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My friend is taking care of her dad who is post stroke. She hires caregivers for her while she is working, and gets up three times a night to attend to his needs (including diaper changes). He is ungrateful, abusive and uncooperative. I suggested respite but he refuses to go to a home. What are her options?

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The answer depends on many variables. Is the person competent to make their own decisions? Does he live in his own home? Does she live there, or are they together in HER home.

If she has been assigned by her dad as his power of attorney, and if she is providing caregiving in HIS home, she might consider resigning her POA and telling him to make other arrangements for his own care. If he can't understand the need for a break, then she shouldn't tax herself this way. She's likely to die before he does.

Is he still competent to make decisions? Is he a selfish narcissist, or simply someone who has lost capacity? She can get a "needs assessment" from the local Area Agency on Aging; this might clarify for HER how much care he needs.

It really sounds as though he needs round the clock care, which is best done in a good facility. She can then go back to being his loving daughter.
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The obvious answer is to hire a week's shifts' worth of appropriately qualified nursing aides from the agency which supplies the caregivers. It would be expensive, and it would be sensible to remove or lock away in advance anything the family really couldn't bear to lose just as a precaution, but it could be done. The father is being rather ridiculous: nobody can be that indispensable, and what would he do if your friend were taken out of the picture by unforeseen events? - God forbid.

How long has your friend being doing this? And what exactly do you mean by "abusive"?
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As much as I would Love a weeks respite from my FIL, who has lived with us in our home for the 13 years, I wouldn't be able to convince my husband to hire a stranger to come into our family home, but I could definitely see sending him to a qualified Respite Care Center! There are other options than a nursing home. Several of the Assisted living facilities near us have the option of Respite, but a lot depends on the Dad's physical capabilities too! If he is bedbound, yes definitely, a nursing home for respite, but it shouldn't be up to him, she obviously needs a break if shes doing this all on her own! He'll get used to it! He got used to the daytime caregivers, didn't he?
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One other thing. You say he is abusive. This is unacceptable. He needs to be seen by a geriatric psychiatrist to see if meds can soothe his agitation.
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