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HopelessMS

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Have been the only caregiver to a "difficult/unsupportive" elderly parent all through medschool. They were against me going to medschool. It's been a constant battle at home justifying daily/weekly what I am trying to accomplish.

With ERAS coming up, anticipate that it'll likely be much harder juggling the responsibility of residency with finding them a new PCP, taking them to their medical appointments, adjusting them to a new location with unfamiliar faces, with no friends or relatives in the area, continuing the daily/weekly justification etc.

There are no options, parent must move and live with me where ever I end up matching.
 
I am so sorry this is happening to you.

Are you in the US? If your parent is elderly, he/she should at least have Medicare if a US citizen. If your parent is hospitalized at any point, you can also get at least a couple of months of skilled nursing care to get your parent out of your house temporarily if not permanently so you can focus on yourself and your studies. I think the limit is something like 90-100 days of SNF post hospitalization if your parent stays in the hospital at least three days but I'd be lying if I said I remembered clearly.
 
It's very impressive that you've taken all that on. It sounds untenable to me, though! Is there no other family who could help during your residency?
 
Thank you both. Yes, we are in the US. My parent is not feeble, just very difficult to live with, very strong-willed, their way or the highway kind of attitude, etc...

Unless I am able to match to an area where most of my relatives are at, I'm out of luck as far as having other family help out.
 
HopelessMS said:
Primary care (IM, Psych, FM, or Peds)
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The good news with these specialties is they are pretty easy to match. I had good luck this year in the match cycle getting interviews with places where I tailored my personal statement - "I applied to XYZ program in particular bc ABC reason." If I were you, I would 100% say something about caring for an elderly parent and needing to be near relatives which live in the city where XYZ is located so you can have help.

Programs in general are looking for someone who wants to be there. A reason like that is a really solid reason to want to be there, probably more solid than a lot of reasons people list.
 
I just hope that whatever residency program I match into, they will understand when I need to take time to take my parent to their appointments, etc. I had several medschool acceptances, but could not attend my #1 in consideration of their needs because it would take them for a minimum of 4 years away from the general area where relatives are reachable. Now with the uncertainty of residency, and where I will end up, it's another headache...
 
This resonates with me OP, I have a parent who is not there yet but I know part of the plan is to follow me wherever I am going. You are not alone, and I think these kinds of responsibilities weigh heavy on a very many few.
 
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HopelessMS said:
Have been the only caregiver to a "difficult/unsupportive" elderly parent all through medschool. They were against me going to medschool. It's been a constant battle at home justifying daily/weekly what I am trying to accomplish.

With ERAS coming up, anticipate that it'll likely be much harder juggling the responsibility of residency with finding them a new PCP, taking them to their medical appointments, adjusting them to a new location with unfamiliar faces, with no friends or relatives in the area, continuing the daily/weekly justification etc.

There are no options, parent must move and live with me where ever I end up matching.
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No other family members to take care of parent??? None??

Parent is incapable of self care?

What would parent do if, say, an Acme anvil dropped on your head??
 
None. They do not want to live with relatives or their siblings. Prior to starting medschool, I reached out to all relatives to ask whether they would allow them to live with them, and that I would pay rent, but TBH, none of the relatives can stand them. My parent's attitude makes relatives be wary of being around them for too long.

Parent is not feeble, but not able to live by themselves as they are getting up there in age where they have become forgetful as in leaving the keys in the front gate, two times not turning the knob on the gas stove off completely (flames are off, but gas filling the house when I returned from school-sense of smell almost lost due to working with chemicals before retiring), forgetting to close the windows when going out for a walk around the neighborhood, etc...

If I get hit by a car tomorrow, then I guess my parent's siblings might assist since they are the eldest sibling but in the mean time, I am responsible as their child.
 
HopelessMS said:
I just hope that whatever residency program I match into, they will understand when I need to take time to take my parent to their appointments, etc. I had several medschool acceptances, but could not attend my #1 in consideration of their needs because it would take them for a minimum of 4 years away from the general area where relatives are reachable. Now with the uncertainty of residency, and where I will end up, it's another headache...
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This is really hard to do for yourself let alone a parent.
 
Yeah. I guess I will cross that bridge when I get to it.
 
Is your parent in any way disabled? A veteran? Eligible for services in any way? I understand your desire to take care of your parent, but parent needs to understand that you will not be able to provide full time personal care and transportation while you are a resident. I’d suggest trying to match into a program near your other relatives, so that they can assist, or in an area with strong elder care services.
 
No to all three. I'm keeping my fingers crossed that I will be able match to a program close to relatives.
 
HopelessMS said:
No to all three. I'm keeping my fingers crossed that I will be able match to a program close to relatives.
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Can you get the help of a social worker/ social service agency associated with your parent’s health insurance? Depending on financial conditions there may be caregivers available in his home. There are lots of home health agencies and if he doesn’t qualify you may be able to pay hourly for help.
 
My parent has Medicare only. I'll likely do more research into the options you have suggested should residency take us away from relatives.
 
HopelessMS said:
I agree. I have no legal responsibility for the well-being of a parent. But I do have a moral, ethical, cultural, and familial responsibility. My obligations for a parent go beyond the law. I appreciate your POV.
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Very commendable. It's great that you have a strong sense of duty.

I hope that comforts you during the miserable next 3-4 years. Or probably longer.
 
I think you need to get your family members to all chip in a little money to pay for, say, 4-6 hours per day of someone to come into your home to help care for your parent. Baby steps.
If someone doesn’t want to spend the money, then fine, they can come themselves for 6 hours instead, assuming you match in their city.
 
That would be ideal, but unfortunately it doesn't work that way in my extended family structure. I could justify asking my siblings if I had any, but asking other relatives who have their own families to worry about just can't be done.

It's part of my culture that the children are solely responsible for their parents, and if one is the only child, then so be it. It'll wouldn't be so bad if my parent was more agreeable and supportive of what I am trying to accomplish. But alas one can't choose what family they are born into.
 
HopelessMS said:
That would be ideal, but unfortunately it doesn't work that way in my extended family structure. I could justify asking my siblings if I had any, but asking other relatives who have their own families to worry about just can't be done.

It's part of my culture that the children are solely responsible for their parents, and if one is the only child, then so be it. It'll wouldn't be so bad if my parent was more agreeable and supportive of what I am trying to accomplish. But alas one can't choose what family they are born into.
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You can’t even ask for some money?

I echo what everyone else has said and sympathize with you. And you can't really do anything about this until you match. But at some point this is going to come down to a question of logistics, and you're going to need to choose the least bad option. And if your parent really is a threat to themselves (ie filling the house with gas) then it's a question of survival for them. Because to just tackle one of the things you mentioned, to put things very plainly, you WILL NOT be able to personally escort them to their medical appointments. Not when you're working 10-24 hour shifts, and especially not on the months where you only get 4 days off. Something is going to have to give, and either someone in your family is going to have to help for your 3 years of residency, or you will need to find the money to get someone to help you.
 
We don't qualify for Medicaid, but I will definitely reach out to a social worker, perhaps at the residency place I hopefully match at, when the time comes if necessary.
 
Perhaps you can contact someone ahead of time at your future program and explain your situation before you even move there.
 
Good idea! Just to clear up any confusion, if any, I will be applying this to upcoming ERAS. I am a rising MS4.
 
HopelessMS said:
That would be ideal, but unfortunately it doesn't work that way in my extended family structure. I could justify asking my siblings if I had any, but asking other relatives who have their own families to worry about just can't be done.

It's part of my culture that the children are solely responsible for their parents, and if one is the only child, then so be it. It'll wouldn't be so bad if my parent was more agreeable and supportive of what I am trying to accomplish. But alas one can't choose what family they are born into.
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I’ll start this by saying that I appreciate that this is part of your culture and I definitely respect that. I don’t mean anything disrespectful by what I’m about to say and I hope nobody takes it the wrong way.

All that being said, I think you may ultimately be up against a situation where your cultural obligations are incompatible with medicine at this stage of your career. I was a psych resident. While it’s probably easier to manage life outside of work in psych than in other fields, I just don’t know that it’s possible to be a sole caregiver while in residency. You’ll probably have weeks at a time where you’re on nightfloat and times where you’ll be gone for 30+ hrs at a time while on call, then inevitably crashing for several hours when you finally get home. Frankly, there are many times in residency (even psych residency) where you’re lucky if you have time to do your own laundry and pick up groceries for the week.

While I wish you luck in accomplishing what you hope to in balancing these obligations with residency, I fear that it might ultimately be impossible. If that happens, you have to decide whether you’re going to bend on your cultural values, because medicine is unlikely to bend to accommodate your personal life.
 
This is very insightful. I appreciate the thought that went into your post. I will make every effort within my powers to match to a residency close to relatives even if it means applying to a specialty that won't be my #1 choice if it means I will have a better chance at being in a location close to relatives.
 
sloop said:
I’ll start this by saying that I appreciate that this is part of your culture and I definitely respect that. I don’t mean anything disrespectful by what I’m about to say and I hope nobody takes it the wrong way.

All that being said, I think you may ultimately be up against a situation where your cultural obligations are incompatible with medicine at this stage of your career. I was a psych resident. While it’s probably easier to manage life outside of work in psych than in other fields, I just don’t know that it’s possible to be a sole caregiver while in residency. You’ll probably have weeks at a time where you’re on nightfloat and times where you’ll be gone for 30+ hrs at a time while on call, then inevitably crashing for several hours when you finally get home. Frankly, there are many times in residency (even psych residency) where you’re lucky if you have time to do your own laundry and pick up groceries for the week.

While I wish you luck in accomplishing what you hope to in balancing these obligations with residency, I fear that it might ultimately be impossible. If that happens, you have to decide whether you’re going to bend on your cultural values, because medicine is unlikely to bend to accommodate your personal life.
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Basically an inevitable decision coming for OP to throw away their life for what sounds like a miserable acting person or let that person finally reap what they sow instead of enabling them and ruining OPs life too.

OP, let go of the anchor while trying to swim. Advocate for yourself. You have a long life ahead of you and there is a reason the other family members preyed on you. This goes beyond culture IMO.
 
You have some difficult choices ahead, with no easy path forward.

Trying to manage this home situation while being a resident is going to be very difficult. You'll need to be at work for 10-12 hour days, with minimal phone interruptions. You may have some flex time to go to appointments, but only at a reasonable frequency. If those appointments are more than monthly, you may find this challenging. You're going to be working multiple night shifts in a row and need to sleep during the day -- will that be possible?

One of the most important attributes of a resident (and a physician for that matter) is reliability. As a medical student you're completely disposable. As a resident you're a critical piece of infrastructure. You can't just leave work for an hour, or spend lots of time on the phone. If there are frequent emergencies it's going to be a huge problem. Your parent is going to need to care for themselves for long periods of time, and you'll need to be comfortable with that.

As others have mentioned, if no one else is willing to care for them, then you can always get them in a nursing home. It will not be easy. You need to separate your finances -- figure out what assets they have, and which are yours. I find it hard to believe that you don't qualify for Medicaid -- they are disabled and likely have minimal income, and you're a medical student with no income. Regardless, it doesn't matter -- they could be placed in a nursing home, they spend down their assets -- all their money goes to paying their stay. Until they have nothing left, and then they qualify for Medicaid. And that pays for the NH forever.

But this is really hard, and goes against your culture. You basically need to "divorce" your parent. There's no legal requirement to financially support your parent. They may hate their life in a nursing home, and you'd need to live with that. Then again, perhaps they might be much happier there with other people around.

Waiting until you match is a prescription for disaster. Getting someone into a nursing home, if that's what you plan to do, takes months. Medicaid applications take months. Medicaid is a state based program -- so if you have medicaid in one state it's a whole process to try to get it in another. The match is in mid March, and your new job starts in June. There's absolutely no way anyone will be able to help you settle this in that amount of time.

And matching to be near relatives? From what you describe here, that sounds like a pipe dream. They are not interested in helping, moving closer will not help at all.

There may be some fields, and programs, that may be more flexible. But doing a field you don't enjoy is certain to make you miserable too. And no field is easy -- all involve long hours that you may have little to no control over.

I do wish you the best. I highly recommend you discuss this with mentors at your school. If your culture has a religious component to it, getting help there may be an option also. Ultimately, even if he is put in a nursing home while you're a resident, you would then be able to afford to get him out and back in your home if you want with supports. If you are unable to complete a residency, then you'll both be stuck.
 
Thank you NotAProgDirector. You and everyone who has posted have given me a lot to think about.

Of note: My parent is not disable. I have looked into Medicaid in the past and they get just a little over the minimum threshold to qualify due to receiving social security retirement.
 
HopelessMS said:
Thank you NotAProgDirector. You and everyone who has posted have given me a lot to think about.

Of note: My parent is not disable. I have looked into Medicaid in the past and they get just a little over the minimum threshold to qualify due to receiving social security retirement.
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I say this with as much respect as possible - if your parent is not disabled, what is it that requires so much of your time and attention for support? You mentioned things like forgetfulness and issues caring for themselves. Have they received a cognitive/psychiatric evaluation? Someone who is just "getting old" normally usually does not require the level of caregiving you seem to be describing. If it's less that they need intensive support and more that you feel you should support them, it may be beneficial for you to seek some counseling for yourself, especially regarding boundaries - as you may need to adjust yours in residency.

Depending on your parents age and needs, there may be other services you can look into such as local senior transport services that would help with things like medical appointments. But I recommend starting to learn about the options now, rather than just waiting until residency
 
Looks like they're going on the "highway".
You're the responsible adult now. It's your turn to establish the "my way or highway" rules.

That's what I do (whenever my parents try to screw with me). Eventually they learn. Parents are like most other people (or worse)- unless you set the rules and boundaries they'll take advantage of your weaknesses (even more so since they know all your original weaknesses)
 
Definitely seek help from social work. Some cities/counties/states offer assistance in such situations to help keep family members out of nursing homes and the social worker can help you find these resources. In California, there is In Home Supportive Services (IHSS) which will pay for the aide to take care of your parent while you are working. The care covered depends on the need, from several hours a day to longer. I have completed a lot of paper work for my patients over the years to provide medical documentation of my patients' needs. Here is the website for more information in case you are in CA. In Home Supportive Services
 
You have made many fair points Telemarketing. I didn't mean to imply my parent is bedridden. They are showing the signs of mental decline that I believe are age related and not enough to warrant seeking any mental evaluation.
 
HopelessMS said:
You have made many fair points Telemarketing. I didn't mean to imply my parent is bedridden. They are showing the signs of mental decline that I believe are age related and not enough to warrant seeking any mental evaluation.
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Disabled doesn't have to mean bedridden. Can I ask how old your parent is? If there is enough decline that they aren't able to function independently without your help, it is enough to warrant at the very least a discussion with their PCP.
 
71. They saw their PCP a couple months ago and the doctor noted the normal physical ailments associated with natural aging (loss of muscle mass, strength, Vit D deficiency = osteopenia) but didn't note anything alarming. Other than a continue stubbornness and refusal to take certain medications, the doctor did not mention anything else to me. My parent is still able to take morning walks around the neighborhood a few times a week, dress, and bathe themselves. I manage the finances and everything associated with the home.
 
HopelessMS said:
71. They saw their PCP a couple months ago and the doctor noted the normal physical ailments associated with natural aging (loss of muscle mass, strength, Vit D deficiency = osteopenia) but didn't note anything alarming. Other than a continue stubbornness and refusal to take certain medications, the doctor did not mention anything else to me. My parent is still able to take morning walks around the neighborhood a few times a week, dress, and bathe themselves. I manage the finances and everything associated with the home.
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You even manage their finances?
Wth kind of relationship is this? You behave like the parent and they're the stubborn teens.
I bet you even do their taxes too?

I say, slap them with their sense of entitlement and chase your dreams of med school.
 
Can't read the whole thread, but the general principle is:
You may take care of them so long as you love them and they aren't dragging you down and ruining your life.

Children owe nothing to their parents.

The term "cultural" and the baggage that comes with it is often seen as natural, inviolable, immune from critique (this is my cultural values it is what it is how dare you). It's not. The "must take care of folks otherwise you should feel guilty and ****ty" is a self-directed loop often set in motion by indoctrination and guilt-tripping of the child by said parents.
 
In Michigan, mental incapacity is grounds for Medicaid. While your parent may have been denied Medicaid due to Soc Sec income, that’s the criterion for a “normal, mentally and physically” healthy person. For decreased mental capacity—perhaps an angle you didn’t pursue— the Soc Sec income doesn’t matter. Typically, your parent would get Medicaid, cover 100% for nursing home care, but the state would take the Soc Sec benefit to to help it offset the cost of the nursing home care.
 
Thank you! I have and will continue to check the Medicaid requirements. It will definitely be on my to do list for each state during ERAS.
 
Thank you all your ideas and suggestions. I believe I have come up with a solution to address my main concern. I'm posting because another MS in a similar situation might find it helpful.

My main concern if I don't match to a region close to relatives is the inability to take my parent to their medical appointments due to residency duties. If that is the case, I will be placing an ad in the local college or medschool through social media or a school newsletter, etc seeking a couple of students who would be willing make some extra money and take my parent to their appointments. They will essentially be "on call."

Due diligence: My parent and I will meet each one at a local coffee shop to see if my parent will approve of them. I will also have them do a criminal back check and reimburse them. Pay will be negotiable, hourly or set rate per call.

I don't know if this idea will work, but I'm going to give it a try should it become necessary.
 
There are services for "day sitters" for the elderly who just need someone to be there during the day and make sure they don't burn the house down making lunch, and in most cities there are medical transportation services to help get people without reliable transportation to/from doctors appointments. You may need to factor these into your resident budget and look at available services in the areas you'll be applying for residency. Also, there are retirement communities (assisted living facilities) that are a step down from a nursing home, but still allow some level of independence for seniors. Basically they live in an apartment without a kitchen and take meals in the community cafeteria, and someone from the facility checks on them regularly. They also have access to community activities where they can engage socially with other residents, but its less hospital-like than a regular nursing home.
 
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