Not really a question, more of a rant. But any thoughts and suggestions are appreciated!!
So FIL who was widowed a year ago April is in AL with dementia, He is miserable, refuses to socialize, thinks he doesn't belong there , refused care, yada yada. Finally is showering 1-2 times most weeks, last couple of months with or without help depending on his mood, but still does not change his pullup often enough and refuses toileting schedule.
This past month has expressed that he knows he is declining. He has been in the hospital 4 times since December with acute on top of chronic respiratory failure. This time he is also in CHF.
The man despises rehab and PT. The last time was this past April. And he did improve , but has been declining again .
Last night he said he does not want anything done , he is too tired. In my head I agreed that he is probably too weak for rehab and was thinking of palliative care in SNF.
Went to see him this morning and FIL was back to "denial" about his condition. He said the doctor said he needs to get stronger. FIL thinks that means he just needs a few more days before he goes back to AL. FIL just wants out of the hospital. He did seem better today, but I doubt he can go back to AL before going to rehab. I also think its questionable that he would do well enough to return to AL at all.
It is so exhausting for all (Including FIL), this back and forth every other month with the same chronic problems. At some point DH who is POA will have to make the call as to how much is done and when to just let FIL rest.
But when that is , is a tough decision again. It was much easier when he was doing more poorly and FIL himself saying not to do procedures etc. FIL is a DNR, which he is still adamant about.
Modern medicine keeps bringing him back from going over that edge, where we would all say for sure let the man rest. It seems so cruel to put this man through rehab again and again , just putting off the inevitable.
It gets complicated as well since FIL has some lucid moments. It would be much easier for DH to say "Stop , let him rest." if FIL was less verbal or less able to make wishes known. But his wishes are often unrealistic as he is not always aware of how ill he is. Last time FIL was very against rehab, but did it to avoid SNF. I doubt he remembers that he wasn't allowed to go back to AL if he didn't do rehab. We may be headed for the same ugly scenario , as he thinks he can go where he wants" so long as he pays the rent".
So now what? how many times does this happen until DH decides that FIL should just rest in palliative care in SNF no matter what he says? Maybe FIL won't be well enough to get back to AL, we will see.
Well, then it's going to be a baptism of fire as they say for him. More than even he needs to get on board with help or they will kick him out.
If he really needs rehab, then he has to go. Otherwise there will be another fall or another crisis and it will be a nursing home.
If he's doing okay, then now would be the time for his son (you man) to tell him how it's going to be so he can stay in AL.
DH and I are both going up tonight . I told DH that he has to be angry when he goes tonight .
TBH . I wish they would kick him out to SNF.
In your professional opinion as a nurse, wouldn’t you say that he needs to be in Skilled Nursing?
Burnt,
What do you think?
Way,
We all know that your FIL can’t live on his own. He is in deep denial. He is manipulative too. He asks for a credit card to take y’all out to dinner for helping him. As you say, the real story is because he wants to go out!
Who is going to take him out in his condition? Y’all aren’t going to agree to this. Geeeeeez! He needs help with everything! Yeah, I get that he wants to be independent but he no longer fits into that category.
The guy is “ out there”. The problem is he can still fool people 1/2 the time in conversation .
He belongs in SNF because he’s uncooperative with showers and incontinence care . AL should kick him out .
I agree with you!
Burnt, *ornery* 😆 Love this word!
I do wonder what on earth families did in the olden days? Leave 'em on the porch?
“ I do wonder what on earth families did in the olden days ? Leave ’em on the porch ? “
That is a good question .
Perhaps in the olden days they stopped taking them to doctors and hospitals so the slog didn’t last as long ?
We had a particularly bad session with FIL last evening . Demanding his checkbook and credit cards back etc . FIL is fine . My BP is through the roof and I am supposed to have a stress test today which they probably will not let me do . DH wasn’t , isn’t even talking since last night , except to say if he could turn back time he would have left FIL in Florida “ on his porch” .
I sincerely fear one of us having a heart attack or stroke at this point over a lifelong selfish man who practically ignored DH his entire adult life.
Will DH resign his POA?
Can he simply tell AL "I have no sway over him. Do what you need to do"?
I think it will be good when FIL's dementia gets worse so you won't have these long and protracted battles with him about giving him his checkbook, credit cards, driving, etc. It's harder when they have these lucid periods and you have to wage WWIII with them about simple things like money or changing their diapers and bathing.
On the plus side greedy grandkid's mother is officially cut off from the purse strings now. I can bet her visits will get less and less now that she knows she can't keep getting money from FIL.
Sad that all the memories that will be left for DH once FIL passes is relief once the anger and resentment subsides.
I will suggest it
Thanks
It's the technical term for the lack of understanding of his own condition that I believe FIL has.
Has he been seen by a Geriatric Psychiatrist? Is he on any psych meds?
Yes , I know he has anosgnosia.
He has been on an antidepressant for many years and has refused med changes . He says “ I know what works !! “.
FIL was told by the doctor last year that he has dementia . FIL blew up and said his “ mind is as good as ever “ . He insists he does not belong in assisted living . He insists he does not need help and that his “underwear is not wet “. He believes so long as he refuses help from the staff, he is independent . On rare days he is more semi lucid . Yesterday was not one of them .
FIL has refused to go see a psychiatrist, or neurologist . He says they are trying to lie and say he’s “ incompetent “ , and the facility’s philosophy is to take his independence away “. He looks at it as him against the facility trying to take his freedom away . A psychologist that comes to the facility talked to him , FIL kicked him out .
FIL believes they are wrong and that he is independent and does not have dementia . He keeps trying to prove he’s “competent and independent” .
IMO , there is no hope. My narc mother (now deceased) had vascular dementia and was very similar . Nothing worked with her either and the geriatrician I took mom to told me nothing would work due to her narcissism . She didn’t even advise a med change . My mother used to talk to a psychologist for awhile at her AL until she found out/ realized he was a psychologist . Then she said she’s “not crazy “ and refused any more sessions .
FIL is just as stubborn and has a very high opinion of himself . My mom was in a different AL than FIL . When Mom got worse , I was given 30 days to get her out of her AL for the same reasons as FIL, uncontrolled incontinence , refusing showering , extreme odor to her and her room.
We told FIL it may come to that . He may be kicked out , but we have told him that in the past as well .
DH came out of his ( home ) office a bit ago. Spoke briefly . I suggested severely limiting visits and phone calls. Just drop off if he needs something , which he shouldn’t need anything this weekend , we just did shopping .
DH emailed the executive director to let her know we talked to him , but FIL is in the same broken loop that they ( the facility ) think he’s incompetent and that he does not need help . He says “they want to take my independence and freedom away “.
DH agrees this is the last attempt . Let AL deal with it , let him rot or kick him out . I recently again suggested trying a different med , but the PA that is his primary at AL says she does not want to give him a different med yet that may cause him to fall . His walking is very unsteady .
It seems to me that are two options here: guardianship, which requires the courts to declare FIL incompetent (which he would fight) and walking away.
Clearly FIL is mentally ill and needs a higher level of care. But as you state, he is crafty and capable of showtiming. He might end up with a determination of competence and the ability to run his own show.
In DH's shoes, I would step away, call a lawyer for advice about to resign POA in such a way that doesn't amount to abandonment and let FIL and the facility figure things out.
They in turn will probably send him to a hospital and refuse re-admission, leaving the hospital discharge team to place him appropriately or send him to a shelter if he refuses.
He may show up on your doorstep, in which case you call 911.
Have you read Liz Scheier's Never Simple?
We will see. I think DH will just try to hobble along with this though, tread lightly as much as possible , and hope for a quicker ending .
DH is non confrontational .
I don’t see him walking away at this point or going to court for guardianship . I will keep encouraging minimal visits .
DH doesn’t owe this man anything . DH was thrown out of the house when he was 21 and still in college . DH parents were trying to get rid of me because I was not raised the same religion as them ( we were engaged ) . We ended up eloping . Not much contact after that . FIL is lucky we do anything for him .
As far as I’m concerned , FIL gets what he needs , not what he wants.
My husband is the same way. He is Mr. Chill but when he reaches his limit, he will say something. Your DH might end up saying something.
You know my husband’s expression when he has had enough. He calls it his, “threshold of pain!”
https://www.delish.com/cooking/recipes/a48612/giant-chipwich-cake/
Order a t-shirt for your husband that says.
I HAVE HIT MY THRESHOLD OF PAIN!
You can wear your favorite t-shirt.
DONE!
When are you going to open up your t-shirt shop?
Way gets the first one off the press!
Hers is, Done!
Mine is, BeenThereDoneThat!
DH - Mine and Way’s is, I have hit my threshold of pain!
What’s yours?
Ask for other sayings. I’m sure that there are plenty that you could make!
Way and I get a discount! 😃
Husbands get a discount too!
You can also do lower priced items like key chains and tote bags.
How about this t shirt ?
NO…..JUST NO !
How about waterproof recliner pads for LO that say “ SIT HERE”
Good one!
And ‘No Way!’
I can’t possibly do that! is another one.
Are you crazy?
You’ve got to be kidding!
Hey, we don’t have to be politically correct all of the time! 🤪
Sit Here! 🤣 Very nice, Way! They can have matching totes!
” I should be on a break “
How much longer?
Hey, if someone asks, ‘What?’ You can just smile!
My Hat: Sensible written on one side, Silly on the other.
Gives options 😉
Hopefully some people can look in the mirror, have clarify to SEE & TURN their shirt, hat & decisions around...
What would your FIL’s t-shirt say?
Venting. Yes, add hats too! Maybe cute socks as well.
When you make a profit you can add jackets!
My FIL t shirt would say
Entitled A**
Abusive
Spoiled
Selfish