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s/o Who do you expect to take care of your elderly relatives?


HS Mom in NC
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In-laws were fairly recently divorced.

We lost FIL earlier this year. He had moved in with his daughter for the last few months and we helped SIL as much as we could. He needed to go into a facility for the last few weeks because of the toileting issues and his repeated falls.

MIL has her plans made and has care lined up for herself.

BIL is single, so we may end up needing to help him at some point. All of us live across country from him so he would need to be willing to relocate, which I don't know he would.

 

My parents divorced when I was a child and I am largely estranged from them. I have a child with special needs and they have openly blamed me for his medical issues. I don't feel any sense of obligation to be there for them.

 

 

One thing I question about family helping their aging parents - How does one deal with mobility issues and Falls? My FIL was maybe 95 pounds when he passed away, but he was so unsteady on his feet and fell so much. He would easily pull anyone over with him when he fell. How does one handle that? We felt like we needed to put him in a facility for his own safety. Family did stay with him almost 24/7 during those last few weeks, so he was seldom alone. But he needed several strong, trained assistants to help him get up into a chair.

 

Well, so that is difficult and something the in-laws dealt with a lot (so I have some secondhand knowledge).  What they did at first was put Grandmother-in-law (nanny) and grandfather in law (grandpa) in independent living, because she was largely suited to it, but he was in a wheelchair and had significant sundowning, etc.  They also had some live=in and part-time aides before they were moved to the group home.  

 

What they did before the group home was make the house wheelchair-friendly and not-good-walker friendly - they had handholds by the bed, a urinal by the bed (so he didn't have to go far at night, could just sit up, pee, go back to sleep), etc.  Then they had aides who would shift him from bed to wheelchair to daytime chair to bed to toilet, etc.  The aides were not any stronger than I am; they were trained in shifting him safely.  Because he could not walk safely -was inclined to fall - he did not walk anywhere.  Nanny could and can walk holding a walker; she was watched and required to hold the walker everywhere she went. 

 

 They had someone come in for bathing specifically - they had this set-up at the assisted living too, as that kind of help is not available until you're in the stay-in-bed-most-of-the-day level (because that is what is financially feasible at a nursing home - they're not moving residents 10 times a day, they're just coming over to do what is absolutely necessary).  

 

At a nursing home the grandfather is not being helped up from falls multiple times per day.  They set it up so that the old person ideally never falls.  Most of the time you can do that in a home.

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Yup.

 

When my paternal uncle was in a care facility, and his kids were out of town, I took food to him every day. I do not understand why medical facilities do not do better. It isn't rocket science to make a decent, well herbed meal. I think they are determined to be so dang cheap that they serve cardboard with gravy on it and call it "the entree".

 

This is something families need to routinely check on.

 

Oh, if I had the dosh, I think my first do-gooder project would be to organise a cheese hamper for the hospital ward my mother had the misfortune to have to eat at earlier in the year. People in hospital don't have much to do but wait for meals, and all they served for morning and afternoon tea was crackers and margarine. One of the meals was so bad nearly everyone tossed it out and one bloke rang for pizza. I wrote to the Health minister!

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I took care of my mom at the same time I had an undiagnosed aspie being very  . . . aspie.

I also had to fight my brother as he wanted control.  he did NOT have *her* best interests at heart.

 

my sils both care for mil.  she pays them.

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My grandparents are nearing 90, but are in pretty good health. They diagnosed my Grandpa with some kind of cancer and gave him 6 months to a year, but the treatments worked better than expected and now he is in remission. They still live in their home and drive, and their daughter and son-in-law live in the same neighborhood and check in regularly. My other grandfather is in pretty good health for his 90 years and is currently living on a rotating basis with various of his several children. Dh's grandparents are all gone. Dh's dad is in his early '70s and in poor health. His mom is younger and retiring this year. I anticipate that she will care for dad until she cannot handle the physical work and then he will move to a facility. I wish that they would move now to a multilevel care retirement community, but those are hard to find without a move. FIL is stubborn, so I am expecting a crisis at some point. My parents are early 60's, still working, and seem younger than their ages. I imagine they will be like their parents, having no issues into their '80s.

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My dad is my mom's caregiver. I think about this a good bit, but he seems intent on taking care of her as long as possible with little outside help. He is out of town and has a caregiver with her now, but she is not usually there even the days a person comes for a few hrs to relieve him and do light housework. The one spending the night is my grandma's former caregiver. We love her, but Mom does not really like anyone other than Dad helping her. I think it's not possible for her to be their regular worker due to either fees or required hours?

 

Anyway, my parents are in their 70s. I am 35 as of this month. My siblings live out of state and country. I live a few hrs from my parents and have seen my mom before/after falls, etc. I do feel a responsibility to my parents, but imagine Mom will mainly rely on Dad and/or hired help (she does not like us, her daughters, doing much like taking her to the restroom) and Dad will try his best to maintain his health. I know he is exhausted though, taking care of her (often having to feed her because of her tremors and limited mobility.

 

I don't know how to help. I bring their only grandchildren over occasionally (now that is a few times a year) in small doses. I tried cooking but they are super strict/picky about diet. Like I respect it but it is so expensive to eat organic this and that. My dad does that muscle testing and will say a dish is "bad" for him. Mom stopped eating meat because she thinks it's too difficult. Dad misses meat, but doesn't want to cook it separately. We do have it with him sometimes. Anyway this post is a long-winded way to say yes I think about it but don't know all the answers. They know I am overwhelmed with my own children. My siblings have FT jobs outside the home are busy in their own ways. They one visits yearly, one visits less often.

Edited by heartlikealion
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Why would it land on your kids to take care of their aunts and uncles (or is it great aunts and great uncles)? Genuinely curious. Is there a law? Is it a certain family culture? I can't imagine turning my life upside down to care for rather distant relatives, unless they had been exceptionally close.

I'm not sure who else they could look to for help other than their nieces and nephew. That's not a distant relative, that's *almost* next-of-kin. On my side of the family there are other nephews that are being raised in the same culture of helping family in whatever way you can, so that's good.

 

Katie, no they didn't plan it that way. In fact, I'm sure none of the five people I'm thinking of have any plan about old age at all. [emoji12]One of my sisters, maybe. Maybe once our parents need help they'll think of the importance of their own care.

 

 

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I am the only stay at home person in the area, so I am pretty sure that things will fall to me. My dmil has planned for years to age in place in her house and she has the financial resources to do it. She has a horror of family physically taking care of her, so she has already lined up help, should she start to need it. She also is tech savvy, and uses Uber/grocery delivery and keeps in contact easily with text/email. She is determined not to be a burden and allows us to do very little for her. Also, she is very mobile and healthy for 82, so we just love her and respect her decisions.

 

My mother, otoh, is starting to be a little difficult emotionally, but in good health. The biggest issue is that she will not move. Her house is not friendly for aging in place and she expects that all of us (my other siblings and grandkids) to drop in every day. Yet, she drives all over town to do stuff with church friends, but will not drive to see us. She is not actually interested enough in my kids to have come to activities or sports events when they were small, nor does she communicate with them, except through me. She would thrive in an assisted living environment, with friends and activities to do every day, but she will not consider it. She could afford it, but would have to sell her house. I do not gossip with her about my kids, because 1. they are older-their business is their business and 2. she is indiscriminate in sharing information. She is not much interested in my life-never has been-and she talks AT me, instead of with me. I cannot deal with that every day. I just can't. So, I don't know what will happen. My sister has used her as a free babysitter extensively for the last ten years, so I sort of feel like she can deal with her.

 

It is a worry for me, because my mom will wait until there is a crisis and then, as in the terrible scenarios with my father (dementia and denial), no one will listen to me and I will be the bad daughter in my mom's retelling and refashioning of the story.

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One thing I question about family helping their aging parents - How does one deal with mobility issues and Falls? My FIL was maybe 95 pounds when he passed away, but he was so unsteady on his feet and fell so much. He would easily pull anyone over with him when he fell. How does one handle that? We felt like we needed to put him in a facility for his own safety. Family did stay with him almost 24/7 during those last few weeks, so he was seldom alone. But he needed several strong, trained assistants to help him get up into a chair.

 

It depends on the cause of the falls.  The solution may be wheelchair with appropriate supports so the body doesn't tip itself out onto the floor.

 

For us, its knee issues and the elder does not understand physics nor remember that I have restrictions.  Elder grabs on the way down, so I do not allow it -- they must use the walker if alone with me and if they fall with that I am calling the ambulance.  There is no way I can lift someone three times my weight, even without restrictions. We have made the home walker friendly and we have shared what the ambulance cost will be, as incentive.

Edited by Heigh Ho
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It depends on the cause of the falls. The solution may be wheelchair with appropriate supports so the body doesn't tip itself out onto the floor.

 

For us, its knee issues and the elder does not understand physics nor remember that I have restrictions. Elder grabs on the way down, so I do not allow it -- they must use the walker if alone with me and if they fall with that I am calling the ambulance. There is no way I can lift someone three times my weight, even without restrictions. We have made the home walker friendly and we have shared what the ambulance cost will be, as incentive.

This. Falls cannot be prevented regardless of precautions, remodeling, and equipment if the elder is uncooperative. While I THINK my mom may be cooperative if these surgeries do not work, the reality is that she is not quite herself mentally after what my father figure out her through so there are no guarantees. That is the tough spot.

 

I would love it if there was a magic cooperation bean that we could put in casseroles and feed to our crankier elders. But there isn't so ya, the medics will be called. The worst thing is though, she doesn't have the money and likely Medicare won't pay for the ambulance unless she is seriously injured. That leaves us with the bill. Really hoping she remains cooperative!

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This. Falls cannot be prevented regardless of precautions, remodeling, and equipment if the elder is uncooperative. While I THINK my mom may be cooperative if these surgeries do not work, the reality is that she is not quite herself mentally after what my father figure out her through so there are no guarantees. That is the tough spot.

 

 

 

Even if the elder is cooperative, there may be medical conditions that mean they are going to fall.  Even if in a wheelchair, they may fall out, because they just can't control their medical condition. 

 

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Even if the elder is cooperative, there may be medical conditions that mean they are going to fall.  Even if in a wheelchair, they may fall out, because they just can't control their medical condition. 

 

Exactly. In the case of my uncle with very progressive MS, he was falling out of wheelchairs by the time he was 50. There was simply no way to keep him safe at home anymore. He was too heavy for any of us to manage him in a bed full time. He did have some savings to tap, and some disability so for a while the family was able to keep him in a nicer care facility than what Medicaid would have paid for, but eventually that ran out.

 

So much to consider. Thankfully, IF the surgeon is right, mom's balance issues will resolve when they get that ankle joint replaced. It'w a two step surgery with the first one on Nov. 9th. Since she will have two weeks on the walker and needing assistance, I have put my foot down about being in charge of cooking and hosting the extended family. My big issue is that Dh is going to be in New York for work until the late evening the 22nd, but I have to get to Kalamazoo to get ds home from college. No one from this area attends his school so he can't get a ride. That's a 7.5 hour round trip. I so far have not found someone to go sit with mom. Ds our high school senior was counting on going with his dad to NY. He has been SO incredibly helpful this fall that I am LOATHE to take that away from him so that he can take care of his grandmother. Seventeen and already in that role. Too young. Too young! Eldest ds as classes from 9 a,m. to 6 p.m. and won't be home from campus until about 7:30. I am not asking him to skip college classes for this.

 

I probably need to hire someone, but am very worried about using college funds for that because once you start down that road......

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 I have to get to Kalamazoo to get ds home from college. No one from this area attends his school so he can't get a ride. That's a 7.5 hour round trip.

 

Hopefully your son can get a ride, if he starts looking now.  Even if he can come part way it will be a help. 

Another thought is to give him your dh's vehicle while your dh is gone, then he can drive it home instead of you going up then.  Takes a lot of time though, unless he can get a ride down transfer weekend.

 

Don't you just love how transport from the colleges is so unavailable on holidays?  The ones for us all go from college to NYC without stopping in the area. Its cheaper for me to go pick up at the college than drive plus tolls into the city. Gpod thing there are ride boards.

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For those who plan to age in place without help or with hired help until they die, what do they plan to do if they lose the cognitive ability to manage the meds they take multiple times a day?  What if they lose the ability get up and walk without help to the bathroom multiple times a day and night?  What's the going rate for live in help? How quickly will they go through their savings (if they have any) if they need that kind of help for the longer term?  What's the going rate for a facility that has that?

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Hopefully your son can get a ride, if he starts looking now.  Even if he can come part way it will be a help. 

Another thought is to give him your dh's vehicle while your dh is gone, then he can drive it home instead of you going up then.  Takes a lot of time though, unless he can get a ride down transfer weekend.

 

Don't you just love how transport from the colleges is so unavailable on holidays?  The ones for us all go from college to NYC without stopping in the area. Its cheaper for me to go pick up at the college than drive plus tolls into the city. Gpod thing there are ride boards.

I'd give him the vehicle, but dh's company expect him to drive because while he'll be off work longer, that is cheaper than flying AND car rental since it is only a one day drive there or back. GRRRR.....

 

I should call my uncle, my mom's widowed brother in law. He WANTS to be needed, and is coming down from his home up north for Thanksgiving with his kids the next day. I wonder if he would come one day sooner and stay with mom while I'm gone. At that point, he'll only need to fetch her lunch and water, walk beside her to the bathroom but not go in, and be around in case she falls and to keep her company. I can be back by dinner time with some take out food. I should do it. I don't want to take advantage of him, but he is very lonely and he does drive down once in a while to visit her, and to putter around the house doing things for her. He needs the conversation and to be needed, and so it might be a win win for both of them. I just need to get over my flutters about worrying that my cousin's might be overstepping.

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I'd give him the vehicle, but dh's company expect him to drive because while he'll be off work longer, that is cheaper than flying AND car rental since it is only a one day drive there or back. GRRRR.....

 

I should call my uncle, my mom's widowed brother in law. He WANTS to be needed, and is coming down from his home up north for Thanksgiving with his kids the next day. I wonder if he would come one day sooner and stay with mom while I'm gone. At that point, he'll only need to fetch her lunch and water, walk beside her to the bathroom but not go in, and be around in case she falls and to keep her company. I can be back by dinner time with some take out food. I should do it. I don't want to take advantage of him, but he is very lonely and he does drive down once in a while to visit her, and to putter around the house doing things for her. He needs the conversation and to be needed, and so it might be a win win for both of them. I just need to get over my flutters about worrying that my cousin's might be overstepping.

 

That sounds like an excellent plan.  Just let him know that he can say no if he wants to.  But if he is coming anyway and he wants to be needed, then it is indeed a win-win. 

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Hopefully your son can get a ride, if he starts looking now.  Even if he can come part way it will be a help. 

Another thought is to give him your dh's vehicle while your dh is gone, then he can drive it home instead of you going up then.  Takes a lot of time though, unless he can get a ride down transfer weekend.

 

Don't you just love how transport from the colleges is so unavailable on holidays?  The ones for us all go from college to NYC without stopping in the area. Its cheaper for me to go pick up at the college than drive plus tolls into the city. Gpod thing there are ride boards.

The biggest issue is they are holding classes Wednesday morning and ds has two. The only ride possibilities he has been able to scare up do not have Wednesday morning classes so with campus closing at noon are taking off the night before. These are 3000 level classes, not freshman electives, so ds can't afford to miss, and one prof is giving an exam that morning. So ouch. If he could have left the night before, I could have made an early supper, and left my high school aged niece with mom. I would have gotten home around 1 or 2 am, but it would have worked.

 

The train does run to a town 35 minutes from here. BUT, two things. One is that Amtrak on this end usually ends up being wildly late so you can spend two hours sitting at the station waiting. Two, it is a once per day run, and doesn't leave until 7 p.m. in Kzoo. He has no where to go for seven hours after campus closes. He asked some friends who live in the area but they all had plans for the evening, or out of town guests to entertain, etc. no one could offer to let him crash for that time with them.I hate to make him sit in a train station for seven hours!

 

I am going to call my uncle. Maybe if I explain to my cousins that she really only needs someone with her just in case but doesn't require any true physical care, they won't think I am asking too much. If not that, my next idea is to ask one of the bridesmaids from mom's wedding who recently retire and moved back to the area. She is in excellent health, and called a couple weeks ago and said she wanted to set up a time to visit. I hate to say, "Hey, mom is on a walker with limited weight bearing so do you mind sitting with her for eight hours?" But maybe she won't think I'm a ridiculous person for asking. They used to be very, very close.

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FaithManor, I'd do a single eight hour stint for a neighbor, or an acquaintance from church. I think you can ask her old friend if you make it very clear that you'll never ask again and that she'll always be very welcome for short, simple visits with no expectations.

 

But uncle should do it. One day with his sister, when he's coming anyway, is hardly burdensome.

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I just want to say that although I clearly have very strong opinions re: putting old people in institutions when it is unnecessary, I do understand that circumstances in the West right now are different than they've been historically.  There are fewer homes where there is always a homemaker present, and people have fewer children on average among whom to spread the burden.  People are also living, quite frankly, a lot longer, and they aren't necessarily healthy for those extra 15 years - they're just alive.  At some point, once the Boomers really start to get old, we'll have our parents (the boomers) and in many cases *their* parents (the greatest generation, or sometimes the silent generation) to take care of.  That is putting a strain on the way things have sort of naturally worked, and it's as hard to resolve as health costs, because it's a lot of the same problem.

 

Yes. Along the lines of what Heigh Ho was saying as well--older people are larger and living longer, but the younger people are not necessarily proportionately stronger and do not have more time and money. My grandfather with Alzheimer's could not continue to live at home when his wife was physically unable to stop him from leaving the house at night--he was a big, strong guy.

 

Thinking more about DH's and my parents, among the four of them, three I probably could not safely help get from seated to standing, and the fourth is a maybe. I'm not tiny, but I'm small for our family. This may eventually be an issue with DH himself, if his health declines: he's much bigger than I am, and our house has stairs. (I'd prefer to move in the next 20 years; I'd be open to it as soon as next year. He's going to be reluctant.)

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For those who plan to age in place without help or with hired help until they die, what do they plan to do if they lose the cognitive ability to manage the meds they take multiple times a day?  What if they lose the ability get up and walk without help to the bathroom multiple times a day and night?  What's the going rate for live in help? How quickly will they go through their savings (if they have any) if they need that kind of help for the longer term?  What's the going rate for a facility that has that?

For my dmil, the answer to most of those questions is moving to assisted living. She is actually on a waiting list right now and said she will make her decision about it when she gets to the top of the list (probably about 3 years from now). Having enough money makes most of those questions easier and currently being in excellent health (takes fewer medications than I do) also helps. She talks about her plans and decisions with us and listens to our concerns. In short, she is acting like an adult.

 

My mom will not discuss the questions, laughs that I will just have to take care of her because I don't work, refuses to divulge how she might pay for in home help, and essentially burys her head in the sand about the future. You cannot force people to act in their best interest; you cannot force people to confront either the emotional or financial realities of their situation. I feel like we are just waiting for a crisis to force everyone's hand and then poor decisions will be made (like a horror story deja vu of my dad's decline and death).

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For my dmil, the answer to most of those questions is moving to assisted living. She is actually on a waiting list right now and said she will make her decision about it when she gets to the top of the list (probably about 3 years from now). Having enough money makes most of those questions easier and currently being in excellent health (takes fewer medications than I do) also helps. She talks about her plans and decisions with us and listens to our concerns. In short, she is acting like an adult.

 

My mom will not discuss the questions, laughs that I will just have to take care of her because I don't work, refuses to divulge how she might pay for in home help, and essentially burys her head in the sand about the future. You cannot force people to act in their best interest; you cannot force people to confront either the emotional or financial realities of their situation. I feel like we are just waiting for a crisis to force everyone's hand and then poor decisions will be made (like a horror story deja vu of my dad's decline and death).

I liked because I agree and believe that the denial thing is really bad for everyone.

 

I don't "like" your situation though. I get exactly where you are coming from.

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For those who plan to age in place without help or with hired help until they die, what do they plan to do if they lose the cognitive ability to manage the meds they take multiple times a day? What if they lose the ability get up and walk without help to the bathroom multiple times a day and night? What's the going rate for live in help? How quickly will they go through their savings (if they have any) if they need that kind of help for the longer term? What's the going rate for a facility that has that?

The ostriches won't notice their decline. They likely don't comply with meds anyway, 'cause yolo. Bathroom -- sleep in a chair just outside the door. Depends is the backup. Won't mention to doctoras as they don't want to tweak the diabetes care. Live in help is a relative- free. They don't plan to be in a facility. My best guess is they hope not to be revived.

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In-laws were fairly recently divorced.

We lost FIL earlier this year. He had moved in with his daughter for the last few months and we helped SIL as much as we could. He needed to go into a facility for the last few weeks because of the toileting issues and his repeated falls.

MIL has her plans made and has care lined up for herself.

BIL is single, so we may end up needing to help him at some point. All of us live across country from him so he would need to be willing to relocate, which I don't know he would.

 

My parents divorced when I was a child and I am largely estranged from them. I have a child with special needs and they have openly blamed me for his medical issues. I don't feel any sense of obligation to be there for them.

 

 

One thing I question about family helping their aging parents - How does one deal with mobility issues and Falls? My FIL was maybe 95 pounds when he passed away, but he was so unsteady on his feet and fell so much. He would easily pull anyone over with him when he fell. How does one handle that? We felt like we needed to put him in a facility for his own safety. Family did stay with him almost 24/7 during those last few weeks, so he was seldom alone. But he needed several strong, trained assistants to help him get up into a chair.

 

RE: falls. In my situation, after Mom's first stroke, we got her PT and OT and various other services . . . they taught us and her various techniques . . . we installed bed rails and eventually got her a hospital bed . . . and we hired a lot of help to supervise her. In some cases, you need a walker, etc. (My mom didn't need one, but did need to use various helps such as a bed side rail that she could grab/use to help get up from bed safely.) 

 

There are a lot of things you can do preventatively for falls . . . We put grab bars all over Mom's bathroom . . . and we also built her shower so it was curbless/just walk in. Her bath tub had grab bars all over the place . . . 

 

Supervision/assistance is really helpful, too. For Mom's last many months, she had someone at her side for getting in and out of bed, for using the shower, etc. Mom never had a fall, ever . . . but that was likely largely due to the massive investments of grab bars, intelligent planning, tools/etc, and supervision. 

 

We also pushed hard for (and succeeded in getting) tons of PT/OT/etc visits . . . Not only did they teach Mom some things, but I took notes through every visit and had paid helpers also there learning/watching/being taught how to minimize the risk of falls and maximize Mom's mobility and safety. I also spent much time teaching the hired helpers, etc . . . 

 

At some point, one often needs 24/7 help. That's $$$$, of course, but it is an option at home if the family has financial resources to hire help or has a large enough family circle to provide the 24/7 supervision on their own. In our situation, we simply used Mom's resources to hire all the help needed . . . After her second fatal stroke, she was bedridden for her last days, and at that time, we went to 24/7 help so she was never alone. (Bed baths, diapers, couldn't eat or even drink substantially, etc.) 

 

We also had hospice care for her last couple months (after her first stroke, which was her qualifying event), which provides much more help (for free via Medicare) than is ordinarily available. Hospice will provide bathing assistance. In our case, they came 3x/wk and were responsible for her bathing, as the "normal" aides I could hire outside of hospice (via agencies and also private pay) were not competent to handle the complexities of safely cajoling my stroke-impaired (but still totally mobile) mom to bathe. The people who work via hospice are MUCH MORE competent than anyone you can hire outside hospice, IME. So, I'd encourage anyone to advocate for hospice as soon as possible, and then to work closely to maximize services via hospice. Hospice also allowed us to access IN HOME PT and OT, etc, which was invaluable in maximizing her quality of life in her last months (before her second fatal stroke). 

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This. Falls cannot be prevented regardless of precautions, remodeling, and equipment if the elder is uncooperative. While I THINK my mom may be cooperative if these surgeries do not work, the reality is that she is not quite herself mentally after what my father figure out her through so there are no guarantees. That is the tough spot.

 

I would love it if there was a magic cooperation bean that we could put in casseroles and feed to our crankier elders. But there isn't so ya, the medics will be called. The worst thing is though, she doesn't have the money and likely Medicare won't pay for the ambulance unless she is seriously injured. That leaves us with the bill. Really hoping she remains cooperative!

Aside from dangerous wandering related to dementia, and driving past the point of being fit to do so, it really is much about the falls. Because one alone could lay injured for hours. And two could result in one falling on top of another, resulting in the injury of both. The biggest reason dad went into managed care was because he kept falling and my tiny mom was not only unable to pick him up, but also at great risk of being knocked over and even trapped beneath him, where they could lay undiscovered for days.

 

Many equate nursing homes with social isolation. I can tell you that each of my folks were more socially isolated trying to live with a child's family. The family had activities, so the kids and spouse were out, in an effort to not keep their own lives on hold. The only regular socializing received was with the primary caregiver. So who's actually most affected by social isolation? The caregiver. Each of my parents eventually found a new community in managed care settings - communities they actually felt a part of. Each time I feel the guilt heaped upon me for not being able to do it all myself, I am reminded (by friends, family, social workers and physicians) that as one person, I could not have fully met the needs of my aging, medically fragile folks, no matter how hard I tried. No matter how many sleepless nights I devoted to it. No matter how many hours I spent running the shuttle to the doc and portioning out pill doses. No matter how closely I kept to a meal schedule appropriate to their dietary requirements. No matter how my husband missed my time and attention. No matter how many times I had to say no to the perfectly reasonable requests of my children to do this or that activity. No matter my own doctor looking at me and asking what the heck happened to me over the last year to result in the sudden decline of my health. It's not always about the heart desire. Often it comes down to simply physically impossible.

 

Perhaps this is doable - and admirable - for a short term, but a dementia patient with other medical complications who might live on another decade? It's me who would be dead first, or at the very least my relationships with my own nuclear family.

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The ostriches won't notice their decline. They likely don't comply with meds anyway, 'cause yolo. Bathroom -- sleep in a chair just outside the door. Depends is the backup. Won't mention to doctoras as they don't want to tweak the diabetes care. Live in help is a relative- free. They don't plan to be in a facility. My best guess is they hope not to be revived.

 

Are you classifying those who want to age in place at home as ostriches?  My experience with people who plan to age at home is that they're very preventive medicine/lifestyle focused.  I think that's a problem with some people not presenting or thinking through the full reality of preventiveness-it can prevent many things for a while, but not everything forever. 

 

Not everything becomes incrementally worse over a long period of time.  Some people do very well then things can change significantly very quickly.  If people are waiting 3 years to get into assisted living facilities, what are they doing in the mean time?

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Are you classifying those who want to age in place at home as ostriches? My experience with people who plan to age at home is that they're very preventive medicine/lifestyle focused. I think that's a problem with some people not presenting or thinking through the full reality of preventiveness-it can prevent many things for a while, but not everything forever.

 

Not everything becomes incrementally worse over a long period of time. Some people do very well then things can change significantly very quickly. If people are waiting 3 years to get into assisted living facilities, what are they doing in the mean time?

No, the age in place crowd varies. Some are advocating for local govt to subidize their needs, others are not planning on anything.

 

While waiting to get into assisted living, people are in senior subsidized housing with a relative helping, or in a relative's home.

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I know with my personality and the personalities of both sets of parents that I could not handle them living with us. We each have a sister and I don't know if either of them would take in the parents. I've told both sets that they need to plan on something other than living with us if they can't live alone.  :leaving:

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No, the age in place crowd varies. Some are advocating for local govt to subidize their needs, others are not planning on anything.

 

While waiting to get into assisted living, people are in senior subsidized housing with a relative helping, or in a relative's home.

 

But people here are insisting 1. they aren't going to have elder dependents living with them and 2. they don't want to be dependent on relatives.  So how does that play out in reality when there's not an assisted living facility available for years?

 

It's this disconnect that I'm I'm trying to resolve.  What people on both sides of each elder care situation say they want isn't always a possibility at each stage of life.  So then what? Are they going to grit their teeth, have mama move in, and resent it? Are they going to tell mama too bad?  So what happens to mama then?  The assisted living place has a 3 year waiting list. Mama doesn't always have savings to spend on in home care.

 

 

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But people here are insisting 1. they aren't going to have elder dependents living with them and 2. they don't want to be dependent on relatives. So how does that play out in reality when there's not an assisted living facility available for years?

 

It's this disconnect that I'm I'm trying to resolve. What people on both sides of each elder care situation say they want isn't always a possibility at each stage of life. So then what? Are they going to grit their teeth, have mama move in, and resent it? Are they going to tell mama too bad? So what happens to mama then? The assisted living place has a 3 year waiting list. Mama doesn't always have savings to spend on in home care.

 

 

 

This is exactly the problem. Money solves a lot of it. And it is why assisted living needs to be planned BEFORE a crisis and really, before it is needed. But very few people are willing to face it. But those that are, are also willing to talk about emergencies and medical crises. So my dmil who is on a waiting list and has plenty of money has also outfitted her home, talked to us about doctor issues and what she would want in an emergency. But my mother has not done any of that, even though with planning she would be fine financially. So she will be in a difficult situation in a crisis and we would do what we think is best, because we do not know what she wants.

 

Again, the elderly are not children, you just can’t force anything. And sometimes people make terrible decisions and there is nothing you can do. I will do what I can, but I won’t bear the brunt of a refusal to face facts.

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The biggest issue is they are holding classes Wednesday morning and ds has two. The only ride possibilities he has been able to scare up do not have Wednesday morning classes so with campus closing at noon are taking off the night before. These are 3000 level classes, not freshman electives, so ds can't afford to miss, and one prof is giving an exam that morning. So ouch. If he could have left the night before, I could have made an early supper, and left my high school aged niece with mom. I would have gotten home around 1 or 2 am, but it would have worked.

 

The train does run to a town 35 minutes from here. BUT, two things. One is that Amtrak on this end usually ends up being wildly late so you can spend two hours sitting at the station waiting. Two, it is a once per day run, and doesn't leave until 7 p.m. in Kzoo. He has no where to go for seven hours after campus closes. He asked some friends who live in the area but they all had plans for the evening, or out of town guests to entertain, etc. no one could offer to let him crash for that time with them.I hate to make him sit in a train station for seven hours!

 

I am going to call my uncle. Maybe if I explain to my cousins that she really only needs someone with her just in case but doesn't require any true physical care, they won't think I am asking too much. If not that, my next idea is to ask one of the bridesmaids from mom's wedding who recently retire and moved back to the area. She is in excellent health, and called a couple weeks ago and said she wanted to set up a time to visit. I hate to say, "Hey, mom is on a walker with limited weight bearing so do you mind sitting with her for eight hours?" But maybe she won't think I'm a ridiculous person for asking. They used to be very, very close.

 

Let him decide if it's "too much."

 

You can use my prelude "I hate to ask you and want you to think about this and be 100 percent honest with me. I won't be offended if you can't or just don't want to."

 

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But people here are insisting 1. they aren't going to have elder dependents living with them and 2. they don't want to be dependent on relatives. So how does that play out in reality when there's not an assisted living facility available for years?

 

It's this disconnect that I'm I'm trying to resolve. What people on both sides of each elder care situation say they want isn't always a possibility at each stage of life. So then what? Are they going to grit their teeth, have mama move in, and resent it? Are they going to tell mama too bad? So what happens to mama then? The assisted living place has a 3 year waiting list. Mama doesn't always have savings to spend on in home care.

 

 

What happens here is that mamma does indeed move in or a child moves in with the elder essentially abandoning his or her own family regardless of previous plans. It is not good because the elder that had insisted on being independent is not happy about the intrusion and loss of privacy. The family resents grandma because they have essentially lost a much needed parent because they cannot afford a respite care person so mom or dad can be with the family.

 

I have many friends facing this.

 

We face it next year. Dh's job needs him to work in Southern Michigan, way too far to commute daily. We are dependent on his income and health benefits. My mom and his mom cannot afford to move, and even if we bought or rented a place with enough bedrooms for the boys and for them, refuse to move. MIL is almost deaf and has serious kidney problems. My mom has health issues and doctors now in Royal Oak. She can't do the city driving. It causes too much anxiety so I have to do it or hire a driver. Since it is eighty five miles away, it is expensive to hire a driver.

 

And I have to go back to work somehow.

 

So I will live here and apparently work some sort of Harry Potter magic that looks after three homes and yards, and manages the elders needs, and my job, and ...My fear is that my grandson is going to grow up never knowing me.

 

Dh will be renting a room from a colleague and when he doesn't have weekend software releases, come home Friday night leaving again Sunday night.

 

People make a lot of claims of this or that is not going to happen. Then x,y, z intrudes - often called reality - and bad things occur.

 

I am not the only person I know who will live separate of their spouse and kids in order to manage elder care. I know some moms doing it now. Some were homeschooling, but they placed their kids in PS and dad single parents. Older teens try to make up the slack where they can.

 

My mom, for the record, is not a bad person. She is unfortunately from a generation that seems to believe they are entitled to age in place. I see this all the time. They just do not seem to comprehend that their own kids cannot quit their jobs, send the kids to boarding school, uproot, etc. I don't know why this doesn't sink it, but it doesn't.

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But people here are insisting 1. they aren't going to have elder dependents living with them and 2. they don't want to be dependent on relatives. So how does that play out in reality when there's not an assisted living facility available for years?

 

It's this disconnect that I'm I'm trying to resolve. What people on both sides of each elder care situation say they want isn't always a possibility at each stage of life. So then what? Are they going to grit their teeth, have mama move in, and resent it? Are they going to tell mama too bad? So what happens to mama then? The assisted living place has a 3 year waiting list. Mama doesn't always have savings to spend on in home care.

 

 

The CBO has the stats. Most people are in informal care - spouse or relative provides non-nursing help for a few hours daily. What people are saying is that they can't give up their lives to be the nurse and the aide 24/7..but what's happening is that they are being held hostage. The elder won't bring in non-nursing help, then has an accident and wants a dc to quit job& abandon children and move in, even when elder has financial resources and cognitive ability to hire help. Everything goes downhill then, as nursing care becomes necessary and nonrelative care is refused.mom isn't going to move in...she has the big house, dc have the apt or trailer bc there is no affordable housing. Best case is mom is 85+ and a 65+ dc is in good health, retired and single, and moves in to provide care or moves mom in to her retirement home and once mom moves beyond unskilled care the nursing home is available. As people say, nursing homes aren't all evil. And mom may not have savings, but she has assets such as family home and winter condo and monthly income from SS plus in many cases pension. These assets can be used for care, rather than the dc's assets.

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Dh's parents passed away in their early 50's. My parents purchased long-term care for themselves after years of taking care of their own parents. We do not live close to them. I hope to be able to purchase long-term care for us as well, or at least myself, since Alzheimer's runs very strongly in both sides of my family. 

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My mom, for the record, is not a bad person. She is unfortunately from a generation that seems to believe they are entitled to age in place. I see this all the time. They just do not seem to comprehend that their own kids cannot quit their jobs, send the kids to boarding school, uproot, etc. I don't know why this doesn't sink it, but it doesn't.

My in-laws still thinks that my generation has job security even when their firstborn is forced into early retirement this year :P Different country but similar issues.

 

Quoted below is from yesterday’s news article Most Americans are unprepared for the skyrocketing cost of long-term care http://www.marketwatch.com/story/most-americans-are-unprepared-for-the-skyrocketing-cost-of-long-term-care-2017-10-18

 

“Biggest long-term care hike: home health care

Of the other types of care included in the study, the category that jumped the most in percentage from 2016 was home health aide. The annual median cost went up 6.2%, to $49,192 a year. Unfortunately, that doesn’t mean you or your loved one would be covered round-the-clock with an aide. Rather, that’s the median national price for 44 hours a week.

...

These are the median annual costs of long-term care, according to the Genworth 2017 Cost of Care Study:

 

Adult Day Care (5 days/wk): $18,200

Assisted Living (one-bedroom): $45,000

Homemaker Services (44 hrs/wk): $47,934

In-Home Health Aide (44 hrs/wk): $49,192

Nursing Home (semiprivate room): $85,775

Nursing Home (private room) : $97,455

...

In a companion survey gauging Americans’ thoughts about long-term care, Genworth found that two-thirds of respondents expected government programs to cover all or part of the costs.

 

But that’s not going to happen — with a few exceptions.

 

Medicare does not cover nursing home care except for limited stays after a hospital admission of three days or more. Nor does Medicare pay for in-home care if it’s not skilled nursing care.

 

Medicaid rules are different for every state. But generally, an individual must have $2,000 or less in assets ($3,000 for a couple) before he or she can be eligible for Medicaid. The rules are complex; find more information about Medicare and Medicaid and long-term care here(https://longtermcare.acl.gov/medicare-medicaid-more/index.html).

 

“One thing we see in the survey research is that there’s confusion. I think there’s a lack of education of: How much do things cost? How do they work?†Saunders said.â€

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My mom, for the record, is not a bad person. She is unfortunately from a generation that seems to believe they are entitled to age in place. I see this all the time. They just do not seem to comprehend that their own kids cannot quit their jobs, send the kids to boarding school, uproot, etc. I don't know why this doesn't sink it, but it doesn't.

This gen passes the buck. They did not fund their pensions or their retiree healthcare, and taking thoseoptions away from their dc wasn't enough. And there is no shame in not giving their employees raises or in voting themselves tax exemption. We had to sit mil down and show her the math. She has more pocket money than any of the families, due to the tax exemptions and the low medical care cost. The families are getting slaughtered with col.

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Here is one article that explains the phenomenon.

 

https://journalistsresource.org/studies/society/public-health/trends-statistics-relating-us-seniors-elderly-census-bureau-2014-report

 

It should be noted that "in the good ole days" it appears that caring for the elder for extended numbers of years was pretty much not a consideration. Now it is. 

 

The sandwich generation isn't really a single generation. While it comprises the end of the Baby Boomers, those that were born late enough to still be middle aged and in the workforce, it also comprises those of us that are Gen X'ers. So dh is the very last year of the Boomers, but I am four years into the X's and we have this shared responsibility.

 

By comparison, my mom and his mom both had extremely limited years of elder care giving. The Greatest Generation - their parents and even themselves as people tended to have children much younger - came through the Depression while still young, lived through the prosperity of the 50's and 60's, had company pensions, didn't have to move a lot in order to keep their jobs. They could stay in one place, get a mortgage young, pay the thing off many years before retirement, and generally did okay for themselves. My grandfather and many like him lived in the era in which one did not have to have two years of professional training, keep expensive professional licenses, or get a four year degree in order to get decent employment. On a high school diploma only, and for many an 8th grade education, they could get good work, stay at one firm, and end up with a pension and retirement benefits never having to go far from home to get it. It wasn't obviously all a bed of roses, life never is. Just statistically speaking they had some economic things going for them and for the early Boomers, that the late Boomers and the Gen X'ers do not have. They also had their heaviest use of the medical system at a time when it was a lot more reasonably priced as a percentage of income, and Medicare didn't restrict very much. That has not been the case for the later Boomers and of course my generation is feeling the squeeze big time on health care issues. Medical bankruptcy was not a thing then, but it is a very big thing now.

 

Millenials need to go to school a lot longer in order to be gainfully employed, start at lower wages in reference to COL and inflation, and will have to move A LOT - as started becoming more common with Gen Ex - to remain employed. Now suddenly people often do not live near their elders. But the older Boomers remembered with love and longing that grandma and grandpa lived next door, and mom and dad took care of them. They didn't have to move. They didn't have to change their lifestyle. That was also a generation with no expectation of "handicap accessibility" and such, things that many Boomers now expect shall be provided no matter what the cost, no matter whether or not they have the money to provide it. So the early and middle Boomers who still got to retire at 62 seem to think that nothing should change, and they should be able to age in place, in the manner that they demand, and everything should just some how fall into place. They do not understand the pressures their kids' face, the economic reality for their children and grandchildren, and the crushing medical bills that everyone NOT on Medicare tend to face with these high deductibles and all kinds of things being disallowed, nor do they understand the issue of student loan debt as tuition/room/board outpace wages by 415% in the last decade. It is beyond the scope of their experience, and as is typical of human nature, they aren't super inclined to figure out "how everyone else lives". Some will do so. Some will wake up and go, "Wow. How can I make this better for my kids? Maybe I do need to move to be closer, maybe I do need to stop taking expensive vacations every year, and save a little of that to put a wheelchair ramp on the house, maybe I should make some end of life directives and get those things in place, maybe I should sell my house and use the equity to help the kids make their house handicap accessible or pay for some in home help or...." some will definitely do that because not all humans, by any stretch, are adverse to change of perspective. Unfortunately, a lot of people will end up being in the "my way or the highway" camp and kill their kids health  when they could make it a little bit better. Stubborn is a pretty strong character trait in a lot of retired people.

 

As Heigh Ho indicated, regardless of what they want, unless they are determined to die in their homes, laying on the floor for hours or even days in agony, despite their protests and the mounting pressures on their kids who are still raising families and need to work to 65-72 years of age in order to even think about getting out of the rat race, they will push the envelope until it can't be pushed further, acquiesce to moving in with one of their kids, and then likely proceed to be very angry, sullen, my life didn't turn out the way I wanted it to NON willing participants in the adult child's household. That has been my experience. Except for in cases of abuse or abandonment, my generation is reluctantly working ourselves into early graves to care for uncooperative elders. They don't mean to be bad, or nasty, or selfish jerks. They don't see themselves this way. They see themselves as victims who have been forced to live in a manner they never wanted to live. Among our family, extended relatives, friends, colleagues, and acquaintances, my own paternal grandmother has been the ONLY easy going elder for family to care for. She was a delight and brought great joy to her kids, grandkids, and great grandkids as she became increasingly more dependent. We only used assisted living for the very last year because mom and auntie were having their own health problems, and we grand kids were raising young children of our own and couldn't physically care for them and for her.

 

The other scenario is the juggling act of moving out of your own home and moving in with the refusing-to-give-up elder, abandoning his or her own family in the process until such time as A. assisted living opens up assuming there are assets to pay for it or B. require round the clock supervision and physical care and go to a nursing home. 

 

These are the two things I see a lot. Not a whole generation of ungrateful children being jerks to their parents. However, as a result of the pressure, I predict that my generation will be less healthy in middle age than the previous one, and may in fact not live as long. Stress takes a toll. Financial pressure for the well being of three generations at once is crushing. I do see a LOT of families in which the Boomer parents were pretty dysfunctional, and oft times downright abusive, so there are a LOT of us who really recoil in horror at bringing such people into our homes because they will be such a profoundly negative influence, namely my father figure who became violent. With the exception of extremes, regardless of what people say, most end up killing themselves to figure something out, and do not just abandon old people willy nilly.

 

For what it is worth, all of you should familiarize yourselves with the Filial Laws in your states. 30 states have Filial laws. Most of those laws are rather old, and many times they are not enforced. They are kind of dusty laws that date back to the colonial era which took them from European laws that dated to the Renaissance in which states created laws making it mandatory for adult children to provide financially for their elderly next of kin - which given the death rate meant you might be the lone survivor in charge of grandparents, aunts, uncles, cousin, who knows - to combat poverty. These laws still survive, and again, while mostly "on the shelf" occasionally social workers and law enforcement do take them off the shelf, blow the dust off, and go after someone. In three states, Pennsylvania is one, I can't remember the others, there have been some attempts to bring back this enforcement. Pennsylvania changed its law to state that unless an adult child had been abandoned for ten years prior to reaching the age of majority, he/she was financially liable for the care of the parent. Abuse was not included. So if mom beat the crap out of you, or dad molested you, according to Pennsylvania law, you can be held responsible for caring for the abuser. It is hard to say if judges will be willing to enforce or not. I suspect that some politicians who want to cut nursing home coverage from Medicare just might.

 

I have been on the receiving end of a zealous DA, social workers who wanted him OUT of the psych ward and off the county dole for his care, and law enforcement that did not want to supervise him in a halfway house or he county lock up.

 

My case is extreme. But please, don't be naive. Times are a changing and there are going to be far fewer workers paying into the system for every elderly person that needs financial support and physical assistance. In the future it may no longer be legally acceptable to "do what you can" or "do your best" whatever that is for you. If politicians decide to save money by forcing a lot of elderly out of nursing care and requiring adult offspring to provide, x y z, you don't want to be unprepared.

 

 

http://www.ncpa.org/pub/ba521

 

http://www.paelderlaw.com/law-can-require-children-to-pay-support-for-aging-parents/

 

 

http://www.habigerelderlaw.com/library/Are_Adult_Children_Legally_Responsible_for_Their_Parents_Car.pdf

 

https://www.thedailybeast.com/are-you-legally-responsible-for-your-elderly-parents

 

 

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Took care of the in-laws in our home in my 20s until the doctor said they had to go to a nursing home.  Second mil lived in an assisted living apt until she needed a nursing home.  Moved sil down to our area a number of years ago after she had a stroke, and oversee her care in an assisted living facility currently.  Waiting to see what care my folks will need.  I'm the dd that lives near them, but they are still taking full care of themselves at 79 and 90.

 

I'm thinking it's not mentioned as part of the empty nesting as one thinks of that as planned for.  Taking care of family happens as needed and is just a fact of life??

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I think defining population growth rates and lengthened life span play into how eldercare plays out. Where there were five or six kids to the family or even more there are more to share the workload than in a smaller family. In the past care would often fall on the shoulders of a daughter who hadn't married or didn't have children. That may not necessarily have been fair though.

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I also see families who try to get around asset limits of elders by passing property and money to kids when parents are in good health. This is so they’ll be eligible for state care sooner. I get it that they want to pass something to their kids, but don’t you work hard and save up so you can be cared for in your old age? I know Christians who talk about this like it’s nothing. I refuse to do this. It’s wrong. It’s lying.

 

 

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With six parents (biological, step, and in laws) and 2 dependent brothers with mental disabilities and only one set of parents has other children that are capable of helping at all I have to say I can't exacatly plan. I was focused on getting 4 children launched. I don't know who will be healthy until 90 and who will have a stroke and need me for the next ten years. I know both sets of parents have attempted assisted living type situation for my husband's brother and my brother and have had no luck. This means our brothers live on our parents property. My brother in law in his own cute little cabin on my in laws property and my little brother with Down Syndrome on my dad's property. But it does add complication if they die. We can't afford to keep the big main house empty just to justify my brother or brother in law in their tiny little house but I'd feel terrible telling them to move soon after they lost their parents.

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