Managing issues with aging parent who lives far away?

We have a similar situation with MIL in rural Montana. Could you have a chat with a couple of her friends and make sure they have your number in case they notice anything really alarming? That’s one thing we did and it’s given us some peace of mind. She also has a watch that will automatically call 911 and dispatch EMTs if it senses a fall (and she doesn’t deactivate the alarm) - because she is very much a fall risk.

Also, since you are in MN, look into the HABIT program at Mayo - although it may be difficult as she doesn't really have a "caregiver" for herself. If you do wind up moving her to MN, better to do it earlier than later, so she can get a new routine established.

My mom has vascular dementia. My sister moved her into assisted living in August. Mom is still in the same city she has been in for most of her life but it still did NOT go well. Don't make your decision to move her based on it going well. Expecting her friends to look after her isn't a good idea IMO simply because you don't know if they are truly capable of recognizing her need for help. They very well could be in early or mid stages of their own dementia journey or other physical decline. As her mental/physical health declines any other friends are going to ghost her and you won't be aware. Your FIL home health aid is your best resource for information. The best time to have moved her was 5-10 years ago.  Her repeated questions are very much a common dementia symptom not seeking a different answer. 

Things to do now is start researching care options where you are and getting her and FIL on waiting lists if needed. Find out what paperwork they will require like a power of attorney. Getting dh and yourself mentally prepared this is not going to be easy.  Mom's assisted living facility allows for residents to have a live in companion. This would allow FIL and MIL to continue living together unless there are step siblings who don't want him moved.  My sister lives in the facility with my mom as her companion/caregiver. She often wants to go home but where home is changes. Sometimes it is her childhood home, or the home she lived in as a teen, or the house she and dad lived in the early years of their marriage, or the house my sister and I grew up in, or the house they bought when dad retired (which we have not sold so my sister can take her there for an afternoon visit) 

I'm sorry, I know it's a lot to take in. If you are close to Mayo, I know they have resources available to help you during this process.

(((Hugs))) and prayers.

I would definitely push to have her evaluated for dementia - the repeated questions as well as the blaming the caregiver are red flags to me. You can contact her doctor and ask for an evaluation even without medical POA - they can't give YOU information but they can take information from you. I know my mum was incredibly resistant to any POAs but she was willing to put my sister down as a contact at her doctors which gave the doctor permission to talk to my sister about mum's health -I believe my sister asked the doctor to bring that up as mum was much more likely to listen to the doctor than to us AND the doctor was prepared with a form there and then to have mum sign before she forgot or changed her mind.

I don't have any advice, I just want to say that I'm sorry you are dealing with this. When all of our family ended up in Dallas and my parents were in WA state, we moved them down here to be close to us. I think that they are now happy with the decision but they miss their friends and not having a car has been hard.

I hope you can get some good advice from our all-knowing peas!

I live about 1,000 miles away from my mom. She's 95 and we finally had to put her in assisted living last year. My sister does live 10 minutes from my mom, but I help out with the things that I'm able to. I handle banking, for example. When my mom lived on her own, I handled grocery orders and having takeout delivered on the weekends. But my sister took her to all appointments. Sometimes we paid her caregiver aid to take my mom to appointments.

Things are a lot easier wither her in assisted living, but it's never going to be completely easy. The best thing would be to move your mother in law closer to you. She's only going to need more help.

I feel for you.

My parents live far away (10 hour drive on a good day.)

I worry about my dad’s physical health and mom’s mental health and what I am sad to believe is likely the beginnings of some form of dementia. She definitely has severe depression (decades- but she refuses to seek treatment.)

Everything I’ve offered to do, she refuses. I’ve bought and set up watches because she falls and it breaks my heart the way that she gets back up. But she refuses to wear it, and I know one day her “method” isn’t going to work.

I wanted to send a person every other week (I think once a week is more appropriate now) to do laundry and cleaning and they refuse to have anyone in their house. Their washer and dryer is in the basement and the only bathroom is on the second floor. I can’t do anything about the bathroom, but I would really prefer she not go down the basement stairs. She can’t carry a basket of clothes up and down. But she’s come up with the “brilliant idea” to TIE a laundry bag to her waist and put the clothes in it- and drag it up and down the stairs. There is a crumbling foundation wall on one side, and no railing or anything on the other side. What can go wrong? I tried to pay to have a railing installed. Couldn’t be done on foundation side. And to install one on the other side, I couldn’t get a licensed contractor to agree to do it, for less than 20k (includes serious digging and laying of concrete on dirt floor to anchor it… ) with the potential to get much more expensive if something goes wrong. Made sense to pay a teen to go spend a couple hours a week. But nope.

Eventually they won’t have a choice but to leave their house and go into assisted living/senior apartment. But my mom says no way. She will be carted out of that house one day. It makes me sad that it will likely be sooner rather than later because she is stubborn. I think she’s perfectly able to make the decision today (even though I disagree) so I doubt I will fight her on it later and force her.

But I don’t know. I’m sorry you’re entering that era. There’s some really good advice in this thread. I didn’t even consider the complication of a blended family. I also didn’t know that companion/caregiver adult children could live in some of these facilities. Best of luck and safety to you.

Since she is still quite rooted to her community, I would work on suggesting a move to an assisted living setup in her current area where she is still able to get out and about with friends while also getting more ongoing help for her DH. This way she still has the independence she wants now but is in a better position if/when either of them needs more help with whatever going forward. It would be easier to move her/them closer to you later on if they downsize their household now while she’s more able to make decisions.

As for counting on friends to step up, I wouldn’t count on that. We dealt with this some when our elderly lake neighbor was staying with us. She is in a similar situation where she really relies on several friends back home to help her with certain things due to her mobility issues. When she was laid up in the hospital, DH was in contact with her friends at home to do things like make sure her important mail could be collected and forwarded to her here, checking on her place, etc. Some of his conversations with them were eye opening for us. It quickly became apparent that a few of these people that she thought were her ride or dies really aren’t based on some of the snarky or disparaging comments they made to DH about being “stuck” helping her. 😕

I haven't read all the responses yet, but I wanted to comment on your statement that "she has a lot of friends in NYC that she has known forever and is close to them". 

My grandmother lived in the same town (in the same home) for close to 40 years when she was diagnosed with dementia. Her three children opted to move her to an assisted living facility in that town, while they all live between a 5-hour car ride and a 3-hour plane ride away, so she could be closer to her friends. 

Almost immediately after she moved, her friends stopped visiting. Every time she had a health scare, one of the kids had to drive and/or fly to see her, taking time off work. She had very few visitors and having her so far away was extremely stressful for everyone. After four or five years, her daughter moved her to a care facility in CA and the situation improved dramatically. Family was a 10-minute drive away, health issues were handled immediately, and everyone was less stressed. 

Friends aren't family, and aging friends will have their own mobility and transportation issues, or pass away, leaving no one to be there for your MIL. A health scare can take days or weeks to resolve and require immediate attention, which is hard to balance when she is several states away. 

This is my perspective, and I understand it's not the right move for everyone, but in my experience, family is who steps up to care for the elderly, not friends. 

Sorry about that. It was a reel so not sure I can find it again.  She was talking about a program called Pace. I think this might be the program.  www.cms.gov/medicare/medicaid-coordination/about/pace