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My father is elderly and has health issues. My mother has always taken care of him but in recent years has had her own health issues. She is now not always capable of taking care of my father. My father, amongst other issues, has the beginning stages of dementia and will not accept in home assistance. He denies that he needs assistance, even though he does, and it is beginning to take a toll on my mother.

Has anyone else encountered this issue and have any advice.

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Sorry i didn't pay attention to the date of that feed (2012), but I hope somebody that needs it will read about, and check out the AAA for their state for a free drug tested/backgrd checked caregiver list.
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I'm not sure how you or your parents finances are but there's a Gov/State/City ran program called AAA (Aging Adult Agency). In 2009/2010, the first companion, caregiver, and light housework lady I hired was from their free list of qualified caregivers, due to the fact mom was 82 then, home alone; I worked and I couldn't just stay home w/mom. Everybody on the list had been drug tested, and background checked (w/dates of test/backgr check), the list had their contact information etc....; and the majority of them listed were Retired: RN's, CNAs, Social Workers, and Senior Home Facility caregivers. At that time it was just me and mom, and I told her it's either let me hire somebody to help her or it will eventually come down to a NH (she was leaving stove on, had diabetes/pacemaker/high blood pressure; involved w/scammer, tired etc...). I interviewed a few right in front of my mom, even though she still protested, but I wanted her to feel that she was a part of the decision of whom I hired. I sort of watched her reaction to each, and "Please Believe" she did show various reactions. I hired her first caregiver (this was out of my pocket, and mom clearly stated that she wasn't paying out of her SSN ck...lol; and mom didn't qualify for the free medicaid state in-home-care, due to the amt of SSN/Widows Medicare). The only thing about the list of people, is that the caregivers were not authorized to handle/adminster any medication. They could give medication reminders or help them in various, but couldn't administer any medication (pro/cons). The lady I actually hired was a 65yr old Retired RN, and we negotiated her fee..ended up w/the middle price of $9 an hr, 3hrs per day for 3-4 days per wk. I really lucked up w/the caregiver I hired from that list, she was fantastic with mom, and mom eventually warmed up to her within 2wks. When my mom offered/asked my bro to move in w/her, I didn't protest etc...but wasn't going to continue paying out of pocket, when the actual reason for me hiring the caregiver was so mom wouldn't be there alone, doing this/that...so the caregiver understood that from the start and we negotiated her release date. She worked for me for about 1 1/2yrs, no problems... Now, that I have guardianship of mom (this yr), I will be hiring another caregiver because my bro can't do it all...and has his own health issues, not to mension putting up w/mom and her senior moment/issues. I'm just waiting till mom get over some of the anger (guardianship) as her doc suggested.

I know it's scairy to have a person come into the home w/all the horror stories out there and your mom sounds like mine; has always been independent and and don't want help, but the above comments are right too, all we can do is what we can do unless your willling to take on petitioning for guardianship when you see things going south... And, don't get me wrong, I'm still battling w/mom as she puts it, but regardless of anything she thinks, I'm still just trying to help....
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Your father is not competent to make these decisions. You need to speak to a social worker at the local Department of Human Services. Coming from the government, it would be harder to resist. Your mother needs the help. You might want to go to court and get appointed guardian so you can legally move them to assisted living where they will be safe.
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Unfortunately, you can't force any adult to do anything they don't want to do, unless they are declared incompetent and you’re appointed their legal guardian.

It was really hard for me to accept this in regards to my mother, who could in my opinion, have a much better quality of life than she is living now. All she needs to do is to allow some modifications to her living environment, like installing bathroom railings, move the washer and dryer upstairs from the basement; change her diet to a salt-free one.

One of the easiest ways to do this is to sign up for a Meals-on-Wheels program; they would make sure she would be delivered sodium free meals. But she refuses to do/allow any of these things to happen. I have offered to make the physical changes to the house, I’ve actually installed a hand-grip in front of her toilet and she actually went ballistic when she saw that I did it. She uses it all the time.

Ideally she should just move into senior housing, but when that conversation is even hinted at, she goes into a histrionic, finger pointing, and ultimately hurtful rant. And I have decided that I do not want to put myself through that anymore.

As long as she is not dependent on anyone, she is free to make her own daily decisions, no matter how I judge them to be not in her best interest.

By opportunity opening up, I mean when something major, that's health related, happens; like a fall, resulting in a broken hip or concussion; a fire/flood is started by them. They're going to be either, A: Scared and be more malleable, and possibly open to a change/help, or B: subject to social services deeming them a danger to themselves and/or another. This can put the next of kin in charge.

It's unfortunate that some people refuse help, but we must learn to accept and respect their decision - unless they are incompetent.
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My mother is 88, lives alone in her house, and unless a specific health crisis is going on - shingles, leg infection - she refuses any outside help. I've tried to get her to at least have someone help her with the household chores: laundry, cleaning, etc., but she refuses. She is in the advanced stages of congestive heart failure, and becomes out of breath with just the slightest amount of activity. However, she still drives her car, grocery shops, gets herself to her doctor appointments, but it all happens at a very slow pace.

I have noticed that she's really beginning to slow down.

I wish you luck with trying to convince your father to accept help, for the time being, I've given up trying to force any issues with my mother.

When there's an actual health crisis you'll get an opportunity to make some changes. Accepting help is seen as a loss of independence and power for so many seniors, while not being allowed to help them is a real drain on us, the caregivers, resulting in lots of guilt.
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