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Now what?

Tracey Columns

Dear Tracey,

My mother is 89 and lives alone in another state. She is very independent! She stopped driving a few years ago (she still hasn’t forgiven us) and uses a senior ride service for necessities. She hates the local senior center, refusing to “hang out with old people” as she says. When we talk on the phone, she is pretty upbeat. Her health is quite good for her age – no major problems.

My daughter visited her recently. She thinks her grandma is going downhill fast. For the first time, the house was dirty, and unpaid bills were stacked up on the  counter. My daughter started crying when she told me that her grandma hadn’t bathed or washed her hair in awhile. But, she said her grandmother was in good spirits and didn’t seem to care about how either she or her house looked.

I’m alarmed. I visited my mother two months ago and by my daughter’s description, clearly, my mother has seriously declined. My sister and I have talked and we will visit her together in August. We think we need to intervene but I doubt my mother will ever consider a assisted living facility. How do we approach her?

Signed,
Worried Sick

Dear Reader,

This is a difficult situation and sadly, it’s being played out all in families across the nation.

You clearly understand how your mother’s independence is working against her. She, however, doesn’t recognize her need for additional services, which is not an uncommon perspective.

But for her quality of life to have declined do dramatically in just two months does set off alarms. Yes, it’s time for you and your sister to intervene, something I highly recommend you do together. (Your mother needs to hear a consistent message of concern from both of you, which will prevent her from trying to play you two against each other.)

No one wants to have “the talk.” But here are some guidelines to consider:

1) Before you ever arrive, look into what options are available to help your mother. Begin with in-home support services. Depending on her financial situation, it may be that with enough services in place, you mother can stay in her home and avoid all of those “old people.” But also do some preliminary scouting for assisted-living facilities, as all three of you will do better if you understand the realities of the next step, whatever it might be.

2)  In spite of what you may learn from your research, please don’t show up with a preconceived plan about what you two think should  happen. It’s disrespectful, can be quite overwhelming, and is typically, counter-productive. The net result? Seniors tend to dig their heels in even more. (I have to admit, I may be inclined to do the same thing when my time comes.)

3) Instead, capitalize on your mother’s independence, and hopefully, her problem solving abilities. After you have been there awhile, share what you have observed: the state of the house, her hygiene, the bills. Gently, and with care, ask her about what is going on? This simple question should give you more information about how to proceed. You will be listening for answers and explanations that are honest and consistent with what you are seeing.

4) Once you know more about how she is actually doing, rather than what she wants you to believe when you are on the phone, you can decide which direction to take; a discussion about in-home support or assisted living. Don’t belabor any of this initially. Give your mother the opportunity to get used to what you are suggesting, as any transition will go much more smoothly if she buys into it.

5) However, if you mother is unable to explain her circumstances well enough, or if you see other ‘glitches’ in her thinking and/or behavior, she needs a medical evaluation immediately. Obviously, this is in her best interest but her medical team will provide added support and ultimately, added resources for all three of you. Attend as much of this appointment as your mother will allow and by all means, confer with the doctor afterwards about his/her recommendations.

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