My Dad (89) desperately needs to be put in a home but my Mom won't do it. Options?

You will probably get lots of advice on this forum. This is a common issue many of us share.

Your mom may not have dementia but her judgement is not strong. My mom is 84 and sounds much the same. The quickest route to resolving this would be to call 911 at the next crisis, ask to see the social worker at the hospital and explain that Dad cannot come home. If you get resistance from the hospital tell them you will call Adult Protective Services.

APS may be the only route if Mom is mentally competent but in denial. She still has the legal rights here until APS or a court says Dads health is in danger.

This is the worst time. That tipping point where our folks can clearly not deal with their own care any longer, are stubborn and in denial but still legally competent. I'm just waiting for the next crisis with my folks.

As it is right now only your mom can make the decision to put your dad in a facility. Waiting for a crisis, where your dad ends up in the ER, is an option many of us have had to count on. Once in the ER you or your siblings can contact the social worker and explain your parent's situation to him/her and the social worker can work with your mom to help find the situation that suits your dad the best.

It's not an ideal plan. Your dad may not end up in the ER and your mom may continue to not admit him to a facility. In that case give your mom all the support she needs. Her life isn't easy caring for your dad.

One of my friends recently went through this. Her mom was killing herself taking care of dad but she would not put him in a nursing home. All of the siblings worried about the "next crisis". One daughter had an idea that worked. Through the nursing home (there is just one in their rural area) she found a wife who had recently put her husband in the nursing home and got this woman together with her mom for coffee. The woman talked about how the care was better for her husband - that there were more people, more highly trained people than herself to take care of her husband and that he was where he needed to be. She also talked about how she saw him every day - so it was not like she was abandoning him. She made it all about better care for her husband. In your case, if dad is not getting medication, bathing, or seeing doctor - he is not getting the care he needs. Good luck. Doesn't your heart just bleed for mom - trying to take care of her husband?

tjivey5, seeing your Dad's age and thinking your Mom is probably from his same generation, it is so very common to see the woman dig in her heels when it comes to taking care of Dad.... it is her "job" to take care of husband no matter what. And by jove she is going to it, come h**l or high water !!

I had the same issue with my Mom back when my Dad had a heart attack, she did not want him to go into a rehab center to get better, so she brought him home from the hospital. She found out quickly she couldn't pick him up when he fell [he was very weak] and couldn't help him up the stairs for the night so they slept in the living room, etc. She was 90 when this happened. What was she thinking?

Mom even made it difficult for the visiting nurses and the physical therapist. They all felt so very uncomfortable being in my parents house as Mom would be glaring at them. And she even didn't want grab bars placed in the bathroom, that would ruin the tile. First day Dad came home he could barely walk even with the walker, so I moved his recliner to be closer to the power room... good heavens, what a battle with Mom as the recliner didn't look good there. First time I ever raised my voice to Mom "this isn't about you, it's about Dad".

Dad did survive all this, whew. But I was on pins and needles waiting for the next crises. The next ER visit with Dad, he finally got into rehab for that condition.

If you can't get her to get him to a facility, with all of its resources and expertise, what about bringing the facility to their home? Do you know/have you talked to their doctor about what in-home nursing and personal care services are available locally?

If your mother's resistant to that idea, too - which she may be, because at this point her overwhelming fear is possibly that he will be "taken" from her and she's determined not to let that happen - then you need to point out that if she wants to stay in charge, she has to *take* charge by getting more help.

What about home help? Or day care for respite? Why is he terrified of the tub? It is slippery and he may be afraid of falling. Do you have a shower/bath chair for him to sit on? Sounds to me like, if your Mom wants him to stay at home, she needs help. Get an occupational therapist to come and assess the home environment to find out what they can do to make it all as easy as possible. Part of her not wanting him to go into care may be the incredible guilt many people feel when this happens, but also it may be that she will be lonely living at home on her own even visiting him daily. What about both of them moving together to somewhere more suitable if there is somewhere like that nearby.

You need to get POA from your father. That might help.

If you just sit tight, something will happen. Then you call an ambulance and get him into he ER for an evaluation, or from the ER to a geriatric specialist. Take it from there.

The situation you describe cannot go on much longer--and it won't.

In the meantime, repeat the serenity prayer!!!!!!!!!!!!!!

If the father has severe dementia, he is not capable of naming a POA if he has not already done so. Unfortunately--and to their detriment--many people (and not just wives), think it's a personal failing if they cannot provide the care their loved ones need. Some also worry about the judgment of other people who may view a decision to admit individuals to a nursing facility as "not caring about" the family member. The find it hard to live with the guilt. Maybe you can eventually convince Mom that placing him in a facility IS caring--she is ensuring that he gets the care he needs.

You have a dilemma for sure. I can offer one observation that might seem to be "off" at first, but if you read it through it might contain a glimmer of an avenue out of this situation.

My wife is in a nursing home...For awhile she "insisted" on being in a recliner (LazyBoy) and never in bed. The nurses and aides graciously cooperated and took care of her anyway, and being paralyzed on one side, this included changing her several times a day. I could see how difficult it was for them and "knew" it would be better for my wife and the staff to have her in bed. She did not want to do it, however...Finally, I lied to her and said the doctor ordered that she MUST be put in bed for two weeks to see how her symptoms would react. She reluctantly agreed. After a few days she had gotten used to it and I lied again and said the doctor said it had to be that way for another month...She accepted it. Soon enough I said my Lazyboy at home had broken and I wanted to take hers home rather than buy a new one. She was fine with that..That was five years ago. She has been in the bed ever since.

Sometimes a lie is not all that bad as I see it.

I am thinking you may be able to have your doctor "order" that he try out a nursing home for its therapeutic purposes, whatever.

Grace + Peace

Bob

All of the above Is great advice. Bubt sometimes you get to the point where you must use tough love. You may just have to take things into your own hands and take action yourself. Call senior Protective Services now or call the social worker at your local hospital now and find out what can be done. Because waiting for the next emergency might be too late then might be the emergency where your father wonders way and is hurt or worse. And in the meantime your mother's life is miserable. She may be insisting I'm taking care of your dad. But underneath part of her might be praying for somebody to take this terrible decision away from her. Good luck.

Sorry for all the typos above. I sure wish there was an edit feature on this page.

"She acknowledges the fact that he needs to be in a nursing home, but yet she refuses to take the necessary steps to make it happen." Perhaps she is simply so overwhelmed by it all that she can't think beyond what is in front of her. This does not sound like a refusal to get help as not knowing where to start. Take the lead in looking for appropriate places or sources of in-home help. Invite her to look at some with you. Focus her attention on what's best for your dad.

If your mom has a hard time accepting help with your dad, start with getting her help to clean the house. If the house is clean, her stress level might be lower and her thinking clearer.

I agree with Windy, the first poster. My Mom cared for my Dad with dementia and declining physical health. My dad didn't want to bathe either. He fell many times and it would take them hours to get him off the floor, while my Mom would wipe up the blood when he would hurt himself during a fall. Of course, I didn't learn of any of this until I would come over with the groceries, or meds etc. But the last fall did him in. I called 911, got him to the hospital. From there, rehab where he plateaued, (stopped getting better), and was still a two person transfer and thus remained in the home. My Mom felt very guilty but eventual she saw that she could not take care of him the way the nurses and facility could. We knew it was the right decision it's just hard to accept. You can also set up a home visit with your local social services department and have them come over and evaluate him. You don't have to tell Mom and Dad that is what the visit is for. You can just say, "they do this from time to time and you're next on the list." Call them ahead of time, tell your story and what you really need to get out of this visit. Best of luck to you and write back so we can follow your situation! We are all here for each other!

xo

-SS

I had the same challenges with my SIG OTHER and his folks-both wDementia. What helped me is to get help for ME. I was watching all of them "go down the tubes" and he (my SO) was stuck and couldnt budge and thinking ALL IS OK.....and I was putting my finger in the dyke......and loosing. For your MOM.....I like "the DR" suggests this......our parents generation look at DRs like the ultimate authority......and, in my way of thinking, it is NOT a lie to say "the DR wants you to do this or that"......you've already said he suggested it! Also I like the idea of another lady IN THE SAME BOAT talking with your mom and sharing her experience and challenges. Often our parents will listen to their PEERS before they will listen to us, their family (so to speak)--even tho' I was NOT FAMILY, per se, my SIG OTHER knew I was the only "real" support for him......his sisters could/would not.....and perhaps it was BEST too.....because their direct involvement seemed to make things WORSE rather than better. Social Workers who are experienced with these challenging issues were MY BIGGEST sources of help to get thru this 5yr family crisis. The local Senior Center had social worker assigned to just such situations........AND she was more forthcoming with me when I FINALLY realized that my SO only had to tell her "yes, it is OK for Jamie to ask you Qs and seek help for our family situation". We did this with a simple 3-way call.....no paperwork needed, because I lived 1/2 hr away from my SO and his parents! Also APS also got involved on and off thru this due to various helpers coming in providing "hot meals", home-care, home-health-care, etc. AND always, at the least, it helped give my SO a caring person to VENT his frustrations and give him moral support. THEY always assessed that his parents were indeed loved and cared for and "safe" AND my SOs biggest fear was that "his parents would be taken away" against his wishes and he is the POA for their medical and financial decisions. Both have varying degrees of dementia. Anyway.....they are NOW safely in the NH....and I am so relieved. Hope this helps.

ADS being adult protective services......and NH being Nursing Home.....and the ADS folks were nice.....and said "someone thinks your family might need some HELP". Keep in mind that we are ALL aging and challenged by the daily technical and cultural changes we face! The difficult family dynamics can become worse before they get better.....so I sought outside help thru professionals, books, minimal online research, and those I crossed paths with daily. Anyone might know just how to deal with the "delimma" of the day! Even a "clerk" at my family dollar store gave me some much needed direction that we could get medical care out to the home paid for thru the Medicare coverage we had. Our family Dr had not even mentioned that option! So your needed "support" can come from the most surprising places indeed--as best you can--remain open and attentive to your own needs. It is indeed an ongoing learning process......from one who got thru the long and dark tunnel and is transitioning to the light and wondering....OK now how do I deal with all the "stuff" I put on the back burner while we were "hanging on"? AND learning all over.....that it is just one-step-at-a-time......enuf for now.....on to the auto repair shop......hope this helps.....and its also part of my debriefing too.....

my mother too was trying to take care of my father, she is diabetic and her sugars were high due to the stress of trying to deal with dad's wandering, up all hours, not eating, sleeping way too much, etc. finally after falling 2 days in a row, he ended up in ER. now both my brother and I are POA's so when he was in ER and they said he didn't break anything, I told them he could NOT go home. My mother had arthritis in back, could no longer care for him properly and she even admitted she didn't know how much more she could handle. they had him assessed and was determined he needed 24/7 care in a NH. we already knew he had dementia and was getting worse. ** Maybe you can somehow discuss with your mom your concerns for her health and that IF something happens to her.....who is going to care for your dad. wouldn't it be better if he went into a facility where she could visit without worrying if she is doing stuff right, not having to clean up after him, making sure meds are being taken at same time, feeding, etc. put the stress on someone else and enjoy the time she has with him"......good luck.......it is a hard decision.

You need to find a very nice place first then take your mother there and convince her your father's care will be far superior! My mother received much better care in assist living than we could give her in her home. They are trained specialists, they have nurses around everyday and the doctors visits them at the facility. They have physical fitness and entertainment. I went through this with my siblings. My mother improved once she had the proper care!

same thing with hub's aunt and uncle and she even just fell and gashed her head but still won't get help, although she was supposed to go with him to the doctor this past Friday to try to insist she do something but after the fall - and possibly concussion - not sure if she did, not sure she's even capable of letting me know anything anymore; she normally would have called by now, but she hasn't - issues with grandson being there now, too, not sure what's going on except wondering about possibly exploitation starting up again but not quite sure have enough info re that yet - when that's going on, don't hear from him or her; get it 2nd hand and they don't want anything done for somewhat fear of reprisal, so not sure what to do now

I'm so sorry this is happening. My advice would be to call 911 today. If he's not getting his INR checked, and if the levels are off, or he's not taking his coumadin at all, that alone could kill him by either a clot or a bleed, or he could have another stroke. For that reason alone, this is an emergency. Once he's in the hospital, tell the social worker the truth so that at the very least, she can arrange for a nurse to come and do his INR, or she can arrange for a little home care help for your mom. It doesn't have to be all or nothing, you just need to relieve some of the pressure...right now.

The guilt issue is huge when it comes to wanting to keep a loved on at home. Especially a spouse who loves them deeply. I finally had to convince myself that putting my mom in the nursing home was the better thing FOR HER. It's about her, and not me... she needed the care a nursing home would provide which I could not do at home. When you frame it that way, it helps. Any resistance to this could be interpreted as selfishness on the part of the spouse who will not cooperate... even though it doesn't appear to be that way. I've had to tell myself... Jocelyne, this is not about you. This is about your mom and what she needs, etc. I think the ER route is the way to go... and a little white lie can solve a great amount of unnecessary bickering.

This is a hard one..Explain to your mother that if she falls and breaks a hip or worse then she will no longer be able to give your father the care that he needs. Also explain to her how much you hate seeing her go thru this and that she needs to love your dad n herself enough to put him where he can get round the clock care, something she is not able to do. I do wish you the best. Good luck.

My mother finally went to the NH, from the hospital. There was no one available to take care of her. But, it would be almost impossible to admit someone to the NH, that doesn't want to be there. And if the wife doesn't want him to be there. They are not prisoners, the wife could go get him.

If you have tried everything, I would have a plan in place, if an emergency arises, but there is not a whole lot you can do.

tjivey5, another thing you can tell your Mom is that 40% of caregivers pass away leaving behind their loved one. What if that happened to her? Who would take care of Dad? Caregivers get to a point where they are so burnt out, can't sleep, they either have a serious fall or major health issues that end their life.

Kimber I agree with you, my furst gut reaction reading this question post was TEARS! True love at work here, just true love. My opinion is your mom would die if you took her husband away. She also may very well die if she takes care of him. You need to step in and help asap! He, and she needs at home care! This way she can be with her love and not do the work. She cant be running to a nursing home everyday, nir can she stay home without his presence. Ive been married 40 years, dated him 6 years before that and in no way could i put my husband in a home either. Look at me, i cant even put my mom in a home, shes been living with us 8 years. I have 4 hours of help i pay for each morning out of moms ss, va, pension, to save my life. Weekends kill me, i need more money for help. Go to care.com if you cannot help them, and get them help, please.

to debdaughter: any older person falling and hitting head could be fatal later. they could develop a brain bleed which could lead to death. my mother fell 2 years ago and hit her head and required 3 stitches. the er doctor said that elders, just like infants, their brains are smaller because in elders they shrink over time, which can cause the brain to bounce back and forth inside against the skull causing damage/brain bleed. my friends father had this happen and did nothing until about 1 week later.......end result he died within 1 month of fall.

You have posed several questions. First, on the surface you are concerned about your Mom's health and the pressure put on her by caring for your Dad. Your concerns are valid. It is proven that care giving is very taxing. Without proper care of the caregiver; that person will suffer health crisis, unless they take proper care.

You have also presented 'why won't Mom consider or accept help caring for Dad.' Mom does not take the idea of moving Dad as a good alternative to him being at home and her doing the caregiving.

Let's take these two questions, as the other questions will be answered as these are. And let's start with the second question. You indicated that your Dad was 89 years old. This generation when married said those vows of marriage very seriously. It is in many cases for the couple to separate for health care due to the part of those vows saying 'in sickness and health'. My answer for this question is to pursue alternatives to your Mom facilitating his care. Look into their moving to an assisted living/nursing home together (many times there is an assisted living on the same land as a nursing home). Many of these facilities do exist for just the reason you are looking at for your Mom. Many times you can help this by having your Mom and Dad sleep in separate rooms, then during the day reside in a common place. You can also look into in home help, however, many of this generation will not accept this as an alternative. See below

The first question was in regard to your Mom's health. You should be concerned as several research elements have proven that a when the caregiver is a sole caregiver, their health is dramatically affected in a negative manner. As I had said the above answer to living apart could be the answer for this concern. If that is not an answer in your circumstance, begin looking for in-home help. Do not let money be the deciding factor for this solution. There are multiple ways to put this to use with little or no impact on the financial status of your parents. I do not know your particular financial situation, however I have facilitated many couples living only on Social Security (which is bear bones financial status).

You will want to do some research into this way of answering these questions. These solutions will allow for your Mom and Dad to maintain their marital union and yet get help for your Mom.

Or, you may want to look into low cost answers for this situation by looking into home health. (Let's be clear, this will not accomplish your Mom's good nights sleep.) However, if she has help during the day this will begin to answer the question.

You can look into family members helping out with solutions to some of the care needs. Perhaps a friend of the family, someone from the church (if there is a community in their lives) or seek help from your local Office of Aging. This last mentioned is funded by Old Soldier's Act and can be found in the County section of your phonebook. They're almost always governed by DSHS.

Most of all take care of yourself as you may be caring for your Dad, as well as your Mom.

what's INR?
wolflover: thank you so much, something never really thought of, at least directly, was concerned there could be issues; she really probably should have had stitches but she never even went to the ER; it's probably been at least that long and nothing's happened yet; she's like reverseroles, it's really that she's terrified if she went anywhere they would take him away and she would die; I really don't think any longer it's about what's best for him; she says she wants help but instead she gives the money to their grandson, who's not helping - so what do you do? my dad also had a fall like that and did get stitches, did scans and stuff and nothing said about anything like that happening but there were other things that did; we did get him some inhome help then and then later after that is when he got grandson (an older one) to move in with him to take care of him - at least better than the other situation

You may want to approach it as a "temporary" measure -- perhaps so that she can go visit a friend or family (who will be prompted by you to invite her!) You can even call it Respite so it sounds different. When she comes home maybe it would be a good time to give the house a thorough cleaning before he comes back....etc. Meanwhile all the assessing etc can be done and professional recommendations made. She'll probably see through it, but you never know. Maybe all she needs is a good "excuse" to get the ball rolling. Another approach might be push her harder to take action but help keep her in control by going with her to several facilities so she can be in charge of picking the one she wants - let her interview them more than the other way around......what is her driving situation by the way? Would she be able to visit every day?