Dad's health crises always seem to happen when he knows I'm busy. How do you balance being the primary caregiver and setting boundaries?

Your Dad has Dementia so reasoning with him is not possible. For me, Mom lost her reasoning before we realized there was some Dementia going on. Shortterm gone, reasoning gone hard to try and explain the situation. You could tell him your on the clock even working from home but he'll forget that. You are his familar and his constant. He no longer understands boundries. So you need to set your own.

Tell the AL that you are not available from this time to this time. Like any other job u clock in and out and need to be available during those hours. So, you will not be answering any calls from Dad during that time. They can call you for emergencies. (By law they have to make you aware of Falls and such) There is an RN on duty and as such should be able to evaluate Dad to be sent to the hospital if needed. Talk to her/him.

The first 4 months Mom was in the AL every time she fell they sent her to the hospital. Not one time had she hit her head or broken a bone. I usually wasn't informed until after she was sent. I stopped that. I told them I needed to be called and it run by me first. I was 5 min up the road. I was told Mom complained of pain. Of course she did, aren't you in pain when you fall. I asked that they give her a chance to get up and relax in a chair. If she continues to complain, then thats when a decision can be made to take her to ER. Checking her B/P would show if she was in pain. Yes there's always that your d**d if you do and d**d if you don't. I told them they could hold me responsible if it turned out she was hurt. Those suffering from Dementia are like small children. They can have a little scrape but they act like they are dying. My Mom hollered every time they took her blood pressure.

Go on vacation.

The outcome of your Dad’s ER visit won’t change, whether you are sitting next to him, or away on vacation.

You NEED to work. You NEED a life.

If your sister has a problem, then she can come and sit with him for the duration of your vacation. Tough toodles on her.

Hope you have a wonderful time. You deserve it.

The times he went to the ER recently... did it turn out that those were legitimate medical emergencies? Or could it have waited for Urgent Care or doc appointment? If it seems they weren't true emergencies I'd tell the facility to contact you first so that you can decide when he actually gets attention. It's not a perfect system but I have sympathies for your self-employment challenges.

Block your dads number and tell the AL to call only if there is a legitimate emergency, then go enjoy your vacation.

I went through the same thing and I learned that the least shared was the best.

I never jumped to after the 1st six months, I had unfortunately trained my dad that I was always available, then I wasn't and I had to retrain him.

I feel for you, I didn't know what I was doing while I was getting him cared for and then settled. Oy vey and I was told dementia patients can't learn anything new, ha, my dad learned. He learned that I responded to ALL his issues, immediately and then he learned to wait. I hope you can retrain your dad to wait.

You are one hell of an awesome daughter.

The boundaries are really just for yourself. It’ll be hard to teach that old dog new tricks at this stage, so it’s really about teaching you some new tricks.

Like, how to learn to say no and not feel guilty. I know, it’s a doozy of an ask, but really that’s life. Of course you want to be there for your dad, but you also recognize the importance of being their for your own family, your clients, and yourself. As much as other people may tell us that we are super heros, we really aren’t. We’re just ordinary people trying to do our best for everyone.

If your sister makes a stink, tell her she can use your house to live in and look after dad for the two weeks you’ll be gone, she won’t do it, but you can always say you offered.

Lighten up on yourself. You’re doing awesome.

Whats the point in paying all that extra money to have him in assisted living if you are still doing the lions share of the work? I agree it sounds like you have to retrain him not to have you as his go to for everything now including ER visits.

Assisted Living is well paid to assist with his living. Ignore him when he cries for attention, just like you would a toddler having a tantrum. You don't need to be a primary caregiver to someone in a facility. If your sister complains tell her to piss off.

Tell, him just that, you are going on vacation and he will be fine until you get back. He is in a safe place that is designed to look after him

I laughed .. or maybe wailed (I can't tell the difference anymore) when you said you were self-employed so didn't have a real job. I am also self-employed and do not have a real job either. I work very long days in between caregiving at my nonjob and have no help from my sister as she "has to work".. part-time.

You tell your dad you have to go on vacation now and when you get back set a schedule of visits that you can stick by. The only way to set boundaries is by being firm and sticking to your guns... which, I know, is so not easy. You are doing a really good job of taking care of your dad so now reward yourself and go on holiday and have a really good time.

I'm thinking Dad is having more health issues, being the sum of more actual health problems + more health worries.

His needs matter but so yours- your life, your work, free time & vacation. More you-time = better caregiver 😁

I'd make him something to see while you are away eg a nice big card or a photo of you & add the following;
* write you are thinking of him (emotional support)
* the date you will return (choose the day or 2 after to give yourself unpack time)
* a reminder who to call for problems (his Plan or 'Helper List').

Make his plan/list simple. Problems - call X. Life threatening emergencies - call EMS.

Hopefully it gives him (& you) a little confidence he will be ok (& if not, who to call).

When you return, keep an eye on how many calls you are getting & why. Is this actually anxiety? He may not be 'dissing' your job or free time, but declining in problem solving - that alone can raise anxiety. The way forward may be a good 'Helper List'. With aim to gain trust in other people - ie non-you people.

I've come to believe this attachment, relience, dependence on ONE person is a survival thing. Like baby-Mother. While it's wonderful he trusts you, it can be crushing. Like with clingy babies, handing them around the Aunts gets Mother a break 😁 (or if no Aunts, using the 'Aunts' at Daycare).

Wishing you a wonderful vacay!!

My mum lives with me and I had to stop pussyfooting around her long ago for my own welfare. A lot of older people like to be victims and can be very selfish. I now say it how it is, tell the truth about any impact she is having on me and actually tell her off if her behaviour is not acceptable. It's amazing how much she has changed!! I would just say exactly how you feel and the same with your sister if she complains. It's usually the ones who do nothing that feel they can dictate what happens when it doesn't affect them!! You need to live your life too. X

My father went to the ER for so many non-emergencies (when he lived alone and while at AL) that the term 'going to the ER' meant no more to me than you saying you were running out for some milk. After 2 years of racing to the ER on a weekly basis for him, I just stopped. Once I received about 10 calls from the hospital every 15 minutes starting around 4am. Luckily I slept through the first 8. When I got up and saw all the messages I didn't jump in the car frantically. I got a shower and something to eat before I called back because I knew my day off was about to be taken over. Turns out they were just looking for a ride home for him. The last message was from him telling me not to worry he called a friend to take him home. The friend lived right around the corner from hospital..I lived 25 miles away. Once he was in AL I only went to the hospital if they wanted to send him to rehab after a fall and he needed clothing for his stay.

Yes, it seemed like every time I had a trip planned dad got sick. Strange how that happened. I got to where when we went somewhere I would alert the nurse care coordinator or director and let them know. Luckily my other sister had medical POA so they would call her for decisions and she lived 4 hours away. But if your sister doesn’t have medical POA, then they can call you only if it’s an emergency. One time they wanted to send dad to the ER because he had a low Heart rate and I said no. I’m glad you are able to say when and if he goes to the ER. My dad would always think he had to go to the ER too. My sister who is an R.N., would say unless he's fallen or bleeding from an orifice or dying it’s not an emergency. That is why he is in AL. They have a 24 hour nurse for a reason. So tell them not to call you unless it is a true emergency and even then you can decide what is needed on your end. Since my sister had POA, I got to where I blocked their calls while I was gone because they would call me forgetting to call her. Also block your dad's number. Remember the days when we didn’t have a cell phone and when we went on vacation no one could reach us? Sigh….
good luck and enjoy your trip.

i can relate. I’m self employed too and because I am a writer and artist my family thinks I don’t ‘work’.
As you are married with kids (I’m not) ask your husband and kids to back you up and explain to dad that you have planned this vacation and need you to be there. At least you are not alone, unlike other caretakers. Surely if your father hears your family advocating for you then the boundary needs to be respected. It’s a shame that the family judges you when you do so much for him but this is the nature of some people (eg your opportunistic sister).

The ambulance ride is usually a covered expense if it is a "necessary ride.". If the patient is ambulatory and it is not a medical emergency, the patient pays out of pocket.

He is manipulating. I wouldn't share when you plan to be on a vacation or have any events happening, sounds like he knows and wants your attention.
I understand this is a life change for him and tough, but the facility must have activities to keep him occupied. Maybe call some churches to see if they have visiting programs, or volunteers who go in and do crafts or watch a football game with him for company.
Do not feel you have to drop your life. He is cared for. You can see him when your time is available. You will be under less stress when you know your own life is in order, and can focus on a nice visit.

I have worked in Senior Care for over 20 years, have seen this many many times. Let the AL handle it - he calls you - don't answer more than X times a day or X times a week. If it is a true emergency the AL will call you, usually, we get complaints from families that we call them too much over things - not that we do not call enough. Also - and this has worked for several of my clients - tell your Dad you got a great new job!! A raise! A promotion! You were offered to be VP of XXX for XXX and now you will be going to the office and also have to travel more than usual. Because you are right - if you "work from home" or "work for yourself" he and many others do not see that as "real" work - so make it "real" by working for someone else. That way you have a boss to blame things on and he cannot get mad at you - in the future, you're not going on vacation - you're going on a work trip - and since it is near (insert vacation spot) your family is going to take the opportunity to come so they can stay in your hotel room for free to go to Disney while your at the conference (or don't even tell him they are going). Because you are correct - we absolutely have some residents that will MAKE themselves sick if their family member tries to do anything for themselves - we tell them to go on vacation and not call - we will call them if it is important - have them call your SISTER while you are gone when she makes an emergency 500 mile trip for nothing she will soon see the light - residents like this also manage to make all the weddings, anniversary and major family birthdays all about them too with a "health scare". There are not many residents that do this - but some do and the staff have seen it before and are not going to think you are being cruel or crazy.

Are there such people as geriatric psychologists who assist people with managing their anxieties? Your father could be suffering from PTSD after his recent health crisis.

It sounds like he needs help, but perhaps more psychological. Would the people at the AL facility know how to set this up?

Tell sister she can stay at your place while you're on vacation.

don't tell him you will be on vacation. Always make sure he has a second, third number in case he cannot get ahold of you. you don't always have to tell him what you are doing, therefore, he won't have an "emergency" that he needs you to come over for. and if he is in an AL........they should be able to handle and then notify family. right?? go do your thing..........wishing you luck.

Hi DoingMyBest73. I can sincerely empathize with you on the time frame and setting boundaries. A social worker told me that I had to set boundaries. I care for a senior parent in her 90's and a disabled sister who is in her 60's. After 10 years of going back and forth to their home to help with cleaning and cooking I moved them in with me and started rebuilding an addition so everyone had their own space. It was no longer a person who assisted my family I am not a full time care giver. They won't do anything for themselves. I leave my house to go to the grocer, shopping, banking mostly for them but that's not the height of my frustration. I've can't take a vacation or even get away for a weekend because the moment I make plans they have a medical crisis. Not so much the emergency room kind but something comes up where they need immediate and undivided attention. I've finally decided to hire a care giver, not permanent and not full time but someone to assist and troubleshoot periodically. I refuse to let their created misery become my total frustration. I cook, clean and even shop for their clothing but when I need to get away even if just for the day I do it. I've asked family members to step in and stay at my home for a couple of days since there are 5 other siblings. Everyone has an excuse. If we don't take care of ourselves we can't help anyone else. Waiting patiently for the care giver assistant solution I am going to take my vacation and check in with them.
Don't let your family situation keep you on a six foot chain. And your sister could take a week or so off and come and spend some time with her dad while you and your family take a vacation. I've asked my sisters and brothers for help with the two family members numerous times to no avail so I am counting on professional services to step in every once in a while so that I can exhale. You have take time out for yourself without guilt that something will changed with your family situation. You wont' enjoy your vacation if you're worrying. Enjoy your family and enjoy your life. You've obviously done outstanding things with and for your father........ All the best to you and the family and All the best to your father.

Don't EVER TELL him you are leaving on vacation. My mother in law's mother would always become "sick", even though she was in a nursing home, when my MIL would plan a vacation. Years later when my MIL went into assisted living we remembered that lesson well and never told her when we'd be out of town. She was never sick when we were gone.

Your father experiences anxiety every time he feels you are not "there" for him. You might want to talk to the staff about diverting him whenever he feels anxious so his first response is not "call my daughter." You might also want to talk to his doctor about this anxiety. He might benefit from a low dose of anti-anxiety medication.

Since your dad has anxiety, it might not be a good idea to tell him about when you are not "in town" since that might be a trigger for him. Of course, let the facility know when you will be out of town and how to contact you. Enlist other family members about being "on call" when you are working or unavailable,

Why can't your loving $i$ter come and take care of dad to give you a break? I'd be having that talk with her. Should be happening on a regular basis!

Just an FYI on transportation, My mom is in Memory Care. She has had 2 trips to ER recently. The facility called "Non-Emergency Ambulance," as one was a cellulitis and one was a mandatory check after a fall. Medicare and her Medigap coverage covered the cost, but it wasn't nearly as high as a regular Ambulance would be.

DoingMyBest73: Imho, I can definitely relate to your plight. My DH and I never took important number anniversary trips OR any vacation because 'Oh, my goodness, what happens if mother takes ill?' Now my mother has passed away and we're too old to take these vacations. I do not advocate this.
Btw, EMS is typically covered by Medicare.

There is so much good advice here. The only thing I can add is, don't tell him until the last minute. No need for him worry and ruminate about it.

Let dad's phone calls go to VM and listen to them when you have a few minutes. Call him when its convenient for you to once or twice a day. Keep in touch with the caregivers to give you information.

Since your dad is experiencing dementia - he won't remember what you tell him. Go on vacation and have the administrators/staff call if something needs immediate attention. Maybe call dad once or twice while on vacation and send him some cheery postcards for him to see.

It is hard balancing caregiving and your job. Leave the heavy lifting to the staff - you advocate to make sure he gets what he needs and handle any problems that pop up at the facility, leaving you to be his loving daughter and family.

Hopefully as he settles in dad will join in on activities and make friends that keep him busy and his mind of his benign health issues and letting the staff know when he really is not doing well.

Good luck and have a joyful vacation.

I would give anything to have my dad back for one more day. Keep things in perspective.

Sounds like a typical dysfunctional Family. Your Dad may have anxiety? Leave him to
his Caregivers and enjoy your trip. Phones can be muted you know.

He sounds like a rather narcissistic dad who puts you down and thinks you should be his nurse like an open twenty-four hour store. You might want to put him into a facility if you're able to because he just sounds mean and plain awful. I hate to say it but he really shouldn't be at his home anymore. He should be in a facility. I'm sorry to tell you. I hope this helped. You deserve to have your own life too and you just can't be there for him all the time especially when you're having to work. You have my sympathy.