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Ok, I think this is the best forum for this but hopefully a mod will let me know/move it as needed:
My wife just fielded a call from my aunt (dad's youngest sister), aunt was under strict instructions not to tell me what follows below... but, true to my family, telling a spouse is fair game. My folks are both just shy of 70, dad has been overweight since getting out of Vietnam and suffers from several things. He accepts shortness of breath (which is now leading to passing out/falling) and high blood pressure but exhibits symptoms of congestive heart failure. Oh yeah, my wife is a Pharmacist... so we may have a little more insight into some medical things. Anyway, mom has MS (though it's been in remission for more than a decade and each occurrence has been less and less intense), but the big issues is that she fell on some ice and messed up her hip about 6 years ago and has mobility issues.
Nothing too out of the ordinary so-far, but this is where it gets worse. I'm an only child and live in Georgia near my wife's family. My folks live 15 miles north of White Sulphur Springs, Montana (here) ~ about 3/4 mile off the highway on an unmaintained dirt road and no permanent neighbors. Mom hasn't driven much in recent years, but apparently she is now the sole driver.
This is where the phone call comes in... apparently my dad has had a couple bad falls in the past few weeks. Losing consciousness and falling... once into a grandfather clock (couple hundred pounds worth) and moving that 6~8 inches, another into a wall that now needs new drywall. He can't do anything while standing, which leaves all the work to my mom. With winter approaching, that means shoveling (they do have a snowplow and generally contract with someone to plow their driveway as-needed), bring in firewood (not strictly necessary), but most importantly they tend to feel the need to drive 3 hours round trip to Great Falls for medical care and groceries. The closest town has a 6-bed hospital, but it's more of an urgent care situation than long-term assistance. They retired to that location from Wyoming and have no real support network.... and the isolation is, well... amazing when you're healthy but probably life-ending if you're struggling physically.
I had to find this out in a round-about manor because they don't want to burden me. That's fine, I'm not particularly close with my parents/family (we email a couple times a year, I try to visit once a year for a ski vacation), they had always talked about planning to take care of themselves. My mom really took a firm stand on taking care of herself after spending nearly a decade of caring for her mother. Problem is, it doesn't seem like they're trying or finding someone to help them. The lack of communication isn't helping anything either as no one know just how bad things are (or aren't), how long it's been going on, etc...
Since I'm sure someone will mention this, we're covered from a legal aspect. I have medical and durable power of attorney, hey have their wills current (well, as of 2 years ago).
I already have plane tickets and plans to visit Jan 11~31 and my aunt will be there in March. Not looking forward to the hard discussions that I thought were still years away, but I'd also like to have an idea of options. I know they won't move, just not going to happen. They also have a spare house (the link above) that could be used by help... the problem is finding someone willing. I'm looking for some thoughts on available options. What should I be looking for/planning for/expecting? Doing this from 2,000 miles away with parents who wrote the book on stubbornness will only add to the enjoyment.
Sorry if I don't seem like I'm taking this seriously. Again, just sorta how my family rolls. When my grandfather passed, the funeral service turned into a remembrance of the funny stuff he did/said and everyone left laughing. I think we all have a healthy dose of "It's just life, no one gets out alive" attitude.
I think that you already know the answer: they will need to find someone younger to live with them and help out or they will have to move. I'll put odds on having to sell and move.
It is likely that your father will go first and your mom doesn't have the wherewithal to continue that lifestyle alone.
Lots of older people want to live in the middle of the boonies like that but it's not practical. Some of the elderly men who do that end up dying out there. That is their right, but I suggest moving your parents to a larger area before the situation gets more dire. Your mom will live a lot longer if you do.
I have had several friends who in the past several months have suffered major lifestyle downturns because one spouse fell and suffered serious injuries resulting in long hospital/rehab center stays. Navigating the insurance matters alone almost sent one wife to the looney bin.
None of them expected this to happen "so early." That's the thing ... Once "it" happens, whatever "it" is, it usually snowballs into major problems that bring big decisions that have to be made quickly and under duress.
I know your dad may be the type who thinks he's just gonna go quickly and quietly, but that would be the best-case scenario.
I wish you luck. If you have any friends it family who have successfully downsized, maybe use them as and example. Or maybe a younger relative could move into the property to help out?
Get in touch with the county's Council on Aging. Every county in MT has one. If you can't find it online, call the welfare office, the adult protective services department, the cop shop. They all work together and know each other.
MT is kind of cool in how they offer some good services to folks in need through that Council on Aging. And the (mostly) women who help those at home know every resource in the area. Guaranteed.
thanks branDcalf, that's something completely new (I was starting to dig through the Federal programs in MT last night).
For the rest, thank you also. We've long expected that my dad would be the first to go, I suspect he thought that willpower alone would keep him going. I'm *certain* he didn't think ahead to loss of mobility and my mom being forced to do everything physical (well, with the exception of building an elevator into their home). Anyway, that's neither here nor there...
As I said, they won't move. This is their "retirement dream" (or the part of it they managed to complete), even mentioning moving will likely set their heels on any other topics. I'm going to, after discussing everything else, but I fully expect anger and resentment when I bring it up.
That means getting some in-home care. Sounds like my mom hired weekly help for cleaning the house, which is a good first step and means they aren't so stubborn as to not ask for help, I just don't think it's enough. Sadly, with the lack of information, it's impossible to know for sure. I doubt they need 24 hour care, but might need short notice help/care.
I fully expect things to get nothing but worse from here on out. The next fall my dad has may well break and arm/leg/hip (or neck, sheesh) and put a Complete stop to any help he may still be contributing while becoming a drain at the same time. Or they may stay stagnant for periods of time.. but in the end I want to know options, have discussed some plans (both of which are what I'm asking for here) and have a general roadmap laid out for them. There are always surprise turns, but some planning is better than turning a blind eye, yeah?
I wish there was someone I knew who would move in with them. But I'm an only child (and in my 40's with obligations of my own), I have a few cousins but one just lost his mom suddenly and is taking care of my uncle, the others are in Germany with the military, 2 are just ought of college and trying to make careers and the last just started college. Similarly, my folks have some siblings (both are the oldest), but have their own lives. No boomerang kids who enjoy being ski bums in the winter and hiking/biking through the summer. :/
Thanks to all for the thoughts though. Trust me, I don't evny this situation myself, but it's something nearly everyone has to deal with at some point. I hope to be smart enough now to ask for help and learn from the experiences of others.
They may qualify for home health through their Medicare benefits, too. You find them through the same sources, usually, and home health agencies can be attached to a small hospital or local nursing home, too. Even if the home health office is located in a larger town, they often have contract staff in the more rural areas.
And personally I have drive 128 miles one way to a client's house in MT. I have also treated at a house where someone would either leave me a snow mobile or a pair of snow shoes to use to get in. I was always eager to see what my transportation would be.
I don't recall if you said you had ever lived in MT, sorry if I missed it. But, if not, most folks just take distance and difficulty in stride.
Try to sit down with them and listen to what your parents really want for themselves. What if they have decided to stay there and die there together? If you are not close to them, as you say, then you may not really understand what their intentions are. Do educate yourself about what is available in their area before talking with them. I imagine they are not the only people who retired to remote areas of Montana and want to stay there no matter what. It may not fit the city ideal of moving into an ALF, but maybe they don't want to prolong their life under those conditions? Or maybe they have no idea what services might be available to them to make life easier where they are?
And personally I have drive 128 miles one way to a client's house in MT. I have also treated at a house where someone would either leave me a snow mobile or a pair of snow shoes to use to get in. I was always eager to see what my transportation would be.
This is kind of what I was getting at too. People have ways of managing in remote Montana.
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My folks are both just shy of 70, dad has been overweight since getting out of Vietnam and suffers from several things. He accepts shortness of breath (which is now leading to passing out/falling) and high blood pressure but exhibits symptoms of congestive heart failure. Oh yeah, my wife is a Pharmacist... so we may have a little more insight into some medical things. Anyway, mom has MS (though it's been in remission for more than a decade and each occurrence has been less and less intense), but the big issues is that she fell on some ice and messed up her hip about 6 years ago and has mobility issues. 
That's fine, I'm not particularly close with my parents/family (we email a couple times a year, I try to visit once a year for a ski vacation), they had always talked about planning to take care of themselves. My mom really took a firm stand on taking care of herself after spending nearly a decade of caring for her mother. Problem is, it doesn't seem like they're trying or finding someone to help them. The lack of communication isn't helping anything either as no one know just how bad things are (or aren't), how long it's been going on, etc...
