I am working with an upper 80's father who lives independently and his middle aged daughter. He is capable of doing almost everything himself. The daughter comes in a couple times per week to cook him meals, clean up, give him his medicine etc. However, she is getting frustrated that she is doing so much for him and he is showing almost no initiative. For example, when she arrives at 2 PM, he is often still in bed, hasn't turned on the fan or air conditioning or eaten. He does not participate in Bingo or any family activities unless daughter is able to sway/motivate him. He is not doing any exercise, which is recommended as part of his diabetes treatment. She is getting frustrated that he lacks motivation to do almost everything and he does not acknowledge feeling depressed or needing any kind of help. He doesn't take his antidepressants unless his daughter gives them to him and she can't come every day. Would it ever be appropriate to set up rewards and consequences to encourage capable seniors to take initiative? Or are there any other ideas to help someone take more initiative? Thank you in advance!

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I think JessieBelle is probably correct, that assisted living would be a suitable solution. A less drastic starting point might be to simply see that he is on a good medication routine and that someone makes sure he complies with it. Are there enough family members/friends/church members/etc to visit him a half-an-hour a day to visit and see that he takes his pills? Will his doctor order a visiting nurse to cover some days each month, and maybe to set up his pill box?

The thing about depression is that it is treatable. And with treatment it does get better (unlike, for example, dementia). It is entirely possible that after the meds "kick in" in a month or two that the gentleman will have enough initiative to take the pills on his own, or with simple phone call reminders.

If there are no other reasons for assisted living, I think I'd try very hard to treat the depression right where he is.
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Everyone's thoughts are pretty much the same as my own. I was thinking that he needs assisted living if he isn't managing his medications. Taking antidepressants twice a week is the same as not taking them at all. They don't work that way. If he is diabetic, medications have to be managed daily. I don't know how you can work this. I would see if he would agree to upgrade to assisted living.
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If he can't take his medicine reliably, is he really capable of independent living?

Having medicine in a bottle in the cupboard doesn't treat high blood pressure or depression or high cholesterol or anything else. Unfortunately one of common symptoms of depression is lack of initiative. That makes relying on the person to take the meds a bit iffy.

The problem to be solved here is not how to motivate the father -- it is how to ensure he gets the medication he needs, whether he is motivated or not.

And the first step is probably a thorough physical and assessment of what meds he needs.

Please understand that his lack of initiative is not under his control. Rewards and consequences aren't likely to change things. Depression is a medical problem, not a character flaw or a behavioral choice.
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You say he is depressed and is not taking his medication. Clinical depression is an illness just like any other, I doubt you would consider setting up "rewards and consequences" if he wasn't taking his insulin or blood thinners etc. The depression itself causes the lack of initiative, he needs help with his medication compliance. If he can't manage his meds he may need to live where there are others who will ensure he is taking care of himself.
Lack of initiative and apathy are also one of the early symptoms of dementia. I really think this man needs a thorough physical and mental evaluation.
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