My father is currently in rehab, following a hospital stay for a MRSA infection. He does not like going to physical therapy, but he goes. The therapist reports that dad can do everything he is ask to do: walk, climb a few stairs, put on his shoes, button his shirt, etc. But, when he is in his room, he lays in bed completely helpless. He makes my mother do everything for him. Dress him, cut his food, change his Depends, everything! He will not even walk to the bathroom. He asks her to hand him a urinal, which she does, even though we have stressed to her he needs to get up and walk to the bathroom. Let me add, he was making these demands of my mother even before the hospital stay. They live at home and she tends to his every need. She is 90 years old and not in perfect health. She refuses to leave his side, even when family offers to sit with dad so she can take a shower or a nap.

He probably will be released from rehab later this week. Since he demonstrates to the therapists that is able to do things for himself, they will probably say he can go home. Going home is what mom and dad both want, but family does not think they are capable. We have looked at assisted living, but it will be a battle to get them to move.

My question is - why won’t he do the things for himself that we know he can do? We know mother will continue to wear herself out doing everything for him once they get home. No reasoning with her about it. They are not mentally incompetent, but are definitely showing cognitive decline.

Any insight is appreciated.

You are fighting an uphill battle. If Mum has met his every need for 50 or 60+ years, she is not going to stop now as she does not know any other way to behave.

It is a sad situation and you may have to wait for a major event to get them to move in to assisted living.

Do your parents have all their paperwork in order? Updated Wills, POA, Healthcare Representative etc up to date? I think you may be better to push to make sure this is all in order, that way when Mum collapses from the stress, a family member can step in.
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Reply to Tothill
Mjs2699 Feb 10, 2020
They do have a Will, POA, and health care directive, stating they do not want artificial means of life support. I am currently gathering information on all bank accounts, insurance policies, etc.

Your assessment of the situation is probably correct. Thank you for your answer.
It’s your mother that has set up the pattern here. If she’s not willing to change there’s little you can do. Your dad has a slave for a wife and it seems she likes it that way. Sadly, it may take her health failing to change their dynamic
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Reply to Daughterof1930

I'd make sure the therapists know the truth. Also, I'd discuss it with the social worker. I'd ask them to consider if wife is an appropriate helper at home, even if he is doing better. Do they have the proper grab bars, ramps, etc. that dad might need?

I've known people who say, him going home with mom to provide care, in her condition is not a good idea and we don't support it. You might not be able to prevent it, but, I would still be clear to them and the staff at rehab. One reason is that it is a recipe for disaster. Things won't go well......and, then the adult kids will get the, the adult kids will become the caregivers while parents live in their own home. I suppose that works for some people.

I'll add this, since you said you thought there was some cognitive decline....I know that prior to my LO having dementia, she exhibited odd behavior of not wanting to do things for herself, even though she could. Her refusal to do use toilet, bathe, change clothes, etc. were the first signs of dementia. She could talk, remember, pay bills, etc., but, it was an odd sort of apathy and lack of initiative. I wouldn't hold faith in you being able to convince a 94 year old person to do more things for themself. He's likely very tired and not motivated to do more, if he doesn't have to. I fully understand how he might feel.
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Reply to Sunnygirl1

Mjs2699, my Mom [also in her 90's] came from a social generation where the wives job was to oversee the household, take care of their husband and children.

I remember when my Dad had a heart attack, he was very weak and it was recommended he go live in Rehab until he got stronger. Well, that didn't sit well with my Mom, she insisted she could take care of Dad, that was her "job". Little did she realize she no longer had the strength to pick Dad up when he fell, which he did on a regular basis until he regained his strength. And Mom wasn't able to help Dad climb the stairs to the bedroom, so she would sleep in the livingroom on the sofa and Dad slept in his recliner.

And Mom even insisted that Dad didn't have a heart attack.... what would be the neighbors think? Say what? Apparently that generation the health of the husband was a reflection on the wife. My Dad being sick would have been a poor reflection on my Mom. Good grief.

My take on this, let Dad be home with Mom, and let her cater to him which she is doing out of love [I know, we may not see it that way]. You can't break with tradition.
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Reply to freqflyer
Mjs2699 Feb 13, 2020
Yes, you are exactly right. Starting tomorrow, when they get home, this is the approach we will be taking.

Thank you you for your thoughtful response.
Work on your mother, first. Two points to get across to her:

1. The sky will not fall in if she doesn't monitor his every waking moment.
2. Even more important: her doing things for him DISABLES him. It is actively the WRONG thing to do for the person you want to remain healthy and functioning.
Every time she hands him that urine bottle, she is stopping his heart getting the mini workout involved in his going to the bathroom. And cutting up his food? - is her manly husband a spoiled infant at heart?

It feels good to pamper and be pampered, but she can do this in better ways that won't render him helpless and immobile. As for why does he let her? - ooh, lots of reasons. Because he's tired, it's easier, it's nice to be cared about and waited on, it's what they're both used to... If you want him to start *liking* being more independent, never criticise him, only ever praise and flatter good efforts and good habits that are more in keeping with an autonomous adult.

Short of breaking her leg, can you get her away on some pretext for his first few days at home? If not that, can someone go and stay in the house with them at the beginning?

We currently have a lovely client with a lovely wife, in her eighties and tiny and she has been forced to accept our service because she physically can't manage his needs. There was a farcical moment a couple of weeks ago when she tried to wrest his overnight catheter bag from me as I went to the bathroom to dispose of it. I hitched the bucket out of her way and kept going with thanks and a smile; but she has a hard time letting anyone take over what she can manage. Doing absolutely everything can be a point of pride, I think.
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Reply to Countrymouse
Mjs2699 Feb 13, 2020
Thank you for your answer. Family and staff at rehab have told her many times she is hindering his health by not making him get out of bed and do things for himself.

As others have suggested, there is no reasoning with either of them. Hopefully, when they get home tomorrow, she will at least be able to get a little more sleep.

Family will keep a close eye on things. We will be calling several times a day, dropping in unexpected, bringing groceries, doing laundry, etc. We can concentrate on helping her, so there is a chance she will stay healthy enough to take care of him.

Thanks again for your suggestions.
Your profile says they both have Dementia. As such they cannot really make informed decisions. This will get worse. Now or later the POA is going to need to take over. If the POA says "when no longer competent to make decisions", this is when you have them evaluated and a letter from the doctor saying they are no longer competent.

They always do well in therapy. Its a good way to be sent come. Like said, Mom waiting on Dad is a pattern that ur not going to break. Early stages of Dementia they lose the ability to reason. So u can't reason with them either.
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Reply to JoAnn29

In the days when they were a young couple (they were young and beautiful once:) the woman doted on the man...hand foot and finger (so to speak) And it worked for them. They clearly love each other very much to this day. And Im sure they are aware they don't have much longer together here on the earth. And are afraid of losing each other.
However, its become a little unbalanced.
Although, from how you explain the situation neither complain..and both seem content with the dynamics.
Your concern for their health is understandable
I agree with other comments about home physical therapy and your Father getting the body moving.
With apathy he will die sooner than if he was mobile.
You might speak to him quietly by yourself and kindly explain that by getting the body mobile daily, it will give him more time here with your loving Mother
This is a fact. If he loves her as I think he does, once he understands the probable consequences of his laziness, he will improve himself.
They are lucky to have such a caring daughter.
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Reply to sunshinelife

You can’t change a pattern that has been in place for probably 60+ years.
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Reply to Papillionmom

Why? He is spoiled by your mother, she obviously thinks that he is her little 2 year old. This is a generational thing, the little woman is the servant of "Daddy", that is her role.

Nothing is going to change, your acceptance is the key. My step father does the same thing, I have learned to let it go and continue to work on me.

Good Luck!
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Reply to DollyMe

If your dad is still mentally competent, I would tell him that 40% of caregivers die before their loved one, and your mom needs to take care of herself first so she can take care of him.  Sad as it is, I think you have to appeal to his self-interest.  

It may be that he thinks, right or wrong, that she gets joy from helping him.
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Reply to FloridaDD

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