What are the must-haves to take in elderly grandmother?

Llamalover47, is your response to me -- Teri4077? I always find your input, along with several others on this site, very helpful. If you were responding to me, please unpack your thoughts -- I know that they are always insightful. I have been praying about this move for a couple of years. :)

You should think long and hard about this.

Wow -- what great answers! These will be helpful to many of us. I am retiring early next May to move to take care of my mom. She is currently in AL. Her LTC care $ runs out next year and the medicaid facilities in her area are woefully inadequate. I can't move her to my state, as the social services for my severely disabled brother aren't good enough and Mom won't move away from him. I, too, feel a strong need to be closer to him to help supervise his care. He is in a good group home with wonderful staff and a fabulous caseworker. Thank you all for this feedback.

Hi garden. What is a shirt trust form ? I thought i knew it all but apparently not.

All of these are great suggestions, especially the detailed information that Garden posted. And yes, it is 24/7, 365. I know because I am caring for my 88 year year old Mom. In 2016 she was living in Ohio with her grandson and great grandson (my nephew and great nephew). She fell, hid her head very hard which caused her to fracture her neck. Luckily, surgery went well. She has some memory issues of the last thirty to forty years, due to the head injury, but she knows who all her immediate relatives are. She spent nearly 6 months in ICU, rehab hospital and nursing home rehab. Then 4 weeks of home health. I live in California, but rushed to be there for her. Both of my younger brothers have passed, so I am the only child available to care for her. I had to retire to take care of her, but luckily I was 66, so I qualified for Medicare and took Social Security one year early.
I brought her home with me to California when she was able to travel. I would never put her in a nursing home, that just how I feel. If she developed Alzheimer's, I may have to consider it, but so far she is okay mentally. It IS a lot of work, mentally and physically, I won't deny it, but I find so much joy in just having whatever time left that I have with her. Good luck in whatever decision you make. God bless you!

Any update Stephgladys1? There is great advice here. Think twice and have a back up plan.

Wow! Gardens, you hit the nail on the head.

Stephgladys1, I urge you to think long and hard. I know you love your grandmother, but I am going to beg you not to do this.

07/10/18

Dear StephGladys -

You have a good heart. Bless you for that.

And, to all of you who have posted - you are being kind to be so honest in your cautions.

StephGladys, I am the caregiver for my 90-year old Mom who has dementia.

Caregiving is the most physically, emotionally and financially difficult thing I have ever done. It has affected my husband and my daughter in ways I am deeply heartbroken over.

It has jeopardized my job in the hours of leave I have needed to take. And, because my employer cannot afford a temp when I am gone, my stress at work has never been greater as I return to work after each absence to a huge backlog and exhausted from caregiving.

It is slowly eating away at our finances because Mom has no long term care insurance and is not Medicaid eligible.

That said - my advice is that you have all of the legal and financial tools you will need to do this. If you do not, you will find your hands tied. And, you will be powerless to have the authority, while shouldering all the responsibility.

If it seems excessive, it is not. I have needed to do all these things.

It is far better to have these things in hand before you become a 24/7 caregiver. You will be too exhausted and may not be able to physically leave your home to do them as quickly as they will be needed. They will allow you to take action when it is needed, rather than suffer the frustration of having your hands tied.

Get power of attorney for her 1) legal/financial matters and 2) her healthcare decisions

Assemble originals of all her identifying documents - 1) Social Security Card, 2) government-issued identity documents (passport, driver’s license, State I’D, birth certificate, marriage certificate, change of name documentation (following marriage or divorce).

Locate and have at least copies if not originals of all of her estate documents (Will, Trust, Advsnce Care Directive, Shirt form Trust).

Get her insurance information and insurance cards - 1) Medical, 2) Medicare, 2) dental, 3) vision 4) prescription card

Get a copy of her medical history from her PCP.

Make a list of all recent medications, immunizations and allergies.

Make a list of all her doctors and their contact information (PCP, geriatrician, eye doctor, specialists, etc.).

File HIPAA/Information Release release forms with all her doctors so that you are on record as being able to have access to and communicate with doctors about her health matters. (Grandma or her designated healthcare power of attorney will need to dig the forms.)

If she does not already have them, work with her to finalize a POLST (Providers Orders for Life Sustaining Treatment) and an Advance Healthcare Directive - so that you know and can honor/uphold her wishes for her own care.

Make an inventory of her assets (pension/retirement/social security, investment income, income from property, annuities, etc). Collect all insurance policies.

Inventory her debt (mortgage, loans, credit cards, liens placed on any property she may have). Cancel all credit accounts in her name.

Get her on a watch list for identity fraud. File change of address with the post office to direct her mail where you can access it.

Become a signator on her bank accounts so you can make payments for her expenses. Meet with her banker and investment reps if you can. Locate any safe deposit boxes and keys.

Speak to her attorney. Speak to her POA if there is already one.

Contact your local elderly affairs office to see what free or subsidized services she is eligible to receive.

Contact an attorney or speak to a legal aid organization about your specific situation and keep this information on hand when questions arise later.

Use this forum. It will be a great help and support to you.

I genuinely wish you all the luck in the world. Be well and take care of yourself.

There several things that might help:

1 - After mom was in care we had to fix drywall & door frames where over the years she did damage - go to any NH & you will see protectors on the corners & frames so it would not be hard to repair later - they no longer had similar to what frames that were in the house so we had to polifill & sand repeatedly to make the house ready to sell

2 - See if you can take a 1 day course on hands on care giving - this could be so good for you both

3 - Make a time schedule for YOUR FREE TIME - do this before she moves in

Is grannie ambulatory? 
If gran cannot completely and totally 100% on her own transition from being in a bed then into her wheelchair and able 100% on her own get out of your house/apt unlocking whatever doors to do this..... then there will need to be someone 24/7 & always available to attend & assist her first & foremost. 
Please have a reality check and do a fire drill.

It’s not a one person caregiver situation, even if you are able to have extensive delivery service where you live.

So who all is going to caregive? 
If she’s 88, then your parents are likely in their 60’s, so what are their capabilities & their own health care situation? And your what like backside 30 or early 40’s? Younger, and much younger like in your 20’s??? Your in prime earning years. Caring for gran can become into caring for your parents and morph into a decade + out of the workforce. You have to be compensated for caregiving for your own future needs unless you all are generationally wealthy and have staff to do the caregiving. But that not it..... so what’s the backstory & reasoning why an 88 yr old needing caregiving oversight is moving into families home rather than moving into AL or a NH? 

I’d suggest that you at a minimum to get involved in all this have a caregiver contract with BOTH your grannie AND your parents (as they have SS/ retirement income) drawn up by an elder law atty, all properly done with taxes paid & paid the maximum for your community standards for caregiver compensation; you become MPOA for gran & parents; coDPOA for gran & parents as well. If they have assets and there are siblings expecting equal Heirship of those assets and they are not caregiving on par with you, then all those assets need to be made POD to you alone or placed in a trust with you as the beneficiary of the trust and they create a separate income stream to pay the costs of anything titled into the trust (like a home). Also keep a journal & have a “me time” routine like fitness class or jogging. 

Or are you expected to work for free out of a sense of familial duty? 

AhmijoyI and Snoopylove has some great financial and care details that you need to think about prior to have your grandmother come live with you. Once your grandmother is in your house, you are responsible for her 24 hours a day/ 7 days a week/365 days a year. You will NOT be able to leave your grandmother alone for even one minute. You will need to have someone in the house at all times. Have you hired any agency help or caregivers to assist you in taking care of your grandmother?

I agree that occupational therapy and home health need to assess your house prior to your grandmother coming to live with you. What type of house do you live in:single story or split level or two story? How much renovating will you have to do to accommodate your grandmother? Will you be living on the same level as her bedroom? Or will she be "taking over" your living room or family room? Since your grandmother "can only get around in a wheel chair", how is she going to get into the house? If there are stairs into the house, then you will need to build a ADA compliant ramp so that your grandmother can be wheeled into the house. Are there stairs in the house? Will she need a chair lift on the stairs?

What does your family (spouse, children) think about your grandmother coming to live with them? Do you realize that you will have to put your grandmother's needs FIRST and your own needs or your family's needs LAST?

What type of vehicle do you have to take your grandmother to doctor appointments? Can she transfer herself with minimal assistance from her wheelchair into the car? Or do you need to purchase a wheelchair accessible van?

I hope that this does not sound disrespectful, because I am not trying to be that. Think of ALL of the items that are needed when someone has a baby and use that list as a basis of all of the things that you will need for taking care of an adult.
Loose fitting clothing that are easy to get on and off with snaps or Velcro, baby wipes, diaper pan for soiled "Depends" (disposable underwear), soft foods, special waterproof bed linens and waterproof pads in any chair that the adult sits in, adult size bib, special plates and silverware or Sippy cups if your grandmother has problems with chewing or swallowing or if she has trouble holding her silverware or cup or glass, along with gait belts and transfer aids (and back braces/supports for yourself or whoever is transferring or lifting your grandmother).

You state that you have a "lift for toilet". Do you mean a "stool riser" which raises the height of the toilet seat or do you mean a mechanical lift machine (Hoyer or Easy Stand) that actually lifts your grandmother up into the air and that you can maneuver from one place to another place in order to transfer her from bed to wheel chair to toilet?

I admire your desire to take care of your grandmother. Many of us have taken care of our spouses or parents and we understand the task/job that you are about to undertake. As Goodintentions has stated "There is the goodness of your heart and then there is the reality." Please let us know what you decide to do and if you have any other questions or concerns or if you just want to "VENT" about your situation. Good Luck and God's Blessings to you and your grandmother.

A baby monitor and/or a wireless intercom can also be helpful if your home has a split bedroom design.

Please read Ahmijoy’s response again and again. There is the goodness of your heart and then there is the reality. All the best for you and your grandmother.

My husband just graduated to a wheelchair and up to that point I addressed each situation that arose while he is in my care. You learn quickly what you need to have and to say you need to know in advance what you need is difficult to answer. Each day will present a new problem. All I can say to you is to have patience, look at the situation at hand and decide who you need to call to solve the problem. Palliative care would be very helpful and has to be ordered by her doctor. Palliative care, when ordered, will call you and I would tell them exactly what your concerns are and they will point you in the right direction as to what you need. They are a wealth of information and will think of things that you didn't even think to ask. Good luck.

a blender or bullet for puree food

Also, think LONG AND HARD before doing this!

How big is your grandmother? If you are transferring someone from wheelchair to bed to commode, etc., it is a godsend if they are small or petite. Thank goodness my dad is short (5 feet 6 inches) and after losing 30 pounds after his spinal cord injury, only about 130 pounds or so. Sometimes I read on this forum of people being expected to move around a 200+ pound person. That would not be fun for one's back.

I also think you should rethink this situation, especially the financials if she's not paying you for caregiving.

Kudos to you for being such a caring grandchild!

BEFORE grandmother moves in, get hold of an occupational therapist to do a home assessment,

Have you been trained to use that lift, by the way?

Steph, how are you going to support yourself? Have you drawn up a caregiver agreement with her? Will she be paying you what you would earn if you had an outside job? Are you going to purchase health insurance from that money? What about a retirement fund?

Is your home handicap accessible with someplace to bathe her ( not all elderly people tolerate showers) and maybe room for a lift, and all the other supplies you will need? My home looks like a medical equipment store. If no patient lift, can you lift her? Elderly people can be like dead weight and if you don’t know how to lift her, you’ll hurt your back.  If she has dementia, is your home safe for her if she should at some point begin to wander?

Will you have help? Or will it be only you 24/7/365? Do you have a social life? Kiss that goodbye.

If you want to know what you need, get in touch with Grandma’s doctor. You will need prescriptions for any durable medical equipment you’ll need so Medicare will pay for it. As for an assessment of your home by a home health care agency. They can give you hints and tips.

If you could share more information bout her condition and limitations members here will be able to give more accurate advice; is your grandmother in a wheelchair permanently?

Hi Stephgladys1 :)

First and foremost - think twice about it.
It is a long, stressful journey.
It has pros and cons.

I am sure others here will be able to point you with helpful suggestions.

I wish you great luck, whichever road you take.