My parents need care but will not accept help. What should I do?

As I talk to friends often the biggest frustration is that we can see the train coming but the elderly refuse to make the proactive decisions to avoid the collision. Having a nurse for a daughter doesn't change that situation. In fact it may make it harder because we know that this is going to end badly. It sounds like it will take a sentinel event to spur action. Unfortunately that will be a fall or a car accident, possibly someeone getting "lost". What you should definitely do is contact DMV and report the need for a driving eval. That I believe you are ethically bound to do because of the potential harm to someone else. In the meantime I would call eveyday. Ask neighbors or church support to watch without letting your parents know you asked or that they are being "watched". You cannot legally force your parents to make good decisions, any more than we can force our almost adult kids. Sometimes those we love make poor decisions, dangerous decisions and then we have to decide how we pick up the pieces. It makes me a little crazy. Be careful, the journey you are beginning as caregiver is a difficult one.

With a few exceptions, I have never had much luck with expecting government agencies to do much of anything. They mostly get in the way, under-react, or overreact. So, like everything else, you will have to find solutions on your own.
I am afraid that tough love is called for here. First, have your parents given you their POAs?...if not, you should do that while you are there. Your father is of sound mind, so speak to him about it immediately. Next, you need to arrange for some in-home care so you can go back home and arrange for more permanent solutions. Get someone to come in at least once a day to both help and monitor their safety and health. They can call you if they find anything alarming.
The house needs to be sold...it is too big, too dangerous, and too much work for them. The assets can be used for their care.
If your mother resists, call in a trusted friend, clergy member, doctor, etc. who can act as a "buffer" as you explain to her why she needs to make this change. Give her limited options that will work for you. (ie: "mother, we either need to do this or that...choose one.")
The sad result of waiting too long is that they will either injure themselves, burn down the house, or neglect themselves until adult services finally comes in and declares them incompetent. That would be the worse scenario!
The one true fact of life is that we can't always get what we want, nor is it always safe to get what we want.
Good luck...let us know how things worked out.

Start going with them to their doctors and keep hammering home your concerns. I suggest that you get your dad's doctor in on the situation. You may want to slip the doctors a note giving them a better picture of what is actually happening. Many elders show one face to the doctor and another one elsewhere. If she is not able to adequately care for your dad, his doctor can order an assessment via medicare of the home situation, to "monitor his blood pressure." Talk to your mother and tell her, in many gentle ways and words, that unless she/they accept some care outside agencies will take control. Then contact a home care agency and arrange for someone to come in and bathe him once or twice a week. That person just comes for a brief time, and does one set of things (stuff for your dad) so this will not be as threatening. After they get used to the person comingin, talk to them about someone coming in and doing something else, also small. This is trying a gradual approach to get them used to having people do thigs for them. We, the cregivers, tend to want to swoop in and fix all things. Think baby steps.

Good luck

ssmiles, In 2005 while visiting my Mother and her husband, I opened the refrigerator and found all sorts of things I had bought the month before in various stages of mold. There was dog hair on the grill of the refrigerator and the dog had been gone for over 5 years. The housecleaning service was charging them a fortune for emptying the trash cans and wet mopping the tile. Mother was arguing with Onstar every time she got in the car. I refused to drive with her husband at night, and would not let my daughter, then a teenager, go with him either. Everything was a fight and the visits became ruined because they would not face reality. I contacted my sister--oh well. I contacted the husband's three adult children--they were afraid of him. HA!
Guess who had to organize the "intervention" and call Home Instead?
Who had to hire an attorney to protect my Mother from the step-kids after he died? Who found her a care home, manages her trust, and who had to finally bring her into our house?
You just have to take charge and as nice as you are, still might not be liked. Well, I can remember restricting my children when they were small, not letting them do certain things. It's called role reversal. You have heard about it, now it's here.
All the Best to YOU, and good to see you interacting and giving us feedback!
Great advice from my favorites friends, too:)) Hugs, Christina

" they dont have the nerve to tell them (including me) that is is not safe." Does the doctor know the realities of their life at home? Can you get a social worker to come out and do an evaluation? I believe you will have to get the nerve to tell them it is not safe. What does your husband think you should do? I assume you have explained to your mother what could happen if she does not take her meds. Your mother does not sound competent and just might need someone to file for guardianship but that would break your dad's heart. I think the reason she has not kicked you and your husband out is part of her emotional blackmail game. Sort of a "I hate you, but don't leave me" routine. How long have their personalities been so radically different? Your dad probably yells out of self defense and aggravation over his wife acting like she does. Have you talked with the pastor of her church? I don't think that legally you can really do anything, and quitting your job does not sound like a good idea. I had to wait until something really bad took place for my mother to give me POA both durable and medical before I could really get her the help she needed. Her stubbornness meant assisted living would not work and she ended up in the nursing home. My step-dad should be in a nursing home, but my step-brother will not take any action because his dad loves his beer. Good luck. Their are not easy answers in this situation. However, I would speak the truth in love that their situation is not safe.

Thank you for your response, I think you are the first person that actually seems to "get" my situation. Yes my husband and I are on the same page. Their doctor is aware of my concerns but does nothing. I have talked to my father many times and he just says don't worry about us, we will get by and whatever happens, happens. Well I dont think I can live with that, what if I leave and 2 weeks later something really bad happens, how will i live with myself. I have talked with the pastor and many people at the church and with many of their long time friends and everyone basically says well good luck in a nice way, feel like they all understand but are at a loss too. I sometimes think the best solution would be to contact the DMV and report my mother for unsafe driving and call APS to report the situation but part of me feels like that is underhanded and disrespectful but I know that there has to be something done and I can't hold my job off much longer. Whew, thanks for listening, but I feel like you cmgnum do understand and I thank you for that. I guess until you go thru something like this you can't really get it, ya know. Thanks again!!

Thank you all for your support. I do agree I will be calling/writing the DMV because if something happened to someone else, how could I live with that. Maybe your right it may be harder being a nurse because I am trained to watch out for the bad stuff. Again, I want to thank everyone for your support, it is so great to have someone who understands my situation and can bounce ideas off of. If you dont have this problem it is difficult to understand all the dynamics of the choices, etc. Thanks and all suggestions appreciated!!

We're in a similiar situation with my mother. Dad passed 7 years ago. I live the farthest away (7 hour drive) and my closest sibling is battling a brain disorder, recently had surgery and lives almost 3 hours away. I do have POA, for what it's worth at this point.
Mom had been doing fine until early in 2010 when she developed a heart problem. Now she is often confused, having difficulty making financial decisions, cannot even begin to balance her checkbook. She is very lonely and hallucinates my Dad and her parents are there with her (sundowners syndrome, we think). I've spoken to her doctor and been to appointments with her. At the most recent visit he did a Mini Cognitive test (at 10:30 am) and reports he sees some mental issues and cognitive weaknesses. It took a week of calls to finally convince his staff call Mom to have her go back to see the doctor. She refused to go.
My other brother lives closer to me than to Mom, has a job which requires a lot of travel and has his own health issues, too. But between the two of us, we try to address Mom's issues. We a met with an in home care representative a few months ago. Mom's reaction -"I'm not ready for that yet".
I could go on and on, but you get the point. We are not alone in this situation and the sad part is that we cannot easily convince our aging parents to accept our good intentions.
Last night, my husband and I argued about Mom for the first time. It will be the last time I can allow that to happen.I have been upset about this for nearly 2 years now and the situation is getting worse not only for Mom, but for the rest of us. I think we have to take better care of ourselves.
I believe I must step back a little and monitor things with binoculars instead of a magnifying glass. I hate the idea that something bad may happen, but legally, I can't prevent it yet.
Like your Mom, our Mom is argumentative and somewhat of a bully with me, in particular. I am sad to say, I'm accustomed to that. I had an aha moment this morning. Though I want Mom to be safe and would love to help improve the quality of her life, if she doesn't want it I can't force it....yet. So I'm giving myself permission to relax a little. The time will come when she doesn't have a choice and I will know what to do.
So, let's take care of ourselves as we wade our way through this most difficult time in our lives. I will try to remind myself that I still have a life and my own family who want me to have a good quality of life, not this hole of dispair I have fallen into. I hope you can find peace, too.

Ssmiles63.... Try a method that works for me with my Mom. If she say's for Example: you stole my clothes, I just respond with "Oh I thought they were my clothes, I am sorry!" She's RIGHT NO MATTER WHAT! Then I change the subject to a happier time that she recalls from the past. She has good memories of her father so I'll ask her about his work or garden how he liked building bird houses anything that triggers a happy thought!!! Try to stay away from reality and your own frustations(not say you can't have them) if you send out peaceful happy vibes she'll most likely react back in same manor, believe me I know how hard it is to change a mood, but if you must go in another room, out of her sight and scream in a pillow...GO FOR IT, by all means. She knows you and what your made of because ~she IS your Mother~ and that no matter what drama she dishes out, you'll take it and still be there for her she knows this, if she didn't trust that in you, she'd be sweet and on best behavior, they never tourture the ones that run away. Your body language and facial expressions are clues to your mood she may not understand or remember everything but she is probably sensative to emotions. Praise her about anything you can think of.... call her sweet, cute, smart, beautiful. When I took my Mom in the car I would act like I was lost and say which way do I go? even if she was wrong, I'd say "Oh your so smart!" Overall it's all in the way YOU think about it.
I got a cute story... a man at the NH sitting at Mom's table was about to eat his desert (best part of the day for him probably)
jokeing,in a silly manner, I said "if you don't want that I got my eyes on it" He said back to me "I'm not sacrificing this for anything" I started that conversation because I knew that desert was his focus at the time and wanted to get him to react, and make him feel he was in charge of his desert. I said "I was kidding I don't want it." He got the joke and Mom said to me "he's a nice man!" Actually my Mother stays far away from the unhappy people and anyone who bothers her or might put her in a bad mood. She also tells me who is "cool" and who "pisses her off". She remembers personalities, but has no idea she's living in a NH or what year,day,month,season it is. It took me a while to figure this out, but, communication goes way deeper than words. The strangest thing is, I know when my Mom is in some type of distress, I get a strong uneasy feeling and I check up on her and 9 out of 10 something is bothering her. I can't explain that but it's like she calls me telepathically. Keep the Faith & go with your gut instinct and stay strong!!!!

Texasdaughter, HIPPA laws prevent the doctor from talking to you about your parents, but you are free to speak to whomever you want! Call or write a letter explaining that you know he or she can't violate privacy laws, but you want to share your observations. Outline what you have seen. Say you are very worried about your father still driving.

I am very sorry, but this sounds like one of those situations where it may take a crisis before anything will change. Continue working with the pastor.