My Father is 93 with mild cognitive decline. He is independent for his age but is a difficult personality.
He has lived with us for 16yrs and has had many medical issues. I am a retired RN and have always felt responsible for being his advocate and caregiver.
Dont feel bad.
Words truly do matter, so use the right ones. I also lived my life as a nurse, and I know that you are well aware of human limitations. I know that most of us who enter nursing do it because we ARE caregivers.
When I decided to start on my career as a Nurse I already had two young children. I remember my Mom saying "Good. That's a great way to handle your caregiver tendencies. Maybe now you won't ALWAYS pick the sickest kitten in the litter". She was right about that. At the time, whether choosing husbands or cats I chose the sickest in the litter. It WAS indeed good to put all of that into nursing and I loved the career.
It's a whole different thing when we are caring for parents and I still remember being on my knees working with my Mom's catheter, talking to her and hearing her snap off "Don't talk to me like a nurse!". Hee hee.
I kind of have a clue what you are going through. Just be certain to use the right words. We both know that much of this can't be "fixed" in terms of changed. There are hard times in life and this this is one of the hardest. I wish you luck and my heart goes out to you.
Caregiving challenges people at many levels and in many ways. To the best of my knowledge, schools don't have a caregiving curriculum; I don't know about colleges, although community colleges may have such courses in a nursing curriculum.
Still, every person to be cared for is different, and has different needs, as is every caregiver.
Alva makes good points about guilt. Turn the issue around, and compliment yourself for the years of support you've provided, and recognize the courage, stamina and determination that required. Listing everything you've done helps you put in perspective how broad a field caregiving can be. And you certainly should be complimented for your longevity and dedication.
I think you might need a break just about now. One of the aspects I've always admired about nurses is the high need for multi-tasking, back and forth to different patients. Consider yourself from that angle; list what you've done for your father, the physical, emotional and other skills required, and how you managed those skills over the years. Build up your self esteem; you certain deserve it.
And take time for yourself. What do you do for recreation? How often? Do you take time out daily for yourself? If not, think not how can you, but when should you. Everyone needs a break.
Think what "escape" activities you've done, or haven't done, and begin adding them. I find reading to be a wonderful source of diversion. Thumbing through magazines is also inspirational and recharges me, especially gardening magazines, which I read with a pad and pencil so I can jot down plans, some of which I'll probably never create (b/c of time). But just thinking about blooming and food producing plants is an excellent diversion.
And kudos to you -- you've done yeoman's work in caring for him.
Maybe do a little research before talking to him and then present him with 2 options that will work FOR YOU mostly, and then him. You should try to anticipate any roadblocks he would put up to your options. Visit facilities and take your own video to show him (so he can't refuse to go see them). Download their Activities calendar, tour the grounds, show him ratings and comments of the quality of care. Prove that he can afford it and/or that Medicaid will cover when he can no longer. And then give him lots and lots of reassurances: that you'll help him every step of the way, you'll handle any complicated stuff, you'll be advocating for him, etc. Assuming he is just a difficult personality from way back, and not just recently (as in beginnings of dementia). You'll know how much he is able to comprehend.
I don't know many elders who were ever "excited" or happy about the prospect of facility care...and your dad sounds like he may need LTC. You will grieve this but please do not feel guilty. This is "just" life, and it is all the more painful when it's our own close family. Work on having peace in your heart. No one gets to live forever, and your dad has had a loving family giving him TLC for 16 years. That's a lot more than most elders get. Keep this thought front and center so that you can beat back the guilt when it tries to creep in. We children can only do so much. Blessings to you!
You ask 'how do I handle this?' so I'm not sure what that means? Hire in home caregivers through an agency, or look into Assisted Living, those are your options as far as I see it. I can tell you from first hand experience that both of my parents lived in Assisted Living and liked it a lot; it's like a hotel for seniors, in reality, vs. the Little Shop of Horrors some like to make it OUT to be. The reality is the polar opposite. Go check some ALFs out for yourself and you'll see what I mean. Avoid Brookdale, that's my only advice; the corporate owned mega-facilities tend to focus only on $$$ vs. the privately owned places (if you can find one) are more resident-focused, I have found. The activities are fun for the elders, and men tend to join the card games and other groups designed for them. You will get a sense for which places feel right to YOU when you go tour; ask the residents how THEY like living there, that's your best bet. Most residents have some dementia going on too, so no worries there.
Put your guilt aside and realize that 16 years is ENOUGH already! Give dad some autonomy now and when you go visit him, you can go back to being a daughter again (and advocate) instead of a full time caregiver and nag! LOL
Best of luck!