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Refuses outside help for him in the house and I need a break.

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My mom took care of my dad, who had chronic leukemia. She took college classes, whatever they gave on Tuesday mornings. She said it kept her sane. My Dad railed and yelled and fought and she simply went off to school. He died after 15 years with leukemia, and not because she got her Bachelor's degree (summa cm laude). He died because he had a fatal disease.
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11 years ago, before I became involved with caregivers, I would never have said "You must put yourself first." Fast forward to today. It's totally valid for you to need time away. If family can't make it, you MUST call on someone else. There are no two ways about it. He needs more than just your face. He would benefit from someone else too. Is he a veteran? IF so, call the VFW to see if someone could volunteer to spend some time with him. You could offer to pay them. How about adult daycare? Anything to get some much needed time to yourself. Even if you sit in a park and feed the birds. You can do this.
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Ba8alou is right. You're driving the bus. Although most of us try very hard to please our loved one, if we don't put ourselves first? We're going to burn out. I think too often we all forget that dealing with dementia and Alzheimer's Disease is a whole lot like dealing with children. We can only expect them to cooperate so much Eventually, we must become leaders and make decisions in their (and our) best interests.

Decisions about when and how to utilize care givers falls under your purview. Without adequate respite, you're no good to him and no good to yourself. We MUST have breaks. We MUST have lives!

You're the boss, Applesauce. ;)
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I'm so sorry that you're dealing with this impossible-feeling situation, but when in comes down to it, it's not his choice. It's YOUR choice. Look, you can kill yourself being a caregiver (my aunt died of a heart attack caring for my uncle; he lived happily in Memory Care for several more years--she had actually signed him in to the AL before she died, but the damage was done; years of battling him physically--he was a "wanderer" and he would physically hit her to get the keys) or you can take the position that you are the caregiver, you know what's best and you're driving the bus. You can give a choice (would you like Daisy Mae to come on Tuesday or Thursday this week, dear), but you MUST GET RESPITE for yourself. If he is truly impossible to please, then I think that you need to start thinking about a higher level of care. I'm truly sorry that you are dealing with this awful disease.
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