My father needs nursing care and is wheelchair bound, but he refuses to move to a nursing home. What should I do?


My Father is at Vietnam Vet and VA patient with many issues. His ability to take care of himself has rapidly depleted over the last year and now needs nursing care, soon it will be 24hr care. And he WILL NOT move. He is being paronid that I will place him in a home, but at the same time I can't neglect him like he wants me to. He doesn't take his meds at the time and lives on the third floor of a house. He refuses to move to even the first floor. Doctors for the past year have been telling me to put him in a home. However he is of sound mind and therefore I will not make a decision for him. However his doctors are about to pink slip him because of his inactions on so many levels. What do I do? I am so torn. I want to take care of him but he won't let me. I got a call this morning from his doctor telling me how paronid he is and I don't know what to do. Help

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Jane, I don't have any practical advice for you---sorry. But others here have more concrete advice for you. I just wanted to tell you that I feel for you. My father can also get combative, and it does present an obstacle for me to do what I need to , to take care of him. Like you said, you want to take care of him, but he won't let you. I can relate to that. It sounds like the potential for him to become violent is what is tying your hands in this. It can be very frightening. I guess if I were you, I'd try to find help from whomever I could---starting with the doctor. You could have a serious sit-down talk with your father's doctor. You could also talk to your own doctor. And you mentioned the VA---The VA can be a powerful aid for you because of your father's emotional connection with it. As I said, I wish I could give you more concrete tips here, but just know that I have a feeling I know how hard you are trying to "fix" this, and I'm pulling for you.
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ail2001 My Dad is getting VA services at home; home health aid and a visiting nurse 24 hrs a week the max that is allowed. The aid goes food shopping for him, cleans and cooks meals for him. The nurse only fills his meds and makes sure he baths twice a week. What he is paranoid about is going to a long term care facility and not living at "home". He is a very independent man that has been forced by medical issues to be dependant on others even though he wants his independence. Tough love does not work on him as he will get violent. It is a care "game" of which eggshells to step on and hope they don't break.

edvieair- My Dad is still fighting the war in his head. And you are not the first or the last that will tell me he is in self destruct mode. And you are right he hears certain words like "action plan", "nursing homes", "day care", "long term care", "wheelchair bound" and he just comes out fighting and the sad thing is ultimately the only one he is going to physically hurt is himself. But it takes a huge emotional toll on him and me. Two years ago I had to convince him to keep on with Chemo so he could see his grand kids grow up. As for the self preservation I wish he had more of it. More of a will to live life to the fullest, like what is out there for him. What other types of services are there that would let him live a fuller life? I can't imagine sitting in a wheelchair for most of the day is enjoyable when you mind thinks you can still walk down the street and go fishing, driving, shopping at the local hardware store, woodworking, ect. My Dad and I are very much alike we are both go getters. The funny thing is he says I'm stubborn and I always tell him I learned from the best! But I just haven't found that spark to light the way so he will see what is on the other side. VA has a lot of services that he would love. The open door policy is something that he would love, where in the private nursing homes it is a lock down facility. I tried straight talking to him this morning but only a little bit because that is what he can handle. I know for a fact that he can handle a whole conversation of a long term care action plan.
If everything goes right he might be going to a short term care (30days) to fix his medication problem.
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He sounds withdrawn and on self-destruct mode. In Vietnam, no one knew for certain who the enemy was. Being scared to death for so long, even a year, turned many young men into complete basket cases for the rest of their lives, but your Dad was one of the lucky ones. Still, I'd get paranoid too if I were told I'm going to be sent into yet another battlefield -- a NH. I'd dig my claws and entrench myself to keep from being removed from the only place where I feel relatively safe.

He seems to have given up hope, and his current behavior can be described as slow suicide. But the fact that he's taking his meds, albeit not on time, indicates the flame of self-preservation is still alive. At least this is a fight he can win. Getting him to want to live again and care for himself, however, isn't going to be easy. You'll need to adapt, improvise, and find other sources of strength like support groups for Vietnam vets, fora like this one, and perhaps faith-based organizations.

In the meantime, straight talk with him. He can handle it. There's still hope he might wake up from that fog, so don't give up on him until you've done all you can and can't do. ... Not yet.

-- ED
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What about an adult foster care place instead of a nursing home or whatever? Sometimes people don't appreciate when you do the 'right' thing. It is, however, the necessary thing for your dad. I'm afraid you're gonna have to be the bad guy here and practice some 'tough love'. It sucks...
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Is your father getting any kind of home health services? Can he get home health services through Veterans' organizations? What is he paranoid about? -- is he afraid of moving to assisted living because he thinks others will steal from him, or what?

If you provide a few more details on the type of assistance he is needing, it may help. If he's of sound mind and refuses any help, all you can do is make sure he has something to eat every day, has access to his meds, can take care of his basic needs of toileting and hygiene.

If he's not taking care of his basic needs and is refusing any help and refusing his meds, then the case can be made that he is not of sound mind, no matter how logical he sounds.
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