Old patients unsuccessfully clinging to independent living

Nurses General Nursing

Published

Specializes in ER.

I see a lot of fiercely independent seniors who haven't planned well for the next phase of life. In the rural areas, they are used to living on their own, sometimes on properties that are deteriorating due to their owners creeping infirmities, or lifelong patterns of sloppiness.

Some have had hoarding tendencies that have gotten out of hand. EMS will give colorful reports on that.

What a good way to help these stubborn folk, who need to be guided into assisted living, or toward accepting family help? Sometimes adult children are spread out, or alienated from their parents.

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1 hour ago, Emergent said:

I see a lot of fiercely independent seniors who haven't planned well for the next phase of life. In the rural areas, they are used to living on their own, sometimes on properties that are deteriorating due to their owners creeping infirmities, or lifelong patterns of sloppiness.

Some have had hoarding tendencies that have gotten out of hand. EMS will give colorful reports on that.

What a good way to help these stubborn folk, who need to be guided into assisted living, or toward accepting family help? Sometimes adult children are spread out, or alienated from their parents.

I think it's appropriate to let them live and die on their own terms. Good care often seems to prolong the inevitable and increase suffering, unfortunately.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.

Yes, it's hard to watch people fall farther and farther behind. It brings us comfort to see our loved ones in well-run retirement homes being properly looked after. But for some people, they want to live on their terms to the bitter end. It is hard on the kids, though.

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Not all older people are stubborn or hoarders. Lots of them literally have no one to help them with anything. Have you investigated the cost of assisted living? OH my word!

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Specializes in school nurse.
4 hours ago, sevensonnets said:

Not all older people are stubborn or hoarders. Lots of them literally have no one to help them with anything. Have you investigated the cost of assisted living? OH my word!

True. It's more like "assisted theft of assets".

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If you have ever investigated the cost of assisted living, that is why they choose to live as they do. State-run assisted living places are not optimum conditions either.

I don't think it is fair to say "they haven't planned well". Not everyone makes enough money during their career to put back enough for retirement and there is no shame in that. Nor should we judge it.

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Specializes in ER.

OK, so nurses should not try to guide and influence patients towards healthier choices of living, but just "let them die on their own terms". Message received.

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Specializes in OR, Nursing Professional Development.
11 minutes ago, Emergent said:

OK, so nurses should not try to guide and influence patients towards healthier choices of living, but just "let them die on their own terms". Message received.

I think you’re taking that a bit out of context. Just like there are patients who choose not to have the life saving surgery or opt not to do chemo or opt not to... what matters is they’ve made the choice for themselves. I’ve worked in assisted living. I do not want to live there. I very well may be one of those seniors on my own. And that’s my choice.

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Many elders have family that wants nothing to do with caregiving or them. They can’t help that their family doesn’t want them around. And just the other day I saw an ad for an assisted living place that offered their great “$6000 off move-in” rate. I thought something like if $6000 off is supposed to be so great I don’t want to find out what the regular move-in rate is. And I don’t.

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I feel your post is judgemental rather than helpful. They haven't planned, their properties are deteriorating or they are sloppy. Who cares!

If they can make their own healthcare decisions, butt out.

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Specializes in Travel, Home Health, Med-Surg.

My husband and I are struggling with a situation like this at present. We have an elderly relative (95yo) who wishes to remain at home. We would feel better if he went to an assisted living facility but that is not his wish and he has made that very clear. We talked him into homecare (Visiting angels type) a few years ago and as his condition deteriorates we slowly add more care. It has not been easy bc he has fought us every step of the way bc he wasnt able to grasp that others were threatening to call APS so it was either this or an ALF. There are still some busy body neighbors that feel the need to butt in by calling the police, calling AMR etc for no valid reasons which makes the situation harder for everyone. So, we continue to fight for him/his rights, for the way he chose/chooses to live out his last days. It is not about the money for him, it is just the way he chooses to live, not in a facility, but rather in the comfort of his own home that he has lived in (and not changed!) for ~50 yrs. I hope my kids leave me alone when I am that old (or how ever old I get, LOL).

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I think sometimes we are just not very capable of understanding exactly what things mean to them, or how they see things, maybe.

For example, on one of the covid threads I think, there was a discussion about loneliness due to no visitors in LTC and someone said, "better lonely than dead!" But--says who? Lots of people who are nearing the end of their life are well aware that they're nearing the end of their life! They figure it'll be any day now... We might be surprised how they would respond to the "better lonely than dead" idea, even if they aren't depressed or cognitively impaired.

I think it means a lot to some elderly to think of not living in the home they've lived in for years...moving somewhere that is never going to feel anything like home and is more akin to a hotel room...and they don't have enough years left to make it feel like home even if they could...even if people try to make it look homey.

And what about their things? The special things that are theirs, that they look at to reminisce...? Who cares if it's old news clippings and odd collections, and weird decor, etc? Those are their memories represented in all of those various items that are junk to others.

Some of them can still walk in their own yard or sit on their own lanai or tend their own potted tomato. Or have a cat. Or do exactly as they please without some they don't know calling them "sweetie."

They don't need as much food as we think they do, they don't sleep long stretches the way we think they should, the people who guided them in their life are long gone and many of their friends are, too. Probably their beloved spouse, too! There's just a lot that I don't know if we can completely understand or appreciate until it's our turn someday.

There is definitely a subset of cognizant elders who are not too concerned about dying if they fall down or accidentally take the same pills twice or skip supper or some other event that seems very dangerous to others.

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