This year, I was able to help a lovely family move their elderly father from the hospital to rehab. As the dad was still in the early stages of his rehab progress, their mom was diagnosed with a serious illness. Her husband/their dad have transitioned to long-term skilled care and are now in assisted living in the same community where their mother is currently living. Sadly, both of their parents are in their 90’s and suffer from early/midstage dementia. The time has come to sell their home to pay for their care. I spent time with each adult child, individually and in family Zoom meetings, discussing the hard questions and trying to find the best solutions for their parents. Below are some of the overarching questions that were raised and discussed.
1. “Mom wants to return home to look at her belongings and participate in the distribution of those items. Should we take her back home for the last visit? What if she refuses to leave? What if she is upset about going or not going?”
This family had deep concerns about how emotional it would be for their mom to return to her home, particularly when it was time for the visit to end. In addition, they feared she would refuse or physically be unable to say goodbye and walk out the door or that it would cause fresh anxiety and increase depression. We discussed the idea of bringing photos and, if possible, some of her belongings to her assisted living apartment and going through them together.
The family discussed the possibility of having someone else accompany her to her home to spend time with her. That person (a care manager or someone else trained in working with people living with dementia) could keep a close watch and look for fatigue, emotion and recognize when it’s time to leave. It is the leaving part that is unknown – how their mother will react and how willing she will be to leave their home. Suggested cues may be “let’s go get a cup of coffee/tea” or “we need to check on your husband” or perhaps “we have an appointment”.
We discussed that perhaps it would be best for their mom not to return home because, in her circumstance, the potential emotional ending when it comes time to leave would be devastating to her since she was generally uneasy and distressed.
2. Do we tell our parents that we are selling the house? Or, how do we do that? The adult children have power of attorney.
This dilemma can be one of the hardest and most emotional that adult children/siblings are faced with. As an aging life care professional, I look for information about the parents’ and their current physical and cognitive challenges. I ask for information and insight about each person’s level of short-term memory loss, wondering how much new information each person typically is retaining. Does cognitive function improve/decline at various times of the day/evening?
When conversations with each person tend to be repetitive, it is best to say very little. People living with short-term memory loss, such as dementia, receive bad or sad news like it is the first time. The person essentially is being asked to experience fresh grief over and over again.
Of course, we never want to lie to our loved ones. Delivering upsetting news can be managed in a way to treat the subject matter as gently as possible. Perhaps, in this case, one might explain that for financial reasons, all options are being explored to keep them in the very best healthcare situation possible, per their doctors.
I ask several questions about the parents’ physical health following their recent major medical events (a stroke and a cancer diagnosis). Would this news be so upsetting to them that it could cause a setback? For each specific family, would it be more appropriate to share potentially distressing news with them altogether, with both parents together or separately? It can be helpful to family members to have a trusted advisor (faith leader, social worker, aging life care professional, etc.) that can facilitate and coordinate the conversation, particularly during the emotional conversation.
The lovely family I supported decided to share the news about selling their home with their parents. They explained that most people eventually have to sell their home to pay for their medical care. They explained that, as adult children, they each are making their own long-range plans about selling their homes by a certain age and moving to a selected retirement community. They reassured that this hard decision about their parents’ home is necessary to ensure that they can continue to live at their care facility where they are receiving high-quality care and attention, close to family members that will continue to visit frequently.
Are you looking for a care manager that you can trust? Preferred Living Solutions is here to help you make a plan, manage the crisis and ease the way. Contact us at 919-554-0675 and let us help you make a plan.
Written by: Vivian McLaurin, Certified Care Manager at Preferred Living Solutions.