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Dad entered NH last January after a bout with pneumonia; worked really hard and brought him home in August. He didn’t keep up with his therapy and developed pneumonia again after 3 weeks home, went to ER and now back in NH. The Therapist has indicated to Dad that they will need to discharge him in 3 weeks because he has reached his best level. He has interpreted that as he’s being “discharged” and can go home but that is not the case. I have talked with the NH and they suggested that it’s time to have the talk with Dad about him needing to stay there because it would be unsafe for him to come home. Mom and I have been telling him that "when the DR. released him," he can come home. Mom can’t help with his care and is in agreement that Dad is very well taken care of at the NH and needs to stay. I’m reluctant to have this talk because I don’t want him to give up or become angry. Can anyone help with giving me ideas on how to approach this with Dad? Should I talk with his Dr. about this? I have DPOA for both Dad and Mom.

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I am sorry you and your family have to go through this. I would have a very frank talk with his doctors about his long-term prognosis. Do they expect him to live for a month or a year? That would factor into my decision. You could probably handle a month but a year would be very hard on all of you.

When my dad had lung cancer, the doc gave him a year and my dad died a year and three days later. My dad died in the skilled nursing section of the facility where he and mom lived (they were in Independent Living). Near the end, it didn't matter where he was, he was just sleeping and disconnecting from mom and me.

My mom died in her bed in the Independent Living apartment where she'd lived for 15 years. But as the end approaches, it doesn't really matter where the person is, they're usually comatose or semi-comatose. So they're not able to "appreciate" where they are (in my opinion). It was much harder on me with mom, because I had to bring in support for her beyond just me. I had hospice and I also had people coming in to check on her when I wasn't there (I was working).

I understand your desire to honor your dad's wishes, but at what cost? If it takes your mom down too, is that fair to your mom or to you? Your dad is being self-centered in his desire to meet his own needs while not considering the needs of the rest of the family. He's not alone in this, he's got a wife and you. None of this is easy...please keep us posted.
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Update - We were going to have the talk with Dad this weekend but he went into the hospital on Saturday with complications with his CHF. He brought up the conversation on Sunday that he didn't want to die in the NH and he wanted to come home and die in his chair. After crying all around and his threats, mother and I folded like a wet noodle. While he is still in the hospital, I'm doing research on having hospice care at the house since he doesn't want any further treatments and will not do surgery if it ever comes up. He would be content living at the house.

Another thought would be to contact the attending Doctor at the NH to receive her thoughts on not releasing him into an un-safe environment. Dad did say at one point that if the Doctor told him that he needed to stay in NH, he would do it but would give up and just die. I'm at a loss. Mom is frail and this will make her go down faster as well. She knows that, but he is stubborn, angry and scared. Any guidance or thoughts?
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A1Texas, when you do have this conversation with Dad, EVERYONE will be the “bad guy”. He will be angry, but stand your ground, especially since you and Mom are in agreement. I read so many posts here from people who out of a kind heart, a sense of responsibility, fear or just having been raised “that way”, take on the really tough duties of caregiver. Then, they wind up despising the one they are caring for, exhausted, stressed out and feeling guilty for the way they feel. Don’t let that be you. Be strong and let us know how it goes.
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Thanks Hugemom. Dad is mentally very sound and I dread having that conversation. But I guess it's best. I'll chat with mom again this week. I guess I was hoping that the Dr. could be the bad guy/girl. Ugh
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I know how difficult this is, and I “lucked out” because Mom was transferred direct,y to the NH from the hospital. I think you may have unintentionally given Dad false hope by telling him he “can come home”. Don’t continue to give him false hope. If he is cognizant of his surroundings, have a talk with him. Don’t make it a prolonged, emotional speech. Be frank with him and tell him for his own safety and quality of care, he needs to stay in the NH. No one wants to be a resident of a nursing home. The staff is very used to that. Monitor his care and speak with the staff if you need to.
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