A Frail Independent Mentally Alert 94-Year Old Woman – Who Decides Where She Should Live?

My 94-year-old neighbor, Casey. is one of the most active people I know.  She is up and in her garden early in the morning before I am even out of bed.  She belongs to 4 bridge groups and plays many afternoons either at her home or one of her friends.  She now lives in a 55-plus independent senior living community.  Before that she lived in one of the nearby neighborhoods, so she has many friends all over the area.

Casey is not afraid to drive the freeways or neighborhoods on the other side of the city.  She knows what she wants to do and she does it.  In addition to her gardening and bridge activities, she also plays Euchre one evening a week and sometimes comes to afternoon dominoes games.  She also serves as driver for others nearby when there is a community dinner or other activity.

In the past few months, however, Casey hadn’t been feeling well.  She continued to garden and play bridge, but said she was often breathless when she took a walk or even after some shopping or gardening activities.  She visited her doctor about this and he scheduled some tests.  She had breathing tests and an angiogram and no cause could be found for her breathlessness.

A week ago she again called her physician because of breathlessness.  He told her to check herself into the local hospital on Monday.  “Oh, I can’t go in on Monday”, she said.  “I have a bridge game here that afternoon.”  So she cleaned her house and entertained her friends.  Then she called her out-of-town daughter-in-law and told her she would check into the hospital on Tuesday.

Her daughter-in-law was here watching over Casey all week.  Casey stayed in the hospital for 3 days and then discharged.  The doctors tried more tests – upper and lower GI to see if she was bleeding – because she was severely anemic.  She was given a transfusion and felt much better after that.

While Casey was hospitalized, her DIL stayed in her townhouse.  We talked in the evenings and DIL told me how frustrated she and her husband were because Casey refused to move near them.  DIL realized that since she and her husband lived in a rural area there was nothing for Casey to do there all day.  They knew Casey was active with bridge and other activities and thought they might be able to find others for her to play with.

One evening Casey’s daughter-in-law told me that evening she would call Casey’s sons and they would have a family meeting by telephone.  They would insist that she move to the rural area with her son and daughter-in-law.  I wondered if Casey would be willing to go along with that.

When Casey was discharged from the hospital the doctors still didn’t know what was causing her problems.  She was back to her own townhouse and her daughter in law returned home.  Several days later her son came and took her to his home for a previously planned family reunion at his home.  She plans to return to her townhouse tomorrow

I have been thinking a lot about this situation as it reminded me of when I wanted mom and dad to move by me.  Before they suffered from dementia they had lived on their own for decades.  I had no way to convince them to move near me and they stayed on their own, traveling from north to south with the seasons.

Although I wanted them closer to me when mom’s health began to deteriorate, I was never able to convince them to move.  I believe in autonomy as long as the elder is mentally able to make their own decisions and physically safe in their own home.  It wasn’t until mom’s health and mental capacity quickly deteriorated that I was able to convince both mom and dad to move to an assisted living facility.  At that point I felt it was necessary because they were unsafe due to mom’s inability to tell dreams from reality, to count out their own pills and to stay out of the emergency room.

As I spoke with Casey’s daughter-in-law last week, I found myself thinking that they should not just have a family meeting and decide what Casey should do.  They needed to include Casey because her mind was still healthy even though her physical health was deteriorating.  She is aware that she is vulnerable all alone.  However, she has many active friends who have been looking in on her and driving her to the hospital when necessary.

I don’t know what will happen next for Casey.  I know the family feels like they need to do what is best for her and I see myself in their concern.  But I also know what a strong woman Casey is and I wonder about how this decision will be made.  If Casey insists on staying here, her family will be understandably concerned about her health.  They know they would have to drop everything and come here again if things go terribly wrong.

At 94, Casey can’t expect to live independently forever.  But I can’t help but wonder if they have explored all the alternatives.  If she is financially able, she might be able to get some home health care or even move to a nearby assisted living facility.  By staying nearby, Casey would be able to continue playing bridge with her local friends as long as her health allows.

Since no one knows if this is “the beginning of the end” as her daughter-in-law fears, this is a difficult decision for the family.  I am hoping that Casey and her family can make arrangements that are satisfactory for the whole family.  What decision do you think would work out best for Casey and her family?

About letstalkaboutfamily

I am a retired and was the primary caregiver for both my parents before they passed. I have children and grandchildren. This blog is an attempt to connect with other caregivers and share ideas and experiences. I hope you will let me know what worked for you if you had an experience similar to mine. The main issues I am going to talk about are elder care, death and dying, assisted living, family relationships and hoarders and hoarding. Other topics will come up as I address the issues and my relationship with other family members.
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7 Responses to A Frail Independent Mentally Alert 94-Year Old Woman – Who Decides Where She Should Live?

  1. Very good questions. I have some friends who I feel like they are jumping the gun, trying to rush their parent out of his home when he is still quite healthy and in his right mind. I have shared your sentiment with them. Even being able to be independent for one year longer – one year is like five to a senior. I hope your friend gets well soon and her situation is amicable for her too. Thanks for sharing.

  2. Thanks for your comment. I think it is common for the children of the elderly to worry sooner than necessary. I know I thought mom and dad were old at 70, but now that I adm approaching 70 myself, I have a different view of things. I did swell my house when I retired so I could be free to travel and not worry about maintenance, etc. in my house. But I plan to live independently as long as I can but now in an age restricted senior community. My children like that I am independent and I appreciate that they can help me on chores around the house, etc.

  3. terry1954 says:

    i am always leaning on the ill ones side, so i think that since Casey’s mind is still alert, and she has her own friends, and she is not only loving life, she is living life, she should be able to enter an assisted living facility right there in her own neighborhood. if Casey is taken out of what gives her job, she may give up and lose interests in life and will herself to die earlier than intended. it is a fragile situation. there is much love involved. this is only my opinion

    • Actually I agree that the decision belongs to Casey. She is not considering assisted living so far as I know. She wants to stay in the townhouse where she has lived these past few years. I am curious if she will be able to considering her recent health challenges. I think an ALF might be her best solution though since that would assure she had help when she needs it. It all depends on whether her symptoms get worse and what is causing them.

      • terry1954 says:

        true. i misunderstood. i thought you were asking if she had to go to one of the two places, and i chose for Casey, but you are right, if she can still handle her own affairs, then Casey should make her decision for her self

  4. Terry, I am waiting to see what will happen next. I think Casey may need some extra help but she will be dealing with decisions as she learns what is happening. Ideally she could have home health come in to help if she only needs a few hours per day or week. Since they still don’t know the cause of her problem, it is hard to guess what happens next. She hasn’t returned from her visit to her son yet so I don’t know how she is doing now that she has been out of the hospital a few days.

  5. Pingback: Living Life Their Way | Let's Talk About Family

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