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He has macular degeneration. He is not cooperative. We have tried to suggest alternative care options and he is very opposed to help. He cannot see but drives, has an iliostomy and needs help with cleaning ect... around his house and is gradually needing more help with this but he is angry and defensive and will not cooperate with our suggestions. How can we get him to be open to this discussion and resolutions? He wants to remain in home but will not allow for services such as cleaning ect.. and still wants to drive.

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Tam, your Dad sounds just like my Mom who also had macular degeneration. Mom also refused any type of help, not even a cleaning crew.

It wasn't until Mom passed that I had a "ah ha" moment why Mom didn't want any caregivers or cleaning crews... nor did she want my Dad to help her unload groceries when I had shopped for her. Mom's eyesight she was legally blind. But in her mind she remembered where everything was in the house. Thus, if someone comes along and moves an item, Mom wouldn't be able to find it.... that all made perfect sense.

Tam, how far along is your Dad's macular degeneration? If he is still able to read and watch TV, then he shouldn't have any problem with local driving, as long as his reaction time is still quick. Maybe you could check with your local Dept of Motor Vehicles and ask if there is some way they can have your Dad come in for a driver's test. If he passes the road test, then he can drive.

I think when we all get to a certain age, our health isn't the best, and our energy slides, we will become grumpy, too. Becoming older isn't easy.
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The fact that your father is going blind and is still driving is very frightening. I know I don't have to tell you how dangerous this is for him and everyone else on the road. Perhaps he would listen to his ophthalmologist if the doctor insisted he not drive. You may have to take the car. As for having someone come in to clean, I sort of understand that. I don't like strangers in my house either and never have. My mom was the same way. If you have siblings, rotate weeks to go over and clean for him. There comes a point when we realize that our parents have become the child and we are now the parent. Dad is acting like a child. Polite suggestions about what he should do are met with temper tantrums. Be respectful but firm. Tell him what you have planned and then carry it through. Be firm in your resolve because you are doing this for his own good.
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Unfortunately, there's not a lot you can do to someone who is resistant, and the more you try, the more he may dig in his heels. This isn't a unique situation. He might be trying to hold onto some nominal level of independence as his life and control of it are slipping away.

You might just back off for a while, and let him adjust to his loss of independence and skills in his own way.

However, I would ask the ophthalmologist to contact the secretary of state or similar state agency to request/order that he come in for a driving test. If there have been any incidents or accidents recently, that's a good excuse for him to have an eye exam.

Do some research to determine if your state has an assistance for people with macular degeneration. Depending on the state of it, there might be some special magnifying glasses or other devices that can be used. My father bought a special reading device for a friend who had M/D.

Was he a reader before he developed M/D? If so, you might try books on tape, something to keep him occupied and divert but stimulate his attention.

But I would really call his ophthalmologist right away, like tomorrow.
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Oh, I just remembered, when my Dad was developing macular degeneration in one eye, his eye specialist was just starting the newest thing which came out of a trial run, special shots that are given into the eye. Sorry, I don't know what they are called.

My Dad mentioned he was starting to see somewhat better, which was a positive. Unfortunately, my Dad passed before the series of shots had been completed. This was about a year ago.
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My aunt also had shots in the eye for her M/D. From what I know about her situation, they did help.
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My MIL as well receives those shots to her eye and they do help her.
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