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Managing an aging parent's health from 1,000 miles away...


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An UPDATE, as I'm getting ready to fly back to D.C. Later this afternoon.

In June or July (maybe late May even), we're moving my dad to a nice, small, family-owned/run retirement community [not even "assisted living", and certainly NOT a nursing home] about 3 miles from his house (so still very close to his Masonic network of friends). This is the same place my grandmother (his mom) went in 1996, when she was 99 years old, where she lived out her last 2 years.

Unbeknownst to us, this place is still in business all these years, despite not really having any online presence (we looked a couple weeks ago, and their URL had been snapped up a couple years ago by some squatter when they didn't pay their URL management fee, or whatever it is), and they still haven't sorted it out.

The place is very old-school, but spacious and nice in a utilitarian sort of way. It's small, private apartments, and onsite elder care services (and 24-7 staff). Nothing fancy, but very good people run the place, as best I can see. Over half their staff has been there over 10 years (some 15-20 years), and the current owner/director was new on staff there when my grandmother was there back in the late 90's. The place has only ever had 2 owners/directors (including the curent one), since it first opened in the early 80's. Both directors have also been the sole owners of the place (which I think says something).

So my Dad has experience with the place, since that's where he took his mother, and he's also known close to 10 other people who've lived there in the last 10-15 years, so he's been there a fair bit to visit people.

On-site dining, and the food was actually really GOOD (for what it was -- my dad and I had lunch there on Monday). So 3 meals a day, medicine management services, rides to doctor's visits (even way over in St. Louis, 30+ miles from where my Dad actually lives - and almost ALL my dad's doctors are over in St. Louis, because the county he lives in over on the IL side of the river, is one of the most litigious counties in the entire country, for medical malpractice suits).

They've had any number of residents there who were in their early 100's, even one who lived to be 108(!) recently. SIDENOTE: one of the original members of the Inkspots lived his last X number of years there too, recently.

They pride themselves on making it possible for people NOT to have to go into nursing homes, if they don't want to. They can handle dementia cases, in all but the worse manifestations. "In home (apartment)" hospice is also possible, and often elected.

The owner/director and all the staff we talked to were super down-to-earth, total straight-shooters, with what seemed like tenacious can-do attitudes. Almost scary how decent these people seemed. Damn good people, was what I got out of all my interactions with them. And they all seemed like very caring, and REAL, no BS-people. And fun too, if you can imagine. Turns out the director and my dad knew about 25 people in common, and she figured out which exact house my dad lived in, with not much info (they still don't even have his exact address), because she grew up about 6 blocks away from where my dad lives.

The place isn't fancy, but we think the place is just about perfect for my Dad, and he's fully on board with it. $1,765/month, all inclusive.

We need to do some due diligence in checking other options, but it would be hard to imagine going somewhere else.

Honestly, I almost can't believe such a seemingly reasonable, and already familiar place has popped up. 5 days afo(!)I didn't even know they were still in business, and yesterday he's already picked out a specific apartment, which they'll hold for 90 days for just $100 (which can be applied to his first month's rent), with just a $300 deposit once he moves in. Or if he goes somewhere else, we're out $100. And they'll even move all his stuff in for free too!

This place is really old school, build in 1982, with some updates, but mostly lots of TLC over the years. Maybe 80 units? Everything is all on one floor, with WIDE halways, and lots of natural light.

Blessed relief. Getting his house sold over the next year; that's the huge headache looming. But getting my dad somewhere that he's safe seems like a very near-term thing now. Maybe in as little as 7-8 weeks, or certainly by the week of July 4th.

I still feel overwhelmed, but not about everything. Just the house. And not as much about my Dad, long as we can make it through the next 2-4 months.

Edited by Rooster_Ties
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I'm glad to hear Dad is on board it seems like a good fit in so many ways. I have to wonder if it was less familiar to him whether he'd be quite so on-board.  Two questions I would have are

is there some sort of on-site "I've fallen and I can't get up" system? If he did fall how would anyone know that he needs help?

So there is no skilled nursing available?  It's hard to believe that dementia short of "the worst" doesn't still require skilled nursing to handle. Its not a worry now so not a big deal but I was surprised to read your description of the care available.

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1 hour ago, Dan Gould said:

I'm glad to hear Dad is on board it seems like a good fit in so many ways. I have to wonder if it was less familiar to him whether he'd be quite so on-board.  Two questions I would have are

is there some sort of on-site "I've fallen and I can't get up" system? If he did fall how would anyone know that he needs help?

So there is no skilled nursing available?  It's hard to believe that dementia short of "the worst" doesn't still require skilled nursing to handle. Its not a worry now so not a big deal but I was surprised to read your description of the care available.

Yeah, if my dad wasn't already familiar with the place, I think this would be a LOT harder, maybe an order of magnatude so. My dad hates change, but at least he's known and had experience with this place, off and on, for 23 years.

As far as skilled nursing, they don't have an on-site RN 24/7, but they do have another lesser level of nursing available throughout the day. I'm forgetting the details, but that is (as I understand it), the sole reason they aren't technically an "assisted living" level center. So close, but not quite. Something for me to follow-up on, though, thx.

Oh, and there are two emergency buttons in each room: a pull-cord above the head of the bed, and similar in the bathroom. He's also going to have an emergency call button around his neck, with automatic fall detection, so he should be covered 24/7 that way too, even if he blacks out.

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Dad got his emergency call button today (that that he wears around his neck now, 24/7 - even in the shower).  It's cellular based, so it works if he goes out in the yard, or (eventually?) if he can get cleared to be driving again (we're going to do a LOT of careful testing to make 100% sure he can drive again, before he ever does).

It also will automatically detect if he falls, even if he can't interact with the person on the other end of the line (like if he's unconscious, or incapacitated).  It gives both an exact address where he is (the best it can resolve to), and his GPS location too.  Supposedly local emergency people are called, like if he was 40 miles from home and fell -- the local jurisdiction's police/emergency are called.  I still have yet to understand exactly how they do that, but supposedly that's the case.  When he's at home (or in his home zip-code), then the first number on his call list is contacted -- which is his local police department.

We would likely continue that service while he's in the retirement community, we think -- or at least unless we determine it's duplicative of any support he can get there.  There will be two call-buttons (pull-ropes) in his room at the retirement center, in what will be his bedroom, and also the bathroom.  Of course that wouldn't help if he fell and was unconscious.

All to be worked out.  In any case, he's got it now, so that's some piece of mind right there.

BUSY, crazy day at work, trying to get caught up.  But it was good to get my mind off my dad today.

Edited by Rooster_Ties
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This is how I was confused ... there are pull ropes to get the desk involved, but the emergency button/fall detection is separate, which is in keeping with the idea of having a private space with communal meals and some personal care services.  Also in keeping with the fact that they don't have skilled nursing and that medical professionals should come to assess his condition, should he bang himself up on the way down, as it were.  I would definitely say this is something to retain after he moves.

 

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7 hours ago, Dan Gould said:

I would definitely say the separate emergency button/fall detection is something to retain after he moves.

Most definitely.  I was thinking way more down the line, if there's some specific reason that the personal (cellular based) button/fall-detection really isn't necessary.  I'm not specificly sure why, but maybe if he's either closer bedridden (years from now), and getting plenty of help getting to meals via wheelchair (or they're bringing his meals to his room).

But yes, initially (and for the next several years), I think the extra emergency button around his neck 24/7 (or whenever he's not in bed) -- with fall detection -- will probably be worth every penny.  It's $40/month, FWIW.  My dad's the one who's cheap about everything, but if we think it's important, it will happen.  We don't want to be penny wise, but pound foolish.

At some point, we could look for a non-cellular button that's landline based (so it would only work in his room, and within 100(?) feet of his room.  But I'm not sure the non-cellular buttons have fall detection.  Those seem to be $25/month -- so the potential savings (over the $40 model) is only $180/year, which in the grand scheme of things, is nothing.

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Mom has a system that is home-based, no fall detection (she's never knocked herself out thankfully) thru Life Alert. They have options for fall detection. The big box that is hooked up to a land line gets someone on the line in a couple of minutes, if they don't hear a response they contact EMTs close by.  Mom's house is large enough that they never hear her but if she can't get up she needs the help anyway.

Is there desk service 24/7? Because they'd have to get into the building and then into his unit. Mom got a free locking key case that is on the front door so the EMTs get in quickly and find where she's fallen. 

(she had a fall once while I was visiting. I am a heavy sleeper and my room is at the other end of the house from hers, she would never wake me up to get help. Can you imagine a heavy sleeper being awakened by an EMT guy trying to tell you that she fell, she's been throwing up and needs to go to the hospital? That was not an experience I'd like to re-live.)

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3 hours ago, Dan Gould said:

Is there desk service 24/7? Because they'd have to get into the building and then into his unit. Mom got a free locking key case that is on the front door so the EMTs get in quickly and find where she's fallen.

Yes, 24/7 trained staff on-site, overnights and weekends too. Not a skilled-nurse 24/7, but staff can jump in within 2-3 minutes in most cases, and call for paramedics, or whatever their procedures are.

And the fall-detection emergency button would call the front desk, if he ever falls and can't reach one of the emergency pull-cords in his room.

Edited by Rooster_Ties
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  • 2 months later...

AN UPDATE...

My Dad is doing really well, almost back 100% really.  He hasn't really had any need to use the wheeled walker we bought for him, and certainly not the wheelchair either.  He's had half a dozen tests done since the initial fall, and they can't really find anything especially definitive.  And although we'll never know for sure, lots of people have suggested that there's as good a chance as any that it was DEHYDRATION that caused his initial blackout back in mid-March.  For one thing, he was barely drinking more than 24 oz of liquids per day (sometimes closer to 30 oz), but almost never more than that... ...when everyone has been saying he really needs to be drinking more like 50-64oz of fluids per day.  He had ALSO had the flu about 5 days before, and that had really taken it out of him (and surely some sudden dehydration there).

ANYWAY, the good news is that his GP, and heart-doctor, and neurologist have all cleared him to go back to driving again (which he's been doing for about 3 weeks now).  He's NOT driving on highways any more (or only very rarely, and never all the way over to St. Louis).

All this has been a big wake-up call, certainly, and -- very long story, short -- *in September* he will be moving into the retirement community I was talking to you all about back in early April.  My wife and I spend a whole week with him in late May, and we went around to 7-8 different retirement communities (and a couple lower-end "assisted living" places too).  And in the end, the best place for what he wants in terms of location, and amenities, is the same place where his mother went (my grandmother), back about 23 years ago, when she was 99 years old.  It's not fancy, but he's going to be getting a rather large 1-bedroom, 2(!)-bathroom apartment that's ~600 square feet (almost the same size as where my wife I and live here in DC).  It's actually two 1-room efficiencies right next to each other, where they opened up a new doorway between the two units.  Which means that my wife and I can still stay with him when we come visit (hide-a-bed sofa in his living room).  And if I have to do some extended visits (which seems probable at some point longer down the road), I'll be able to be right there with him the entire time.  Tons of space (relatively speaking), and only $50 more per month than their 450 sq-ft units.

My wife and I will be there for about 10 days around the 4th of July, assessing what he wants to take with him, and doing some initial packing.  Then I'll be back another week sometime in August (just me this time, not my wife), doing some more serious packing.  And then he'll move in mid-to-late September.

I can go more into our plans for how to sell the house, and deal with all the contents in another post -- but the news there is mostly really GOOD -- and a much longer story.

But overall, everything's going well.  My Dad is getting more repetitious in telling me stuff, and it's clear that if we weren't moving him soon, that within 1-2 more years it would be much more of a necessity.  So years from now, I'm sure we'll look at this fall he had back in March as a big (and really good) wake-up call.

Edited by Rooster_Ties
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My 82 year-old mom fell again last week and split her knee open. Rushed to the hospital in an ambulance. 17 stitches to close the 3.5 inch cut and she's back home alone - AGAIN. She's had 3 fairly serious falls now in the past 3 years, with one resulting in a broken femur up near her hip. She still refuses to consider moving into a senior residential apartment building. She's got all her mental faculties so we can't make her move. I was actually hoping the doctors were going to refuse to let her go home alone again after this fall but nope - home she goes.

Can you tell I'm frustrated?

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5 hours ago, bresna said:

She still refuses to consider moving into a senior residential apartment building.

What are her main reasons for opposition? - if you don't mind me asking.  My dad was kind of hesitant (more than a little, actually), but after the kind of 'out-of-the-blue' blackout and fall he had -- it was a really was a huge wake-up call for him that he really needed NOT to be living all by himself, without anyone who wasn't also in their late 80's or 90's able to check on him.

I don't know that he's exactly thrilled about leaving the only house he's ever lived in (his entire life, save for college and a couple years in the army).  But at 92, he's ready not to have to be responsible for a fairly large house and large property, which is not getting any easier to take care of (for anyone over 80, let alone 92).

The other real wake-up call for him was that (at least for 6-8 weeks), he wasn't able to drive (and none of us were sure if he'd ever drive again).  It was a HUGE pain in the ass for him to have to rely on other people to help him get to the grocery store, and get to appointments, etc.  And he HATED having to rely on so many other people, and so frequently too.

My dad can be pretty darn set in his ways, and getting him to budge on something he's decided on is often like moving a mountain.  But he's been surprisingly willing to make this move, perhaps because it didn't have to happen overnight (he's not moving until September, is the current plan).

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19 minutes ago, Rooster_Ties said:

What are her main reasons for opposition? - if you don't mind me asking. 

I know you weren't asking me, but I will tell you in my case, my mother refused to move into independent living, despite the urging from my sister and me.  She was probably 77 or so when we first broached the subject.  Neither of us lived in the same city as her, and were 3+ hours away, so wouldn't have been able to respond quickly in the case of an emergency.  Ane no other immediate relatives lived nearby, either.  Her health was deteriorating, she was on oxygen 24/7 (she had pulmonary fibrosis), and she had gotten to the point where she needed someone to help drive her for routine errands.

Her primary reason was that she didn't want to die in a place like that.  She wanted to die at home, in the space she was comfortable in and had lived in for over 25 years.  She wanted to enjoy her possessions (acquired over a lifetime of living in a number of places around the world), and not be forced to downsize to just a small portion of her "things". Her mind was good, so we had to accept her decision.

She passed away in her house at 81 years old, so another 4 years after we first considered her alternatives.  I think she was generally happy, so it's hard to be upset about her choice, and how she lived her remaining years.  Though it did create a huge undertaking for us after she had passed, having to go through 80 years worth of her possessions, and figure out how to get rid of most of it.  And then sell the house.

 

 

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  • 2 months later...

ANOTHER UPDATE...

My wife and I are due on a plane in the morning, helping to finish packing up my father's stuff and then he's moving on Wed (Sept 4) into the retirement community detailed up above in various posts.  Then we have 3 days to help get him settled.

His house appraised at well less than half of what he was hoping it was worth, and given it's condition (it's been well kept, but there haven't been any substantial updates since the early 1960's -- original "updated" 1960's kitchen remake, complete with the same 1960's oven -- which only half works, etc...).  Much longer story, but given the issues with the house, which has never been inspected (since he bought it from his mother back in the early 60's), we have little choice but to sell it at auction (in early October).  The auction company seems very on top of things, very professional, and I've gotten nothing but good vibes from them (in terms of their competence).

The auction company is cleaning out the entire house, and auctioning everything Dad's not taking with him -- and thank goodness, because it would take my wife and I at least 3 months to do all that (working over weekends, and some evenings) -- but of course we live 1,000 miles away.  We expect the proceeds of the auction (of the contents) to cover their cleanout services, and we may net $1,000 from that (at best).  But I've heard nothing but the highest recommendations about them, including (unsolicited), by the appraiser we hired to get a better sense of what the house is worth.  I won't detail everything, but the house is all still knob-and-tube wiring, and there are 5 different electrical boxes (half fuses, half breakers), surely none of which would pass a modern code inspection (though the electrician my father had to have sign off on the whole thing -- my Dad did all the actual work himself back in the 70's and 80's -- that electrician said my Dad did excellent work).  But none of that is up to modern codes, to say nothing of the knob-and-tube.

The house has solid bones, and is in great structural shape.  But it's an OLD house, in very "average" (at best, and that's being charitable) condition.  And it doesn't help that it's located in only a "fair", very working-class part of town, and less than 2 miles from what is very perceivably "the wrong side of the tracks" (not that *I* think about it that way, but the reality is that buyers sure will).

My dad's mostly come to terms with it all, and he's taking it all more in stride than I would have expected.  ("What else can you do?" - is one of his 'favorite' sayings - or at least something he says frequently).

So his, and my boyhood home will be no-longer his (ours) soon.  He'll be out of the space about 95% by this time next week, and then the auction is October 5th (which I'm flying home for too, not that I really have to, but I feel like I should be there).

Just today -- really only in the last 2 hours actually -- I'm feeling like a ton of bricks on my shoulders.  Maybe the gravity of all this is just settling in.  I've been close to tears, back here in my office at work, at least 3-4 times.  Haven't actually broken down or anything, but it's all in there.

All in all, we're all -- my Dad included -- all pretty (reasonably) upbeat about the impending move.  And to say it'll be a HUGE relief that he's somewhere that people can check on him if he has issues, and where he gets three squares a day without having to lift a finger.  And where he doesn't have any stairs, or he doesn't have to go outside at all (in the winter, or in bad weather), if he doesn't want to.  All that will be a HUGE relief, and that's just days away.

I would never want to own or live in that house again, but I guess I've got more of myself tied up in it than I really realized.  Remind me sometime, and I'll share some photos.  My Dad also has this HUGE cross-stitch that my grandmother (his mother) did of the house, back during WWII -- it's about 6 feet wide, and 2.5 feet high.  Shows the house, and the whole yard.  She sketched it all first, and then designed the cross-stitch around it herself, and it's just an incredible piece of art, really.  I wonder if I can upload it here now, maybe I'll give it a try real quick.

Anyway, wish me well.  All positive news mostly, and a good transition, and not really a "tough" time, per se.  But I'm feeling way more emotional than I ever expected, on the eve of all this.

Edited by Rooster_Ties
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My mom finally decided she needed to be someplace with other people so she is moving into a retirement community on Sept. 3rd. I am very relieved as she has been falling more & more and I worry about her being alone in that house. Now she'll be where there is an on site nurse with fall monitors.

Like you, I am going through through the gut-wrenching task of preparing to sell the house I grew up in. Unlike you, it's in decent shape and not nearly as old. :) 

I am getting sick just talking about it. So many memories going away... well, a lot went away when my dad died but this feels more "final".

Edited by bresna
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This cross-stitch/needlepoint is a good 6-feet wide, and 2+1/2 feet tall.  My photo really doesn't do it justice -- the colors are just as vibrant as when she did it, I think (it's never had any direct sunlight on it, in all these years).  A true piece of folk-art, I guess you could call it.

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Edited by Rooster_Ties
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Do you know what kind of lumber was used to build that house? I ask because I've got an old friend who bought and old house in St. Louis decades ago, and come to find out, the joists and beams are all from some tree that's now extinct! It's a sturdy wood, and he said he's had offers to buy the house just to raze it and get that wood.

Bizarre, I know. But if you're taking the house to auction, hey, every selling point helps.

That cross-stitch though, my god...keep that with you or your dad by any means necessary. That thing is amazing.

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I managed both of my parents health for over two years from a half a mile away. . . it was still really really hard, I had no life of my own. 

But I'm glad I did it. I'm so glad my Mom ws able to have a peaceful passing, and that my Dad is so well-situated where he is now, even preaching again once a month in the chapel, and serving as "new resident greeter and orientation" for assisted living. He really blossomed again.

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Gents,

I'm having similar experiences. But it's my father-in-law, not my father. He's in hospice care at an elder care facility near us. About a year ago, we had to move him closer to us. He'd lived his ENTIRE LIFE on the same street in Rossville, GA, a suburb of Chattanooga. It was tough for him to leave. And it's been very hard watching his health decline.

Be mindful of time, friends. It's not going to last forever.

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4 hours ago, JSngry said:

Do you know what kind of lumber was used to build that house? I ask because I've got an old friend who bought and old house in St. Louis decades ago, and come to find out, the joists and beams are all from some tree that's now extinct! It's a sturdy wood, and he said he's had offers to buy the house just to raze it and get that wood.

No idea about the lumber in the house.  Far as I know, it's not a frame-construction house, and I think(?) the brick walls are load-bearing.  By way of contrast, our "brick" house that my wife and I owned back in Kansas City -- it wasn't covered in brick veneer - but the full-thickness brick was structurally considered facade.  But I think(?) my dad's brick isn't(?) facade, but load-bearing.

Of course, there are are joists and beams inside the walls.  But other than one small (narrow, but floor-to-ceiling) built-in bookcase near the front door -- there's actually no exposed woodwork in the entire house (except a bit in the attic, of course, and a couple really thick posts in the basement, load-bearing too, far as I know).

My great-grandfather was an architect (not of any renown or anything), and he actually designed the house (the father of my grandmother, who did the needlepoint).  And we STILL have the blue-prints, which are in excellent condition, and I plan to get framed one of these days -- as family keepsake, and as a memory of the layout of the house.  PLUS, I absolutely LOVE blueprints, just generally speaking (remember the architectural museum I work for here in DC? - since 2012).  So the fact that I have the plans for the house, and also manifest(s) of the goods and materials that went into it's construction, etc. - while not earth-shattering, is still kinda nifty.

My love of architecture kinda came a little through my Dad's love of BIG civil engineering projects (dams, bridges, etc...) -- but really more so, it came from my aunt (my Dad's sister), and my uncle (her husband), who were both art history professors, and they both had a deep love of architecture, Louis Sullivan, FLW, Eero Saarinen, Mies van der Rohe, and the like.  I used to listen to my uncle talk about architecture a few times a year, just extemporaneously when we would visit (same uncle I got my complete Downbeat collection from, starting in April 1965 all the way up to the mid-1980's -- every issue).

Anyway, enough rambling this late, I'm due to walk out the door here for the airport in 8 hours -- so I gotta hit the hay.

PS:  Come to think of it, though, those building manifests would have the type(s) of lumber all specified (I'm sure I've seen that), so what kind of materials went to it is not only a knowable fact -- it's something I'm sure I have ready access too.  Those manifests are still with my Dad at his house (I only have the blueprints here in DC with me, at the moment).  I'll have to look this week, if I get the chance -- or when I'm back in early October.

Edited by Rooster_Ties
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