How can I deal with a dysfunctional family?

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I am the main care taker for my 77 year-old father-in-law. He has severe copd/emphysema and is an alcoholic. My husband and I moved in with him last year to care for him. During this time, we have had many horrible situations involving my husband's sisters, who were both living with their father.
During this trying time, the drinking has continued. My father-in-law is a very difficult man. Constantly, my husband and I are batteling with him. To even get him to change his clothes every week, takes three days. Before, he would leave on smelly, urine stained pants for weeks.
I have begun to notice a major decline in his thinking. He can barely walk, without holding on to furniture or a wall. He shuffles. He has tremors and shakes and his face turns bright red. He eats very little and has lost a lot of weight. The smell of urine and alcohol is so overpowering that I cannot even stay in the same room with him any longer.
I have talked to my husband about this, until I am ready to scream. I have talked to his sister. No one wants to do anything about this. I have suggested calling his doctor ( s ), getting an aid in to help with bathing and grooming, looking into the future,as far as a rest home or assisted living. I know he will probably get to the point of complete dependance, and I have made it very clear that I am unable to provide that type of care ( adult diapers, bathing, etc., ).
I am at a loss. I have thought about calling social services to look into this.
Any suggestions would be welcomed. I am trying to prepare for a bad situation getting worse. Thanks
P.S.
Getting him to quit drinking is impossible at this point. Even though I do not care for the man, I would like to make his days comfortable. He will not agree for Hospice.

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I had the same thought, krnhersh. I don't think that drying out would help the FIL a lot. The main problem comes if he needs to go into a LTC facility. Many or most would probably not accept an active alcoholic. I don't know much about that. My brother died young before he needed LTC. His heart just gave out on him.
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i wonder if it is even realistic to think that he will or that anyone should or could stop him from drinking-
if he has done this most of his life-
if his body is has already been damaged by his addiction,
if he is already in his older years,
other than managing how much he drinks a day-
what is expected to happen if he can be detoxed?
i wonder how much "better or easier" life would be for him and for u..

of course if is a problem,big time,and it damages body and soul,relationships and
quality of life- but i cant help but think ,the detox and the disease ,will take its toll-
i know it must be so frustrating-i have had experience with people with addictions,
and its just so complex-
could he be medicated ..but towhat extent? overmedication seems to be a given
when dealing with elderly- and that also is very destructive.
my thoughts and prayers are with you-
maybe it just comes down to what is best for who?
this is just another way to look at it-
something i tend to do-
keep posting-
hugs to u-
k
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DG:

My instinct would be to run for cover, but the man needs a major intervention. As Jeanne suggested, talk to his [primary] doctor. See if they Rx something for the tx of alcoholism, like Naltrexone. It'll help him drink a lot less, and relieve symptoms of COPD/emphysema w/o having to check into detox/rehab. If you treat the addiction first, everything else should fall into place.

Still, I'd like that cottage in the woods. No trolls under the bridge, no foul smells. ... A place where you can dare to take a deep breath and not vomit.

Dare to dream.
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BTW, if your FIL is a hardcore alcoholic, I do not think many NHs would be able to deal with it. They do not have that type of medical staff. My brother was hardcore. He would drink a half bottle of whiskey when he woke up "just to get right." The cells in the brain and other organs of people that drink that way have become adapted to working with ethanol around them. Sudden withdrawal of ethanol can send them into DTs and death. Most NHs are not equipped to deal with it. Withdrawal should be done in the hospital, since I don't think many LTC facilities would allow excessive drinking.
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dgrey, my brother was an alcoholic, so I know a lot of what you are looking at. From what you write, your FIL is nearing the end of his road. I'm sorry that others are being pulled into it, because it is a very destructive place to be. For a true alcoholic, the drink takes precedence over everything else in life. Your FIL, unless legally forced, may not consent to any placement where he does not have access to his alcohol. It limits what you can do without actually having him committed.

People who are in poor condition have little concern for their personal hygeine, so others have to be concerned for them. I know this because of my father. He would never take a shower if he wasn't pushed into it. He would wear the same clothes forever, even if something was spilled on them. In his youth, his was the cleanest person, but when he grew weak and unbalanced, his hygiene was one of the first things to go.

There are people to help with baths. I've looked into services for my father. In Alabama Medicare will not pay for personal services, such as bathing. The social worker told me I may be able to find someone to come in for $30-40 each time. I am hoping to find a strong male aide, so my father will not be so worried about falling.

There are also bed baths, but from what you described, it seems like a shower would be better. Does your FIL's house have a walk-in shower that will make it easier for him?

Hospice sounds wonderful, but I imagine your FIL likes to keep himself isolated. People with addictions often do. The only advice I can offer is to work with the family on a plan, then take it a day at a time. Don't give you FIL the option of baths. Make him take one. His private parts and bottom will become raw if not kept clean. I know he does not want infections.

dgrey, I am sorry for what you are going through. There is the other side, though, and I'm sure you'll make it through. You sound like one tough lady.
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I am from a very dysfunctional family and the issue of dealing with parents has been touchy. Of my three siblings, I am the only one that is not a heavy drinker or an alcoholic. My father's extended illness was a nightmare for all of us, but my husband, son, and I ended up doing most of the actual "work" that others avoided because they found the smelly and messy part of a bedridden father too uncomfortable.They loved to criticize and did so with great frequency.
With the help of a therapist, I have finally decided that I cannot control what will happen with my mother. I take it day by day and do what I can. I no longer feel that I can stop the drinking, including my mother's. I walk away when the stress becomes too much, and I plan to be there for Mom if she ever needs someone to do the "messy and smelly" stuff. However, I now realize I do not have to be a part of the dysfunctional group unless I want to be. We cannot alter the choices of siblings, but we can try to find the best care for our parents. Just remember, that does NOT always mean they need to live with us. We may need to have the role of a guardian angel and make certain their care is good.Best wishes. Rebecca
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my parents both drank, but i was fortunate, since i was rescued & became a ward of the state. i'm not sure how they coped, but i know mom died in a manor retirement place. i dodged ever having 2 ever deal w/ them again after surviving severe childhood abuse. i'd never want 2 provide bathing/diapers either. i'd never want 2 do all the risky lifting some elders need. i can do light work, but not all the heavy stuff. a familyless friend is aging, & there's no way he'll accept help, & i'm stuck. i'm glad he's a non-drinker, & a former smoker. he still hacks up that ugly mucus from his chest, but he won't eat right, & doesn't drink enough water. he eats mainly greasy fried chicken tv dinners, & thinks anything he won't eat is junk. what a hopeless situation this is!!! it's a no-win situation; an endless cycle. all i can do is stand silently by & watch him slowly die. as bad as i want 2 save him from his own fate, i can lead a horse 2 water, but can't make him drink.
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I would follow up on the hospice idea. He must be terminal in some way if you bring up hospice as a rejected possibility. You may get all kinds of help if he's terminal. It depends on which hospice you use. Medicare loves hospice since they don't have to pay for expensive treatments.
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I understand your situation, and what you are feeling is not wrong or bad. Your father-in-law needs medical help, and perhaps your husband will be open to the suggestion that a doctor may be able to help him with the incontinence issues through medication. I have found that approaching things as a medical issue instead of a personal issue seems to make my siblings less angry and defensive even though I am impacted personally. Take a written list of the issues to your father-in-law's doctor, and include the ones you are sharing with us. If he decides that a different type of care is needed then you are not the "bad" one suggesting it. If you cannot use the doctor suggestion, than go to YOUR doctor and ask him for help with social services. Your health will be impacted soon if something does not change. Because we are not living in your situation, our suggestions may not work. If that is the case, please write us and tell us so we can help. Take care and don't forget we are here for you. Rebecca
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It sounds to me as though your FIL is beyond assisted living. I would start now as suggested by others to place him in a long term nursing home. Put his name on a wait list for the facility you want him in. Check with social services since, I am assuming the state will pay. If he owns a home, the home will probably have to to be sold to pay back the state unless he has a trust set up with an attorney. Does anyone have Power of Attorney regarding his assets/health? If not, and he can not pay out of pocket for long term care, then the state (social services) should cover it. I do not believe social services will cover in home care at least not for long term. I would tell your husband that insist on help, if he won't get on board, then hire some one to come in and help you and present him with the bill. That should wake him up and stick to your guns on it. I had to stick to my guns on other issues with my husband to wake him up, and when he realized I was not going to back down he came on board. If your FIL's other children are not willing to help with the duties required to care for their father or not willing to help with the financial obligations for his care, as in home care, then make it clear to your FIL and his children that you will not do it and can not do it without help and he will have to be placed in a long term care home at the expense of the state. Also, start looking for another place to live. Do you work? If not, you may need to get a job to help support yourself and to further state your position with your husband. I don't want to sound harsh, but sometimes we need to stand up for ourselves when others are so willing to take advantage of our kindness. God Bless you and I wish you success!!
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