We have a dilemma that I can’t seem to fix. Any advice?

i am right there with except my parents refuse to hire anyone at all. Dad just had knee surgery and needs stretching and exercises if he has any real hope of walking again and they will not pay for it. They have the money. I pushed for caregivers pretty hard but they would not even try it so I am backing away. I have no authority to make them do anything. Whenever the complaining starts I just say maybe you should hire the caregivers. But I don’t get mad or upset anymore. At least not much. Their life their decision.

Take care of yourself and give yourself as much time as you need to recover. You have the caregivers setup for your parents so probably will be pretty easy to turn it back on if needed.

You are going to have to take the reins here. They will let you literally kill yourself. You are going to have to stop enabling their poor decision making and that will be tough. Please pay for a few hours of counseling with a Certified Licensed Social Worker in private practice so you can learn how to gently set down the realities of life as it is now, and you limitations, and so you can learn to stick to this so that your parents enter the care they need. Otherwise this will go on, getting exponentially worse and worse and worse. I surely do wish you the best. Honesty is difficult, but there are times that nothing else will do.

There are two of them so it’s very unlikely that one could become incapacitated without the other knowing it. If either of them are still cooking, the other can look out for leaving the burners on, burning food and things of that nature. You also need a discussion about throwing out spoiled food. Though you didn’t say so, it sounds like they might still doing their laundry and performing most of the normal household tasks that all couples of any age do. Perhaps a weekly housekeeper would be sufficient if that person is also a close family friend or someone they can develop into one who can be trusted.

My mother lived in her own home alone until the age of 94. She drove until she announced that she thought it was time for her to stop. She had no signs of dementia or frailty until she was about 95 when my brother moved in with her. Her husband, my father, died when she was 77. She always had a trusted housekeeper that not only cleaned every week but also had a decades long close bond with her and she checked on my mother regularly. As they both grew older, they became more like pals who watched soap operas together than employer and employee. All of us five kids also called my mother constantly. If your parents are still able to function as a team, your worries may be more about your own fears than real concerns about their safety. I have known many couples who lived safely together until they were in their late 90s.

Their irrational preoccupation with money is probably just a smokescreen that they are using to ward off your insistence that they give up their home and their independence. They are not ready to do that. Wait for some sort of crisis, hopefully not too big of a one, and they will realize when they need more care. In the meantime, be sure to let him know that you have to take care of your own needs and if they choose not to have any care in the home, you cannot make up for that lack of service. Have a pretty frank discussion with them about what you can and cannot do in both the short and long-term. In the meantime, do you have any brothers and sisters who can help out by maintaining regular, sustained and frequent contact with them?

Talk to them about your own needs and that you will not be able to stop by their house to help them with doctor appointments, groceries, etc. while you are recovering from your surgery. What would happen if they were left on their own? Would your mother be able to do the shopping, drive your father to appointments, cooking, laundry, etc? Also reassure them that they have enough money to hire people to help them. If they still refuse to have in-home caregivers, can you stock up their fridge and freezer with food so that they have enough to tide them over until you are recovered after your surgery? If they are of sound minds, they are entitled to make their own decisions about how to live, as long as they don't endanger themselves or others. My parents were like that. Only when my father passed away did my mother agree to move to a senior residence nearer to me. Good luck!

"Is this independent living?"

They may live alone.. but..??
This is an excellent question.

They can *independently* buy a burger - but this is not "cooking meals".

They could receive a meal delivery service you ordered - but could they independently arrange one? Store the food safely, look at use by dates, reheat?

This is the start of the slide...

PS Being *stubborn* about their level of independence is common.

Could be Denial - the cure is letting the consequences prevail eg cheeseburgers on rotation until they get sick of this, give in & accept an alternative.

But can also be Cognitive Decline, learning from consequences much less/absent.

Time will tell.

bliss - I know it's hard, but try to let go and let them be. They are of sound mind, and at 88 and 89, they should be able to eat whatever they want, as much or little as they want, when they want. If that cuts a year or several years off their alreadt very long lives, so be it. At least they enjoy what they can while they can. NO sense lengthening pleasureLESS lives.

They sound like their happy being at home. if this is their wish please let them have it.

Awww. God Bless your parents. They have one another they can and will manage at home. If for whatever, reason they need home care and meals just have them contact u. u go on and take care of u.

There are some people in this world, that translate every decision into $$. That way, it is easier for them to make decisions. To them, the lower cost alternative is the path to take. You are not going to change that method of thinking.

However, you can use that to your advantage. If you were to add ALL the costs it takes for them to live in their house (food, electricity, heating, water, sewer, lawn service, car, property taxes, etc.---make sure you account for all of your time at either caregiver's wages or how much you get paid at work, especially commuting costs), does it cost more than what an assisted living center costs? If you are providing food, make sure you consider your time and cost in getting the food, preparing it, and delivering it and include the gas or electricity cost for the cooking the food and cleaning up after cooking the meals. If you are only going there once a week, add more in for refrigerator cost. Does he have repairs coming up on the house? Could you rent their house? If so, subtract rent out of the cost for the assisted living center.

Sometimes seeing it in black and white is the only way to open the conversation so that you can convince them. Change is hard. Moving is hard. To them, your time is free, therefore, they don't consider it in the equation. You need to make them aware of the cost of your time. See what the numbers show....hopefully, the numbers point to moving to the Assisted Living Center as the lowest cost alternative.

Good luck.

What needs to be done is that you take care of your health and wellbeing, and you let them take care of theirs. Which includes stepping back from your role as their chauffeur, medical escort and grocery boy.

You've put them in touch with the services they need. Add in reliable cab companies, and if they like they can give you a weekly shopping list which you order online for delivery.

Establish the new routine now and save your time and energy in preparing for your surgery. Best of luck, hugs.

Your priority is you and getting well after surgery however long that will be, could be month or three.
Your parents at this point should help you, offer support.
There is no dilemma, frugal is one thing, taking care of their needs and paying is what responsible adults do.

blisss2022: Discontinue enabling their so called 'independence.' You are no longer readily AVAILABLE and also your health needs attention in the form of your scheduled back/spine surgery. This may force them to look inward and say quite possibly 'Oops, guess we do need that help that we cancelled.' Bottom line: The way I see it is if you keep being available for these periods of time, they then do nothing to change their life, which needs to be amended. It is THEIR dilemma and not your's. Don't put that on yourself.

I think that you are hoping that your parents will change their minds, if only you can convince them. I suggest that you stop all the ‘discussions’. Talking about it is not helping, and is only stressing all of you.

Just start saying that you can’t come this time. Don’t turn up. When they phone, say that you aren’t feeling well and can’t come. Repeat, repeat. Perhaps every time, perhaps once to experiment, then build up to make it frequent. No arguments, just actions – they speak louder than words, can be much less painful, and much more effective.

If this seems a bit irresponsible for you, tell them the visit before that you have not been feeling well and may not be able to come so regularly. Leave them with a list of people they could contact for jobs. Don’t offer to organise it yourself.

Ask them to do it for you. They are both in excellent shape but deep down they know they need a little help and it would be great if it was just 5 minutes away from you.

I know the feeling w/my wife passing recently I am the primary care giver for my my mother in her 90s...I may be facing knee/leg surgery if injections/therapy do not work. Rehab for me could be 3 months plus..My mother constantly says put off surgery..I try to remind her if I DO NOT care for myself I will of little use to her...her reply is normally just put everything off. Sometimes you have to be & blunt care for the care taker. Best wishes as I understand...

If your parents won’t listen, then you will have to let them sink or swim. The best you can do is leave them the contact information for the home health aid company, provide them the brochures for the assisted living companies in a folder, provide a list of handicap accessible taxi services to take them to their doctors, and phone numbers for meal delivery services.

Then notify them that you will not be available for between two and six months depending on your doctor’s advice due to your surgery.

They will have to sink or swim without your help. They were able to do it when they were fully functioning but not now. They will have to experience their current situation on their own to understand what they are unable to complete.

My in-laws gradually were unable to do things and their home fell apart around them because they didn’t want to ask for help. It would have required too much of a change. The only way things changed was when my FIL, a sweet man, passed and my wicked MIL was frightened to remain in the house alone. She made a mess by calling the police all the time and we were told she would be taken for evaluation if something wasn’t done. She ended up in assisted living as an angry person taking it out on her family who refused to take her in because of bad behavior. She has doctors come to her, gets to keep a nasty little dog, and gets the care she needs. She repeats that this is not what she and FIL agreed upon but she couldn’t stay in the house where she was frightened and refused services.

When you are unavailable to your parents for your surgery and recovery - it might be their required wake up call. Elderly parents can be selfish and in denial regarding their circumstances when they refuse to consider the physical, mental and emotional toll they make on their adult children / family members. IMO the home assistance setup you had provided for meals and health aides was IDEAL for them. They were selfish in denying those services and forcing you to pick up that support. They may appreciate it when you are not there but NOW you need to focus on your health care FIRST. I would be pretty blunt with them about your medical situation. Otherwise, they may think you will return as before post recovery if they believe this is just a short medical leave for you.

livingintx - made some valid observations that I had seen when our mother initially moved to AL before she needed to move to NH. Our experience was certainly not as bad as her mom's experience. However, it was very clear the facility was for profit and not up to caring for elderly residents as their care needs increased. Also, a resident could be discharged for whatever reason on short notice and many AL will only allow a minimal number of Medicaid residents as required by your state laws.

I certainly am NOT saying all AL facilities are negative places as many residents have very positive experiences. It is excellent that you have several AL choices to compare them. Just go in with eyes open and understand how they operate and what additional fees are charged for added services.

This is going to be difficult but absolutely necessary.
Leave them the numbers for a senior shuttle service (for doctor appts); leave the pamphlets you collected at the AL facilities and make sure they have enough groceries and home supplies to last a few weeks; and kindly but firmly tell them that you will not be back until after you recover from your surgery; or if they want to discuss the options for assisted living.
Explain that you love them enough to want the decision to be theirs; but you can no longer watch them make bad decisions and have to take care of your own health.
We went through this with my in-laws and it was the only way to get them to understand they were in need of more care than we could provide. Our health and marriage was suffering as well; but they dug in their heels until we put a line in the sand. It's generational - not just your parents.
I hope when you spoke to these facilities; they told you if they have a waiting list?
It's not uncommon for them have a 1-2 year wait; so it's imperative they get on one. Some hold a fee; other's just put your name on a list. When they call to say they have an opening; your parents can always decline and go back to the bottom of the list.
As to the money; remind them that this is what they saved their whole lives for - to be able to care for themselves and not depend on others.
It is extremely hard to walk away; but they have become utterly dependent on you, and until you cut off your visits for a few weeks they won't appreciate just how much you do for them and how badly they need to get into assisted living.
Please take this step and do not cave when they call begging for help or yelling at you because if you don't take them to an appt. Have all the phone numbers and contacts ready for them and remind them that you are unable to come; so if they need something they need to contact someone.
Pray for strength and resolve. This won't be easy; but it's necessary to get them the help they need.

To address "livingintx" comments: I wonder if her Mom was in 'independent living' at first. They don't provide the same services as AL. Assisted living typically provide all meals; they don't have stoves; only microwaves); and have a nursing staff 24/7 (not just weekdays 9-5).
Also; as to her other comments regarding care; med management etc:
1) check your state (in Nevada and New Mexico); the AL facilities are all regulated by the state.
2) Unless your parents are declared incompetent; you have no say in hiring/firing of a home health company; unless you pay for it or they live in your home. The elderly are well protected from 'elder abuse' and most facilities will not act solely on your request.
3) AL often charges by tier of care needed; and resident interaction is based on this. If a resident doesn't want monitoring (such as wellness checks every few hours); they will leave them alone to live their life as they choose.
4) They will charge more for additional levels of care; and yes; you would have to talk to the staff to find out what care is included in certain levels; but because they allow the residents as much freedom as they want (until they are declared incompetent); you may have to intercede and ask for help.

Based on my experience; our AL facility is reasonably priced; not over the top snazzy; but well maintained and highly sought after. All meals are included (they will deliver to the apartment if they are sick); they have activities; vans to appts. (if you prefer; they also have doctors/nurses that will come to the facility regularly so they don't have to travel)
When they first moved; they didn't need any extra help; now after a few months; MIL agreed to med mgmt (slight added cost monthly); and they just recently started wellness checks on them every couple of hours (no added cost). PLEASE do not shy away from encouraging them to get into AL. We are not all 'caregivers' at heart and your health is important too!

So assisted living sounds like the panacea you want. But it's not. Depending upon the facility you will still have to get them paper products, diapers, and some food. You will probably have to take them to drs. appts. because the van will probably only take them X number of miles away or only to appts before 1pm.
And when one of them or both gets too much work for the staff, well, they'll kick them out without having to provide any reason, and do it probably the day they are supposed to return from the hospital. OR they will tell you, you need to pay more and the cost you thought was X will be XXX.
I've just gone through this. No, not all ALs are the same. But most are. And you can't judge a book by its cover. They usually are not really overseen by the state, like nursing homes are.
To me, an AL is just a waste of money and a problem waiting to happen and a lot to have to deal with from the caregivers to the director, to the nursing staff, etc.
And that is almost MORE stress than dealing with an elderly parent.

You should re-hire the home health care and meal delivery. Tell them that's required and you're not going to discuss it. Buy them both an Apple watch so if they fall it'll call 911.

Tell them you can no longer care for them. It's not your job or your responsibility.

Everyone thinks an AL will help. Maybe for a few days/weeks/months, maybe years, but it depends on the AL. There are TONS of news articles about how ALs dump people once they become too costly to support. https://www.cnn.com/2018/09/20/health/assisted-living-eviction-partner

If they have a safe place to live now, keep them there and just hire help. If it has to be 24 hours, and they have the money, do that. Find a few caregivers who want to work for them long term.

My mom's in one of the nicest places in town. They keep forcing her to pay another $400 for this and another $400 for that. She's fallen twice and had to go to the hospital. Both times she laid there for hours screaming for help. Their call buttons don't work or the staff don't show up. They tried to give her someone else's medications twice. (I think they were actually trying to drug her.) Her toilet backs up into the shower frequently. They went from saying they'd do her laundry daily to now saying once a week. The food is up and down, but definitely not giving her enough nutrients. Although she's gotten older, she's gotten worse from the stress, the bad food, and the falls. One was probably because the shower doesn't drain and she slipped on the water.

This was the second one she's been in. The first, a brand new place, didn't give her meds for three days. She's on high BP meds. The med techs didn't know how to take BP, and the food was horrible. The staff could never tell me specifically what she was getting in terms of care. So she really never got the care they promised during the sales pitch.

What an elderly person needs is a) a safe place to live with assistant items like wheelchairs, bath chairs, etc. b) someone to oversee daily living activities like bathing, meal prep, etc. c) some stimulation mentally or emotionally.

A home, apartment, can provide a place to stay. The rest is really hired home health care workers.

Best of luck.

How about turning it around a bit and telling them that having someone there 2-3 times a week to take care of those things you have been and actually seeing them enables you to focus on you. If they don’t have that while you are having surgery and recovering you won’t be able to relax knowing they are safe and everything is covered which will disrupt your needed surgery and recovery. Once you are all recovered you can talk about the services and possibly moving so again you don’t have to make the 2 hr drive and 2 day hiatus from your own life but for now could they please humor you and do this so you aren’t worrying about them?

Giving them some ownership and an important way to be taking care of you might help them at least embrace the home care again and it may help them see that they need more help than they thought and even if they put it on you (you worry so much and we want to help relieve that) maybe they will decide more help or moving is wise after your recovery.

Good luck on your surgery, there is only so much you can do to care for and protect your parents and if they can’t bring themselves to cooperate you need to work at letting go and let the chips fall where they may. It is not easy but this surgery actually provides you the perfect distraction, you can’t protect them without their help unless they are deemed incompetent to make their own decisions and you have DPOA and you have done all you can to set up help, you are not responsible should something happen, should they have problems keeping up with their needs. It is very hard for some elders to accept that they need help, especially when they are fully competent mentally and have learned to compensate for growing needs physically over time and the only way they see the light (sometimes they never see it) is when something big and scary enough happens. In these cases unfortunately we the people that love them have to step back and just pray it isn’t life ending. It’s still their lives, their choice and kind of like watching your teenager make poor choices and just hoping it will be life altering in a positive way rather than a negative one.

The elderly become very self absorbed and almost blind to the work and time that family members are giving to sustain their so called independent lifestyle. You don't need to be hateful, but you do need to be firm when telling them that you are running around like a chicken with its head cut off and you cannot sustain what you are doing. Point out the things that they can no longer do and then tell them how much you love them and you want to resume being their daughter and resign from being their work horse. Remind them that you have a life and a family of your own and you have health issues that need dealt with. Tell them their choices are to hire everything out or move closer to you in assisted living.

So would they still believe that they independent if you stopped doing what you are doing for them?
Tell them that you can not do this and since they seem to be able to manage you are going to need some time to take care of yourself.
Take a few weeks to get yourself, your household ready for your surgery. And see how they do with 2 weeks of no help from you. They might realize you are right.
If so then they can make a decision as to where they want to move.
OR
Tell them that they are going to HAVE to move to AL for a month or two (I would go for the 2 months) while you recover.
Help them move in a week prior to your surgery no longer so they can adjust to asking AL staff to help them with what they need. Then it is possible that after a month they may realize that they like it.
If they still want to return home you have to tell them that they will have to have Home Health Care and meals delivered because you are still unable to do what you have been doing and tell them it is Doctor's orders. You can use that excuse for at least 6 months! (maybe even up to a year but you can't take that ski trip!)

It's so hard to cross that line from doing what your parents tell you to do to putting your foot down and telling them how it's going to be. I know. it probably won't be pretty. Parents just think of themselves as independent and not reliant on their own children, but there comes a time for everyone when we need help with things we can't do. It has to be somebody, and if it can't be you then it has to be someone else. I would just TELL them your needs, and let them chew on it for a while. They'll talk about it between themselves and I'll bet you'll be shocked to learn that they'll come up with solutions, and think it was all their own doing. If they want to be independent, that's fine, they can make independent choices of how someone is going to help with their needs.

I understand you dilemma. If only our parents would accept the reality that the time has come to accept help or move to a safer location, etc. They make it such a struggle.

My mother was did the same thing your parents are now doing. Then one day, her back fractured from osteoporosis - could have been a fall but no one was there and she didn't admit to anything.

That was the final straw and I moved her into my home - she didn't want to, but I had let her wait until both of us had no other choice.

I wish you the best. Your parents are blessed to have you.

Try putting it bluntly... with your health (and theirs), there may very well be a health crisis that could change the situation overnight prohibiting you to continue helping. I have a friend in that situation right now caring for her husband... she now desperately needs surgery because she put it off with no care plan. With you out of the picture even for a few weeks, what will they do without your care? Because you love them, you are trying to have everything in place so you can take some time to take care of yourself when you have your surgery.

I learned this when my husband fell and broke his hip. I had to make an immediate decision what rehab to send him to and it turned out to be the worst place because I could not check around. With all three of you being vulnerable to a health crisis, because you love them you want to be sure they already have a plan in place. You may even want to appeal to your father, if he has another heart attack, what would your mother do by herself trying to arrange all the care they both need if you happen to not be available due to your health.

They need to be reminded how blessed they are to have you. I've tried to approach this very subject with our sons and they totally agree it is important but have not responded to my attempts for deep discussion of how to take over in an emergency. Several years ago my youngest, out of the blue, asked what would they do if something happened to me! At that time I had not given it much thought and simply said I don't know. Since then I have made attempts to discuss it and at least have our documents in order to try and make it easier. Hopefully your parents will become more open to discussions you need to have with them and to a care plan that works for all.

Have you tried saying "mom, dad, I can't do this anymore. I can't come once a week and stay for 2-3 days. You'll need to make other arrangements if you don't want the services I've set up"?

Don't be tactful or dance around the issue. Just "no, not doing this any longer. Your choice what to do next".

your parents sound so selfish I feel bad for you

If you have power of attorney I would move them to an assisted living. My mom actually “loves” it now that she is there..she maintains lots of independence but is safer. Good Luck..

Yes, I see your surgery as a good time for them to realize that they are not as independent as they think they are. If my Mom can't keep up with the cleaning, she needs to hire someone. If she can't cook, hire a Home Health aide. If Dad can't mow the lawn, hire someone. A HHA can do their shopping. Tell them you will not be available for a month and maybe longer. They will need to do it themselves and thats finding transportation to doctors. Office of aging can help with that.

I realize that there is stuff they cannot do but are you disabling them in other ways? I would make it clear now, that you will not be their hands on caregiver. That by moving to an AL there will be someone to help them 24/7.

While you continue to be the solution to their problems, they will not look for alternatives. First, sit them down and tell them that the 24-48 hours weekly visits are getting to be too much and you will not be able to continue. They cannot rely on you for long-term care. It is not practical and certainly not fair to you. Plus use your impending surgery as an excuse. If they still refuse to see reason, you may just have to leave them to themselves until a crisis arises (ER Trip). Not the most pleasant way of doing things but sometimes an emergency is the only way they will see the light. At least you have ALs already researched. Immediately move that once a week visit to once every other visit. And after surgery you will be done for at least 2 months until you can heal. Then again, that weekend visit goes to once a month. They think they are independent because you are propping them up. Let them see what life will be like when you cannot be on speed dial.