How do I force my parents to get the in-home care they need?

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How do I force my parents to get the in-home care they need?

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My dad is bedridden, full care, but has retained his mental faculties. Mom had a stroke 6 weeks ago and is now home. She is physically strong but confused about everything. (cannot prepare food, use a phone, etc) I lived there for 6 weeks, and have arranged care 4 days a week during the day and now have moved back to my home and returned to work.

They really are not safe and need 24-hour care. They have the finances to pay for in home care, but dad does not want to pay. They have refused POA, and he insists they are fine alone. We have been arguing about this daily for 4 weeks and he is very stubborn. I feel guilty leaving, but I should not have to give up my life and job, when they are able to pay for care. Is there a way to force them to pay for in home care? They do not qualify for Medi-Cal.

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I hate this for you as I have parents also who are in denial. I assume you don’t have siblings? If there are people in the community they trust, they may listen to them. But even that may take time. I would put in provisions for a home health aid to come in a few hours each day to check in and communicate with you. I’d also tell mom and dad the stress they are putting you under unnecessarily. It still may not change but once you’ve told them and given them options and they remain stubborn, you may just have to call their bluff and be strong enough to hold your ground.

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There are times in life, as much as this is NOT what we want to see, we try and try and try to "enlighten" someone but nothing works and disaster looms ahead. Sometimes in those situations the ONLY hope we have of change is telling the person they are on their own....Let something happen and then, and only then, will they learn and listen to what is best. And if not, it is THEIR PROBLEM - NO LONGER YOURS. Walk away.

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My father refused to get help when he needed it for both himself and my mother. They were not safe and my mother, who needed lift assists, fell so often, the fire department refused to come out. This resulted in my mother laying on the floor for hours. They lived fairly close, but I had relatively young kids and a full-time job so couldn't be there daily.
I didn't have to force them as the situation eventually forced them. When the fire department started refusing to come out and said they needed to find a different situation, they finally did it.
When someone is so stubborn they are willing to put the life of their loved one (your mother in this case) and their own life in danger, there is nothing you can do. Especially as their child as they always believe they know better because they are your parent.
Social services can help as they can be more direct about the consequences of their decisions. Whatever you do, don't give in and start caring for them. It will be a 24-hour job and become totally dependent on you.

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He is bedridden because he can't walk or feed himself, etc, but he still is thinking straight most of the time. I finally told him I would not manage his bills, pay caregivers, etc, without POA. I told him I will do everything in my power to give them the best life they can have. He finally relented today. What actually convinced him was me telling him what would happen if the county took over and made the decisions about their care. I am piecing together in home care, with me still spending every night and weekend. I am realizing elderly can be in so much denial about their loss of function. I guess it is really hard to let someone else take over your life. Hard time for everyone. I also contacted an elder care attorney to see when they will qualify for Medi-cal to help.

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GenJohnson,

I am happy to hear this. The only way to deal with the stubbornness is to just speak plainly and tell the senior exactly what's going to happen if it continues.
It is hard for people to give up control of their lives and to allow hired help to come and do the things they've always done for themselves.
It's certainly easier on a person when they can stay in their own home and not be put in a care facility. I've done in-home caregiving for almost 25 years. I became like family to clients who were among the most stubborn to accept help in the beginning.
What I found is the best bet for most people in need of round-the-clock care is to hire two caregivers who split the week. Or one who will work weekdays and one on the weekends.
Try looking on care websites. If your parents have day help you can also hire someone for 'Sleep Duty' and it's less expensive than what you'd be paying the regular caregivers.
'Sleep Duty' is a person who comes in to stay after hours. They pretty much are just so the elders aren't alone at night. They don't usually do care. They get up a couple times in the overnight and check on the clients or take them to the bathroom. That's about it.

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This morning, my SO ferried his mom to what he was told a doctor's appointment. It turned out to be a full-on outpatient surgery. Meanwhile, the mom was pressuring him to go home and help DIL as dad was not getting out of bed and mom believed, in her words, that he had "s-t himself."

He looked them in the eye and said you need a bunch more help.

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"He looked them in the eye and said you need a bunch more help".

Yes. Do that.

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What about the other 3 days & nights? They need 24/7 & need to go to facility if you have not supervised the 24/7 hour aides …& who’s going to let them into the house? What happens when they don’t show up? What happens when there’s incontinent #2 accident…& nobody showed up? Do you expect your mother to clean him up all by herself? You’re going to have to go back there..& find a better solution. If your Dad a War Vet, apply for Aid & Attendance. Or maybe caregivers from VA can come to house. Hugs 🤗

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No they cant be left alone at all, it is just not safe. I am working with the VA, submitted application a year ago. I was told it can take a long time!

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Elder attorney to help you , social worker to support you . VNA to come in to check on Mom and Dad . Maybe with some Outside support they can help convince your Parents they need extra help .

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GenJohnson: I just looked at your profile after reading Beatty's post (thank you, Beatty). You state in your profile that your father has Parkinson's, but in your post you state that he "has retained his mental faculties." Hmm...
Edit: He requires twenty-four *hour* care.

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Advanced Parkinson's according to neurologist, but no dementia. Although I am seeing either worsening judgment or just plain stubbornness! Not sure which. Neurologist actually said it could be a "parkinsonism disease," like multi system atrophy, or something similar. Diagnosed very late, at 86 year old.

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Is Dad mentally competent? Really? Bedridden with Parkinson's or it from another reason? PD effects brain too, not just mobilty & speech.

I saw a case similar last year. She was bedridden. He was able, driving, heating meals but with some memory issues until Boom he falls & # hip. Full delerium in hospital, relatives called. They disclose the Mom is at home, left unattended - panic ensues.

Call to Human Services (our APS). Mom taken into emergency NH care. Emergency Guardianship applied for. Dad discharged to rehab. Then either home (if able) or into care also.

Was a sh*tstorm basically. He was confused, she was unable & those adult kids clueless.

But this OP has the brains & strength!

Best of luck (((hugs)))

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GenJohnson: Perhaps your mother never should have been discharged to home via presumably the hospital. It should have been an UJNSAFE discharge. As your father is bedridden, he REALLY requires twenty-four care. Perhaps a social worker in their locale can be contacted.

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She was discharged because I said I would provide 24 hour care, I just didn't realize my dad expected it to be me all the time! He has a real fear of running out of money. It is a slow process of bringing about change, and I tend to try to rush things with him. One thing I realized is that providing full time care for elderly parents takes an emotional toll even more than physical. I had to finally admit I cannot do it all and save them.

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I would speak with an eldercare attorney for advice on what can be done and how. I would report them to adult protective services who will come in and investigate. And you should give them an ultimatum. This nonsense stops now and they either get help and a caretaker and do the right thing or you walk. Let them reap what they sow but you live your life and keep your job. And stick to it. You may have to get guardianship if a POA won't work. You need professional advice.

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Stop arguing with them about it. Tell them in plain language that there will be 24 hour care in their home or you will be making a call to APS.
Explain to them what APS is and that they are at-risk vulnerable adults. If they continue to be stubborn about it, the state will place them both in a nursing home against their will. They will go ahead and do this whether they agree to it or not and there will be nothing you or anyone else will be able to do about it.
Tell your father that care is not going to be free for him or for your mother and that if they want to remain in their home, 24 hour homecare is their only option.
Stubbornness has a way of getting cured when there's a real threat of nursing home placement.

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Sometimes you have to do the tough love thing.

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@GenJohnson. In my state a POA doesn't allow the agent to do much. They can pay bills and do as the LO asks. But, having a POA will not allow the agent to move/place them. Or have caregivers come into the home if they refuse.

Guardianship would need to be obtained. And that's only if they are deemed incompetent by their local court.

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My thoughts:
Your dad is of sound mind, so you can't "force" him to do anything, even though he has physical challenges.

However, your mom sounds like she is not of sound mind, and your dad is not physically able to provide care for her.

What you can do is call Adult Protective Services and have them come to the home and do an independent assessment of the situation. If they find that mom is not receiving adequate care and supervision, and that dad is incapable of providing it, they will likely offer dad two choices. 1) Put mom in a facility or 2) Pay for in home care, since he is not physically capable of providing it.

If, on the contrary, APS deems they are both capable to function and/or make decisions on their own, then go about your life as usual. You should not have to sacrifice your job or your nuclear family because they make bad decisions.

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Clarakate,

If the father is of sound mind his daughter cannot force him to do anything, but APS can and will.
Even if he is considered of sound mind he is a bedridden invalid. That makes him an at-risk vulnerable adult. They can force him into care.
They can put his wife into a care facility as well. She is not of sound mind. Their care needs cannot be met by part-time caregivers a few days a week coming in.
The OP needs to level with the father and tell him plainly that this kind "stubbornness" often results in nursing home placement. This will very likely bring him around and make him receptive to the idea of having 24 hour homecare.

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Your father isn't thinking correctly. IMO, you need to convince him there needs to be a POA because state can come in and take his assets and ruin his life if he or mom gets sick again. Once you or whoever has that poa, then you can proceed to have someone come in or have them placed. This good old boy attitude of having your poor mom tends to his every need while she's not in good health herself is abuse on his part and nearly on you because you are allowing it. Fought away you need to call APA and make a report and be honest worth them about his Sobieski and controlling storied. He needs placing first so your mom can rest. She deserves it and sounds as though she could be open to having help around the place. Good luck and many hugs.

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Yes he finally signed POA today when I laid out to him what will happen if the county gets involved. Since mom's stroke, she cannot remember much, and accuses me of moving/hiding/losing all her stuff (keys, jewelry). I told him he was making decisions for mom's life too, and that was not fair to her. She needs guidance and monitoring.Had to use a little bit of scare tactics, but at least I can arrange and pay for in home care now.

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Negotiate by making a list of their activities of daily living before you discuss it with your father. Give it time to soak in: “well if you don’t want this and this, let’s get at least this for mom” Run the sweeper throw in a bit of laundry. Offer to take over ordering the groceries and have aide pick up the order to get her foot in the door. Or, a male shower aide(?) one time a week. My mom never allowed the personal care when she was at home, but she enjoyed playing cards for 4 hours twice a week. The paid aide would run sweeper, take out trash and do small load & fold while playing cards with my mom.

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'Forcing" is not a good strategy: Greater Force leads to Greater Resistance. Especially since your parents are fortunate enough to have some resources, discuss with your father what kinds of help he is willing to pay for. Yard work? House tepairs? Cleaning? Wellness check-ups? The list might grow lonher if your father feels he is making the choices.

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None of this will be effective. I've worked with more stubborn seniors than I can count with families that were at the end of their ropes trying to reason and plead with them about care. They have to just tell the elder in plain language.
Here's the thing. The father doesn't get to choose what he's willing to pay for. None of us do.
You nor I get to choose what bills we pay either. If I choose to say no on the electric bill, the lights get shut off. Or choose to say no to the gas bill, they turn it off.
Here's what the father can choose to pay for.
Either pay the money for live-in care to stay in your home,
or you pay it to a nursing home.
Those are the choices.

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Call Adult Protective Services and put it into their hands.

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dear OP,

hug!!

sending lots of compassion from me, to you (and your parents).

it’s verrry frustrating/exhausting/angering/worrying, when one clearly sees LOs need help (and possible solutions to make life easier, are X, Y, Z)…but the LOs fight us, every step of the way.

a friend of mine managed to convince her mother to get 24-hour in-home care by saying, “Dear mother, don’t you want me to sleep at night? I lie awake every night worrying about you. I go to work the next day, totally exhausted.”

another friend convinced her mother by getting someone else to convince her of in-home care. (many parents don’t want to listen to their adult children).

——
a side-note on in-home care…if possible, it’s good to check that the hired people are good, honest people (sometimes one can only realize the truth after they’ve worked some time, caring for the LOs).

one needs luck, perseverance, in finding good, caring, trustworthy caregivers.

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What does Mom have to say about Dad's decision? The money is her's too, presuming they are married. Doesn't she get a say in this, especially since she's the one he expects to do everything?

I agree with calling APS for a visit. Someone outside of the family can be more convincing.

You deserve to have a life! Just because Dad assumed you would drop everything to take care of them, doesn't mean you are obligated. That assumption is old-fashioned and not realistic even if he could afford to support 2 households. It doesn't mean you are capable of or willing to doing it.

Best of luck!

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Dont force them sit down with them and ask them , say Dad & Mom I love ya & I don't want nothing bad to happen can we please get someone to come everyday and check on ya bathe ya change ya & doing some cleaning around the house , even laundry .... It's not easy getting help my mom is the same way . I'm a private in home aide I take care a 98 yr old woman I do everything cook, clean , bathe her , n clean her bottom it's not easy I gotten so close to the one I take care of I feel like she my momma but if you sit n try to talk with your parents maybe they will do it but don't force them .

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When I read the initial post,, I don't see a dad who has all of his faculties. At least,, his decision making skills are jaded and pride is likely playing a part. They sound ill prepared and ill equipped. You may have to get conservatorship through the court. I found this week, that there comes a time when one may have to step in and say "This is how we are moving forward. " Period. Asking a person who has lost the ability to reason to think things through about a major life decision is harmful to them, frustrating for us and can create an unnecessary cycle of negativity that could be avoidable.

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Since he is mentally competent, you can not force him to do anything. The hardest and best option is to step back. You need to allow him to see for himself that they need more care. Continue to be firm in your position on what you will do to help them.

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Wait, OP. You say you already arranged care to come in four days a week but have no POA. So did you just pay for it and now you want them to pay for it?

I'd have to honor their decision to elect not to get care if at least one of them were of legally sound mind. Which sounds like the situation presently but may not be relatively soon.

I'd have a talk with them.

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They are scared of having a "stranger" in their home. Hire someone local for a couple hours twice a week on a "trial" basis, and say it's your friend. Once they get used to the company and the help, they will begin to see the value there. Your Dad will appreciate the help. This is the roundabout way to "force" them into it.
My Mom always said," I don't need anyone". I ignored her and hired someone I really liked that I felt was a good fit, and eventually they both fell in love with each other. My mother used to say she's "like a good friend"!

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Not OP but, thank you I am going to try this tactic with my terminally I’ll, disabled, defiant, “I don’t need help” mother. The only problem is that her health status and complete isolation from anyone aside from my father (her full time caregiver who also has a full time corporate job that pays for the health insurance) has forced a lot of people out of her life. I would feel guilty asking anyone to put up with her negativity and opposition. Perhaps a neighbor would be helpful for me. Thank you for this recommendation.

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Good Lord, she was discharged HOME? Did the hospital realize that she was expected to return to being his caregiver?

At the least hint of an emergency, call 911. And yes, call Adult Protective Services and their local Area Agency on Aging tomorrow.

The conversation you need to be having with dad is "If you don't get yourself an eldercare attorney, A POA and the proper in home care for you both, the state of (fill in the blank) will gain guardianship and take ALL of your assets and put you in a home of THEIR choice. You can do this the hard way or the easy way, Dad. Your choice".

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What a dreadful situation for you to be in, my condolences. When stubborn parents refuse in home help, what can you do? Nothing, really, except call APS for a wellness check and let them evaluate what's going on and make the call. It blows my mind that your father would expect his wife who's had a stroke and is confused to be his full time caregiver while he's BEDRIDDEN!! Absolutely ridiculous.

Hopefully APS will pay them a visit asap, see what's going on and determine they need placement, BOTH of them, or at least 24/7 in home care.

Barring such a determination from APS, you'd have to wait for a crisis to happen to one or both parents where they're sent to the ER and then rehab, where rehab refuses to release them back to independent living. That's another way a stubborn elder gets forced into managed care or into getting in-home care against their will. Or they're hospitalized and you let the social worker know they're an 'unsafe discharge' and require placement, at which time the SW would get busy finding them a spot in residential care.

Wishing you the best of luck with a very difficult situation. Sending you a hug and a prayer this all works out.

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I'm afraid this is what it will come to with my own father. His personality is such that he would never ever allow in home care or be placed in AL. No way. It will probably come to him having some sort of accident or a second stroke and ending up in hospital. From there as POA I will have to say he does not have anybody to care for him 24/7 and they will make the call. It's a heart wrenching situation for everybody.

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How do I force my parents to get the in-home care they need?

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