Helping Elders Accept They Can No Longer Live Independently

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I've been caring for my parent, need to leave now

June 2010

I've been assisting my aging parent through a hip replacement surgery. I live in the home, but need to get back to my own home and life in another state. Its going on two years and my parent is going backwards. My parent has less mobility. My parent would otherwise be living alone. Safety is my main concern. My parent insists on driving and living in a huge home that requires lots of up keep. My parent is not capable of taking care of it (nor am I). Can anyone suggest where I start? Whatnow

Where do you live? We had similar non-cooperative parent problems several years ago and got a lot of helpful advice and resources from the Redwood Caregivers Alliance which serves the North Bay and I'm sure they could refer you to something similar in your area. By the Way-some of the denial and rigidity might be a symptom of early dementia. In our case Grandpa had been having numerous tiny strokes before a big one hit. Sometimes, also you have to just leave and let things fall apart before an older person will accept they need help. No one person can cope with everything. Don't feel guilty. Been there.

Oh, I have walked in your shoes. I spent 5 years commuting long distance to take care of 2 elderly parents, and have spent the last 5 years up here doing the same: one crisis after another, months of unpaid labor (goodbye career), years of anxiety. I have been to hell and back.

1--For practical guidance, contact Family Caregiver Alliance ( and see what they recommend.

2--now comes the hard part. All of the practical guidance you get will still mean lots and lots of work on your part. Maybe it will work out and maybe it won't--accept that. Changing your mother's mind and getting her to move is likely to be an uphill battle. Do your best, express your love and your concerns, then LET GO. Tell your mom what the consequences of her behavior are likely to be--i.e. if she becomes disabled, you'll make a choice that is convenient for you, rather than the choice she'd make given the chance. (That's what I did.)

This is the mirror of your parents watching you go through your teenage years, except your parents are indeed going backwards. Your mother's power is waxing, and that's terrifying. Growing old and infirm with grace is something very few people are wise enough to do. Your mother would be safer in a care home--but that means losing privacy, independence, mobility, many of the things that form part of our identity. You can help her with this journey but only if she lets you. Set boundaries, do it on your terms, don't let her dictate everything.

In my case, my mom has continued to make poor choices and leave it to me to clean up. It's hard to grow old; it's worse not to live your own life because you're trying to make a crazy situation functional. Now, after multiple crises, I've had to step away just to live my own life. I still love my mom; I just accept that I can't fix what's wrong with her. --Wish I'd Taken As Much Care of Myself as of My Mom

Alameda County Aging and Adult Services provides free Information & Assistance by telephone (800-510-2020 or 510-577-3530). Contra Costa County also has a similar office.

The Center for Independent Living (Berkeley & Oakland) may be able to give you some advice - they are people with disabilities who advocate living independently. If you don't live in Berkeley or Oakland, ask them for the phone number of a similar office in your area.

Ask them about transportation and getting an application for paratransit, too.

If driving or taking the bus is a problem for her, you should probably fill out a ''paratransit application'' for her right away stating that there are certain circimstances and times that she cannot take the bus or BART, and describe those times and circumstances. Then she will qualify for some paratransit services which provide subsidized rides -- not free or as convenient as it sounds, but helpful. And it takes a while.

Senior Centers are worth contacting. You didn't say what town, but there are some in Berkeley, Oakland, Hayward, and I'm not sure where else. Carolyn

You should call Amy Pieri, who is a certified Geriatric Care Manager in the East Bay. Her phone number is 510 507 0788 and website is Amy managed the care of my Dad from 2002 until he died in 2008. We were at our wits end, trying to figure out how to look after a 90 year old man with Alzheimer's who had just lost his wife after nearly 60 years of marriage. She was an invaluable help, compassionate, competent, available whenever we needed her. You can't do better. Leo

My mother is trying to care for my very ill father

Sept 2008

Rossmoor? Another place? Another idea? Where do I go from here? My parents live out of the area. My father is sick, and needs help with everything - bathing, eating, going to the bathroom, walking, etc. He will not get better. My mother is in good health and has been his sole caretaker for nearly 2 years. She is, of course, tired and depressed but working her tail off with pleasure to help my father. She also stubbornly does not want to move out of their 2-story house (they haven't been upstairs in the 2 years). Insurance covers someone from a home care organization to come in and help with bathing, but the hours are not right. These home care orgs. can come once during the day for a 4-hr block. This is not what she needs. She certainly needs someone in the morning, and someone in the evening, but also during the day. Home care orgs. do not offer split shifts. She also needs a nurse as she is taking my father's blood sugar and making (random?) decisions about administering his diabetic medicine (home care orgs. do not send RNs). Further, she needs someone to talk to. They have no friends in the area. Basically, my mom needs a nurse and a wife in one! I would love to have them closer - does Rossmoor offer this type of service (wife joke aside)? Is a retirement facility right for them since my Mom is in good health? Is there an agency they can contact to interview live-in nurses for their current home? Anyone else out there ever deal with this? I'm at a loss for ideas! Thank you! Only child at a loss in Berkeley

it maybe helpful to look into speaking to a private care manager in the area your parents live in (you maybe able to google this). they will know all the resources of that area. If you are considering moving your parents out here i would consult with someone out here as well or call or look on the website of California Advocates for Nursing Home Reform for a complete list of facilities in the area. good luck

Depending on where they live, there can be many ways to support aging parents to 'age in place' which is what most people want. It is not always the best idea to move people away from all the informal support (neighbors, grocery stores, friends, church, etc) they have to be near family that may not have much time for them. They have a great resource in this house of theirs -- an extra story that someone can live in, someone that can provide help. Every city should have some kind of Area Agency on Aging, some social workers that can assist in assessing the situation and creating a plan. Many cities have Catholic Social Services or Jewish Family Services, etc. With just a bit of help (day programs, meals on wheels, a respite worker, a live in...) people can stay in their homes safely and happily. Your mom is an adult -- what does SHE want? Does she want to move? If so, there are people/agencies here that can help with that decision and if not, then it just sounds like she needs to be shored up! Not easy to worry from afar, but moving them here has its own problems, too. Good luck! Nancy

I empathize with what you're going through with your folks. Unfortunately, Rossmoor is probably not a good choice for them, as it caters to active elders who are able to live (mostly) independently. A lot of people hire caregivers, of course, from within the community of residents as well as through agencies. As I understand it, the Waterford at Rossmoor provides a bit more attention for residents, so you might check that out, but it sounds as if you'd do well to start looking at assisted living facilities with graduated levels of care. A good place to start is, which offers great information about the different types of facilities and a comprehensive data base of places in the Bay Area. Since your mom is, understandably, having a hard time letting go of her home, you might arrange for her to talk with a good social worker (try the senior service agencies or the area agency of aging -- -- where they live) who has a lot of experience working with seniors. My dad rejected everything I suggested and was minimally communicative but was amazingly forthcoming and responsive to a professional. I wish you well as you help your folks make this transition; get some support for yourself, too, as it can be really tough going. Good luck. Been there

Linda Wurth, of Better Care Choices, sounds like the resource you are looking for. I have met her personally a number of times and have heard a lot of good things about her. If she doesn't do specifically what you are looking for, I'm sure she would be able to guide you in the right direction. 925-932-1400 -- Greg

Have you looked into The Redwoods in Mill Valley? They offer a continuum of care options (independent living, supportive living, and skilled nursing) that works well for couples when they have differing needs. In the past they were also much more affordable than Rossmoor, but I don't know if that is still the case. I've visited there several times (looking for a place for my grandmother, among other times) and always got a really good feeling. The people who live there seem to feel a real sense of community. Part of the Sandwiched generation

I recently helped my healthy (now 80-year-old) mother who was the primary caretaker during a protracted decline in my father's health. (He had a stroke that obliterated his expressive and receptive speech and complicated existing chronic medical conditions that included diabetes and a heart valve defect that was only partially assisted by a replacement valve that involved life-long use of blood thinners.) His care was complicated by obesity as he became less mobile.

My mother did not want to leave her community or home where she had lived for 50 years even though she frequently expressed rational doubts/fears about her ability to adequately care for my father in their home. And at times, I doubted her ability to make good decisions for herself and my father. Now that we have come to the end of a four year struggle to care for the needs of both parents long-distance, she has strongly rebuilt connections with her friends of many years and regained a vibrant life with pride at her ability to support and care for her beloved husband through his death at home. This wasn't easy for her or for me.

These are resources that made this possible:

1. My father's excellent primary care physician who gave straight information about his health, the required care, what his insurance would and would not provide, and a smattering of paid care resources in my mother's town. In order to get reliable information, I went to significant appointments with my parents. I'd help my mother form a list of questions she wanted addressed and added a few of my own. Then I'd make sure we covered the list, recorded the answers, and made sure my mother understood the implications before we left the appointment.

2. The Senior Center had excellent information about local resources, support groups for caregivers, infrequent ''days off'' for caregivers and lunch. This was an important starting point for my mother to develop a network of advisors, friends and paid assistants (who could build a low cost ramp? who was a trustworthy night time assistant?) and free or borrowed equipment (like a hospital bed).

3. Adult Day Care whose bus picked up my father three days a week and strongly supported my mother's needs paid for with my father's Social Security. It was very hard for my mother to feel comfortable spending the money and to require my father to go when he was unhappy (which he frequently was). But without it, she could not have managed his care.

4. A neighbor who gave my mother permission to call him if my father fell in the middle of the night and she was unable to lift him up (her worst fear). She asked the neighbor for help twice in four years. Her fallback was calling 911.

5. A trustworthy financial advisor who thoroughly understood my parents' financial situation and the available funds to spend on my father's care. My parents used his advice to set up their living trust, living wills and potential powers of attorney. My mother is still in a strong financial situation for the rest of her life.

6. Me. I started by listening to my mom and finding out how she wanted to manage this time in her life. Then we set up a means of organizing support and structures that would give her the help she needed. She actually did most of the work but I followed through on my part. I also listened to my needs and built that into our lives as well as I could. But my primary goal was not to take over from a capable woman who had built a strong partnership with my father over many years. I tried to become a partner, too. When my mother talked about her fears and how hard physically and mentally it was to care for my father, it was hard. But I let her take the lead. During those years, she needed a lot more phone and face time from me. So I cut back on activities and spent time and money visiting her. In some ways, it's been hard now because she doesn't need me as intimately in her life anymore.

While my family's solution may not be best for your situation, I'm glad I trusted my mother to know what her capabilities and limits were. She is now in the right place for her life in the community where she belongs. If her health slips, she trusts me enough to move to where I am. I know this is a difficult and uncertain time. My heart goes out to you and your parents as you work out the tough decisions for this time in your father's life. Wishing you the best for the road ahead

First, UC has a web site that provides basic information on arranging care for elderly parents. If you are a UC student or employee, I have also found that the UC CARE service has counselors who can help with specific questions, and with finding distant resources. It sounds like your parents are in a similar situation to where my parents were starting 8 years ago, until my Dad passed away 4 years ago. My dad became disabled, my mom cared for him, and he did not want to move. OVer time, we got the word across that we simply couldn't travel 600 miles every weekend to help out, and they very gradually added help, first a lady who came in about 12 hours/week in 4 hour blocks, then night-time help (but they only agreed to that when insurance covered it), and finally the 12/hr/wk person offered to live-in for less than all the night time people cost. My mom continued to have this companion live in after my dad passed away, which has turned out to be a blessing for all, because she now needs round-the-clock oversight herself. WE did investigate other living situations. There are some places that recognize that couples may need a combination of care, and offer apartments for a couple to share with assisted living attached. Hyatt has a string of places like this--none in the Berkeley area, but one at Stanford. There are undoubtedly other providers that offer something of this type.

Good luck with this difficult transition, and help your mom find some help! Sandwich generation

I'd start with the Family Caregiver Alliance (head office in SF) and see what they recommend. 800-445-8106

Perhaps they can refer you to a Geriatric Social Worker in your parents' area who can do an assessment, and who can put them in touch with appropriate caregivers (such as an RN). Probably your mother needs a good training session in diabetes care as well.

If your parents aren't willing to move, getting help for them is all you can do (provided you can figure out how to pay for it).

I have no personal experience with Rossmoor but was told by someone more knowledgeable that they are oriented towards ''Independent Living.'' Sounds like your parents are ready for Assisted Living. If you move them here, I would look for a Continuing Care Retirement Community, such as Piedmont Gardens, that offers Independent Living, Assisted Living and Nursing Home Care. That way a resident can move up and down among the various levels within the same community. Good Luck

Hi -- our family faced a very similar situation: parents in Southern California, Father debilitated with Parkinson's, too large a house, mom and dad in denial about the extremity of my dad's illness or their ability to take care of themselves without help, Mom a ''do-it-all-do-it-alone'' with growing resentment, stress, and effect on her health. They ended up moving up the Bay Area to a multi-generational Cohousing community, and my mom really whipped into acton finding support services. This was a few years ago, and my did has since passed away. I asked my mom for some advice and referrals. You do not have to be the primary caregiver to avail yourself of these services. I would suggest a consultation with:

1) Family Caregiver Alliance in San Francisco--1-800-445-8106 or (415) 434-3388 and/or

2) Eldercare Services 1808 Tice Valley Blvd. Walnut Creek, CA 94595 Phone: (925) 937-2018 (They also have an office in San Francisco).

#1 above is great for supplying information and resource lists. #2 is a highly respected agency which is about 18-20 years old which does geriatric management, but also does consultation and support to families as well. They are experienced and knowledgeable. They also offer workshops and provide support groups. Sara

A quick thanks to everyone that wrote in with advice for elder care. Good advice and contact information for places I had not heard of. Your kind words and advice helped me so much. Thank you!! Only child at a loss in Berkeley

Aging & ill parents not accepting how life has changed

January 2007

Can anyone here share experiences and make recommendations on how to aid aging and ill parents? My parents-in-law have aged significantly in the past year due to my father-in-law's (FIL) battle with cancer. My mother-in-law (MIL) retired from her job and was almost immediately faced with the near death of her husband and new role as caregiver. My FIL had to quickly retire from his job in a business he co-owned (and which was in debt) and has undergone a number cancer treatments. As they begin 2007, my MIL is exhausted, depressed, suffering from her own health issues that she has completely neglected, and worried about finances. My FIL is in remission now, tires very easily, but is already itching for his independence, so is doing more than is recommended by his doctors. Despite their offspring being local and doing all we can to help them, they are not communicating with us and are in complete denial about how life has changed, what they are capable (or incapable of), and what they should probably alter to make life safer and more comfortable as they move on from here. Can anyone recommend services, therapists, activities for adults who have rapidly aged (or been ill) and not fully accepted it? Can anyone suggest an in-home nurse we might be able to hire to check on them and counsel my MIL through her emotions about all of this? What about a group therapy we could encourage her to join? We are trying to be as sensitive to their needs and feelings as we can, so any techniques we can use to push them through their barriers in a positive way would be extremely helpful. Thanks in advance and happiest wishes for 2007.
daughter in law feeling helpless and frustrated!

Sounds like you need the services of a professional elder care manager. The one I've heard of is the Cohen Cormier Group, website is

I am sorry to hear about your in-laws' struggles. It is great that their children want to help, but it is a shame that they will not accept that help. They probably want to maintain their independence and privacy, which are, of course, important concerns for people in their age group. Unfortunately, there is not a whole lot you can do without their consent unless they are in truly dire straits.

One idea is to speak with their respective doctors. A doctor may be able to recommend therapists or household helpers, and your in-laws might accept the idea better than if it came from family.

If you are in Alameda County, you can get an idea of what kinds of services are out there by checking with the Alameda County Area Agency on Aging (1-800-510-2020 or Other counties have similar agencies. They might be able to give you further advice about what to do in this situation.

Probably the best thing for you to do is to let them know that you care about them and that you are there for them. anon

My 80-year-old aunt needs to move from her home

July 2002

My 80-year old widowed aunt is not really capable of living by herself in the Berkeley hills any more, and has some difficulty in realizing and adjusting to that fact. Does anyone have any recommendations for decent local living situations for someone in her position? She has some 'haziness' of mind and judgement but not a diagnosed dementia of any kind; she has some health issues but is not bed-ridden. She owns a house in the hills that could be sold to pay for some years of hopefully decent, caring living in a managed situation. Any advice would be appreciated

There are a number of good options for your aunt. As Leanne mentioned: in-home support services are available which includes people live in or individuals who can come in on a daily basis to do chores, cook, be a companion, drive and whatever is needed.

here are some other options


  • Assisted living facilites in the area.
  • Hiring a geriatric case manager who can do an assessment of your aunts situation and provide referrals and assistance on an ongoing basis. Some caregivers at UC Berkeley have found this service extremely useful.
  • The woman who wrote the book Moving Mom and Dad, Donna Robbins works here in the Bay Area and is available for Consultations to caregivers for a moderate price, she also will do onsite Lifestyle evaluations she helps with moving plans etc. should you decide to go that route.

    Em Gomez, Elder Care Counselor