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Me and my siblings don’t know what to do. Our 70 yr old father's health is deteriorating before our eyes. What started out a few years ago as just numbness in his right leg, and “ dropped foot” (can’t pick up foot) he constantly falls. He blew it off as a pinched nerve in his neck. Now, he is incontinent, hands are almost incapacitated, can’t grip, looks clinched, extremely thin, hardly can walk without assistance, always cold, can keep his head dropped for hours, like tripod position, and refuses medical treatment. His speech is fine, memory is good. He denies pain, and says just numb. We feel we are neglecting this by his defiance. Since not having a PCP, and no diagnosis, can we take him to an ER ? We are desperate. Please advise ..

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He can refuse to seek medical treatment (if deemed competent). He has that right.

He does not have to right to insist YOU or your siblings fix his issues; help with falls, with incontinence problems, house him if he can't look after himself.

I had cleaned up one too many incontinence problems. I suggested my relative tell her Doctor about this worsening problem (refused). I sought a referral to a specialist clinic (she agreed). She saw the nurse but had denial over the problem, would not take the advice (diet, medication, products, behaviour). So.

The Social Worker told me;
Advice.
Let them choose.
Let the consequences be their own.

When we went out she expected me to fix any incontinence issue. So I no longer take her out. When coming to my house she expected help. So she is not invited to my home. When I got calls for falls/mess I told her to call EMS, if she did not, I did.

Tough Love was not a concept that came easy to me, but I have a clear conscience that this was the best way to provide help.
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CharlieSue Dec 2020
Me, too, Beatty. My mom calls life alert about falls, because I didn't come; couldn't lift her. She called me once or twice about messes, but I can't, just can't do that, so she calls one of her several paid caregivers. I've been there when her weekly nurse comes, and she showtimes; also at the doctor's. Like you, I've learned to stay at arm's length, partly so that she will do what she needs to and go into care before she gets really hurt - so far no dice, but still hoping. This tough love is tough stuff, but so necessary.
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Your father needs medical care and he needs it badly. That he is in denial to this extent is NOT normal and competent behavior.
I would say that yes, it is time for desperate measures. Tell your father that if he will not go to the ER you will call the EMT ambulance and have him transported there for diagnosis. That this started two years ago and has had no care in all this time is bad news. Do not delay.
To be frank, his refusal to seek help is at this point is indication of incompetence in decision making to transport him.
You could also report him to APS as adult in danger, and try to let them handle it.
You are up against a person who is in deep denial. Explain everything to them.
If seeking help in this manner, first speaking to him about ER, and second ambulance, third being APS does not work I have utterly nothing else to advise. If he refuses all care I would then withdraw my care, and tell him to call only when he understands he needs medical help and diagnosis. This will come to a head with a fall soon enough, and then transport will be done.
This could be anything from nerve to tumor to chronic illness, but without medical care you cannot begin to guess.
The EMT can refuse to transport someone who appears to be competent in own decision. But you will have done, then, everything in your power. Don't continue to enable this denial. Two years has led to this. It will go downhill from here.
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Mazinmets9 Dec 2020
Thank you very much. What you have said is what I presented. Ambulance .. to definitive care and at least we know he is safe and going to get a diagnosis. I do fear him refusing to go, because then we are left to watch him die slowly as we smells terrible, urinating on our furniture, depends exploding and leaking out his pant leg. The only “ help” he wants is to live with me so I can basically get him what he needs, but I am refusing until he is seeks medical attention and gets a diagnosis. Epic stubborn and arrogant. It’s very upsetting
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Alcoholism leads to liver failure which leads to encephalopathy--an inability to think 'normally'. Alcoholism slowly but surely kills. It's a nasty death.

SIL is a GI doc and lot of his patients are end-stage alcoholics whom he cannot help, as they don't want to stop drinking. He's pretty 'over' trying to get them to dry out, esp the elderly ones. The damage is done and is usually irreparable.

Your dad sounds like he is end stage alcoholic poisoning. Not much you can do. A Dr. or ER would simply work him up, maybe keep him for a day or so and then send him back home.

I'm sorry for you--it's awful.
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My hubby has dementia. He is at the stage that he cannot make decisions for himself without harming himself. However.......... He fell and injured his leg . The paramedics came and he had difficulty raising his leg so they suggested that he go to the hospital for evaluation. He said he did not want to go to the hospital. They said if he refused to go that they could not take him. I explained his dementia to them and they said it did not matter if he had dementia or not. If he refused to go that was his decision regardless of a dementia diagnosis. So, they left. I had to get neighbors to help lift him and get him into the car and drive him to the hospital because he could not bear weight. It was not an easy task. Ended up that he did not fracture his leg or hip but did have a severe bruising of hip and leg. Our laws are sometimes counter productive to the needs of the client.
Sandy
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Beatty Dec 2020
How hard for you! And for him... making a poor decision that meant waiting longer for treatment.

My relative has refused EMS transport too. But EMS did override that once when a head strike was evident.

A friend's Father has suspected dementia & fallen multi times this year, refusing treatment & transport each time. His wife could not lift him alone, but neighbours now say no more, as does daughter. She no longer attends. Last straw was when son refused to lift him. Told him to stay on the floor for the rest of his life or accept EMS help. His wife provided a blanket & served snacks while he sat on the floor. After sitting in his own filth for about 6 hours he finally gave in. Another time he gave in earlier as he was lying down & couldn't manage to eat & was hungry. Another was 12 hours - had refused EMS but wife called again & again & they monitored him over the phone. Came for him when he couldn't talk properly. That was confusion with UTI, dehydration & poor kidney function.

So very hard. Strength to you Sandy.
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He Has a MRI of lumbar spine and cat scan for chest scheduled for next Saturday. 1/9. Then a neuro on the following Monday. We should know more very soon.
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Unfortunately, since you mention your father is an alcoholic, he has chosen his life and also his death. He may not want medical intervention b/c then he would have to stop drinking in order to rehab, etc.

You can't save a person from himself.

This has to be extraordinarily difficult to witness, I'm sure. I'm sorry you are going through such a terrible ordeal and that your father is behaving in such a selfish manner.

You are not 'neglecting' him; he is neglecting himself. You have tried everything within your power to help him; HE is the one who's refusing the help.

If the event happens that he falls & you can't get him up, THEN you can call 911 and have him taken to the ER for an evaluation. If he's of sound mind, he'd have to consent to treatment, of course, putting you back at square one. But if he's broken a leg or a hip in the fall, there will be no other choice BUT to get treatment. And you go from there.

Wishing you good luck and Godspeed with such an unfortunate situation. Sending you a hug and a prayer as well.
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Mazinmets, I think you hit the nail on the head when you mentioned his alcoholism.   I won't pretend to guess how or why this happened, but it would impair his judgment, especially if it comes to making decisions on how to proceed.   He might be drinking also to avoid the realities of his declining health.

With a dropped foot, I think it's only a matter of time before he has a significant fall and ends up in the hospital.   (My sister suffered a dropped foot when metastasized cancer affected her ability to use that leg and foot.   I've witnessed how difficult it is to balance and walk.)   If he's been drinking, he's not attuned to balance or safety, and one serious fall could seriously send him to the ER.

Have you thought about asking local police to do a welfare check?   If you explained to them ahead of time what the issues are, they might determine he needs to be taken to a hospital ASAP.

The corollary issue is how his lack of hygiene may be affecting yours.    No one should have to live with that kind of lack of care, and you don't want to end up sick and in the hospital yourself.
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This is breaking your heart, and you are all lovingly seeking a solution to this problem, but before you go any farther with any approach that presents itself, DO NOT ALLOW HIM TO MOVE IN WITH ANY OF YOU.

As it sounds based on what you’ve written THE ONLY bargaining chip you have is insisting that you have a diagnosis and treatment plan before you will consider allowing him to live with any of his children.

No, NOT what ANYBODY WANTS TO DO to a dearly loved parent, but you MUST do a shift to DO FOR HIM. Surely it is beneath HIS DIGNITY to allow him to continue this way.

You have tried reasoning, acceptance, kindness. Nothing had succeeded in getting him help. Lay out the facts with as little emotion or judgement as you’re able to do. You love him dearly and his presence in his present condition is causing you all unmanageable distress. It’s a medical evaluation or you will all withdraw your assistance and leave him to his own devices.

If matters tragically deteriorate to that point, then the call to your local adult protective agency.
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Thank you so much for all your compassion and wonderful answers. You have helped me a great deal. I will copy all answers and send to my siblings in an email and see where we go. I think I have chosen to give him tough love and take him to an ER. Hopefully once in the caw of a physicians, he will understand why we did this. Thank you again, his forum is amazing❤️
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Update: he has an appointment Wednesday, tomorrow the 30th! He has agreed to go. Will follow up with his diagnosis! Thank you everyone for helping me push to get him the help he needs!
total relief!
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