SENIOR Q&A: Siblings caring for parents

Q: For years my sister cared for my mother. She did not include the other siblings in her decisions. She complained to all of us about how much she does but when we offered to help her she said “no.” Now our parents need more care and my sister only complains about all she does but when we offer with concrete advice or offer to help she again says “no.” I worry about my parents and question if my parents should move closer to me rather than stay where they are. I live about three hours away and I am the health care proxy. Any advice?
 
A: If your parents are competent to make decisions they need to be included in the discussion. They may be relieved to move or the opposite; they may be scared to move because they know what they have even if it’s not perfect. The fact that the health care proxy was completed with your name means your parents chose you as decision maker when help is needed. Change to a new setting is never easy but this is the time to make plans for the future. Making a change before a crisis and before an acute illness is always best.
 
Q: With everything changing on the federal level I worry that my mother will not be eligible for Masshealth on the state level should she need care. What can I do to prepare and plan for the future? My mother has some assets and a home.
 
A: You are right about changes on both the federal and state level. In MA, legislation is being debated to tighten and change some laws. We suggest that you and your mother meet with an Elder Law Attorney to strategize and discuss present and future needs. The Elder Law Attorneys are up to date on current rules and stay current on what is being debated at the state house. For anyone who has done some planning it is always a good idea to review the plans with an Elder Law Attorney yearly or every two years. There are often changes on the state level and it is important that all documents are current.
 
Q: As my father’s dementia is progressing he is becoming resistant to showers and taking his meds. He does not want to shower any more stating he just took a shower yesterday or took one earlier in the day. As far as meds he often will say I’ll take them later. Any ideas on how to convince my father to shower and take his pills?
 
A: As dementia progresses it is very typical that people refuse a shower. Per the Alzheimer’s Association water coming down can be seen as daggers instead of beads of water. Also getting undressed and naked causes fear. The shower experience needs to be turned into something that is positive. For every person what feels good is different so often it is trial and error. Some ideas can include playing music in the bathroom and then escorting someone to the shower. Start singing as the undressing begins. In the shower the back should be to the water not the face. Use a washcloth to wash and start at the feet and go up. If someone becomes extremely agitated at getting undressed then let them take a shower with a T-Shirt. Soap up the T-shirt which goes directly to the skin. Wrap someone with a towel and then say you need to change that wet shirt. Another idea is to try to keep someone occupied in the shower by giving them something to hold; for women you can give them a doll to wash and for a men hand them a facecloth and ask if they can clean the tile (as long as it’s within reach). Another idea is to put together pictures (and laminate them so they can get wet) of someone’s favorite sports heroes. This gives someone something to look at and also something to talk about. Always say thank you, smile, and compliment; thanks for washing the shower you saved me time or you are really a help etc. As far as taking medications, consider talking to the doctor to see if your father needs to be on all the medications. Some doctors will recommend stopping some vitamins, etc. Maybe some meds can be in liquid form and put into water but the person needs to drink all the water. Ice cream is good to give with meds or offer chocolates once the meds are taken. If there are many meds in the AM ask the doctor if any of the meds can be given at lunchtime; too many meds can be overwhelming for someone with dementia.