He currently lives in senior housing apartment (no assistance is given here), it's just an income-based apartment. My sister is his primary care giver as she does not work due to her own health issues. I have recently moved out of state since my husband retired. My Dad can walk with assistance of walker and can't stand for long without it. He needs help with bathing, grooming and cooking. We were told he doesn't qualify for home health care because he has what is called, share of cost which would be $1200 a month out of pocket. This is due to the amount of money he receives from his social security and his living expenses being low due to his housing. I feel so bad for my sister because she is TOTALLY burned out. My sister has become cook, maid, errand runner, you all know, the whole gamut. My dad can be very strong headed and opinionated and stresses her all the way out. She gives him explicit instructions as to what to do or not do and he says yes to her and the minute she walks out the door he just does whatever he wants to do. It has become too overwhelming for her as she goes by every day because she is constantly worried about him hurting himself and becoming depressed due to loneliness. She says she tried talking to him about how tired she is and maybe we should see about him moving to a facility where he can be helped more and he yells, "you are just trying to put me in one of those places." We don't "want" to put him in a facility, but my sister is at a breaking point. I currently looking for an assisted living facility as he would be somewhat monitored. He for sure will forget to take his meds and may only feed himself once a day if not reminded to. I would have taken him with me, but I still work and feel it would be unfair to ask my husband to care for him while I am at work, especially since his toileting habits and have declined and that's a lot to ask someone to do for another person. So now my sister and I are both feeling so guilty, but don't know what to do as he refuses to go. He says he can take care of himself, not willing to accept that he can't anymore, or rather he needs help. When the doctor talks to him and ask if he is willing to go to assisted living or skilled nursing facility my Dad says no and the doctor says he can't make him go since he still has most of his senses and can speak for himself. We are just at a complete and utter loss as to what to do since he can't be forced to go. We do have POA for his medical and financial, but are unsure if that gives us any control over being able to place him somewhere. Any advice would help.
There are time like this where "therapeutic fibs" can help, and are ok to use. Your sister can make up some excuse for not coming to her Dad's to help, I know it won't be easy.
For me, I use an arm sling which worked wonders. I actually had broken my arm, but I was surprised how that visual worked so well. I couldn't drive as it was my right arm, can't drive if I can't turn on the engine and not be able to put the vehicle into gear. That's also the time I started with on-line groceries, and that was a godsend for me.
I tried to get Mom a cleaning service but she felt insulted that I would think her house wasn't clean enough... oh boy. Do you think your Dad would accept a cleaning service [he would need to pay]? That would free up your sister a bit.
Truth #1:
Dad lives in a senior apartment, alone.
Truth #2: Dad needs much help for all/most ADLs.
Truth #3: Dad is dependant.
Dad cannot reason/understand/accept that he is dependant. He is being stubborn, in denial or has true lack of insight. Whatever the reason - the fact remains: he is now DEPENDANT.
Lie #1: He lives alone therefore he is still independent.
Lie #2 Having family help doesn't count as real help so he is still independant.
These are lies that many elders tell themselves.
As a dependant person, Dad may choose his help from the available choices. These usually come down A. Age in place (with family & non-family assistance) or B move into residential care eg AL.
Option 'Enslave Relatives' goes OFF THE LIST.
So... Is it possible to have a really good chat with your Sister?
Find our how she is, what her thoughts & feelings are.
Would she want to continue if paid aides took over the bulk? Is she sad, angry, done?
Dad appears to be holding your Sister Hostage but she DOES have choices.
Eg if your Sister came to stay with you for a week.. Dad (as a dependent person) must either hire an aide or move into respite accom. Sister could spell this out in front of his Doctor. That she will be out of town & Dad is refusing care. Boom. Still competent?? While the Doc is technically correct that no-one can't force Dad to go to AL - no-one has the right to enslave your Sister! She has the right to QUIT. This is exactly how I got my LO into respite care.
PS. The 'I'll manage" of "I'll be fine" is often used as a blacket cover up answer. Try asking specific questions & see what his processing & planning skills are like. (I got "Don't know" to what would you do if you can't get out of bed alone, if EMS can't get in, if the toaster caught fire).
You and sister need to know that you are NOT ‘guilty’ of anything. You may feel Grief that old age makes so many things so difficult, but that is not ‘Guilt’. You may feel ‘Fear’ that it will all turn out badly, and you may feel ‘Obligation’ to care for Dad the way he wants, even though it’s unreasonable. Look up FOG on Google – fear, obligation and guilt – and understand what and why you are feeling.
You are a new poster, and may not be aware that FOG is one of the biggest issues, particularly for people with ‘old country’ values. Find out more by clicking on Care Topics at the top of the screen, then on the alphabet letter for anything you want to check out. Best wishes, Margaret
Once she stops enabling him, he may still refuse to see the light. Then you have to wait for a crisis to happen; for dad to fall or have another accident happen, be rushed off to the ER and then THEY refuse to release him back to independent living. That's when his power of choice is taken away from him and he has to go into Assisted Living. You may want to tell him that, too.........you make a good decision NOW dad, or one is made FOR you down the line.
Neuropathy alone will cause dad to fall; I know. Both of my parents suffered from it in their feet & legs. Dad refused to use his walker and fell one night when he & mom lived in Independent Living. Guess what happened? He broke his hip and went to the hospital to have it repaired, then off to rehab where he made no progress. So rehab refused to release him back to IL even with mom helping him, so I had to scramble to get them into Assisted Living right away (with mom kvetching the entire time!) What these elders do is fail to take US into consideration and wind up leaving us with a nightmare on our hands! Every. Single. Time.
Your sister has to tell dad, point blank, I'm sorry but I can't do this anymore dad. I love you but it's too much for ME to bear and it's ruining my health and my state of mind. I'll be happy to help you move into AL, otherwise, I resign my post. See what happens from there on out.
There isn't always an easy or cut & dried answer to an elder with stubborn ideas in his head. Sometimes it takes a crisis to wake them up to reality. I hope your sister doesn't wind up in the hospital as a result of not being able to put her foot down about all of this. There IS an answer, your father just doesn't want to hear it.
GOOD LUCK!
Usually one has to wait for a medical emergency.... 911 is called.... parent stays in the hospital.... parent gets transferred to rehab.... and now two things can happen:
1) Parent comes home, or.....
2) You refuse to bring parent home, and the rehab will find a bed in a nursing home facility. You can use what is called "therapeutic fibs" by telling Dad that where he is now is an extension of the rehab. Telling him he needs to stay until the doctor says it is ok for him to leave. That there is a major plumbing issue at his apartment, etc.
Dad will either pay out-of-pocket for his stay, or he can start the paperwork to qualify for Medicaid [which is different from Medicare] to which Medicaid will pay for his stay.
How old is he? Has he had any memory testing? Is his short term memory bad? I would get him tested and probably push for neuro involvement cuz the first level memory test they typically give leaves much to be desired. It doesn't delve into things that my mom was having issues with but the test didn't pick it up. Like trouble planning things. Trouble making decisions, etc.
You and/or your sister should write down all the things he does, says, etc. that support that there is some decline so the doctor will know what is really going on. This info needs to be sent to the doc in advance of the evaluation appointment.
Does dad have any extra money or it all goes to his bills and the remainder to rent? Does he have literally nothing except his social security check? If there is any money, use it to hire a housecleaner or an aide. Your sister needs to look at the things she is doing and see what she can offload. Meals? Get meals on wheels. He may not like it but too bad. Meds? Have them delivered. Shopping? Use amazon, etc. and cut down on that. She needs to cut corners while you figure this out.
Does his POA have to be activated by a doctor saying that he is incompetent? Once it's activated, you would be able to place him but not before. If he is competent, sister can cut back on the high level of assistance she is providing and see what happens.
If any events of note happen, like a fall, have him transported to hospital for an eval and from there you should be able to get him placed in the appropriate setting for his needs.
Best of luck.
And if your sister doesn't start taking care of herself, she will be in the statistics where the caregiver dies before the one they're caring for. I'm sure neither you or your father wants that right?
Is your father open to hiring some in home help to give your sister a break(with his money not yours or your sisters) whether he qualifies for any help with it or not? Having someone else come in 4-5 days a week, would allow her time for herself and for her to have somewhat of a life. It may just have to come down to giving him an ultimatum, he either hires in home help or he's on his own to figure things out.
Often children are left with no other option but to wait until something bad happens again with their parent before any necessary actions can be taken. It's sad but true.
So the next time your father ends up in the hospital for any reason, you let the social worker know that he is unsafe at home and cannot return there. And don't let them talk you into taking him home for any reason, as it's their job to find the appropriate facility to place him in.
And as long as his mind(for the most part)your POA's don't carry much weight right now. But don't worry more than likely it will be sooner than later that they will come in handy.