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My 81 year old mother is in a nursing home with advanced Alzheimer's. My 84 year old Father still lives in his own home about 6 miles from the nursing home and makes a regimented habit of visiting her 3 times a day. In his refusal to deviate from this routine other things are being grossly neglected in the house. He won't take his dog to the vet and her toenails are curling around her feet, the house in filthy and is only cleaned when my sister and I can visit once a month. He will not change his clothing or his bedding and is starting to have a roach issue, He's fallen down several times in the house and in the yard. I call him every Wednesday night and my sister every Sunday night just to make sure he's not lying injured somewhere. Any suggestions we make to get him some additional help are met with outright refusal because he does not want to be inconvenienced or in any way deviate from his "routine". On the surface it looks as if he's "functioning". He drives a car (although probably shouldn't be) he pays his bills, he feeds himself (TV dinners is what he opts for) however he is severely depressed and doesn't care about anything else other than getting to the nursing home 3 times a day and sitting with my mother. We understand how hard this is for him emotionally and although his dedication and advocacy toward her is commendable it isolates him and he will not listen to anything we have to say. Visiting him is difficult because of the condition of the house. It's a 3 and 4 hour drive for me and my sister respectively to go there and staying over is no longer an option. We can't do all that needs to be done ourselves crammed into a weekend. He won't let us get anyone else over there to do anything even though we've made it clear we will arrange it AND pay for it. If my mother was to pass away first I am almost certain he will just stop eating and not communicate any longer. He has some health issues of his own (COPD, high blood pressure) and honestly should right now,be living in that nursing home with her as opposed to visiting her, but when we suggested this he became irate. I don't know what legal options we have in regard to this since he technically is independent, or at least would seem so to an outsider. We don't know what we can do, if anything, to change this situation. Feedback on this is appreciated.

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GardenA: Our State (La.) has a Governor's Agency on Aging, but each Parish has its own Council on Aging (we don't have counties... some people really DO re-enact the Civil War); however, since I live in a smaller parish outside of the capital (Baton Rouge), I have access to 2 agencies: my local (smaller) COA and the Greater Baton Rouge COA, which covers 10 parishes. I just assumed all states had 1 in each county. If not, then hopefully the Governor's office would have something (you'd think!). Signing off for the day... just needed some encouragement and a few good laughs, which I can always count on here! It also helps to TRY to help other people (besides my "tenant")!!
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KayBee, I see you're in LA. Is the Council on Aging a local or state governmental agency there? I'm wondering if it's the same as what we know as Area Agency on Aging.

I'm getting Meals on Wheels for my father at a cost of $3/meal, which seems to be the standard here. AAA subsidizes the portion we don't pay. If I could get them for free, that would be great.

Just wondering about this Council on Aging; I googled it but it seems to be only in a few counties in this area. I think perhaps it isn't in all jurisdictions.
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Have you tried calling the local Alzheimer's Assn in your area? They have social workers assigned to cases like yours/your Dad's. In fact, the NH your mom is in should be on top of this, I would think. The other thing I'd suggest is the Council on Aging. They should be providing free meals, delivered daily, that may or may not be better than this TV dinners, but at least someone would be coming to his door daily. They won't stay and visit with him, unless he wants someone to do that, in which case, they'll assign a nurse or social worker to check on him weekly or whatever is needed.
By the way, if his dr's office hasn't called you back (don't get me started), call them back and tell them that you want a return phone call ASAP because you aren't dealing with a head cold; tell them that this could be life-threatening and that should get their attention.
Lastly, I always suggest that people contact the Governor's Office of Elderly Affairs. I believe that every state has one, or something similar. I understand and can sympathize with the STUBBORN parent issues and the refusal to accept help, but sometimes you just have to put your foot down. Thank God you have a sibling who's willing to help. I have 3 siblings who aren't doing a dang thing!
Just take it 1 step at a time. That's ALL you can do! Trust me: I've learned that the hard way.
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I greatly appreciate everyone taking the time here to give me feedback about the situation!
My sister and I have already done a few of the things you mentioned. We have a key hidden outside (in a very unlikely spot so it's secure) in the event EMS do have to come in.
We also have a woman up the street who I've spoken to and is aware of my Dad's situation. She is more than willing to help if needed with EMS and in fact, is the head of the neighborhood watch.
I actually DID call his doctor on one occasion and spoke with his head nurse trying to get some answers. She said she'd call me back and never did.
I think what you suggested is best about the dog. I will plan to take her to the vet myself on my next visit and my sister and I have already talked about the medical alert device. You're right......he is resistant to that too but I think we should just get it and tell him "tough noogies" while reminding him that 3 to 4 days between our phone calls is a long time to lay on the floor (or in the yard) injured at which point maybe he will relent.
My parents have known each other since she was 15 and he was 19. When they got married she was 17 and he was 21. They will be married 64 years this November.
My father has always been someone who has made sure all their ducks were in a row ALL the time. I am that way myself to some degree, but I don't go in a tailspin if my "ducks" end up scattered across the pond now and then. Life does that to you sometimes.
Life has REALLY scattered his ducks when my Mother became ill and he just can't rebound at all. He's angry, sad, disappointed and lonely and I cannot "fix" it.
I also should mention that they are both on social security and of course the nursing home gets all of hers and some of his. That makes the cost of assisted living is too great to consider.
I thank you all for sharing your own stories and allowing me to "use" you all as a sounding board. I'm certainly not trying to "pigeon hole" any ideas you throw my way. I just want to let you know what we've run into so far.
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Few more thoughts on what you and your sister can do:

1. Make a vet appointment for the next time you're there to take care of the dog's nails.

2. Get a medical alert pendant for your father; he may resist, and he might not wear it, but he also might if you can convince him it will help him take care of your mother - i.e., if he falls, he'll get help quicker.

3. If you know the neighbors and they're sympathetic, let them know briefly about the situation and ask that they call you if he falls (after calling EMS if necessary) and/or if he becomes ill in some other way.

4. Get a lockbox and have it installed next to the front door. Don't get the kind that has a u-shaped handle and fits over the door. My father tested a good one but found that a smart thief could figure out how to remove it from the door. Get the kind that screws into the studs.

If EMS has to come after your father has fallen, they'll at least be able to get in.

Couch everything you do in terms of helping him take care of your mother.
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As do I. Your father is overwhelmed with concern for your mother and that's his priority now - nothing else.

The only thing I can suggest at this time is to begin telling him that you want to make sure his own health and situation are as good as they can be so he can continue to care for your mother.

This is a tough situation; my father went through something similar before and after my mother died, then again after my sister died 16 months later. He eventually ended up with multiple life threatening illnesses and in long term care hospitals for several months before he could stabilize and return home to stay with me for further healing.

If you take your father to medical appointments, perhaps you could contact your doctor or his PA before hand and ask him to counsel your father on the need to care for himself. Otherwise, he's going to be in the hospital or a rehab facility himself.

Wish I could offer something more than just verbal support.
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I agree and support everything blannie has said.
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Would your father consider independent or assisted living? It doesn't sound like he's ready for a nursing home from what you've written. With my dad, if you positioned something along the lines of "You deserve this" he'd listen. I have no idea what would motivate your dad - you know this better than we would, but if you can come up with a line of approach that is more carrot and not stick, maybe he'd be more open to listening.

It is clear his concern is for your mom, so maybe position it that he can take even better care of your mom and be there for her longer if his stress level was reduced. He needs to take care of himself first, so that he'll be there for mom. With independent living, all of his day-to-day tasks are taken care of, he wouldn't have to cook or clean or worry about the yard, etc. He'd have more energy for his wife and maintain his own health so he's there for her. Maybe something along those lines? Other than that, I think you have to wait for him to crash and burn before you can step in. I'm sorry you're having to deal with this. I admire your dad's devotion to your mom. My parents were married for 65 years, but if something had happened to my mom, I don't think my dad would have visited her - he just didn't do visits to hospitals or nursing homes. So props to your dad.
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