My advice is to keep your parents moving for as long as possible.

Motivation and exercise is what keeps people alive and happy. I once knew a 92 year old who benched 140lbs and who’s grip was a vice. He worked out every day for ~2 hrs. Was one of the most impressive things I’ve seen.

All that said, perhaps ask them what they want? For instance, their motivation might not be meals or cleaning. Getting a maid or food service can lighten their load. Similarly, consider a cleaner for yourself! And give yourself more time to spend with them and your young family.

At the end of the day, they’re their individuals. I suspect they’ll have some thoughts. It’s honestly hard to watch sometimes, but all you can do is try to spend time and enjoy each other’s company.

One major thing you have to worry about with octogenarians is falls. There are all sorts of injuries related to falls but the worst one is to break a hip. It can happen very easily.

When old folks break a hip, it sets off a chain of consequences that are really, really bad for their health and quality of life. To begin with, it immediately requires hospitalization and major surgery. Then, a period of immobilization starting with a "short term" stay in a nursing home followed by weeks of rehabilitation. During all that time, they're susceptible to many different complications. It's basically the beginning of the end for many.

This happened to my mother. In the course of 3 years: broken hip, stroke, and UTI followed by near-fatal sepsis (which precipitated dementia). After all that she lost the ability to walk and we had to put her in a skilled nursing facility for the rest of her life.

Best thing you can do is to make sure you get advice from an elder-care attorney about end-of-life problems and financial planning. There can be dire financial consequences for the family if any money is transferred from the elderly to family members within 5 years of going on medical assistance (thanks to George W Bush's "deficit reduction act" of 2005).

Yes, a fall also was the beginning of the end for my uncle.

My mom also had a (non-hip-related) fall and that resulted in a hospital and nursing home stay (fortunately she seems to have recovered for the most part).

I read this illustrated aging-parent-focused autobiography lately https://www.theguardian.com/books/2014/jul/13/cant-we-talk-a... (by Roz Chast, a New Yorker cartoonist) and it was very much about these issues, and her mom had several falls as well.

There are auto-inflating airbag belts that protect the hips for seniors during falls. I think the tech started in motorcycle racing then became available for cyclists, and is finally available for seniors now.

Here's one company I found but I think there are others offering solutions too: https://en.helite.com/hipguard/

This looks like an interesting product but how do you get them to wear it consistently? Half the problem in hip fractures is mentation: Many elderly people have decreased balance, decreased pain sense, and decreased muscle strength. And yet they're not cognizant of any of this, so they continue to try to behave the way they did 20 years ago and of course they fall. Getting them to become aware of their limitations would prevent a lot of falls but it is very difficult. I'd expect that getting them to wear this belt would be similarly difficult.

I think it's definitely a struggle, but if my choice were to move into a care home or wear this, I'd choose wearing the belt.

Yeah, and people who have fallen once already and ended up in the hospital are probably now plenty aware of their limitations, whatever illusions they may have once had.

i just want to say, I concur with this sentiment. A fall and "simple broken hip", unfortunately is usually the beginning of the end. Sadly I've witnessed it several times. It just kicks off a chain reaction of events that leads to most old people not coming back from it.

that is all true, i've seen two ideas :

- western way: use tech. some people have floor detectors, doesn't avoid the fall but helps saving people early. Maybe soft floors help too

- easter way: daily taichi .. so then you just roll and never fall

My grandmother who lived to her mid 90s did a lot of arm exercises to get the blood circulation going. She would stand up and just fling her arms up and down.

Saw this earlier this year (it's a body airbag for old people in case they fall. Invented by a Chinese so eastern way haha), reminds me of the bike helmet some Swedes demonstrated a few years back

https://www.youtube.com/watch?v=p9W6wNfzsIE

honestly it's pretty awesome to see this prototyped.. i dont know how it will be received and sold but it's super useful

I also thought we should have cushioned sports area for 60+

places you can just try shit and never fear shocks

Yeah, I think the best thing for this situation is to pay someone to stop by for an hour a day. Probably around breakfast time or lunch. They can make sure they are eating and taking their pills. They can be someone to talk to and something to look forward to. That person can also be someone who can notice if someone is limping a bit or looks "off". Obviously this is expensive but could be a reasonable middle ground to a facility.

Keep moving! Yes! Also, emotional health is important. Many elderly people die of loneliness. If one parent dies, be VERY vigilant about getting the other into a situation where he/she has friends.

> Many elderly people die of loneliness.

Good thing society banned people from visiting their relatives in nursing homes and assisted living facilities. We sentenced the oldest in our population to die in what amounts to solitary confinement.

I don't understand why you are getting down voted. You are dead on.

My wife worked with geriatrics. She directly saw the impact of having friendly people around the elderly. Even if you aren't visited by your family, any visitors can help. The pandemic made this especially difficult. My wife worked to overcome this: she partnered with a local "sniff" (think: old people left the hospital, but they need some help before they go home, so they go to an old-people hotel) to have fun events where people from our church would visit the elderly and just have fun.

Please visit the old people in your life.

Video calls are not the same. Never will be, we like to see our loved ones, hug them, seeing them on a screen is nice, but it is not the same.

I agree with you.

But it is dismissive to those people with nobody at all in their lives, to equate "got calls instead of in-person visits" with "nobody knows or cares about you and you will never receive a call from anyone for the rest of your life".

The GGP conflated those experiences but they are qualitatively different.

I'm fully in favour of visiting the old people in your life.

But I wish people would also spend some time brightening the lives of other old people as well.

I watched a TV documentary recently that was making a serious attempt at addressing this problem in Australian society.

It was about older people in nursing homes who were sent to pre-school, with unrelated children a few days a week.

The effect on these senior citizens heath and quality of life was profound.

Old People's Home For 4 Year Olds https://www.youtube.com/watch?v=13_rJVvxx_g

Yup. I believe it.

Consider, also: not all old people are mobile enough to leave their home (or even bed!). They need friends and happy people.

If you work with elderly, please be friendly. If you know elderly, please be friendly to them.

> Many elderly people die of loneliness.

How does this work exactly? Medically speaking.

Depression -> not eating -> weakness -> accident or opportunistic infectious disease.

It's also underappreciated how often depression in the elderly can lead to confusion or even psychosis. Which can also lead to a fatal accident.

Yep, keep him moving, and check on him frequently. At least a daily phone call, but the more you can visit in person, the better.

This likely isn't relevant to you OP, but perhaps for someone else who is a little earlier in the process here.

I'm in my late 30's and my parents are in their early 60's (Dad will be retiring next year). Two years ago we decided move into a multi-generational home. We found a place big enough for our family of 5, in addition to an "in-law" apartment big enough for my parents.

This was born directly out of my parents' experience dealing with a very difficult aging/end of life process for my grandfather. We realized that the best approach would be to get well ahead of things (assuming a normal aging progression, we're a couple decades ahead of the issue).

Obviously this was hugely specific to our situation, and wouldn't be an option for the majority of families, but it has worked very well for us so far, and hopefully will simplify a lot of the future.

Just a handful of the specifics that have allowed this to work for us:

* Both my wife and I have a very good relationship with my parents (my wife and my mom especially are very close)

* I have a background in healthcare and don't have any concerns about participating in end-of-life care when the time comes (we certainly plan to bring in external help for day to day stuff)

* We have young kids and my mom especially relishes being able to spend time with them. Obviously we're not accounting it for it hourly or anything, but the general approach we're taking is "You're helping us take care of the kids now, and we'll help take care of you when the time comes"

* We live in Central New York, a place with pretty cheap real estate, so it was reasonable for us (on a single software developer's salary) to buy a big enough place (4 bedroom home on our side, in addition to their apartment). The home we found was pretty ideal, with two separate living spaces/kitchens/etc. The only common area that connects the two is the laundry room.

So yeah, pretty specific circumstances that allowed us to do this, but I'd be happy to chat with anyone considering a similar plan.

I'm in an expensive city facing a similar scenario with my mother and my father-in-law. My wife and I are planning on adding space in the form of an ADU, which we will be able to rent out before and after our parents use it. The catch is that so far we only have a plan for how to house one of them at a time. My father-in-law is ten years younger, in good health, and already living in the same city, so we're hoping we don't need space for both of them at the same time, but if we do, we'll need another idea.

It's interesting how much the conversation around this has changed. Twenty years ago you could believe you could find a nursing home that you could afford and that your parents could have a good enjoyable life in. Now I kind of figure that when they need more care than we can provide, the best institutional care we can afford, even at our income level, may well be a neglectful hellhole, so we're concentrating on keeping them with us right to the end if possible.

> Now I kind of figure that when they need more care than we can provide, the best institutional care we can afford, even at our income level, may well be a neglectful hellhole, so we're concentrating on keeping them with us right to the end if possible.

Working as a paramedic definitely influenced my desire to do this. Even the best nursing homes are... not great.

> Twenty years ago you could believe you could find a nursing home that you could afford and that your parents could have a good enjoyable life in.

I thought the opposite, due to increasing average age and the population pyramid inverting from people having fewer kids.

If I recall, there were quite a few articles even back when I was in late high school of college in early 2000s about the solvency of social security and the problem of baby boomers all retiring and living to older ages without a bigger population of younger generations behind them to keep up the labor supply. And my perception of nursing homes was terrible when I was a kid, so I cannot imagine what it will be like in the future.

It is also why I have been so conservative in my estimates for how much I would need to accumulate during my working life to live my target retirement quality of life.

For the right group, that sounds ideal.

It's hard to tell sometimes what the right group is, though. My grandmother moved in with us. We all got on so well it seemed like the obvious thing to do. But she became depressed and just felt like she was living in someone else's house (which she was, really). Living together is a tricky thing and in my experience it's hard to know what will work. Worth a shot, though. They might love it.

I think separate living spaces is really critical (I can't imagine doing it in the same space). My mom usually comes over in the morning to help get the kids out the door for school, but other than that it's not uncommon for us to go at least a day or two without seeing them.

If you're going into it with a "give it a shot" attitude, be sure to do it early enough that changing plans is still an option.

Being neighbors is a preferable situation in my opinion also. Like everybody loves Raymond, but maybe a few more houses down.

I think this is a good solution, but I want to add a few disclaimers after watching my parents make a similar decision with my grandparents.

My parents moved into my mom's childhood home with her parents, and renovated to build out a second floor with separate living/sleeping space (no extra kitchen). This was great in that the property became the de-facto gathering place for a large and geographically distributed family, and in a crunch the house could comfortably sleep 10 while my grandparents kept their comforts.

That said some things were not smooth:

* My parents and grandparents had trouble directly addressing uncomfortable topics. A significant example of this was when it was time for my grandmother to stop driving. The car would start to show surprise scratches and dents. My parents did not want to challenge my grandmothers stated sense of independence, and also had not budgeted a way to allow her to run her errands while they worked without driving (a driver a few hours a week, essentially). I consider this a high-liability failure.

* I got the sense that money was also not talked about directly enough, and there was frequently an undercurrent or sense of resentment about who was footing what bill, and whether said bill was even necessary.

* My mother, very sadly, started to deeply resent her parents after a long while for her perception of being trapped by the situation and unable to move on to other lifestyle choices. Part of this was due to my father taking a job out of state and being flying back for weekends, and my mom wanting to just join him in the new city full time. This resentment really soured their final years together, and is a real shame. Know going in that the decision you're making may go a decade longer than you initially calculated, and that your goals and priorities may shift in that time too, I guess.

* My younger sister moved in with the four of them in her early 20s while trying to re-figure out how to launch. The result was a lot of arrested development and strange regressive relationship behavior - my sister literally started acting like a pre-teen around my parents again, they started talking to her like a child, and my grandparents went back to the scorn-filled gramp-grumps they'd been with little kids. Everyone leapt backward 10+ years in terms of their adult relationships and communication methods with each other.

In the end, my grandparents were well cared for in their final years, and everyone did have more together time. The main benefit was the central gathering place for the extended family, and the house would fill for a few weeks of each year across all the holidays. I bought a house with room to build out a first floor en-suite that I hope my parents or in-laws will someday use, but I'm also keenly aware of the hiccups above. I think the main thing is clear communication about expectations, finances, and boundaries. Which I guess isn't different from normal life :)

Struggling to directly address things isn't really our failure mode (if anything, we tend in the other direction). With the specific example of driving, I don't expect much of an issue there. My wife and my mom frequently run errands together anyway, so I expect that will just become the default. My dad will be annoyed, but he's a _very_ pragmatic and risk-averse person and my guess is he'll be the one to make the call (probably earlier than we would)

We talked a lot about money going in, and one of the requirements was that the house had to be something that my wife and I could afford entirely on our own. We own the house (my parents aren't on the deed). If my parents moved out tomorrow, we'd have to tighten up a little bit, but we wouldn't be at any risk of having to move if we didn't want to. My parents pay us monthly based on a sq ft percentage of the house (utilities, taxes, etc), and they have invested a fair bit in their side of the house out of their own pockets (renovating the kitchen, building a small addition, etc... things that also benefit us in terms of value of the property)

As far as your second two points... time will tell... We're not far enough in to run into those issues yet. I think we're all on board for the long haul (3+ decades), but that's easy to say now. We do have regular intentional check-ins about how things are going to make sure we all still agree on where we're at and where we're going.

Your summary is spot on. If you nail expectations, finances, and boundaries, I suspect you'll be in good shape.

All in all, it has been a huge quality of life increase for us. It's really great for our kids to have such a close relationship with their grandparents, and there are significant practical benefits for us as well (my wife and I are able to get away for a weekend every few months, something made much much easier by the fact that we have "live in childcare")

That all sounds great. I'm happy for you. Good luck!

Thanks for sharing and it is a great idea. I am currently in same situation where we are moving to a new home where it is big enough for my family and parents to live in one place. There is a lot of activities to do near by and weather is milder where we are going but agree the separation of space you have is the best to avoid petty disputes/differences that occur when living together.

I'd love to do something similar, but I have to move to a lower cost-of-living and warmer location for my parents to even consider it.

this sounds like a very healthy approach; Central New York would be a swing but i think i'll try to make something like this work out by me :)

beautiful, thanks for sharing.

Your dad crawling up the stairs is helping to fend off muscle atrophy. There's a risk of course. Falling down the stairs could lead to death after complications. But it's not as out-right bad as you might assume, and crawling reduces the fall risk a bit.

Falling is a risk even with normal walking. But if you don't have some movement in their life, they degrade faster and die sooner. There is risk from all choices

My dad suggested there are three events that turn an individual from "able to be home" to assisted care (which is very expensive).

1) Change in ability to walk, which triggers 2) Inability to take care of and feed themselves, which triggers a slew of medications to try to combat 3) Inability to go to bathroom by themselves

Keep people moving. Build strength early - strength training is great (people begin losing strength as early as 50's and it dominos). Eat more healthily earlier in life and continue (when a person cannot cook for themselves, they tend to eat high salt, high fat, frozen foods - which becomes less healthy). Also, look into assisted policy care insurance.

Agree with you on everything, except frozen foods. I am in my mid 30s. I like to cook and try to eat healthy. I have read at many places on the internet that frozen vegetables in some occasions are healthier than the ones I can at the supermarket- because they are flash frozen, retaining most nutritional value vegetables stay out in shipping and shelves far too long losing nutritional value. Also that they tend to be picked before their time to accommodate for shipping and shelving while frozen vegetables are picked ripe for freezing.

Frozen processed foods like pizzas, ready to eat foods loaded with preservatives are bad as one can imagine.

It was counterintuitive to me that frozen veggies can be better than fresh looking ones from supermarket. Same goes with tomatoes from supermarket shelves versus tomatoes in a tin - apparently the tin ones have better nutrients because they were more ripe when they went into the tin, while supermarket tomatoes were picked well before they were ripe.

I was eating frozen pizzas quite regularly in my twenties and thirties. At 32 I was diagnosed with pre-hypertension. The doctor was suggesting pills. I went home and evaluated my sodium intake. Those pizzas are insane with the sodium. I stopped eating them and haven't had one since. Shortly after, my blood pressure went back to normal/good levels. Ten years later I'm still healthy...and eating much better than I did when I was younger.

Pizza can be a downward spiral- huge amount of carbs, salt and cheese in a single slice, and most people eat multiple slices.

https://xkcd.com/1616/

I read that as "frozen foods that are high in fat and salt".

Your interpretation is what I meant. Above poster does have a point about vegetables frozen being more healthy.

It depends on how you prepare the food too- many type of vegetables have different nutrition content when eaten raw rather than cooked.

I know this is another information rabbit hole. But, I’d love to know what happens to nutrients with various forms of cooking and combinations with various cooking elements like salt, pepper, chillies, turmeric, cumin etc. A purely scientific approach to cooking that experiments to improve commonly used recipes for nutritional value would be amazing.

The best way to cook vegetables, according to research papers: https://youtu.be/8aIyb4atRjk

See if you can access food science papers through your library.

Falling has worse outcomes than the immediate ones. Both my parents passed away after a chain of events that began with a low-speed fall just onto the floor that damaged their lower body. The resulting incapacity and muscular wastage led to a multitude of issues that I don't want to go into but I would say that keeping elderly people safe from falls is extremely important. That and diet and healthcare. Activity is crucial, but done safely.

My mom went a similar way. Low speed fall right after her bath, no obvious damage, but she was on the floor for over 48 hours. Life alert was not a waterproof model and so she had not yet put it back on. The weakness induced by lack of food and water then being in a hospital bed for weeks rendered her unable to walk (she had used a cane prior, though would have been better with a walker). While in hospital and the recovery facility she was not allowed her medications for breast cancer, and within 5 weeks of her fall, cancer cells were found in some pleural fluid buildup. At that point it was hospice. These things just pile on top of each other, and at a late stage in life recovery is much harder.

A relative of mine (M/90) recently went from fairly independent to passing within three weeks of what appeared - initially - to be a moderate fall. The cascading health impacts were all secondary to the fall itself.

I am no expert but I do question the tactic of avoiding dangerous things like stairs based on unscientific anecdote of my own experience. Both my parents live upstairs in a two story house. My Dad still drives, which terrifies me. He recently started a drive from San Francisco to Los Angeles with my sister in the car who took over after a bout an hour, understandably. My Dad retired from work reluctantly at 90. They do a bunch of things that worry me but they are also 92 and 91 and living active independent lives. So there is some value in the risk taking.

I do think there is science to back up the idea that as your parents get older it is really helpful for them to have younger friends. For my Dad this came through work, for my Mom through friends who enjoyed concerts and plays. The point is to try to get them to have a connection with younger people. It's depressing, but my Mom says all her original friends have died off. For your parents it could be a hobby, taking care of grand kids, etc.

Similar boat with aging parents. It is really tough with few solutions. In a very HCOL area and parents own a condo. So stairs are less the issue but there a ton other challenges that emerge. Simplest solution would be to do a joint-family system with the parents. That is not feasible because single story houses are pretty rare in our area and spacious housing is stupidly expensive in general (Toronto); moving my family with them just would not work. Back in the old country, houses were designed for this scenario .. 2 stories (old parents can live on first story and not have to deal with stairs; second story where the younger generation lives. Things like kitchen and dining were replicated on both stories. My spouse and I sometimes wonder why so many people who could choose to migrate to the west still stay in India, Pakistan, etc. It is a reminder that those societies do a few things better than the west.

>My spouse and I sometimes wonder why so many people who could choose to migrate to the west still stay in India, Pakistan, etc. It is a reminder that those societies do a few things better than the west.

After witnessing my mom waste her prime years caring for my dad's old parents, I pity other women (and anyone else in the same situation) who have no choice due to lack of economic opportunities and are essentially forced to live as maids.

I also suspect the people who could choose to migrate but choose to stay in India, Pakistan, etc are rich enough to hire cooks and maids and drivers. The people who have no option to migrate are the ones you should be wondering about.

I hope that my children do not spend their prime years chronically taking care of me, just like I would not want to do it for someone else. Note the use of the word "chronically", which for my mom, between both paternal grandfather and grandmother, lasted 33 years.

You must be very omniscient to be able to judge that her life was wasted. I pity others who are forced to go work outside the home, who have no choice due to lack of economic opportunities and are essentially forced to live as serfs. Somehow taking care of parents is a waste of life, but finding new ways to sling ads on the web (e.g. working at Google/Alphabet or Facebook/Meta) is not?

I have spent about a decade of my life being the primary caregiver for my aging parents so far; I'm in my mid 40's. And yes, I hope my kids do the same for me.

We don't outsource raising our children (homeschooling) or caring for our parents; having tutors, coaches, or domestic help is fine on occasion, but not wholesale replacement of family care.

No, I just listened (or had to listen on trips to grocery store) to her commiserations since I was the only one she could vent to.

Slinging ads for Meta and Alphabet affords you the ability to go on vacation. My mom was not getting anything for cooking and cleaning and taking care of my non driving, non English speaking, non working grandparents. On top of my mom having to work and help my dad try and operate a small business. In fact, she regrets not being able to spend more time and resources after her kids because so much of her time and energy was spent after two 80+ year old babies (one grandparent died at 99, after 7 years on dialysis. Why the hell are we giving 90+ year olds dialysis? The other grandparent died at 95, but was 15 years younger).

And I saw what my aunts lives who had old and disabled in laws to take care of was like versus aunts who had young and helpful in laws. I have seen tribes that tilt too far in providing resources to the elderly and infirm, to the detriment of the young. I do not see any point in that.

I think this is the most.. humane approach. For everyone involved. From what I've read about the nightmares of old folks' homes, that way of handling elder care has been failing us for a long time (and only recently has come into view).

Multi-generational households really seem like the way to go. Everyone gets to play an age-appropriate role and (in an "ideal" family) everyone is taken care of.

Multi-generational households are a non-starter when you are a child of divorced parents.

My dad and step mother, mom and step father, and my mother in law, step father in law, father in law and step mother in law are not going to be living in a shared household ever. And if that somehow happened, I wouldn't want to be anywhere near it. :)

MG homes are the best solution all around. It's a shame more homes aren't built to accommodate that.

Now that remote work is more accepted, do you think people will choose to return to multi-generational homes instead of moving to the big city to work at the office?

Toronto does not equal all of the west. There are a lot of low cost of living parts of Canada where you can affordability arrange that exact living situation. My home town in Ontario which is around 80k people has had a lot of Indian-Canada families move from Toronto to my home town in the last decade for that exact reason.

Can you pls share the city? I've looked as far as London, ON but houses are still too expensive to make it work.

A little further south west, Sarnia. To be honest, it’s cheaper than London, but I don’t think by a lot. There’s also the option of living in Corunna, close to Sarnia, but even smaller and less expensive.

Here’s a semi recent article to give you an idea of the prices https://www.theobserver.ca/news/local-news/home-prices-conti...

The lake is nice in the summer and you’re close to Detroit for a weekend of cheap entertainment.

Good luck!

Hey, I'm 42, Father 81 and every time we visit his doctor (now it happens no less than 10 times a month) he refuses to use elevator and insists on walking to the second floor on his own feet (in fact also his hands - one for the stick and the other for the railings). He says: "I must train as much as I can".

I personally respect that and consider it to be the a sound choice. Not only this helps him to get some physical activity, but also a sense of control over his body and life which is a crucial thing to have in his age/situation. I really can't overestimate how important that is for his is deteriorating self-being. That allows him to keep some measure of self-respect and pride. At my 40 I started to understand that old people (I mean OLD, like 80+) are not strange yoda-like creatures from outer space (like I suspected when I was younger) but actually not different from us except for their bodies not working right anymore in many different ways and w/o any hope for getting better. Most of the time men feel pity and shame in such situation, no different from somebody younger. Whatever they can do to prove themselves their ability - I appreciate that.

I'm 40 and my dad is 72. A couple of months ago he had an emergency spine surgery because apparently a spine bone was clinching a nerve. Before the operations, in a couple of weeks he started losing feeling in one leg.

After the successful operation, the doctors told him that the fact that he could still walk was product of his VERY active life, and that he has athlete's body. He has always been super athletic: He was in the Olympic (Mexico) gym team when he was in his 20s, later he was a scuba diver and always did a lot of exercise.

I have always been the opposite (computer programmer, nerd, etc). It was after this that I decided to fully dedicate to improve my body (I walk 90 minutes 3 times a week, and row 30 minutes 3 times a day. I am planning to start doing weight after I get some muscles with the current exercise). I've decided that what I am dedicating my next 40 years is going to be exercising my body and being fit.

Did I read you right that you do 90 minutes of rowing a day? How do you fit it all in?

No good advice to share on the juggling bit, and I apologize if this sounds ghoulish, but plan now for their eventual incapacity. If they haven't done so already, get all of their financial info together in one place while they are still able to help you. Mortgage/deed, car info, credit cards, major recurring payments, investments,and insurance policies. Also all email and web passwords.

I would also suggest a visit to an estate lawyer to make sure that wills are in order and that there's a plan for all major assets.

All of this can be difficult if your parents are in denial and plan on living forever, but the more you can do now, the better off you will be later

In Indian and Asian culture in general you will take care of your parents just as they have taken care of you when you were a child. Old age is just like childhood age where you have to look after them just as much as you would look after a young child. Having your parents move in with your family is an option so that they don't feel lonely. They can also see their grand children and not feeling lonely at home. Loneliness is one of the main reasons to loose hope in life if they do not have good neighbors or support system. Once hope is lost then motivation to live long also goes away.

Not sure what other think of my opinion but I am living with at my parents at their home currently and just bought a new place and moving with my parents and wife/kids. There is attachment to the home we lived in for this long but we are looking forward to better life in new home together. There can be small disputes living together that may urge you to live separately but I feel if you look past them you all will feel stronger as you all know there is someone in the house to look out for each other.

The sentiment of elderly become like children is very strong IMO and it actually makes sense; not in terms of innocence of children but the physical(and somewhat mental abilities) weaken as time progresses.

As per ancient texts, there are four stages to one's life. Brahmacharya (student), Grihastha (householder), Vanaprastha (forest walker/forest dweller), and Sannyasa (renunciate). I always wonder if the ancient Indians really did that and how the society would have looked back then.

With that said, modern Indian's diet is drastically different from what the ancients ate and also the daily physical work(insert yoga, going to rivers for water and rituals, farming etc) ancients must have done is very different. Not only that, the elders were considered scholarly and wise since they have the done the walk of life; and because of that, alms were given out by the Kings and other working men to the elderly. Today's society holds less relevance to all this and renunciation is clearly not an option and has faded away into the history.

Vanaprastha (forest walker/forest dweller) aka. hiking, and Sannyasa (renunciate) aka. off-grid are the new age terms and I find that very interesting idea to purse at least for my old age.

Isn't it traditional Indian culture for old people to become ascetics and indulge in spiritual pursuits? The Hindu texts talk about renunciation being most important in final ashram/stage of life as a Sannyasini. Wonder how is that goal achievable if old people are treated like a young child. Letting go of attachment amd material comforts is difficult, but it is the right thing to do according to Hindu Dharma.

This is becoming a common quandary for GenX(ish) folks - how to care for both parents and children at the same time. Especially hard when so many of the former didn't plan well.

My suggestion would be to seek out an elder-care specialist. They not only know what kinds of support are available - including issues or options you might not have thought of - but they have contacts with all the different sorts of service providers. My brother and I engaged one briefly when we needed to find a nursing home for our mother. Both of us had already tried and mostly struck out on finding anything decent; she was able to get us a spot at a much nicer facility than anything we had even been able to look at. This was especially valuable when COVID hit; the peace of mind from knowing that they were on top of things was invaluable. Money very well spent IMO, and not even all that much.

From what I hear, quality in-home care can be even harder to find, so those contacts become even more valuable. If you can't find such a specialist on your own, your parents' doctor(s) might be able to give you a referral.

Macabre tangent warning. Related to this, and having seen several cases where elderly people had very unhappy end years for various reasons (dementia, incapacity, etc.) I am starting to wonder not for our parents bur for myself - how could I make sure I don't live past the point where I stop adding value and become a drain. It's an interesting engineering problem. Presumably this would be when I lose mental capacity to make certain decisions, so it would need to be some kind of automated dead-man switch type mechanism, that is undetectable so the descendants can have a warm and fuzzy "grandpa went in his sleep" type experience, instead of "grandpa hung himself" or "grandpa pressed the accelerator instead of brake by accident."

Maybe an implant that needs to be re-armed every month or so, and if not it releases some toxin that causes a natural-seeming shutdown. Or ironclad ream of paperwork to make sure plugs get pulled.

Build strength by middle age, eat nutritious foods, move daily for 30-60 minutes in a large capacity, keep the brain occupied, be social, intermittent fast to remove weight which builds up. They all need to be started earlier in life to create them as muscle memory habits, rather than "motivational habits" in old age.

As one ages, body parts hurt, which demotivates people from moving, which adds weight, etc. Couple that with the potential loneliness and isolation that can cause depression - old age takes more extrinsic and intrinsic motivation than being a youth.

Great advice. You won't have to worry about the things the person you responded to until your 90's rather than your 70's. It's still worth thinking about.

My dad is in his 70's and is dealing with Lewy Body Dementia. It's terrible. If I start showing the symptoms, I'm definitely going to take control of my own death. Quality of life is far more important to me than quantity of life.

Robin Williams got Lewy Body. I guess he decided to take the same door you're looking at. I would too.

He didn't know that, it was diagnosed as Parkinson's. He also had addiction problems, depression and anxiety as well as heart issues.

Generally good advice but intermittent fasting is not recommended for patients suffering from sarcopenia (skeletal muscle wasting). This is a hidden epidemic among the elderly and seriously increases the risk of falls or otherwise losing mobility.

After watching our father die from advanced dementia, my brother established instructions that no one is to feed him. If he can't bring a spoon to his mouth unassisted, he would like to stop eating. He works at a hospital, so I believe that he understands how to do this in a legally binding way.

This tempts me to leave similar instructions if I can't cook for myself.

Such advance directives aren't completely legally binding, and rely on family and caregivers respecting his wishes. If your brother is mentally incapacitated and his next-of-kin asks a healthcare facility to put in a feeding tube then they'll probably do it.

Also, if he has dementia and is begging and crying to his family for food, they're not going to respect the prior wishes. They're just not.

My father's last intelligible words were "I want a pill." My mother understood this request, but we could not act on it.

A year later he stopped swallowing. My mother polled the family, and the consensus was to try intravenous fluids once, to see if this was temporary. With the fluids it took him a week to die. See how hard it is to even follow someone's last words?

My brother would like to avoid that year.

This is exactly what I am afraid of.

Everyone, regardless of current age or ability, should absolutely have advanced directives in place outlining what they want done (or not done) to prolong their life.

Talk to your doctor about filling out the appropriate paperwork.

Even if you want everything humanly possible done, it's best to document it, and keep that document up to date (check in with your doctor every few years to see if what you want has changed).

I'm 37, and in good health. I have outlined the (pretty limited) scope of advanced care I would want in the event I became incapacitated, and have a designated healthcare proxy that I trust to make decisions consistent with my wishes.

Will he starve to death?

That's his hope. He doesn't want to live as our father did.

Assisted suicide is becoming more accepted as an option for the elderly. I suspect that some day it will be as normal our current options for extending life.

I for one would rather die on my own time, surrounded by family when my quality of life declines, rather than clinging on to a miserable existence.

I've had this discussion with friends many times, and I do hope it becomes legal and socially acceptable (I know it is legal in some places, but not widely). I find it ridiculous that we come into this world through no choice of our own, but we can't leave it when and how we want without resorting to some horrific or painful action. Medically assisted suicide should be a basic human right in my opinion.

One unfortunate aspect of this that while some jurisdictions have this available, they are sticky with informed consent on day of.

As a result people will sometimes opt for this months, even years before they really needed to, because of the fear of dementia or similar taking the choice away.

'stop adding value'? WTF.

Outside of HN that would probably be phrased as 'become a burden on my family'.

So my father-in-law passed away from dementia recently so I've been thinking about this a lot. Some family members could not be arsed (to borrow a phrase) to really care for him over the last several years, and from their viewpoint he was a burden. Some could, though, and to them he wasn't a burden, but a way to express their love. And looking back his long decline of course had a negative effect on a lot of people, but I don't know if it would have been any less negative had he put a bullet in his brain 5 years ago.

I'm sorry about your father in-law.

My dad is going through the same thing right now with Lewy Body Dementia and it's terrible. I've seen enough to know that if it shows up in me, I'm outta here. It might be hard on my family, but I'm not going to endure years of decline where most days I'm terrified from hallucinations which leads to violent outbursts directed at the people trying to help me.

This is a reasonable concern for oneself, if not a reasonable criticism of others.

Genuinely curious: Why is your reaction to that "WTF"? I think it's totally valid.

Well, for one thing, "adds value" on HN is a pretty loaded term that comes down to "making money for someone else". You're basically saying that when you can't pull any harder, you'll line up behind Boxer at the glue factory so the pigs get one last cent out of your hide.

But lets assume a more charitable definition of 'adds value', then when does that end? I'd argue 'never', but I've also lost a parent and an in-law this year, so maybe that's still a little close for me.

It sounds like something you say about employees, not about family members, and certainly not a way of calculating "self worth".

What you perceive as the value you contribute to the world is the most important way of calculating self worth, is it not? If you felt like you contributed no value any more and were simply a resource drain you certainly would have a low self worth.

Really, a huge part of my quality of life is knowing that I'm doing stuff that makes the world better in various ways-- offsetting some of the ways I make it worse and the resources I use. When I am not able to do this anymore--- what's the point?

George Eastman (founder of Kodak) left the following note explaining his decision to take his own life (at the age of 77, after several years of failing health and chronic pain).

"To my friends, my work is done – Why wait? GE."

Start wingsuit gliding an the problem will take care of itself

I have seriously thought about leaving a bucket list of expensive & risky stuff for when I'm old (why not take up motor racing, acrobatic flying, sailing around the world at 75?) but whenever I bring this up my gf is horrified.

The trouble with that stuff is you are much more likely to end up an invalid rather than kill yourself. You are then even more of a burden on people around you and less able to control the final outcome.

which is why I suggested things with big motors and high speeds; if things go wrong they go really wrong

For my grandparents it came down a combination of persuasion (hard when cognitive condition declined) and just making decisions for them.

Finding housing that works better (an apartment on one level) is one approach - sell them on the benefits of independent living for longer.

But eventually it was finding a home with 24/7 nursing care they weren’t too opposed to.

It’s not easy and as the parent of a young child I realize how being the “parent” happens twice in life - one with your kids and once with your parents.

Did your grandparents end up liking their new home?

My grandmother resisted going into a home for a long time. When she finally did, her quality of life improved considerably. She was much more socially active just because she was around so many people. She played cards, sang in a choir, and ate meals with friends every day. She even found a boyfriend.

She was too stubborn to ever admit such a thing, but I think she would have been happier if she had moved a decade earlier.

Very similar. Strong resistance to the loss of independence but eventually they realized their quality was drastically improved.

You might need to wait for something to happen, and then force the issue.

One things you can try: Did one of your parents' friends enter a retirement home? What about one of your childhood friends parents'? Start visiting them, with your parents, occasionally. Sometimes, just visiting a retirement home for a social visit (and no agenda on your part) can plant the seed that older people are very happy in retirement homes.

My grandfather lived alone after my grandmother died. He had a stroke a few months before his 100th birthday. Instead of calling 911, he called my uncle, who fortunately was only a few minutes away.

That was when my dad and his siblings forced the issue and placed him into a retirement home. He was quite social, so after a few weeks, he made a lot of friends and adjusted. The vibe was kind of like freshman year at college, only for geriatrics. (Among his children and my cousins someone checked in every few days. This was how we were sure the retirement home took good care of him.)

Even when we had to move him to a nursing home, he was very happy. Again, he made friends.

I speak from experience. Aging parents, especially the stubborn type, will be a massive health drain on YOUR health. For little in return. They are still going to die. Don't put them before your own family, even a little bit. It will end you. They lived their lives, you're entitled to the same.

Jesus man. Please, your experience is your experience and does not generalize. Plenty of people love their parents and would gladly sacrifice a little to make the end of their lives better. Your conclusion might be appropriate for your circumstances but it is horrible nonetheless and no one should take it as the right way to live.

>I speak from experience. Aging parents, especially the stubborn type, will be a massive health drain on YOUR health. For little in return. They are still going to die. Don't put them before your own family, even a little bit. It will end you. They lived their lives, you're entitled to the same.

That's the problem I'm facing since last year

60 yo, half life long alcoholic with dementia/stupor that really tries hard to make our life as miserable as possible and it started affecting health of other people from my family

And I do seriously consider what you're suggesting - just fuck him and leave him alone

It depends but in general, I think taking care of Parents is not a burden but a privilege. It's an appropriate way of showing affection after receiving affection from them growing up.

I'm a realist. I told my parents (one retired but active and one preparing to retire) that they needed to get their end of life plans and elder care plans in place because I wasn't going to do it for them. My wife and I don't have children and are hoping to spend our retirement being semi-mobile around the globe. We simply won't be available to take care of them in their old age. I threatened (only half joking) that if they didn't arrange things and they got sickly I would put them in the cheapest elder home I could find an afternoon of calling. They're grown-ass adults. They need to figure out their life--not lean on me to figure it out for them.

I bet you're glad that they didn't view you as much of an inconvenience to their life ambitions as you view them.

I find this kind of appeal to "reason" questionable. While I am thankful that my parents took care of me while I was dependent, did I ask to be born into this world? I don't view my parents as an inconvenience to my life ambitions but it's a lot more reasonable to view them as such compared to parents that feel that their children (who are there because of their decisions in one way or another) are an inconvenience.

Tough luck I guess? I didn't sign up for this. I love my parents, they made their decisions, I've made mine. I'm not wrecking the future I've planned for and built with my wife because they've failed to adequately plan for their care.

My parents are functioning adults. They've had decades to figure out what they want to do as they age. They haven't been hit with unexpected ruin or financial woes or other troubles. Their lack of preparedness is strictly on them.

At least you are communicating and being honest. It is super shitty when people act nice to the elderly in hopes of being in the will, only to send them to a cheap nursing home to save money.

I don't think parents should having children expecting those children to grow up and take care of them in their old age. There's sooo much that can happen (what if you have a bad relationship, what if one falls into drug dependence? etc) that you should have a solid plan for yourself.

They raised him to be like that.

Perhaps karma does exist.

Children lack agency, and can’t be expected to plan ahead like that.

Having a kid is a choice they made. You don't choose to be born.

>I would put them in the cheapest elder home I could find

I don't think any of them are very cheap.

>They need to figure out their life--not lean on me to figure it out for them.

At least in the US, there aren't a lot of options unless you're pretty wealthy. Medicare doesn't cover nursing care. Nursing homes cost around $5k a month or so last time I checked. They will literally throw them on the curb if they can't pay.

https://www.nytimes.com/2020/06/21/business/nursing-homes-ev...

I know. And its not like I'm a monster, obviously I'll try and select the best elder home that matches the amount of money they have plus what I can afford.

However, and this is what I was trying to humorously get through to them, I will not compromise the life my wife and I have built and worked towards to arrange care for them. Call me callous, call me cruel, but my wife and I are working towards something for ourselves. We're making our future and so should they.

This... Is probably one out of a few viable solutions to this.

Make sure they have a will and whatever end of life medical forms are appropriate for their jurisdiction. This will greatly simplify handling legal matters unless there’s a single child to do it all. Remember that (in the us anyway) powers of attorneys end in death so do everything that is necessary “in time”. Even mundane things like collecting the contents of safety deposit boxes. Finally, if you’re not somebody interested in accounting, make sure you have somebody lined up who can wrap up an estate.

As others have said, work to balance your desire for their safety with their desire for independence and resisting change. Where they live, driving, all of these things might be a struggle. Perhaps start with changes while they’re accepting, things like grocery delivery, transport help, etc. and empathy, don’t forget the empathy.

Finally, remember that work will always be there. Family and friends, however, will not.

Based on personal experience, one might not know how much more pleasant a (good) elder-care living experience can be without experiencing it personally.

It has been a godsend for our family that my parents were able to move into a retirement community that offers a progression of care. My Dad has progressive supranuclear palsy and requires relatively constant care, while my stepmother is better able to live her life with some of the chores/maintenance handled by professionals.

I don't know if there are eldercare places that let potential residents try retirement living/assisted-living out for a month or so, but the community and amenity experiences can yield a flowering of life after elders have though that they were condemned to almost home-isolation by their mobility.

The fact that your Dad has the fortitude to crawl up a flight of stairs every day is truly admirable -- the key is helping him find his way toward a situation where that kind of effort is optional and safer, rather than a requirement and a risk. As @crispyambulance says in a nearby thread, falls are the big risk.

Good luck -- none of this is easy, but with experienced assistance, it need not be a series of unexpected calamities.

Experienced caregivers are incredible. And expensive, but worth it.

We started off by being completely unwilling to accept how my mother was losing her abilities. In hindsight, we should have gotten her a medical alert button way earlier. Eventually we started sending a helper every day to my mother's own house, then moved her to a full-assist home. Then hospice, then death.

It's difficult to plan in advance for these things. The only way to get reduced-cost services (in the US) is for the parent/s to become legally destitute and then each state is different on what services they offer (if any).

Having been in a many Assisted Living buildings, I would echo this sentiment. Some homes are run by incredibly caring and thoughtful staff and could be the right home for a loved one. It's not for everybody, but as healthcare needs rise, it's definitely an option to be considered.

PS: check us out at augusthealth.com and reach out if this is a space you want to work in.

Life is hard for honest people. Just so you know. Good luck

An older uncle I had insisted on stepping stairs everyday. One day he fell off the stairs, and died.

Her wife, my older aunt, had help. Three hired people took turns to keep an eye on her around the clock. She still died because she fell off the bed several times in spite of that.

See a therapist yourself, try to remind family to help (usually a failure), pay for the help you can.

In the past I used to tell my mother that I would send her to a retirement home when she couldn't be independent. She shortened the discussion everytime until it was just a two word answer "F U" Now it is a running joke but I acknowledge she prefers any other alternative if I want to help. And since I want to help she probably won't end in a care home.

I recommend reading 'Being Mortal' by Atul Gawande for some good insights into dealing with end-of-life issues. My wife & I found this very helpful in making decisions around the care of her aging father.

https://www.economist.com/books-and-arts/2014/10/04/helping-...

Your dad makes his own decisions. There's nothing you can do about this.

I had a similar story with my grandmother. Eventually, she fell in the stairs (93 years old). At that stage, she had to move to the first floor but after her accident, she lost her autonomy fast and had no other choice for her other than going to a retirement home. She declined and died within a year. Quite a common story I believe.

I feel you. My father just passed at 86 last year. I told my family the only way he was leaving that house was feet first, and he proved me right. As others have said, get your parents' financials in order. You don't mention where you live. In the US, offering to do your parents' taxes for them is an easy way to get a handle on all their finances without hinting your concern about how long they have. Here's the challenge we are facing, all of us, these days. Modern medicine has extended life, but has not extended quality of life. Our parents really did not have to deal with their own parents spending decades in decline. In particular, they did not have to deal with their parents' cognitive decline. If they had, they might have a very different perspective on the burdens and worries they impose upon their children. My mom and dad kept each other company. Yes, they were frail, and my mom's cognitive decline has been progressing slowly over the last decade. But they had each other, and could watch out for each other, and call for help when needed. Your biggest concern, at this point, is your parents driving, if they've gotten to the point where driving is dangerous. It's a much bigger deal when one of your parents passes. The other one is then alone, with no one to call out if something happens. About a year after my dad passed, my mom was able to acknowledge that living alone was no longer viable. My brother took her on a tour of several independent living facilities near his home. They found one where the residents seemed happy and friendly. Included in her lease is a spacious one bedroom apartment, three meals a day in a group dining room, scheduled shuttle service to church, stores, and the occasional outing. She gets a little wrist buzzer she can press that alerts the central office if she has a problem. This makes me feel a lot better than services where, essentially, EMTs will have to break down her door to get to her. And she has company. The cost of her lease is covered by a combination of social security and income from the rent from her house. This facility also has an assisted living wing. When the time comes, we are hoping they still have room in that side of the facility. I will tell you one of the challenges, which perhaps your father is aware of, on some level. My mom has been in her new facility less than half a year. Already, she cannot remember what the house she spent 50 years in looks like. She confuses the place she raised a family with the place she grew up. Losing anchors like this can be quite disheartening.

Please edit your comment to have paragraphs. I get nausea from this (might be my dyslexia).

We got one of those stair lifts installed. My grandfather (Also 86) got new hips some 4 years ago, but had been pretty much bedridden for 4 years prior to that. He'd basically live on the couch, and struggle his way throughout the 4 story house.

Unfortunately, he had a pretty serious stroke during rehabilitation, which left him with dementia-like symptoms - luckily not deteriorating, just very poor short-term memory. He never regained his prior strength, so he's mostly walking inside the house now. Grandma is still alive, and they live together. They, too, absolutely refuse to even consider the alternatives.

When she started experiencing dementia, we started to use meals-on-wheels services - but unfortunately, most of the food gets ignored and just spoils. They've been incredibly independent and DIY all their life - just 10 years ago, they remodeled a rental unit they own. Changed the windows, flooring, walls, etc.

Right now, we're kind of lost. They sort of refuse to accept that doesn't involve us (family) directly, so the whole family is doing shifts on helping them. My aunts/uncles are regularly there cleaning, taking groceries, etc.

Tbh, I think it's going to continue until one of them passes away, and the remaining one becomes too senile to function. It's hard to watch, but that's just the course of life.

Upvote for chair lift. This is the piece of technology needed to make sure he can stay in the house safely.

It sounds like OP’s father is motivated to stay in the house, which means things like exercise bands will be useful things he uses. Emphasizing meaningful exercise instead of continuing to engage in dangerous exercise is going to help.

No direct answers, afraid, but wanted to mention a related book on this topic: I recently got Being Mortal[1], by Atul Gawande, that tackles the difficult topic of how to gracefully navigate end of life / palliative care discussions.

[1] "Being Mortal — Medicine and What Matters in the End" — http://atulgawande.com/book/being-mortal/

Seconding this recommendation, it is an excellent book about a hard topic. Just wanted to add that it is a hard read if you're in the middle of actual severe health problems with you or loved ones.

I've been through this the last few years before losing my parents. First the easy and cheap things. Get them a Ring to see who's coming and going. Get an Alexa video device for each floor - go with the Alexa ones because they are the only ones that let you to check-in without the recipient accepting the call. Get them Apple watches. Knowing that they just need to yell "Alexa, call johnny" and that you can peek in provides quite a bit of peace of mind.

Get a Power of Attorney for each. Make sure your understand their finances.

Go to Home Depot and get the bars for the bathroom. Check into the stair lifts, they aren't super-expensive and some Medicare plans cover them.

Do they still drive? If feasible, get them comfortable with Uber while they're still driving and the transition will be easier.

Talk to their doctors. See if you can get the doctor the prescribe home nurse visits and PT visits. It's another care vector that's covered by Medicare.

Start cleaning the house out now. I really didn't go through dad's stuff when he died, and then when mom died, I had to sort through everything. Figure out what's important while they're still around.

This hits home for me… my parents are about the same age as yours and I’m 43.

We’re both part of sandwich generation [0] - the link provide general overview of how common it is and tips.

I’ll add that what you can do truly depends on your culture (and even tribe for me) - Americans or Westerners to generalize can simply put their aging parents in elderly care and call it the day - life moves on. If you’re foreign-ish then that a sensitive thing to do and even not an option to consider.

Luckily, for me, my parents live in rural Kenya - so it’s cheap to hire help and provide them with all the care they need in multigenerational setup.

While my parents are relatively healthy- my dad is starting to have recurring medical issues that needs close attention. He’s as stubborn as it gets - I cannot even mention the need to prepare for eventuality with stuff like a will because it a taboo.

My experience thus far has me thinking how I need to prepare myself so my kids don’t get sandwiched as well.

[0]https://en.m.wikipedia.org/wiki/Sandwich_generation

I wondered if there was a name for it. It seemed strange to me for OP to be raising a young family while his parents are so old. That means both him and his father had children in their 40s (or perhaps one was even older). It honestly does seem far better for everyone if people have children in their 20s. I wish I could have done that.

> It honestly does seem far better for everyone if people have children in their 20s.

There are lots of tradeoffs. On the one hand yes, maybe it means the kids will be out of the house before you start having to deal with parents. On the other hand it's quite likely to be bad financially, as in many cases you'll be down to one income and slower growth in that income during those critical 20s and 30s. That can leave you a bit strapped when you have to pay for college costs and parental-care costs and eventually your own retirement. I had my daughter at 39 and retired at 55. Without that last 10 years of income from my wife and rapid income growth for me, plus the magic of compound interest, I'm pretty sure I'd still be working and none of us would be any happier for it.

It's all very personal, obviously, which is precisely why I don't think one can (or should) generalize about an ideal age to have children.

The negatives are all constructed by the financial system, though. People need two incomes because everyone else has two incomes (two incomes are also usually more tax efficient than one big one). Why aren't people financially stable in their 20s? They're literally in the prime of their lives. Much less likely to fall ill etc. Essentially everyone has to delay their lives until later because everyone else is delaying their lives until later. There are no benefits I'm aware of with having children later (outside of the financial stuff) but there are many, many downsides.

> The negatives are all constructed by the financial system

There are two answers to that.

(a) So what? Financial realities are still realities, and impose yet other realities on those who live them. And those realities are not going to change in any conceivable short or medium time frame.

(b) It's not all financial. Time, energy, maturity are all factors too. I happen to believe the vast majority of 20-somethings are not mature enough to be responsible for another person (barely enough so to be responsible for themselves) but I don't turn that into an edict for others. When I had to help my daughter with something recently it was that decade-plus of extra life experience - not money - that turned out to be most helpful. The list goes on.

If you want to claim that the 20s are the ideal time for anyone to have children, you have to prove it. It's not sufficient to say that "you don't see it" when that could just be a reflection of your own limited circumstances or perspective. The reality is that having kids later works very well for some people. Accept that they're not you.

I’ll concur to a point on financials - but older generation got married at 19 and had stable families, so it’s not truly about responsibilities.

I think the idea of career first is a bigger factor and also we now live in a false “construct” of true love and everyone is waiting on or looking ideal mate.

> older generation got married at 19 and had stable families

Have you looked at divorce rates lately? Rates of child abuse, addiction, suicide? Seems to me that many of those families are not so stable or - even more importantly - functional. Also, if you look at how many of those formerly young parents in my generation and before have conducted themselves since their nests emptied, the picture's even grimmer. I suspect that they - and the rest of us - would be better off if they'd had children to help guide them into modernity in their later working years. Winding down any connection to the younger generation - and through them to changes in technology or society - at barely 40 doesn't seem to lead to a healthy 60, 70, or 80. The appeal to tradition fails.

My oldest is 24 and my youngest is 2 - I thought I would be done having kids by 30 but life happens (story for another day).

In general people are waiting until they’re stable financially before they have kids.

As for older parents, they simply had plenty of kids spanning 2-3 decades. For example - I’m 6th born of 8… so when I came along they were in 40s.

"Americans or Westerners to generalize can simply put their aging parents in elderly care and call it the day - life moves on." That's quite a dismissal. Reading it sound like 'westerners and Americans just don't care about their elderly ones'. I assure you that's not the case and in general every generalization it's wrong almost by definition. Be well.

It’s sloppy on my part… I meant it’s more acceptable culturally to do so… not that they don’t care.

It's definitely tough to juggle these roles. A few things that helped me and my partner -

* find local help for parents to do chores like groceries,meal prep, help with personal care if they need it, etc.

* make sure there's a way to pay their bills, manage their finances. You may have to do some of this for them by making sure they have access to their money, pay their bills, etc.

* if you are able to connect with their doctor, this would be great to keep a pulse on their medical needs. If you aren't able to drive them to doctor appointments, etc, funding help to do so would also be good.

* be prepared to drop everything and help them for emergencies. This meant letting managers know a bit about our situation.

If you have siblings, see if you can share responsibility for these things.

There is no single correct way to handle these situations so do what works for you and your family. Remember to take care of yourself and your family in the midst of this! Talk to a therapist if it helps.

I also suggest reading the book _Being Mortal_ by Atul Gawande that goes into some ageing related issues, which I found helpful.

Good luck and take care!

There are very few real communities left. Human communities, tribes, clans, whatever you want to call them, knew how to take care of each other. Of course most humans back then didn’t live till the age we do now, but still. We try to distance ourselves from death as much as possible, whereas past communities had more stories and rituals around it, likely making it more acceptable and in some cases celebrated. Obviously there was the burden of grief, but it was spread across the community instead of concentrated in a few.

Loads of sensible comments. I would like to add that you should address the stubbornness. Now its about stairs, but soon it will be about driving, or other contentious issue. Speaking from experience, this requires persistence, might take a year++ to come round.

Very good point. Driving is a sticking point for many. With my mother it was basic time/energy management. She used to wear herself out doing stuff that provided little happiness to her or anyone else, especially around the holidays, and then be absolutely exhausted - or even in the hospital - when a bit of energy/wakefulness would have had more positive effect. It took many years of often-acrimonious discussions involving myself and my brother before she started managing those precious "spoons" more carefully, and by then it was only a couple of years before we lost her to dementia so my daughter barely got a chance to know her at all. It's not easy to be that forceful with one's parents, but sometimes it's necessary.

Spoon theory, mostly used for chronic pain (which my mother also had) but also applicable to aging and even to "normal" life: https://www.painscale.com/article/what-is-the-spoon-theory

Honestly friend, my Dad struggled with this before my Grandma died and while I'm blessed that both my parents are still in good health, I'll likely be in a similar place. Knowing my Dad and how he struggled, the only advice I can give is that you have to stay healthy through this process. My Dad has running, curling and riding his bike - those hobbies and social outlets really helped him through the kinds of necessary decisions that only have bad options.

Aside from that, I'm sorry and wish you the absolute best.

With birth rates decreasing, there will be less people like the OP to take care of their elderly parents. I wonder how people with no children will fare in a world with no support system in place for them. In 40 or 50 years things will be very dire if nothing changes.

I think euthanasia should be legal, the idea was sown in various media outputs like Hogans Run Carousel scene https://www.youtube.com/watch?v=41tYQ18oK40 .

Personally I feel its insanity to be experimented on with a cocktail of medicines in the last parts of life when there are more important concerns to spend money on for people at the beginning of their life and I think its selfish to hang on if you are not contributing in someway but I'm sure others will see things differently.

I fully support the work of Dignitas http://www.dignitas.ch/?lang=en and I see other countries are slowly beginning to make euthanasia legal. Unofficially some Dr's do give lethal cocktails in hospitals in some circumstances but its not spoken about because laws prohibit Dr's from doing this. Alot of people I have spoken to think its the Church and religious followers preventing euthanasia from becoming legal and thus creating this perverse situation where people are tortured on a cocktail of drugs keeping them alive.

I also know Nurses have been known to meter out their own justice to patients in nursing homes and hospital wards based on rumours or gossip and many blind eyes are turned because these are Nurses!

Another interesting development being seen is "no fuss" or direct cremations are becoming more popular with the elderly. Basically, no service at a church or crematorium, its just a simple collect the body, paperwork completed and then the body is cremated.

Personally, if I had a cremation service when I go, when the curtains go down and the coffin disappears off to the burners, I'd want this tune playing! https://www.youtube.com/watch?v=wmin5WkOuPw LOL

If you want to be taken care when you're really old, your best bet is to save money to pay for that service. Kids are no guarantee.

I think it's more accurate to say, kid's may not be in a position to do it all.

I just went through this with my mom. She needed 24/7 care that I couldn't give her. Thank God we had the resources to get her into a "good" place. It was $5k/mo for 300 sq ft in a very low cost of living metro.

Readers here might not realize that $5K per month is really affordable. Outside a major metro area, it could be as much as $300-$500 PER DAY.

And just because the building is new and the grounds are beautiful does not mean you get better care.

Movement is good, let him move around. Keeping the movement safe is harder, a broken hip at that age takes a long time to recover from. Are the stairs unsafe? Slippery? Too steep? Insufficient handholds (not enough support, large gaps)? Those things can be fixed. In addition to those fixes: 3M makes an anti-slip tape that you can install at the lip of each step to prevent slips and falls [1]. There is a clear variant available too.

[1] https://www.findtape.com/3M-Safety-Walk-Non-Skid-Tape/p1217/

Parents are a bit younger (late 60s), but the biggest thing I keep watch for is their mobility and anything that affects it. My relatives that passed away all had one great correlation in their decline -- the loss of mobility, which really caused everything else to spiral out of control.

Body movement affects a lot of how the entire system works, and also gives them a lot more options to the outside world. Make exercise as fun and frictionless as possible. My parents joined an all-ages ping pong club, a gardening club, and a hiking group... so it covers both physical upkeep to an extent + social/mental one.

Probably off topic:

I wish we talk more about those difficult topics, parenting, or in this case aging parents, sex, childhood, or right to die over certain age. All the things we are all too afraid to ask and no one told us what to do. ( But as with every thing in life I do think not knowing has its own sets of benefits ) And Even in the example above, we are suppose to be adult and over 40, and we are just as hopeless as a child.

And on the subject it also offer different set of lens and views on aging population, instead of mostly an economics angle. Personally I have no idea because I fall out with my parents a long time ago. It is sad.

The single most important thing that an older adult can do to stay independent and aging in place is strength train. Period. We all lose muscle mass as we age, and this is ultimately what robs us of our independence. But you can actually do strength training at any age and rebuild muscle mass and regain strength and function. If there is a fountain of youth on this planet, it is strength training - no joke. The benefits are so numerous, it's incredible.

The biggest challenge, of course, is convincing an older adult to do strength training and to do it consistently and challenging enough so that they see outcomes. One way to facilitate this is to do it with them. Their greatest motivation is likely to spend time with their adult children, so if you can use that as the primary motivator, do it. I'm actually the CEO of a program called Vivo (teamvivo.com) that provides this service through online, live and interactive classes. I've been doing Vivo twice per week for the last 18 months with my dad. We live in different cities but participate in this class together, and over this past 18 months my dad has NEVER missed a class. It's crazy to see the difference in his life as a result.

Whether it's Vivo or anything else, find a strength class or personal trainer that your parents can participate in and that will hold them accountable. And if you need to participate with them to get them started, do it. It will provide the motivation they need to start and will ultimately improve your relationship, as well.

Best of luck and I'm happy to answer any questions!

When he is at home he is only a harm to himself. At his age if that is the risk he wants to take... (though do make him wear an emergency call button in case he survives a fall)

I'm more worried about other things. How do you take his drivers license away? I know far too many old people who keep driving even while they are a real danger to others. If there is bus system in town get him a schedule and post it by the door, even get him a monthly pass. Or he might qualify for the local disabled transit (don't call it that in front of him) to get rides wherever.

This isn't entirely relevant, but my dad passed away a couple years ago, he was only 67 and I was 30, and during the course of his illness, I had ample opportunity to think about aging and dying. I think the most important thing to remember is that people grow old and die. This fact seems so obvious that people nearly roll their eyes when you tell them, but I've seen people in their 60's and older just torn apart by the very normal things that happen as their parents die, mostly revolving around really not wanting to believe that their parents are dying. I remember someone in their 70's saying that it wasn't fair that their father, who was in his 90's, had cancer. What should have been gratitude for such a long life was replaced by bitterness that it had to end at all, which seems unfortunate.

It's hard to handle mortality gracefully, but really, fully internalizing that you have a finite amount of time with your parents makes it easier to deal with the frustrations of daily life, and also helps you keep a clear head when it comes down to it and tough decisions need to be made. As much as it sucks, you will be the one holding their hands through the end, and it can be a profound experience if it's not just a giant cloud of negativity and overwhelm (which is totally understandable, but not necessarily the only way!).

Do not rely on them to take care of each other. Get involved in managing their health care and finances.

One of my parents died a terrible, painful death; we found out too late he'd missed key treatment appointments and his GP had prescribed a drug that undermined his cancer treatment.

I don't have specific advice for the original question. But I have been exceedingly happy with what my own parents have done, they're both in their early 70s.

During the last 10 years, all 4 of my grandparents have passed away. They lived long good lives, and did my parents the service of "taking turns". Though one had 3 kids and the other 6, it fell to my parents to do the majority of the work during each's final years due to many issues, geography being one. It was a LOT of work for my parents. Many times they joked that, just when they got the kids out of the house and on their own, it was time to start taking care of grandma and grandpa.

Having been through that, my parents have taken some steps to avoid some of the pitfalls they experienced. Once a year, we have a family dinner (us and their children + spouses). It's usually a sort of joint anniversary dinner. And after dinner, we have a "state of the union" type chat. At least an hour or more. Our parents talk about how they're doing, how their finances are doing, how their health is doing, even their mental health, what's bumming that out, etc. We ask questions. It's all very candid.

This discussion is never had without everyone present. My Mom's explanation is that she doesn't want there to be any sort of "well, when I was talking to Mom she said, and what I think she'd want is..." There won't be arguments about when or if to put them in a nursing home. We know how they want to be buried. Kind of service, etc.

There will, I'm sure, be surprises and we'll have to adapt. But we've tried, and it's a together effort, because they kicked the ball off that way. Before it was too late to have these discussions. Their biggest frustration with their own parents had been that they didn't want to talk about it, and when it came time to have to talk about it, it was too late. People's faculties and emotions were compromised at that point.

My wife and I have compared this to her parents who are in their late 80's. It's going to be a mess. They won't talk about it. Don't want to. It's uncomfortable. And the kids all have their own viewpoints on thing.

If you can, before it's too late, start having the candid discussions now, together as a group. It makes things way better in dealing with the downhill years.

If you haven't done so already, think hard about how you feel about being a care giver. Think hard about how you'd feel if that arrangement extends 10-15 years. Talk with you wife about how she feels about those topics. If you feel one way, don't assume she feels the same. Marriages can be destroyed over this very scenario.

Then I'd have exactly the same conversation with each set of parents. If the parent's won't talk about it, you're going to have a very hard time.

Medicine has made it possible to string out catastrophic, debilitating geriatric conditions way longer than might seem possible or just. Your parents are going to die, and it may not be quick. You need to be prepared for that possibility.

Remember, there's nothing that says you must take care of anyone in old age (unless maybe if you live in Japan). You parents are adults making their own decisions and taking the consequences. Your Dad refuses to listen to you. Think about it from his perspective. Would you want to admit that you're headed for an unknown future of progressive degradation, having had a lifetime of experience seeing people on that path? Would you not want to hold on to independent, full-powered adulthood as long as possible?

He's made his choice. But the consequences of his choices only become your burdens if that's what you want. This is what you'll find being a parent as well. Ultimately, your loved ones make their own choices. But where you have no control, you also have no responsibility.

I highly recommend to book "Being Mortal". It tackles this exact problem and gives some real examples of approaches and how things turned out.

http://atulgawande.com/book/being-mortal/

+1 for Being Mortal.

We are dealing with the same issues, but not with a multi-story home. My in-laws are roughly the same age, have medical issues ranging from fall risks to severe dementia, yet drs won’t remove drivers licenses. In-laws live in another state, yet still rely heavily on us for many things, so we have made the decision to make the cross-country move to go live with them so they are able to stay in their home as long as physically possible. We will be their caregivers for as long as we are physically able to do so. All of us have discussed this in depth, what it will entail to make this happen, etc. In my opinion, it may be time to start thinking of doing the same, if the home is large enough to accommodate all of you, as it will give plenty of time to spend with your parents as well as taking care of your own family. It is difficult dont get me wrong, so take what necessary steps you need to do to make your life easier as well. I know I will be once we are there.

The only small piece of concrete advice I have for you is to do with online security. My 90-year-old mum was using a single password for all services, and had started to use it for places that allowed you to purchase things, like Amazon and PayPal. I added her to my 1Password account and helped her change all her passwords to 32-character mixes of letter, numbers and symbols, then taught her how to use it. All of her password are stored in a vault that is shared with me, so if she needs to set up an account on a new site, I can do that for her and add the item to 1Password so she can use it straight away. I always had this nagging feeling about her using the same password, and I'll happily trade the occasional 1Password support phone call for the peace of mind I get knowing she's not using the same password everywhere.

With the benefit of hindsight, my biggest priority would be finding someone you (or they) can hire to help them around the house, at least a few days a week. In my experience, as they slow down they will let more and more housekeeping tasks slip, and when pressed will have plenty of rationalizations that they themselves believe "we'll do that later" "doesn't need to get done right now" "we don't use that enough for it to get dirty" etc. Someone coming in once or twice a week for 2-4 hours at a time will make sure those tasks get done, bring a spark of young person energy, and give them a cadence to their week (much more important for people living alone after their spouse has passed). It will also build a relationship with someone you/they can trust for later. This is perhaps easier said than done based on the stubbornness and that both of them are still alive, but I think this would have added the greatest quality of life to my own parents' end of lives.

Also I'm going to say that you haven't described much of an acute problem. Assisted living is a middleground, but that's a personal lifestyle choice and it appears they're deciding against it. By the time they're old enough to need help, they're past the point of assisted living, from what I understand. Having seen it, I would never want to go to a nursing home for my final days. Nursing homes are ugly end games that mostly exist because euthanasia is frowned upon and we don't want people dying in the street.

Other comments have touched on the legal stuff, but you want them to have Wills, DURABLE Power of Attorney, Health Care Proxy, and Living Will. Estate planning will depend on their/your level of wealth, whether you have siblings, and the state they live in. It's not just about divvying up their stuff when they pass, but is important for their own well being. Some of these documents need to be definitively in place now (Wills), whereas others the right time to have the conversation may be soon, or it may be after something significant happens to one of them. FWIW your Mom probably already has some rough expectations for what her life will look like after your Dad passes, if it ends up happening in that order.

Stepping back, you might just find that helping them at all is mostly impenetrable until one of them passes. And if that is the case, that is perfectly fine as well. It's more work when you finally do have to pick up the pieces and come from behind, but IMO you won't get anywhere by trying to force things ahead of time.

1. Walking. 4-5 km per day or more. 2. A system of meds and supplies and checkup.

I be cared for my dad with Alzheimer’s fir the last 10 years.

Walking helps: 1. Keeping muscle tone 2. Healthy lungs 3. Aids digestion 4. Fixes knee and back issues 5. Creates a routine 6. Aids blood flow 7. Helps sleep

It probably won’t help in the OP case unfortunately but the faster you can make walking a Solid habit for your parents the easier it becomes to take Care of them.

I have a whole system to make sure there’s 3 month of meds and supplies available.

Plus doctors and nurses for checkups and daily care.

Hard but very doable. My parents are in india. In the US setting this up will probably be 5-10x more expensive.

Similar situation. I would suggest installing an implant that needs to be re-armed every month or so, and if not it releases some toxin that causes a natural-seeming shutdown. [1]

No, wait, that's _insane_. What the hell is wrong with people?

In this thread, SaltySloth's comment [2] is most prescient and provides the best practical advice.

[1] https://news.ycombinator.com/item?id=29430888 [2] https://news.ycombinator.com/item?id=29430583

My mum is 63 and single and almost no friends left. I can assure you I am worried of how the next 37 years will be for me as the closest family member.

Advice from this thread which I will employ:

- I will hire helpers to do chores

- I will hire helpers to do larger things like lifting heavy stuff, ie. when buying a new fridge

- I will hire helpers to do gardening chores

- I will go to see a psychologist

There is a tendency to need help for everything, when it could be solved on her own volition. This will not scale into the future. Therefore I will hire helpers. I will need to deal with this situation which will degrade, so I'll see a psychologist.

Thanks, good thread!

I currently struggle with a 80+ parent who does not want to move and does not believe they have cognitive deficits. If possible, get added to bank accounts so you can electronically pay bills and check if they are being paid if not on autopay. This is valid if your parents are local or abroad.

Some of the tension I have felt is around notions of "dignity". When I read about OP's dad crawling up the stairs my reaction was negative. However, reading farther down about physical strength, autonomy, agency, made me see this differently.

Possibly the hardest part of my life. Almost all of the other family members decided they were not going to try to help. Mother did not really want help taking care of father, resorted to yelling sometimes when he couldn't move and she didn't have the strength. She insisted on lifestyle choices that accelerated her death and refused medical treatment that could have extended it. After she passed, still close to zero help from most family members taking care of father or hiring help.

That type of behavior, crawling up the stairs, is not rational. If you have funds, I would start by looking for help such as on https://care.com. If you are lucky you may be able to find someone who can convince him to stop.

It's easy to say, but you can try insisting, or even physically blocking off the stairs. And if having hired help around the house does not seem like enough, do not feel guilty about putting him in some type of facility, as long as it's a good one. There are a lot of bad ones unfortunately. The hardest part of that is the cost.

I don't know a good way to handle it. It might come down to him having the choice of living downstairs or being dragged into some assisted living facility. Or the third option of just waiting for him to roll down the stairs and break his body.

But my suggestion is to get professional help if possible, and make it very clear to other family members that this is their burden also.

Watch Tokyo Story

https://www.imdb.com/title/tt0046438/

#5 on this list

https://www.theyshootpictures.com/gf1000_all1000films.htm

Not sure it will actually be helpful but I found it interesting both in its topic and its conclusion, message.

Note: My dad has alzheimer's His wife is taking care of him at the moment but we, my brother and I, can see he's mostly done and she's having a hard time. By "mostly done" I mean while he still seems like our Dad it feels more like he was replaced by a robot. He recognizes us and has lots of memories and can still have a conversation but he's got no "spirit", motivation, will. He does nothing. Apparently he'd have stayed in bed 24/7 if she hadn't moved the TV to the living room.

We don't really know what to do or how to help. I suspect if she left we'd put him in a home. Neither of us have the time or inclination to be there for him. It doesn't help that he moved 2000 miles away for ~30yrs so as much as we love him he hasn't been a part of our lives. He's now ~100 miles away but even if he was 1 mile away I'm not sure what more we'd be willing to do.

If you haven’t done so already, make sure you have the essential paperwork in order— Especially helpful, durable power of attorney. Don’t procrastinate on this.

Eventually, (and without warning) you may be called upon to make key decisions for them.

> https://moneywise.com/managing-money/retirement-planning/ess...

It is their life, they will die soon anyway. It may be better to have one good year, than five bad years.

Does your father gets dizzy or does he sometimes loose sense of stability?

Also limit damage from possible fall. Cover sharp corners. Ad rails on both sides.

If he falls, you should know about it. Some smart watch should be able to detect it. Or cameras with motion detection. Monitoring can be probably outsourced to India.

And some neighbour who lives nearby.

My grandmother struggled with Alzheimer's for a few years until she passed. The entire time, she stayed with my grandfather in the house they had always lived in. There were falls, there were too many stairs, it was far too big, we all had many conversations about them moving out (which would've made the Alzheimer's worse.) They were both quite old (late 80s/early 90s)

I don't think anything wrong or tragic happened. My grandmother got to live her life out at home and my grandfather spent his time taking care of her until she passed away in his arms. He said he wanted to take care of his wife until he couldn't.

The only advice I have for you is the same I had for my mother (their daughter): Try not to over-focus on the living situation and all that. Focus instead on your parents. The end of life and death are crucial and beautiful and you don't want to miss out on it due to a cloud of worry. Be present.

Thank you for this comment. So beautiful.

Similar experience three years ago, including Mom's Alzheimer's, and falls for both. Dad lived long enough to see Mom out. It's all he wanted, then he was ready to go, and did two weeks later.

Couldn't agree more with the following line: >I don't think anything wrong or tragic happened.

It was a couple years ago on maybe a FIRE subreddit, but in terms of expenses for aging parents who didn't save for retirement, or saved little and for the kids to pick up the expense, it works out to you needing 140% of what you think you'll need for your retirement to also help parents out. So = 100%(you) + 40%(them) of that for them. Luckily medicare helps out quite a bit, but long term insurances should be looked at and it may be worth a few bucks now to cover things later in their long lives. Originally social security was setup to give people dignity after retiring for a FEW years after 60. But now people are living a lot longer and simply are not of the generation to have planned for that. You too may live far longer than you expect. If you've made it past 30, you'll likely hit 80, if you make past that, it gives you something to think about.

I suggest adding grab bars to the bathrooms and shower, and see about improving the railing in the stairway. If the steps are slippery, you can install a carpet on the steps.

Install a device like Alexa where they can yell for help.

See about removing any obstacles from the floor that they could trip over.

My dad is 81, bricklayer by trade and had his own small construction business, he worked 6 days a week. The physical strength certainly helped him for a good while into his old age, but walking is becoming increasingly difficult (now using a walking stick, very slow). He also fell twice in the last few years.

In my research i found this clever stair-lift solution https://assistep.com It's mechanical, and helps prevent falling, also encourages to further "workout" and contnue to walk up and down by himself. I contacted this company to see how expensive it is - definitely way more affordable than a chairlift and a more "active" solution.

But here is the bummer: He doesn't want it. Too stuborn, and just turns me down.

You're saying his bedroom is on the first floor and he only goes upstairs for computer? If so, I'd go ahead and move his computer down for him.

Older individuals eventually need to accept that their autonomy is going away. They're mentally declining, they're already physically declined. They're not in a fit state to decide basic things like: how to prevent falls. While it may be your father's right to stay in his home stubbornly, I don't think it's ridiculous to ask him to minimize the potentially deadly fall risk of a staircase at 86.

Do family members really have the right to tell their own nuclear family: I am correct to risk my life, you are wrong for trying to keep me safe? I think if your nuclear family suggests such a slam dunk win, it's best to just accept it.

I heartily disagree that older folks automatically lose autonomy. They lose physical ability. They lose some mental agility, but they are not all in dementia. And they have every right to decide for themselves when they can or cannot handle living independently. If they want the pain and trouble to make it work, we are the ones who have to accept them.

I'd say yes, absolutely, family members have the right to risk their own lives. Have you ever driven too fast on an interstate? Climbed a mountain? Gone skiing, bungie jumping, skydiving, or even swimming? Then you have risked your life. You are proposing a huge double standard if you argue that youth are allowed to have risk in their life while the elderly do not.

Or just buy him a nice laptop (maybe a surface with a touch screen) so he can also use that. That way he doesn’t feel like he is being forced to change his setup.

If your dad wants to stay at his own house and crawls up stairs, I suggest you embrace it. Don't take it away from him. It is good for his mental and physical state to be doing things on his own terms. His autonomy is good for him, and it is good for you.

Fix what vexes him, not what vexes you!

If you're well off and the parents are not going to move until dead, then you can do a few things.

Some renovations to the house including a lift might work. You probably want to look for replacements to the bathroom shower / tub (think walk in tub). Its amazing how much a bench in the tub/shower helps. Putting in some pull down cabinets in the kitchen would be good. Basically, look for spaces that are becoming inaccessible and fix what you can.

At some point some service that does visits (nurse) is going to become a need if you cannot make it over there. Also, a security system with the elder care options is good. A mirror or similar exercise system (particularly with some competitive features) might be a good purchase.

I'm sorry this isn't much use to the parent poster, but I think these conversations really need to happen years if not decades before it's time for the change. 70-somethings can be lively and wonderful, but as a generalization they are going to be very set in their ways and extremely loathe to changing their valued routines. At their age, even something simple like getting acquainted with new neighbors (and losing decades-long connections with old neighbors) can be really intimidating. They can have emotional attachments to rooms of their house that they probably can't even verbalize.

Unpopular proposal: the animal world does it better. Older animals never slowly degenerate into nightmarish parodies of their former selves. When they slow down too much, they are killed and rejoin the circle of life.

When I think about slowly deteriorating into a dementia-ridden, wheelchair-bound elder living in a nursing home I am struck with horror. Old people are an enormously expensive burden to society and mostly live in misery and pain waiting for their next doctor's appointment and their next friends funeral.

I wish there was a societal mechanism for an easy and clean death.

I am sorry for this situation. My brother-in-law’s parents were also super stubborn and it cost my sister dearly until they passed away. I am very lucky that my own parents usually are very reasonable and accept that they are getting old. My mom stopped driving and they also moved into a smaller, easier to maintain place.

I don’t think there is an easy solution for your situation other than learning acceptance and tolerance so this doesn’t affect you too much. I bet people who live with alcoholics have a lot of lessons for how to deal with irresponsible people while maintaining your own mental health.

Can you make the home more accessible? i.e. put in a chair lift for the stairs

Had a co-worker who senior-proofed his elderly parents' house. Put in a chair lift, grab bars, etc. One thing that really helped were smart cameras: He and his sister were able to monitor their parents from anywhere. He put one camera in the kitchen so he could see the pill container, one upstairs, etc. Then set up alerts for when certain things appeared to move like the oven, front door, chair lift, etc. They knew the cameras where there, but got used to it and ignored them (that may be an issue here, I don't know).

Both siblings were close enough to react to the alerts if they needed to, but the cameras allowed them to see if they needed to go in person, or just call or just wait until the next time they visited.

Good luck.

This is a great question!

It helps to put things at waist height minimize reaching easier (essentially apply heuristics from Human Factors Engineering like we do in factories). For example, in her 80s my grandma started keeping a small trash bag on the countertop at waist level so that she doesn’t need to bend as much or walk all the way to the larger kitchen trash while cooking or doing dishes.

Another focus area is weight reduction. For example, buy pints of milk or bottles of water instead of gallons (or transfer from large containers into smaller, reusable ones to help your elders and the environment at the same time).

Recently, my cousin got my grandma an Alexa speaker. He also put a large text note up on the wall next to it with phrases my grandma can use. Stuff like “Alexa, what time is it” or “Alexa, play classical music”. I thought it was silly, but then I realized it’s actually pretty cool. Plus, Alexa games give the great grandkids something fun to do in grandma’s sitting room.

Once people stop driving, grocery delivery can make a big difference.

Think about flooring. My grandma seems to have an easier time on wooden floors than carpet. It’s easier to slide a walker. Of course, if the floor has too much slide that can become a problem.

If you can afford it, a walk in bathtub is a game changer. My grandma is 98 and has used one for 15+ years. Late in life, even a 6-inch step up to a sidewalk curb can be a challenge.

Edit: I bet there’s a YC startup hidden in your question, especially with people investing more in their homes again now that they live and work at home.

Be very weary about this and investigate carefully, IDK the financials of OPs family but they can become a costly burden to maintain and fix if issues arise. Especially if they are on a fixed income.

It's indeed something to be wary* of, but that's true of any suggestion. There are pros and cons to every approach, and they should be considered within the context of the specific circumstances.

My mom has arthritis, so they bought an elevator chair.

It definitely has reduced the risk of falls, but like other people in the thread have said.. maybe it's decent exercise?

We had to deal with this; in our case, my daughter moved in with my mother as a (paid) caregiver. My Mom got to live in her home a lot longer, and my daughter had meaningful work. It was great to keep it all within the family.

You sound a bit younger than me, but take a look across your family connections. There might be somebody who could use a gig, and could benefit from close contact with an aging relative's wealth of life experiences.

Best of luck!

A bit of an aside, a fascinating video [0] that reviews a recent metastudy: "how many steps per day does it take to reduce all cause mortality".

Turns out the answer is between 3000 and 7000 steps a day. This is a sample of 30,000 people between the ages of 45-80.

Get yourself and your parents moving.

[0]: https://www.youtube.com/watch?v=J6nW55kH7Do

My Mother have some knee issues. I knew that bike exercise is easy on your knee so I bought her a room exercise bike. The type where you can lean lean back. I think it’s called recumbent type. She says she uses it while watching TV and her knee is getting stronger. I think it was the best gift I ever gave her. I really want her to stay healthy. It will benefit herself, but the entire family really.

Has anyone looked into shared support resources on a friend/intentional community level. Obviously, this wouldn’t be practical in HCOL areas, but buying/building properties in a close space and sharing a privately employed nurse/caregiver doesn’t seem so far fetched for the period between fully independence and full-time care needed.

I had considered it briefly. Unless it is for a tiny number of residents (2?) then I think that the CQC will want to come and do inspections. It would be necessary to assume that the residents are, or will soon become, highly dependent (needing 24/7 care).

In the UK I believe that at least two qualified nurses are required on site at all times, plus carers sufficient to care for the needs of the residents. Assuming 8 hour shifts you will need to triple that number. Multiply by a further 7/5 to account for weekends. Multiply by a further 52/46 for holidays, sickness and training. Add some for receptionist, accountant, handy man, cook(s), cleaners, manager(s).

That is quite an overhead just for wages. Add to that any mortgage for the property, heating, rates, repairs, office equipment, etc, etc.

With rooms becoming vacant and requiring redecoration between residents, there will not be 100% occupancy. The cost to break even is substantial. Even commercial care homes go out of business quite regularly. I can understand why residential care is so expensive.

Having been a frequent visitor to care homes I know that many / most of the residents most certainly do not wish to be there, and want to be back in their own home. Almost all of the staff do a fantastic job, doing unpleasant tasks without complaint, and doing their utmost to create a friendly and inclusive atmosphere.

The existing care system is very expensive for users. A more informal arrangement with less bureaucracy providing care at home would be useful.

There is no easy way around this.

> my dad refuses to leave his house until he dies

Fair enough.

> my dad currently crawls his way up the stairs each day to use his computer.

These could be solved by elevator chairs. Might need to look for a creative person/company to install them.

> I have my own young family and my partner and I have jobs

It does help if you have siblings. Otherwise, you just need to assign a part of your time to them.

I am in a similar situation, but we live separately. Now I don't have stories of nonagenarians lifting weights, but as long as they keep moving in the house and take a gander outside every once a while, they will retain their muscle mass and remain independent. If that means crawling up the stairs every day, so be it.

I know people think of Hospice as supporting your final months but their only criteria is a terminally sick patient that will never recover. They can come and do an in house visit several times a week and bring health care to your parents, and it’s free. I knew somebody who had hospice care for years.

The best thing you can do is realize these are unique individuals. They’re your parents, sure, but it’s not your responsibility. Live your life, let them live theirs. It’s ridiculous the way we as a society have normalized the idea that we need to care for our parents.

Don't blame the kids for "normalizing" what their parents did. I couldn't have changed the choices my mother made, obviously not when I was still an infant but really even much later. As you say, parents are unique individuals living their own lives. If their choices eventually lead to them being unable to look after themselves, what are the children to do? Let them starve or freeze to death on the street?

Like it or not, we all do have a responsibility to look after those who can't look after themselves, even if they're not related but even more so if they spent years of their own lives looking after us. There seem to be people here who would prioritize getting the latest greatest 4K OLED monitor over ensuring their own parents' welfare, and that's literally monstrous (look it up).

Spending years of your life rearing a child is your decision and obligation as a parent. It’s not fair to put that on children to care for their parents, particularly when they’re stubborn and when childhood trauma is involved. We didn’t all grow up in good environments.

No, we didn't, and you should be more careful making convenient assumptions about your interlocutors. If you want to make exceptions because of extreme circumstances that's fine, but that's a far cry from your original "unique individuals" argument. Almost seems evasive TBH. The normal case is that people deserve to live with basic human dignity even if they might have made some poor choices. Does that create a burden for others sometimes? Yup, sure does. It's this little thing we call civilization. And where there's a burden there's always a question of who should bear it. Again, the normal case is that it would be those who are already reaping what their parents helped them sow. This is not some super exotic or recent philosophical idea. If anything, the idea that you don't owe anyone else anything at all no matter what they've done for you or how that plays out when everyone's acting that way is the newcomer, still wanting for evidence that it can lead to anything good. Most often, it's just rationalization for doing what's convenient instead of what's right.

Is there a society out there that doesn't care of their parents? It is part of being human yo

I'm looking into reducing loneliness and providing companionship for aging parents with an AI powered talking companion. If you have faced any issues with providing companionship to aging parents, I would love to hear more about it!

You can offset some of the risk in the stairs with simple aids, like a secondary banister, better carpet (no trip hazards).

Ultimately you'll need to employ in-home carers in increasing numbers unless you're going to give up work.

It's his choice. Because it's his life.

It's not yours. Because it's not yours.

He and your mum are who they are.

Maybe he is open to the idea of installing a stair lift.

Good luck.

I don't know your specific situation (location, financials, etc) so I can't share specific advice, but will share what we experienced with my grandparents.

My grandparents lived to be 94 + 95. One of the biggest improvements for them and us was hiring in-home help aid as they aged. Someone to do laundry, cook a good meal, clean up a bit, etc. It took a lot of the time commitment off my parents to constantly be making sure they were ok. Not to mention it gave my grandparents some much needed social interaction outside of our core family.

Another important factor was attempting to get their financials in order before they passed away and became incapacitated. After some review, we found some... shady accounting from a family member who was managing their affairs without much oversight. I'm not sure who is handling your parent's finances or if you have other family members, but once money is involved, people can get weird about inheritance. I've experienced and heard multiple horror stories about families breaking apart because of mismanaged finances.

I'd also recommend keeping your parents moving, and trying to keep their brains engaged. Bodily health is a vicious cycle once you lose muscle mass. Falls are also a huge issue for elderly people. YMMV, but installing smart speakers in each room of their house that they can use their voice to call for help in an emergency after a fall might be smart. We tried to get a life alert bracelet for my grandmother, but she always took it off. You'd have to train them to use it, but it sounds like your parents are tech savvy enough to get it. My grandparents missed the window for learning how to use the internet, so Alexa was tough. My brother actually took this funny video which got featured on a few meme sites of my grandparents trying to use Alexa: https://www.rightthisminute.com/video/rtmtv-grandpa-doesnt-g...

Finally, I'm going to plug my older brother's service, nanagram.co. It allows you to sms photos to a phone number that get printed and shipped to your loved ones in the mail each month. He built it to get photos to my grandparents without the internet. It won't fix the core problems you're describing, but can be a convenient way to give older people something nostalgic to look forward to each month, especially if it's pictures of their grandkids in the mail that they haven't seen on a photo stream.

Full disclosure re: Nanagram - I helped get the product off the ground, but am not involved anymore. Just a proud younger brother sharing a relevant service.

[Update] Another thing you should do is record their stories sooner rather than later. Using old photos as a story prompt is a good way to get the synapses firing on old memories. Once they pass away, all that history in their heads is gone, but it's easy to document some of it with video nowadays. If I'm missing my grandparents, watching old video of them and hearing their voice also really cheers me up.

[Edit - grammar/typos]

Walks, talks and time.

America is a terrible place for the elderly.

Read Atul Gawande's Being Mortal

I am 80 years old and live in a Continuing Care Facility (Independent, Care, and Memory Care) and will live here for the rest of my life. I will get progressive care as I need it. Right now I am in good health and live in the independent living part of the facility (600+ residents). Moving here simplified my life tremendously. No house to take care of. Good meals are provided. Housekeeping provided. We are surrounded by people in the same stage in life and a well-trained staff of people. I pay $4,600/month for my wife and I to live here. Social security and retirement checks pay for most of that. The rest comes from savings.

A few comments from my perspective: the #1 killer of older adults in loneliness. They become isolated and are, frankly, forgotten. I see people here where I live have their spouse of 50-60-even 70 years die and they go into depression. A friend here had his wife pass away recently. Everyone made sure to include him in daily activities and conversations. Here it is not as bad because there are always people around to talk to and do things with. That is so important to older people who are alone. We are a social animal and need contact with other people. People here have group meals where 6 to 8 people put tables together and eat. Lots of stories and laughing. There are lots of social activities and events here too. As people age they do not want to leave their houses - mobility issues or cannot drive as well, so living here means getting out and seeing people is just a matter of opening the door and walking (or riding) down the hall to a public area where there are always people. I belong to several groups (watercolors, table tennis, and ukulele) and my spouse plays mahjong and bridge every day. People meet down the hall 2 or three evenings a week for sing-a-longs someone organized. We use the beautiful gym and pool a few steps away where there are exercise classes everyday.

It was hard giving up our nice house that was full of memories and things we were comfortable with but it had become a burden. Something always needed fixing. It was a cluttered, disorganized, and sometimes dirty mess. There were people in our neighborhood that had no friends and relatives. They were utterly alone every day with nothing but a TV, a phone and maybe a computer that confused the hell out of them. Very sad. Life can be a hassle. Moving here lifted a huge load off my and my wife's shoulders.

Not everyone of course can afford living the way we do. But you can.

If you haven't saved a nickel for your retirement, it is time to do so. Our savings over the years has allowed us to do what we are doing now and allows us to travel extensively all over the world. We have never been rich. At the time, it was hard to save. Because we did not have top level jobs, we had to sacrifice but it was, looking back, worth it because now we live a safe, dignified, interesting, and healthy life. And our kids do not have to worry about where to put Mom and Dad or to dispose of a house full of what they would consider junk. That has all been done. Our kids fully support our decision to come here to live. We live very simply without a lot of material possessions that just clutter things up.

So save your money and pray that we get politicians that realize that inflation is the enemy, the real enemy of older adults. A few years of what these clowns lie to us and call 'temporary inflation' and our hard earned savings will be gone and they will still have their mansions, servants, boats, and air planes. Think about that when you vote the next time.

Let me extend my sympathies to you. I think a lot of folks hang onto a fantasy that as your folks get toward the end of their lives that you'll somehow be more ready to lose them. We're not too far off age-wise. I'll never be ready to attend my mom or dad's funeral.

That wasn't your question, and I don't have any direct experience, yet (both of my folks are in relatively good health at the moment), but I have some thoughts if it's worth anything.

Our Dads sound like they'd get along. Were this my dad, I'd save my breath before trying to convince him that he's too old to continue with the stairs. My Dad required back surgery about 15 years ago -- almost a year's recovery and was the worst medical experience of his life. He spent much of it barely able to move (complaining so little that you'd have no idea most of the time). You don't ever really "go back to normal" after surgery like that. You also can't stop my Dad from pushing someone out of the way to get on one end of a couch being moved, or keep him from bringing over his tools when he finds out one of his kids is working on their home. It's a losing battle. And I've learned that while I may believe he's doing more damage (and he probably is), at his age, he knows his limits and will exercise them. One way to guarantee he sets those limits too high is to hint that maybe his body can't handle it.

The bedroom thing is interesting, though. I'm assuming your parents mental health isn't declining enough that you suspect the stubbornness is caused by dimentia. If that's not the case, are there other reasons that you haven't shared (or maybe you haven't thought about?) Is there something of sentamental or emotional value about that room that keeps him wanting to remain upstairs or is it just conveinece? Either way, the incredible inconvenience of having to crawl up and down stairs has apparently been judged "worth it" to him.

And I get the unwillingness to move. Even at my age, I've my elderly grandparents/great uncles/aunts and some other extended family have moved from "the family home" to "the home they're going to die in" (usually something smaller, sometimes assisted living). Most passed away within two or three years of that move. Even though I can rationalize that "of course they did -- many of them were moving because they were too frail to remain where they were", when you've watched the progression from "home->condo->grave" happen so quickly for so many, it's hard not to ignore the other variables. If your Dad has lived in this home for a lot of his life, it's the home he's "lived in" -- the next one is the home he'll "die in". I believe it would be impossible for me to make that move without feeling like the only thing you're saving up for anymore is a funeral you won't be conscious to attend.

Unlike you and I (hopefully, anyway), however, your Mom and Dad have probably not gone very many months without a person they know/knew/grew up with ending up on the obituary page. You're literally confronted by your own mortality all around you -- moving to "that last house" makes it part of the rest of your life in a way that accepting "I'll die where I lived" does not.

... when I was younger, I always wondered why people go through the expense of installing stair-climbers in their homes -- the inconvenience/grief of strapping yourself into a chair and having a machine take you up/down because you're too frail to manage the stairway and the expense of having one of those installed seemed crazy compared to the benefits of just selling the place and moving somewhere without stairs. As a younger guy, I would always weigh the cost of upgrading my home against the cost of moving somewhere that already met my needs -- especially if moving would result in me making money (as such a move from owning a larger to a smaller house in about the same location would cause).

So twenty or so paragraphs to summarize with this: Recognize that your father's motivation is almost certainly a combination of: fears about his own mortality, unwillingness to move to "the death house", unwillingness to accept that at some point people will need to take care of him/he will not be able to take care of himself, unwillingness to leave the memories of his life behind from within those walls. If you can help him to understand that moving/correcting some of these issues means having more of that life to enjoy with his family and loved ones, you might be able to convince him to choose circumstances that are easier for him to live with.

Either way, enjoy the time you have with your folks for as long as you can.

[0] Well, those who came from stable family upbringings and have strong relationships with their folks; obviously there's many exceptions, there.