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My father had a stroke in 2019. He walks slowly with a cane or walker and still drives his car (which scares me a little) to go food shopping once a week. He has gone food shopping every Thursday since I was a small child and I am now 40. He is 67 now. The Walmart is 1.5 miles from his home. He is already depressed and this weekly trip gives him something to live for. He uses the mobility scooter to shop, which he sometimes has to wait over an hour for once he arrives. A few weeks ago he drove himself to the hospital for a bowel blockage. They sent him home after a couple days. Since then, he has gotten a little weaker and I am afraid he is going to fall, which could set off some very serious consequences. I added some stabilizer bars in his bathroom and got him his own small mobility scooter to use around the house. His face lit up with excitement. I tried to discuss getting some ramps so he can access other areas of the house (it is only 2 steps down) and a hitch for his car so he could bring his own scooter to Walmart on Thursdays. My mother lives with him, but they have separate bedrooms. It is a very bad relationship and they live together for financial/convenience purposes but she won't help him with anything. Neither my mother or sister will help or even discuss if we should be getting ramps to help keep him safe or not. It is expensive and it is all on me. I don't know if I am making the right decision. Should I just leave things as they are and wait for him to fall? Won't the scooter and ramps make it safer for him to move around so that he is not as susceptible to a fall? Is there anyone I can call to help me evaluate something like this. Because my mother won't help, I have to treat the situation as though he lives alone. Any advice would be much appreciated. Thank you in advance.

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It seems to me your father needs you as his advocate. It's not much of a 'convenience' for him to be living with your mother since she and your sister refuse to help him at all, or even discuss his safety requirements since having a stroke! How does it benefit him at ALL to continue living in this home? His needs have got to be taken into consideration; living separate lives is one thing, but your mother MUST allow changes to be made to the home in order for him to continue living there and contributing to the expenses. Otherwise, he should move out, get a place of his own where he can live life on his terms and finance it alone.

That said, you can hire an Occupational Therapist to come into the home and evaluate dad's needs regarding a ramp, and other things that should be done to accommodate his deficits. Of course the scooter and ramps would make it safer for dad to get around, but only if the correct ramps were installed and maintained, and if dad is able to operate the scooter properly. The OT can advise you on that as well, I would think. Then you'd need to also make sure mom is on board with having some changes made to the home ie: ramps & things to make dad's life there more comfortable and safe.

I wouldn't wait for dad to fall in order to look into making his life better and safer; that could result in a broken hip or worse, and require him to move to Skilled Nursing permanently! Worst case scenario now, dad moves out of the home he's currently living in and into a handicapped accessible apartment unit or duplex which already has ramps installed.

I hope you can get an OT in to look the house over and to help dad with his issues. He's fortunate to have a daughter like you to look after him and to care enough to see that he's safe.

Best of luck.
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NicoleC Jun 2022
It definitely does not benefit him or her for them to live together. Thanks for your suggestion for an OT, I will try to start there. Honestly, it would make me so happy if he would move out and my parents lived apart. Both of their lives would improve. It is extremely difficult to watch them stay together like this and I would never want my children to experience the pain it causes.
If he moved into a handicap accessible apartment he could have a chance to live, I just don't think I can convince him to do it unfortunately.

Hopefully, I can convince them to let an occupational therapist come to the house to assess the situation. I am willing to do whatever I can to help but I am not a professional at this and I am very afraid of inadvertently making the wrong decision by trying to do the right thing.

Thank you so much for your response. It really helps to talk about this.
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Oh goodness.

The person to help you evaluate your father's environment and recommend equipment, adaptations and techniques to reduce risk and enable him is called an Occupational Therapist. His stroke team, assuming he has one, should be able to refer him.

But that's not really all there is to it, is it?

Assuming (again, sorry) that your mother is approximately the same age as your Dad, they are both very young to be resigning themselves to living miserably with a partner they don't seem to love for the sake of avoiding inconvenience and financial penalties. Does your Dad feel the same about her?

Was it like this before the stroke, before Covid, before whatever happened to create this very difficult situation?

It's bizarre - the home is your mother's environment too. You'd think she would be prepared to discuss it, even if only to say "eff off, you're not sticking ramps all over my bloody house." And why is your sister taking the same attitude?

To begin with, my advice would be to stay well back until either you can see a clearer way forward, or your help is requested. Do not spend money, and do not intervene (you can be supportive to each of them, but don't get in the middle).

Is he able to meet his own basic living needs, such as eating, drinking, washing, dressing, laundry, taking medications; and if not are they being met with reasonable civility if not actual kindness?
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NicoleC Jun 2022
Thank you so much. I am going to look into an occupational therapist. His stroke was in 2019, so he is finished with any physical therapy they were offering him and no longer has contact with the stroke team, unfortunately.

My mother and father are both in their sixties and have been living like this since I was a child. Never did I think I would still be dealing with their hatred for each other in my forties. I have gotten used to ignoring it but with my dad's mobility deteriorating, it is hard not to want to be there to help.

My sister said that it is just too much for her to deal with and she can't get involved. I understand but here is the crazy part, she and her husband own the home my parents live in. It is situated adjacent to their company and they need access to the home/driveway for their employees, so it would be difficult to have a tenant that wasn't understanding of this.

He is able to meet most of his own living needs but I am terrified he is going to fall while doing so. The home is not set up for any kind of accessibility needs. I have added some railings around his toilet and my husband will be installing a grab bar. There are only 2 steps down from the kitchen to living room, which I think I can solve with an 8 foot portable ramp. Even if he uses a cane/walker instead of his scooter, I think the ramp is safer. I know I cannot prevent him from falling forever but I would like to try to avoid it as long as possible and I am kind of shocked i am being met with the attitude I am getting from my mom and sister about it. It is just a little hurtful and is making me question if I am doing something that I should not be doing.

Thank you again for responding. "Talking" about it helps a lot and I appreciate your advice.
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As CountyMouse said, an OT is what you want.

They can assess homes for rails, ramps etc & assess people for mobility aides & equipment to make life easier & safer.

OT could even be worded up that Dad's situation is tricky. A full 'functional assessment' covers mobility, ADLs & I'm wondering about emotional/social needs? If there were big red flags that his needs were not being met now, or in near future.. maybe this could open discussions to his future living goals?

Your folks sound kind of stuck. Stuck is better than sliding into depression.. but thriving would be so much better, yes?

Would a nice AL with ramps in place, more social activities be his thing?
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One thing that you want to be mindful of. The less he walks the worse his mobility and strength will get.

He should continue to walk as much as possible and exercise as much as possible.

Using a mobility device around the house will cause him to deteriorate quicker.

You really don't want him becoming wheelchair bound.
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TekkieChikk Jul 2022
WISE WORDS. I worked in a vocational rehabilitation facility for nearly 30 years and the one thing the OT/PT staff always told our clients was to keep walking for as long as you could, because once you started using a wheelchair or scooter chances are your walking days were over.

Saw this happen to far too many young adults... they'd want a motorized scooter, PT/OT would not endorse it, so they would circumvent the system and get the agency paying for their education to buy one for them, and then they'd eventually just stop going to PT altogether and turn into marshmallows that walked only when necessary. Same advice is still relevant for all adults of any age- my 85-year-old aunt's orthopedic specialist just told her the same thing last week, to keep safely walking as much as you can (they even encouraged her to keep bowling but to start using a lighter weight ball). She uses a cane for stability, that's it.

*** To Nicole: 67 is pretty young, so if dad is fading you may want to schedule an appointment with his primary care doc and go with him so you can hear what the doctor has to say. And he obviously craves the social interaction (Walmart) so keep him interested in that however be mindful that since he now has a scooter, he may try to drive it there at some point (3 miles round trip) which might be dangerous... and if the battery conks out (or it starts raining, snowing, etc.) better have a contingency plan so someone can go get him and the scooter. Does he have access to any kind of senior transportation service? Even in our little corner of the world our county's transit authority has a special service for seniors and people with disabilities who need rides to shopping centers, etc. you just have to schedule the ride with them.

If he doesn't already have one get him a walker to use around the house and encourage him to use that and not the scooter. Goodwill usually has a couple on hand at any given time, so you don't need to buy a new one. We got one for my father for $5 last December.

Also.... if mom and dad are paying your sister rent, I would imagine she would have to allow a ramp as a reasonable accommodation according to the ADA. And you should not have to shoulder the cost, contact your Area Agency on Aging and see if they can help (is dad a vet? Call the Veterans Admin too). There are such things as portable ramps that don't require major renovations to property, might be worth checking into that.

Dad is fortunate to have a caring daughter like you so keep your relationship the primary reason for spending time with him, not just to solve problems. I found that the relationship I had with my dad in his later years was different, but in many ways much more interesting. I think the older I got the more I found I had in common with him.
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The OT assessment is a wonderful idea and I hope you are able to follow up on that. Even though Dad's stroke was in 2019, his PCP should have all the necessary documentation and should be able to follow-up with and provide any additional therapy scripts that might now be needed. If Dad has traditional Medicare, he definitely doesn't have to wait for a stroke or fall for balance and gait therapy.

Since your Dad enjoys his excursion to the local grocery store, do you think he would enjoy going to a Senior Center a few days a week. In my area each municipality has welcoming senior centers that have activities such as book clubs, chair yoga, cards, etc. We also have a community bus that provides transportation to the center and to various activities including shopping trips. Anything like that available in Dad's area?

It's awful that your parents (and therefore, you) are in this situation. Would be so much better if they were able to get separate apartments and enjoy their lives but we can't force folks to anything as long as they are cognizant. The grab bars are an excellent addition to almost any home. I would follow the advice given and see if there are any community groups or grants available for installation of ramps but again the OT will be a great resource in this area (one note: in NJ it is recommended that outside ramps be of "temporary" construction so as not to cause an increase in property tax but each state and community is different).

Dad is lucky to have a caring concerned child. Good luck and peace on this journey.
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The thing that scares me the most is the fact that he is still driving with his diminished capacity. My two oldest children were in an accident, over 25 years ago, caused by an old man who had no business being behind the wheel of a car. To this day, my daughter suffers from PTSD because of this. I almost lost 2 of my 3 children because of a selfish old man. Can you live with what might happen just because he enjoys his trips to the store?
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Well--we can't step in and run our parent's lives--as sad as your situation seems, maybe it's the devil they know and are accustomed to it.

Housing is crazy expensive. 2 households in this day and age would take every cent they have...unless they WANT to physically separate (and it sounds like they don't want to) then they can continue to live as enemies in the same home. Sounds way weird to me, but what do I know?

It wouldn't hurt to put a couple of ramps on the most challenging steps--but IDK if I would go the motorized chair route in the home. The less your dad walks, the quicker he will lose the ability to do so at all. And he's only 67? That horrifies me. I will be 66 in a few days.

I know that my mom, after having one knee replaced did NOT walk more. Started to use a cane when she left the house. 2nd knee replacement and she HAD to use the cane. Hip replacement and she was using a walker, full time. She has begged for the 2nd hip (which is fine) to be replaced b/c she is afraid she will fall and break it--but her surgeon said she'd be wheelchair bound, and that would mean she'd have to move to a NH.

She was only compliant with OT and PT as long as they were coming to the house. Once they left, she stopped doing any exercise. That's very typical.

If you can get dad to understand that a regimen of exercise is going to give him MORE mobility, then maybe he can venture out a little more. Being stuck in the house all day sounds awful.

Good Luck--you sound very alone in this.
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You didn't mention how far you live from him, so I don't know if you can do this personally, but I'd find a way to have him continue his weekly trips to Walmart (that mean a lot to him), but have someone *else* drive.
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I forgot to ask if you can help Dad apply for transportation services like Access a ride..for disabled people.
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NicoleC Jul 2022
I do think this is something that will be needed at some point but for now (even if it is just for a few more months) he is ok to drive. I am working on getting him a lift for his car so he can use his own scooter for shopping. Thank you!
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You are concerned as a great daughter would be, his safety is a concern as well. Check w/ his local Area Agency on Aging zip code locator: https://eldercare.acl.gov/Public/About/Aging_Network/AAA.aspx for program that may can assist w/ the ramps needed.

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I wouldn't seek to take driving away until it is absolutely dangerous and unsafe, the elderly need independence for as long as it is safe. If he have funds to hire a in-home caregiver/ companion for a few hours a week would be beneficial. If he has low income, see if he qualifies for Medicaid which comes with much more benefits than Medicare alone and can qualify for In-home care paid by Medicaid. Medicaid - varies by state
https://www.payingforseniorcare.com/medicaid-waivers/home-care - paying for home care
You are doing the best you can and m sure your father is grateful to have a daughter that cares and love him.
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NicoleC Jul 2022
Thank you so much for the information. Everyone here has been so helpful!
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