Preparing With a Parent in Decline. Bugging Out is probably not going to work.

It’s a hard thing to watch a parent who is in decline. This may include physical failings, cognitive decline, loss of memory, forgetfulness, disturbed sleep patterns, and bad decisions. The person who once took care of you is simply no longer able to take care of themselves. What responsibilities do you have toward family?   In this article, I’m going to relate some thoughts regarding the care of an elderly parent and some considerations for general preparedness planning, not necessarily TEOTWAWKI. This is not intended to be an exhaustive treatment of the subject of hospice, elder care, legal issues, or anything else. It is simply some of the experiences my wife and I have had taking in an elderly parent and some Lessons Learned. As with everything else, Your Mileage May Vary.

Background

Our family moved to the northern Ozarks a bit over forty years ago. My parents purchased a small plot of vacant land. A well was drilled, power brought in, septic dug, and the family homestead established. It was home for a long time as the children grew, graduated, and left. Eventually Dad passed and only Mom remained on the property. Fortunately, none of us had moved terribly far away.

My interest in preparedness began as a child through reading Boy’s Life magazine and Outdoor Life. There seemed to be a monthly article of how someone found themselves lost in the wilderness and in a life-or-death situation. I drifted away from this as I grew up and went off to college. Eventually I joined the reserve forces, had a couple deployments after 9/11. It was after one of these that a neighbor sent a link to SurvivalBlog to me, and this rekindled my interest in preparedness. I didn’t really start working toward goals until a few years ago (following the election of BHO) and retirement from the National Guard. Most of those have been financial and land acquisition. There is a long way to go.

How did we get involved? In 2019, after forty years on the homestead things started to break. The well pump, installed in 1979, gave out. Honestly, it lasted that long, there is nothing to complain about. However, a few months later in February, the furnace burned out in the middle of a “polar vortex.” I was traveling for work and fortunately the sisters were able to step in. Mom was convinced that she would be fine with a few space heaters. The result of this was that she (and her dog) would come and live with me and my wife. It was my wife’s idea, and she was right. We are the ones with both the space and resources to make this happen.

Changing Plans

I had always thought that bugging out would have been appropriate for my situation. My essentials would fit on the truck and drive to the family homestead. Since then, I’ve been married and taken in a parent. Also, the former retreat has been ransacked several times, even with nothing of value in it. The plumbing has been destroyed from the initial freezing. Several years ago, the county sheriff stated on a major social media platform that they would no longer respond to property crimes. The place is still there as an illiquid financial asset. I think of it as being in mothballs, but needing additional work.

The onset of the Covidiocy served as a test run for a partial bugging in. We were in pretty good shape compared to many. The larder was stacked deep with staples for at least a year, and we were both fortunate to be able to work from home.

Lessons learned from parental decline

• The world of the aging parent will shrink. Trips to the bigger town for shopping will be replaced with trips to the small town that has few or no options. The same with visits to family. Everything becomes “too far,” even if only 20 minutes away. This may be the most obvious indicator of an approaching inability to live alone.
• Stubbornness. Mom grew up on a farm without electricity or running water through WWII and the decade after. They didn’t frequent the doctor and that attitude has lasted her entire life with few exceptions. There may be friction over medication: “I had a doctor tell me that aspirin is the best thing you can take.” Of course, that was in 1960. It took a year to convince her to get cataract surgery and a fall at home before she’d see a doctor for some arthritis medications. We have come to expect minimization of any pains or other medical issues and that may be common among that generation. If they are asking for pain medication, it must really be bad.
• Memory issues. You may not notice unless you are right there and they may well develop far earlier than you realize. Mom complained of calls from the phone company about bills not being paid. Often the checks were written but not mailed. Going through her papers, I found she’d left one of her daughters off the will. Not intentionally, she just forgot. The will was written fifteen years prior, long before any of us realized Mom was losing her memory. It is helpful to stick with a consistent daily routine if possible.
• Physical frailty. Loss of muscle mass and bone density is well documented elsewhere, no need to discuss it here. Most notably, everything will take longer, whether this is going for a hair appointment, dressing, walking out to the deck, or just down the hall.
• Diet. The elderly may have a lack of interest in food. Of course, some of this is a reduced need for calories due to less exertion. However, once enjoyed foods may no longer be wanted at all. We’ve switched almost entirely to meal supplement shakes. This changes the contents of the larder and is an increase in food costs. Fortunately, they are shelf stable and you can buy in bulk. Also, watch their fluid intake. Dehydration can lead to infection and hospitalization, as we found out.
• Medications and Hospitalization. It is important to have a doctor that specializes in geriatric care. A few months back we had a sudden hospitalization, which was life threatening. The doctor changed many of the medications prescribed by the GP. Though fine for someone the age of me or my wife, they were far too harsh for someone of more advanced years. An issue is that hospice medications are only dispensed with a 15-day supply at a time. I gradually built up a year’s supply of blood pressure meds for myself by simply ordering refills as soon as possible. That won’t work in hospice.
• Hospice. After the infection had cleared, Mom was discharged to hospice for continuing care. Prior to this, I had only thought of hospice as apropos for end-of-life, but apparently this is not the case and has been extremely helpful. Something to consider is that you will have several healthcare strangers coming into your home. In our case, there is an RN and a couple of CNAs that assist with bathing and a monthly visit from a social worker. They seem great, and have been very helpful, but do not forget OPSEC. Preps remain out of sight and they only get access to the parts of the home needed for their jobs.
• Affect. Aging may lead to disturbed sleep patterns. It may be necessary to remove distractions such as a television and DVD player from the elder’s room. Do your best to encourage good sleep hygiene. A daylight lamp can be helpful for season depression during the winter months.
• Reason is not always effective when dealing with an elderly parent. Avoid asking open ended questions. Don’t ask “Would you like chicken or fish for dinner?” or “What would you like for dinner?” These seemingly innocuous questions can cause something near mental paralysis. Simply state “We are having chicken, it’s time for dinner.” This not only reduces stress on the elder, but also on the caregiver.
• Power of Attorney Legal Papers: PoA-Medical and PoA-Financial. Please have these conversations earlier rather than later. Once there is a diagnosis of dementia all bets are off and the parent cannot legally sign either. We got this accomplished late, but prior to such a diagnosis.
• Vital papers. At some point, Mom lost her purse with all identification in it. Apparently, in 21st-century America, identity comes from the government. Do you have any idea how hard it is to get identification without having identification? This has been very difficult and is still ongoing. Some states have digitized records, but only going back a certain time. They have also replaced state employees with contractors that you never seem to be able to talk to. Washington State, for example, has digitized back to 1968. Records prior to that time (that we need) are only available from the local offices. These offices, when called, roll over to the contractor company. It is insane. Also note that just because you have a birth certificate, it may not be acceptable. Mom’s was issued by the Bureau of the Census in 1939. Although issued by the Federal government, it is absolutely not accepted by any government agency at any level. Go through papers with your parents and see that they have them and what you might need to have reissued. Multiple hard copies are advisable.
• Bugging Out is probably not going to work. An 80-something-year-old with dementia and arthritis will have enough trouble riding in the car for a lengthy period of time, much less walking somewhere. At this point I doubt I could be walking very far. Certainly, I am not abandoning a family member should the SHTF. Are you going to abandon your family? I didn’t think so. So, our near-term focus is to remain in place. Fortunately, we are in a smaller town adjoining a small Army installation in a pro-gun state. Rather than gardening, we frequent the farmer’s market and have made some connections there for the winter months. Your courses of action should be under constant review.
• Take a look at your supply list. We have added a number of items to our home that I never thought about. Walkers. Canes. Wipes. Mobility chair (different from a wheelchair). Adult diapers. Beside commode. Liners for the commode. A shower chair. A powered hospital bed. Toilet rails. A powered recliner might be a good idea if you have the resources. It will help the senior with standing and when the power goes out, it is still a comfy chair.
• Get the family involved if possible. Quite some time ago, my sister and I decided that Mom would not be going to a nursing home if at all possible. Part of this decision was from her experience working in nursing homes and my view that it is a family responsibility. Our family has come together to make this happen.