It has been a rough week on the old homestead.

Part 1: Accepting a Paid Caregiver Battle

My husband’s family has been arguing with his parents about bringing in paid help. Since the pandemic started, my sister-in-law and brother-in-law have been working from home full-time. During that time, my father- and mother-in-law have gotten more and more dependent on them for little things and big. My SIL spots my MIL when she showers, to be there in case she falls. My SIL’s family prepares food for them. They remind them to take their medications and to walk in the mornings. They do their laundry and put it away and change their sheets. They help my FIL when he has trouble with his laptop or his phone. And WFH being a foreign concept to my FIL and MIL, they don’t understand how disruptive it is for them to reach out for help when my SIL or my BIL is on a conference call.

Now that things are starting to open back up, my SIL and BIL will start to phase out WFH. It’s time to reintroduce the caregiver that they had started to introduce in early 2020, who is now fully-vaccinated. But my in-laws are unable to see how dependent they have become on help from the family and they are fighting the idea of the paid caregiver tooth and nail. It has become a symbol for them that they are unable to do things for themselves, something that has always been a point of independence for them.

They don’t even notice how dependent they have already become. My husband had three separate conference calls with his family about this in the last week.

Call 1: his sister’s cry for help.

Call 2: my husband broaching the conversation with his father, whose stated position was:

• I am not resistant to the idea
• I don’t like the idea of hiring someone to sit around
• I want to make sure we have a list of clear responsibilities
• And, most importantly, I don’t want people yelling at me, telling me that I am incapable. I want to be treated with dignity and respect. I want to be a partner in decisions that impact me.

At the end of that call, my FIL agreed to a family conference about this.

Call 3: my husband prepping his sister for the family conference

Call 4: family conference. Outcome: my SIL and BIL would put together a list of responsibilities with his input.

Call 5: another cry for help. My FIL looked at the list and said, “But we can do all these things. We do perform them on a regular basis. Yes, we sometimes forget. We will do a better job at remembering. The only thing we need the caregiver to do is drive us to meet you at doctor’s appointments. That way, you don’t have to take time off from work to drive out to the suburbs to pick us up and bring us home afterwards.”

Call 6: my husband, 1:1 with his dad, trying to persuade him to accept the caregiver.

Basically, back to step 1.

This is frequent battle within families. Older people feel that they are being singled-out, that their children think them incapable. They don’t want to become dependent on paid help. They don’t see how dependent they have become on their own children and the toll it is taking on those children.

I went through this with my own Mom a few years ago. It’s painful. It requires a reorganization of thought, a willingness to step into vulnerability, that you and I would find challenging even now, as young as we are. Once you pass a certain age, adapting to change becomes even harder.

And it becomes even more frustrating when you add on hearing problems and cognitive decline. Call 6 lasted over 2 hours late into the evening. Most of this delay was because my FIL couldn’t hear my husband and couldn’t remember how to increase the volume on his iPhone. So he ended up restating his position in the same long monologue, regardless of what my husband said. At one point, my husband said, let me repeat this back to you, to make sure I understand your position accurately. Because my FIL couldn’t hear very well, he said, I will repeat my position so that you understand. And launched into the monologue again. And each time he restated his position, it became more firmly entrenched into his mind.

The latest approach: the paid caregiver will come in part-time and she is ostensibly not there to care for the parents. She is there on behalf of my SIL and BIL to assist with their own needs… which include helping the parents…

More to come on that.

Part 2: Managing the Paid Caregiver Battle

My sisters and I had gotten my own Mom to accept paid caregivers a couple of years ago. It’s easy, when you are in the acceptance mode, to see hiring the caregiver as the final step.

But once you have them, you have to manage them. Paid caregivers generally make little money, especially if they work for a service who takes a big cut. For Mom, who needs full-time care, independent assistants cover weekdays, and we use a service for nights and weekends. Staying in with the service is also helpful for covering last-minute call-outs or PTO for the independent assistants.

Except that the independent assistants are young women and they have new boyfriends. And, when you’re young and in love, you tend to miss a lot of work. And, it’s tempting, when the old lady you’re caregiving for falls asleep, to sneak in a quick chat with your boyfriend. If, when she wakes up, she’s happy dozing in front of the TV, it’s tempting to keep chatting with him. And so on.

So things have started to slip. My sister who lives locally is pretty fried and called for help.

So 90 minute phone call to step in and deal with the situation. Of course, one problem – managing the caregivers – turned into multiple problems.

• Mom’s dog needs vet care. If the caregivers take the dog to the vet, they aren’t in the house, protecting Mom from falling. My sister can’t keep taking time off from work to care for the dog. Solution: I will get the phone number of a “doggy” friend of Mom’s and see if she can take on any vet appointments that are needed. My niece and nephew will start dog-walking again.
• Mom sometimes wants to order take-out or needs someone to pick up birthday presents for her. She is in the habit of handing over her credit card to the caregivers to pay for things. Which puts everyone at risk, including the caregiver. But if the caregivers pay, they forget to get receipts so that my sister can reimburse them. Solution: my other sister will order a Venmo card that we can load with minimal funds for these purposes. I will monitor usage so that we can reload the card when it runs low.
• When my local sister comes to visit Mom, Mom has often fallen asleep in front of the TV. When she wakes up, Mom needs a few minutes to come fully awake then needs to use the bathroom, then gets distracted by the TV. My sister is unable to have a conversation with her. Solution: my other sister will tell the caregivers that my sister will text them when she is 30 minutes away. They will wake mom up, help her to the bathroom, turn off the TV, and engage Mom in conversation so that she is fully awake by the time my sister arrives.
• The caregiver shift changes happen at the same time that the dog is supposed to get fed. No one is ever sure if the person before them fed the dog or not. Solution: I created a dog-feeding chart that they can initial to show that they fed the dog.

These are all minor problems. What came out on the call was how unappreciated my sister who is the local caregiver feels. She feels unappreciated by Mom, she feels unappreciated by the caregivers, she feels unappreciated by her family (who are wrapped up in their own problems).

We scheduled another call for three weeks from now. I sent out action items. At the next call, we’ll review progress on the action items, identify any new action items, and spend the rest of the call appreciating my caregiver sister.

It was a rough week on the old homestead.