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Hi, all. Glad I found this site.
My husband and I are newly married (2.5 months), and have been together for a year and a half total.
A couple weeks ago, his 89-year-old grandmother was sent to us after her daughter-in-law (my husband's mom) was burned out from taking care of her. Grandma's son (my father-in-law) had passed away last year, and gram had nowhere else to go. Her mobility is very limited, and she's mentally and physically declining more everyday.
We're getting into a routine with her, though ideally, her living in our home is not going to be a permanent solution, as we both work full-time. However, we're going to have to start from scratch in order to get her qualified for AL, as nothing of the sort had been done for her yet. We don't have medical directive or POA over her yet.
I'd appreciate any tips and advice from the more seasoned caretakers on here!

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The POA documents must be done NOW. They have to be done when she is competent. Make an appoint with an elder law attorney at once. Same hold true for MPOA. These will be impossible to get. You don't get POA "over" someone. You get it FROM them and they must be competent to give them to you in the attorney's office. Do look up what you want in the POA document. For instance if she has property you should have the power to sell it for her care should funds be needed.
Discuss with this attorney a care contract in which it is set out in black and white exactly what the Grandmother's contribution to household costs are. This cannot be considered gifting in case she needs further care in future with Gv assistance.
Make an agreement between all members of the household to have every six month checkins and checkups on how this is working for everyone. If it isn't working for everyone that's a deal breaker. Discuss everything including expectations of privacy, who does what and etc.
That's for the beginning. Step one, the attorney appointment.
Then go to the blue line at the top of AgingCare page and look for CARE TOPICS. You will find any number of items there to start looking and to start triggering questions you may have.
Good luck.
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MavisBacon Jun 2022
I've drafted up documents for POA, MPOA, and living will for our state, naming my husband as the agent. Please send prayers and well-wishes that she'll agree to sign them.
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Hi Mavis, contact the Maricopa County Counsel of Aging. This is the agency that can get a needs assessment done, that will be required for any facility she goes to. They have all of the local resources available and they can hook you up with a senior placement specialist, this person can help you find a facility that meets grandma's needs and she might be able to pay for without ALTCS, which is AZ Medicaid for long term care.

You say in your profile that she has Alzheimer/dementia, depending on her ability to comprehend, the POA boat may have sailed. Along with the AL boat, any ALs that I found that would accept ALZ/Dem were cost prohibitive and ALTCS wouldn't pay. This was 4 years ago and I don't know the current rules, MCCA will be able to guide you.

I downloaded the DPOA, DMCPOA and Mental Health POA from the AZ Attorney General website and didn't have any problems with them being accepted, make sure you do Durable and not just General POA. UPS stores have notaries.

How is grandmas functioning? Can she do things for and by herself?
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MavisBacon Jun 2022
Great info! Thank you!
She can only do things by herself sometimes. Most days, she can barely get off the couch without assistance. But every now and then, she'll have a good day and wander all over the house. As recently as four months ago, she was able to do household chores like washing dishes and doing the laundry. Nowadays, though, she's unable to do things like that.
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Arizona's Medicaid app has a 5-year financial lookback period. This means whoever is managing her finances (FPoA or otherwise) must be really informed and know exactly what they're doing so they don't inadvertently delay or disqualify her. This person should consult with an Arizona-based Medicaid Planner before they begin to manage things. Medicaid only covers LTC in most states but you should check on what AZ does, even though this is a federal program each state gets to make their own rules and they can all be very different.
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This is a heavy burden on a new marriage. You're not just still in the honeymoon phase of your marriage, you're still in the honeymoon phase of your entire 1.5-year relationship. But it's noble of you to make a go of it.

My only advice is to make your marriage a priority, as much as is possible in a situation like this. Don't put it on autopilot until you have the house to yourselves again, but really work at it, just the same as if grandma hadn't moved in. And if it starts to affect your marriage in ways that will be hard to undo, do not feel bad about saying "We gave it our best shot, but grandma needs to live elsewhere now." There are options, and you'll learn all about them here.
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MavisBacon Jun 2022
Thank you! And yes, we're definitely doing our best to prioritize our marriage. We've installed cameras that connect to our phones so we can leave the house and go spend time together for a bit, and we've recruited his teenaged sister to watch grandma this weekend while we go to a concert in Vegas
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Oh my...this could easily become a full-time job. After having burnt out your mother-in-law, she is no good news. Do not think that it will be like babysitting for a child. Old people grow down, not up. They don't learn, they have fixed unchangeable old habits. They are heavy to carry and they do get worse with time physically and mentally. You might have to hire people to watch her while you are at work. Make sure the arrangement is temporary, do not let other family members dump her on you and run away.
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MavisBacon Jun 2022
Thankfully, my mom has worked with seniors for most of her adult life, so I was able to witness secondhand what that world entails. My husband is new to all this, and is understandably overwhelmed (he's still freshly grieving his dad, and now this).
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Mavis, can grandma feed, dress, go to the bathroom and all other activities of daily living (ADLs, you will become very familiar with that acronym) by herself?

Is she being left alone while you both work? Is she able to comprehend if she is in danger? Like can she exit the house if there is a fire? Can she have a sensible conversation? Does she use any mobility device?

You are really fortunate to be in Phoenix, there are literally thousands of facilities there. So you have a great chance of finding something that works.

I highly recommend board and care homes, they are more like a home environment, they cost less and most of them allow the residents to stay through hospice. Not all facilities accommodate the elder through end of life, this is something you want to ask of every place you interview.

I, also recommend getting her a chair that has arms that she can get herself up from. The more she does for herself the better.

She lost her son and that probably threw her into a depression, has she been seen by a doctor recently to make sure that her medical needs are being addressed? I would definitely do that asap. Loss is hard for elders and change is especially hard for dementia, finding her base line will help you guys be better advocates for her, no matter where she lives.

Sorry, I know I have kinda bounced around but, I can't get my copy/paste to work and don't want to rewrite everything.

Oh yeah, you are getting ready to find out how much you didn't know you didn't know. That's something all of us find at the beginning of our caregiving journey. :-)
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MavisBacon Jun 2022
To answer your questions, she can feed herself, and use the toilet herself. She does have a hard time standing up, and needs to use a walker to get around. As far as exiting the house if there were a fire, I don't have much confidence in that. Her conversations makes sense about half the time.

She's been in for a checkup recently, with bloodwork and everything. A cancer center just called my husband and said we needed to make an appointment for gram. Not sure what that's about, so we'll see.
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- It’s hard to watch a human being deteriorate and harder to be the caregiver
- It’s a slippery slope that brings more heartache than joy.
- Get POA. Otherwise she has to okay every time you call a doctor or bank on her behalf. Understand her medical coverage so you know what is and isn’t covered.
- Say thank you for the little things even if it’s not exactly what or how you wanted. It might be all the appreciation you or your husband get.
- Don’t let work and caregiving take over your marriage.
- Find things that make you happy. Make sure DH (dear husband) does too.
- Be patient because it’s easy to ramp up expectations from a spouse when we get overwhelmed.
- Look for humor and joy.
- You might want to have an agreed upon time to process negativity. The idea isn’t that you can turn on and off emotions, but you can agree not to wallow in them or have an unspecified expectation that doesn’t match your spouse’s.
- Sometimes it’s not worth going down the rabbit hole when your instinct is to correct grandma’s misunderstanding.
- Don’t expect help from family members who should and readily could help.
- Don’t let family members tell you what you need to do (while they pat themselves on the back for calling once a month).
- Check out local resources. Btw, you might want to see if there’s a local a buy nothing group on Facebook if you need things for grandma.
- Understand grandma might live longer than you thought (when the 18 month plan is on year 4 ….)
- Accept there may come a time when you or DH can’t handle it and grandma needs a nursing home.

God bless.
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Mavis, none of this is a complete do it yourself project. I

Get her to an elder law attorney. If she came from out of state you will have plenty of legal entanglements to deal with.
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POA is good. But guardianship is better than that. If you're going to involve an attorney and and court papers you need to go for guardianship. There are companies that will help you gather your paperwork to submit it to the court and they'll be with you from beginning to end. I just went through the process for guardianship of my father-in-law. I appreciated their help and it saved thousands of dollars. Good luck
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Try to get her paperwork in order as soon as you can, if her condition is declining. She needs POAs for medical and finanaical matters, living will, a will, all have to be set up while people are still capable of signing legal documents. Banks and financial institutions usually have their own POA forms. It may be necessary to place her in a facility where she can have 24/7 care, especially as you and your husband both work full time. Get connected with a local social worker who can help you expedite her paperwork for AL and who can explain what her and your options are. Much will depend on her financial condition. She may be eligible for some home care. Take advantage of it to get some breaks and help. If you are handling her financial matters, set up her accounts online and set up automatic payments where you can. It will make things easier. If you have aides ("strangers") coming into your home, lock up your valuables and financial papers. You may need an attorney who specializes in elder law to assist with the paperwork if she has assets. All the best to you and your husband and grandmother!
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gladimhere Jun 2022
Most banks will not accept a POA form other than their own.
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Get POA and talk to an attorney first, one that specializes in elder law. If you cannot afford one, contact Alz.org or legal aid in your state and maybe they can point you in the direction of some qualified attorneys that are affordable. Most attorneys will give a free hour long consultation to get you started.

As for daily care for the time being, I’d say get all the details from your husbands mom. She’s the one who has been with gram and she’ll know what she likes, doesn’t like and how to handle daily tasks that she needs. If you can afford a part time home care, that would also alleviate some of your work. However, finding one you can afford may not be easy. Even one day a week would help while you get the AL figured out.

Also, it must be so hard as newly weds to have this responsibility, Find her AL as soon as possible. An elder care attorney can help. Your gran is very old and as you said, declining. It will be a huge test for you and your new husband. Stick together and get gran into someplace that will care for her on a level that most family caregivers can’t handle.
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One day at a time Sweet Jesus!
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Immediately get in touch with Elder Law Attorney to help advise you on placing grandma...........I'm surprised that grandma is being treated like the potato in the "Hot Potato" game. It's unfortunate that your mother-in-law didn't invest in getting her placed instead of waiting for the next burn-out victim to show up.

Protect your marriage and grandma by placing her with professional help.
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While she is still mentally competent:
1 - Get an appointment with a lawyer (family or elder law is better options) to get power of attorneys for medical and financial affairs (so have decision-making power when the time comes), will, and possibly an advanced directive (states what kind of care she wants in hospital or long-term care when she can't verbalize her wishes).
2 - Make sure she is receiving Medicare and book appointment with a primary healthcare provider near you for a good physical. Bring all her medications. Try to create a list of her medical problems and prior surgeries and allergies. The goal to make sure she has all her medical issues addressed and you know how to care for them.
3 - Go over her finances with a financial planner at her bank. Talk with them about her future move to assisted living and now long her finances with cover the costs versus skilled nursing care versus adult day care with some paid assistance during the week.
4 - Try to get grandma into an adult day program (check skilled nursing facilities and anything in your area). Most programs are Monday - Friday days and will provide care while you and your spouse are working. You might also consider hiring an aide for the weekends for at least a 4 hour (or more) period so you and hubby can have some time off to yourselves.
5 - If bank's financial planner indicates, help grandma apply for Medicaid. Those finances can help pay for assisted living or skilled nursing care. Look for assisted living places that can phase to skilled nursing and will take Medicaid.
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MavisBacon: I did see that you're in the process of drafting Power of Attorney while your grandmother is still lucid; that is what I was going to suggest. Also contact your town's COA (Council on Aging).
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No tips or advice, just a hardy GOD BLESS YOU for being willing to take on this burden.
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Hello- the most commonsense piece of advice I wish someone told me- when I started caring for family members - is try to enjoy the time you have with them by picking your battles and showing respect for their preferences and likes/dislikes by creating a daily routine and staying consistent with everyday tasks. It's awesome you are already on top of creating a daily routine. This is key.

At first, I was a little concerned I have to say by the way things are worded in your post, such as "gram had no where else to go" and "Gram was sent to us", because viewing your role in her life as one by default or as being the last resort, are cause for burn out in and of themselves. Try and remember, or at least tweak your mind set, to she is the matriarch of the family and the only thing she has done to become a "burden" is be healthier and/or outlive the other elders in the family. Sounds like your on a compassionate path to help care for her, your husband is very lucky.

It is def a huge adjustment accepting a senior into your home. Therefore, as much as possible, remind yourself that your role is to assist her where needed throughout her day, as well as maintain a safe environment for her that she could not do on her own. Safety concerns are the main reason that aging parents or any disabled family member ultimately come to stay with us- despite so many complaints about hygiene I hear- assistance does not begin with not showering regularly.

Family caregiving is not about creating a schedule that incorporates all the tasks YOU think they SHOULD be doing every day, or all the things they used to manage independently, such as changing their clothes, combing hair and showering etc. PLEASE do not make these petty hygiene tasks a battle in your day. Again, it is about safety and health risks, not keeping up with the expectations they had for themselves even a year ago.

When I stopped and finally asked myself, why am I battling my mother to regularly shower? Is that for her sake or mine? My priority or hers? Why did I care anyway? My mom was home with me mostly, she didn't have an extreme body odor, was willing to change clothes so showering every 10 days made sense after talking to her PCP as well. When I finally backed off her and started listening to what she wanted and stopped treating her like a child, she became willing to change clothes every other day, unless she spilled or soiled them. I adjusted the products she used to maintain good hygiene. I introduced "no rinse" products like they give in the hospitals and dry shampoo. I also fell in love with moist toilettes/flushable wipes that ended up being our saving grace.

She would use to wash her hands before and after eating, since mobility was minimal and washing in a bathroom was just not conducive for us. She liked them to "wash her face", ear care, wiping her glasses, cleaning her magnifying glass, bed side table and on and on. I highly recommend investing in some type of anti-bacterial moist wipe. These type of adjustments show that you are putting her emotional well being over hygiene tasks, and that you are treating her with respect by valuing her wants, and not societal norms, and finding a way to support her changing needs, instead of expecting her to change. Most importantly, adjusting to her as she ages shows her quality of life matters most to you both, and not taking your caregiving role to represent a checklist of tasks to complete and forcing issues.

Last I can add to stay creative and fill the gaps in the schedule with her interests or social ideals. Schedule time for an old TV programs she likes smart tv's have them all- try jigsaw puzzles with images she likes, you can pop in to help 5 mins here and there an it appears to her as social time with her. Try listening to old music she enjoys, every song is now on the internet. My final point is everyone is better off with a routine balanced with her interests and your care duties. Keep her busy. Hope this helps
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Ella2021 Jun 2022
I am 4 years on the other side, and I laughed when a person posted on here, "How do I get my mother to put things back after she uses them?" My answer: You don't. That's your obsession, not hers. Something I've discovered about the brain, is that it picks up static, in a sense. Or it skips a step. My dad would go to make coffee, and do all the steps and he forgot to pour out the old and get new water. Or he would remember every other step. I do that now at 63! So, give her some grace.
I would give anything to sit out in the backyard swing with my dad drink coffee, and watch the dogs run after each other. Sometimes we'd drop everything and go to Dairy Queen, order and sit in his truck listening to a tape of Jerry Clower and laugh ourselves silly.
Listen to calmandsense's response on here. Great advice.
If a person taking care of an elderly relative realizes that they are like a baby, or a child, and their bodies are literally wearing out, then it takes the pressure off of doing EVERYTHING.
Sit down and ask her about her childhood or things she loves. At her age, you might be the last person she encounters on this side of heaven. If she can do for herself, by all means, let her. By doing so, you are allowing her to keep her dignity.
Lastly, since I had to work during the school year, I hired a lady from the local church to "sit" with my dad. She wasn't there all day, but checked in to keep some eyes on his. She sat down and drank coffee with him, sometimes making lunch for the two of them, or taking him to the park or over to the airfield to watch the airplanes land. I wasn't able to pay her alot by she was a retiree that needed a little extra money and a reason to get out of the house. She loved my dad and was even there with us at the end.
If you've done all the paperwork that needs to be done, then wait until the time you need all that. If it comes to having to place her, then you will be ready. God bless you!
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Join a caretakers meetings a ASAP. Contact the local
“ council on aging “ and ask for a list of all resources they offer
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I started caregiving last year and it can be a roller coaster ride. So be kind to yourselves and take care of yourselves first as it helps you to be more mentally prepared to take on the difficulties ahead
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