of you to just accept that your sibblings will not help much.  They seem to have come to their decisions quickly, for whatever reasons, which you accept.  Please be as generous with yourself.  If you decide to do as they are.......be kind to you, ok?   It's alright to not take this on, if that's what you need not to do.

What will work out best for everyone?  This might be a very important question to ask yourself ??

Last..........if it were you...........what would you want your child to do?  How much burden would you want to put on that child?  How much would you expect your child owes you?   Which particular child do you think should bare the responsibility of your care? (sorry...I can't remember if you even have kids..but let's pretend you have a few).   If you knew your child would suffer......would you still require this of them?   Would you want your son or daughter to rearrange their home, their life, etc ...to focus on you and your care?  Would you want your child to "sign away" their "life" to your "care"?

The golden rule really is golden, if you ask me.   That includes...not doing to others as you would wish they would not to do you (maybe??).

I just want you to be sure that someone lets you know that if you choose not to take your mother's care on, that's ok too.    I hope if you deicde not to that you will really, really, do your best...not to feel badly about that decision or about yourself.    Your best decision will be the one that is best for EVERYONE (everyone........including you).

((((((((((((((((((((((Daylily))))))))))))))))))))))))))

Sela

Bloopsy

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Re: Caregiving decision
« Reply #5 on: October 19, 2005, 02:40:42 PM »
((daylily)))))sending you a hug!

Marta as guest

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Re: Caregiving decision
« Reply #6 on: October 20, 2005, 03:59:09 AM »
Hi Daylily,

Please forgive me for saying so, but I find myself getting angry and resentful on your behalf. If someone who's never met your mom can feel this way, then it is completely understandable that you and your near and dear ones may feel this way. I feel the pain and agony you are going through as you make your decision, and i think that you are an incredible person for submitting yourself to this. I don't see how with your courage and integrity you can go wrong.

Love, Marta


write

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Re: Caregiving decision
« Reply #7 on: October 20, 2005, 12:25:10 PM »
what a difficult decision, though you seem to know exactly what you want to do!

I do know though that caring for someone 24/7 is very draining ( even without your previous history ) so even if you can't afford constant care I would try to hire someone for a few hours a day if possible.

Good luck (((((((((((((((((((())))))))))))))))))))))))))))))))))

daylily

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Re: Caregiving decision
« Reply #8 on: October 22, 2005, 10:33:28 AM »
Thanks to all.  I'm in a slightly different place now, because my mother didn't have a very good week.  She has an infection that in ordinary circumstances would be minor, but now it flattens her.  I have to face the fact that she may never get well enough to leave a nursing home, no matter what I want or am willing to do.  I think there's a part of me that is saying, "If I just take total responsibility for this, it will have a good outcome."  And that's not true.  Her body has to allow her to recover, and she has to work at it.  Both of those variables are beyond my control.  All I can do is reassure her that she is not alone or forgotten, and be absolutely clear on what I'm willing to do for her if and when she's capable.

As far as my siblings go, and the division of labor--well, I've known it was going to end up this way for years, and frankly, they're behaving better than I thought they would.  Everybody deals with these things differently, and privately, and it's all too new to start demanding things.  (Although pretty soon, I'm going to have to.  My mother did not execute a power of attorney, and I've spent several thousand dollars on her bills--unfortunately, her property tax fell due right when this happened.  However, I know I'm in a better position to do this than the others.)

Right now, I'm sad, and I'm tired, and I find this all pretty hard to accept.  I have to remind myself that recovery from this sort of injury is measured in months, not weeks, and it will be a long time before there's a "final" outcome.  I think everybody's doing the best he or she knows how to do, and I'm grateful for that.

Anyway, I apppreciate your supportive words and good thoughts.

daylily


miss piggy

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Re: Caregiving decision
« Reply #9 on: October 24, 2005, 01:26:16 PM »
Hello Daylily,

Your selfawareness is really great:
Quote
I think there's a part of me that is saying, "If I just take total responsibility for this, it will have a good outcome." 
  Good for you for noticing this thought and questioning it.  It's such a human response to want to affect things positively. 

Uh, the billpaying caught my eye...have you spoken to an estate planning attorney about a conservatorship or some other legal way to allow you to do for your mother what she cannot do for herself?  IE her bill paying, etc. out of her checkbook?  You might want to look into that.  Also talk to him/her about keeping things "transparent" so your sibs know you are not ripping her/them off.  Also, if anyone puts up a fuss, tell them they can do it then.  :)

Just food for thought.  Good luck, MP

Hopalong

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Re: Caregiving decision
« Reply #10 on: October 24, 2005, 02:57:52 PM »
Daylily,
I moved in with my elderly Nmom seven years ago, as a "trial." (I hadn't even learned the word narcissism then). The thing is, as I worked through that learning, I didn't stop loving her or feeling compassion for her increasing ailments. So, I learned all about Nism. Meanwhile, she went from robust health to repeated, and likely inevitable, health crises and hospitalizations. Her sense of entitlement to remain perfectly content and perfectly comfortable in her perfect home with everything perfectly unchanged has aged me, worn me out, and literally affected my health in permanent ways (back injury from lifting her off the floor, emotional exhaustion from trying to maintain all her accustomed routines, and mental stress off the charts, zero help from a sibling). I seriously question whether my impulse to sacrifice my life to her care has been worth it. It will end some day, in natural course, but meanwhile, it's been very sobering.

I would just echo Sela, too. Be VERY careful to think of yourself with as much urgent yearning for your own health and wellbeing as you are thinking of hers. I've decided that as tough as it is, I'm going to intentionally train myself to LOWER my expectations for the end of my own life, so my child won't feel obligated to care for me into numbing exhaustion. Aging and dying are no fun. But that's the ticket price.

If she's in a nursing home, can you go by every day to just give her love for 30 minutes? If you can do that, then I think you'd be doing the loving thing. And an ample thing.

Every family's choice in these things is very personal and I know you'll find the right answer for you and yours. I just thought I'd share that the burden can be unexpectedly heavy, and have truly enormous effects, some of which alter your life in ways you might not visualize when you're awash in grief and compassion. So I'm a little more hard-headed about these situations now.

It's clear you are a very loving daughter. Deciding either way, or anything, will not change that.
Hopalong
"That'll do, pig, that'll do."

daylily

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Re: Caregiving decision
« Reply #11 on: October 24, 2005, 10:49:34 PM »
Hopalong,

Thank you so much for sharing your experience.  I've thought about a lot of those issues, of course, but it's easier thought than lived.  I very much appreciate your willingness to tell it like it is--and it often isn't very pretty.
Dickens was wrong when he put the delightful "Aged P" into Great Expectations.  I'm sure such smiling, wise, sweet old souls live somewhere, but I have yet to make their acquaintance.  Most of the old people I've known are mad as hell over what they've lost, and they often try to argue that it has been stolen from them.  (Although, to be perfectly fair, I ask myself whether they aren't completely justified, given that the culture in which they live marginalizes and minimizes them.)

As I'm sure you're aware, there are many nuances to this situation.  If things were just a little different, I probably wouldn't even consider taking my mother into my home.  I tell myself a hundred times a day to be sure I know what I'm getting into--you know, "be careful what you wish for."

But then I see that yesterday she was more awake, more alive, than she's been since this happened.  I actually sat and talked with her, and it was fine.  I thought I'd never do that again.  We're still on a day-to-day roller coaster, and it's really too soon to tell what will be best over the long haul.  But I'm trying to be as honest with myself as I know how--to ask myself whether I can live the life I would have if I did this.  And as of now, my answer is, "Within certain parameters, yes."  But those parameters are drawn almost entirely by her condition.  So you see, it will take some time to work this through.

But it means a lot to hear from someone who is living it, and who understands what is at stake--for both parties.  Thank you again.

best,
daylily


Hopalong

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Re: Caregiving decision
« Reply #12 on: October 25, 2005, 12:33:03 AM »
Any time. I could talk about caregiving issues for days...
I know that noble intentions can turn painfully sour, but I do still admire them.
In a nutshell, I know I have added to her already very advanced years.
But i believe she has taken years off my life. I am much, much older than when this started.

Keep us posted...
Hopalong
"That'll do, pig, that'll do."