My dad has a history of doing nothing about his health until it’s too late/he’s in crisis. Then my mom and I end up taking care of him. This has gone on for years.
For years and years he refused to go to the dentist. Well about 7-8 years ago, his plate broke so he had no choice but to get help with his teeth. But by then his mouth was in such a state that the dentist had to remove 8 teeth at once so he could make a new plate. And since then Dad has never been the same. He was unable to eat properly because of mouth pain, the new plate not fitting, and so many other issues. So he lost a TON of weight.
That was the beginning of extremely rapid physical decline for him. He never recovered from that experience. He is now skin and bones — 128 pounds; he weighs less than me, his youngest daughter!!! He’s extremely weak, frail, and tired all the time now.
Another contributing factor to his decline was a hormone treatment for prostate cancer. Side effects of this treatment are loss of appetite, loss of bone and muscle mass, and cognitive decline (among other things). Dad has all of these side effects. He’s no longer taking the cancer treatment, but the damage is done.
He has also developed several bulging discs in his lower back. So he’s in pain all the time and the pain drains his energy.
Mom and Dad moved to an assisted living facility at the end of 2024. And since being there, he seems to have withdrawn even further. He’s in pain all the time and barely eats because he struggles to chew his food (and could be suffering from loss of appetite due to the cancer treatment). He is so tiny now. He doesn’t engage with people anymore like he used to. He has always been very charismatic. But lately all he wants to do is sit in his chair in their little apartment and sleep between meals. He has no desire to do anything. Mom and I think he’s suffering from depression. They gave up their house and now all they have is this little apartment. He is not coping well.
The thing I really wanted to share is about his stubbornness. Meals are served on a schedule at the facility. Breakfast is at 8am. So my father pushes himself (and my mom) to get up at 6:30am every morning to go to breakfast. That might not be a big deal for some people. But my parents are night owls. So this is a huge huge adjustment for them. They’re going to bed earlier now. But even so, they are tired all the time. And it’s clear that my dad is wearing himself out. I was with them on Mother’s Day and after we had lunch, he sat on the couch and fell asleep. He looked so haggard and pitiful… He’s absolutely exhausted. He didn’t even want to watch Mom open her Mother’s Day gifts.
I’ve tried to tell him that he doesn’t have to get up so early for breakfast, that he’s not getting enough sleep, and he’s wearing himself out, that they could arrange to have their breakfast brought to them so they can sleep later. But he will not listen. He’s adamant about going and he doesn’t seem to understand that he’s hurting himself.
This is exhausting for me because over the years Mom and I have had to fight with him to take better care of himself. He just refuses to listen.
The other thing that I fear will be a fight is getting him to go to the doctor and get injections for his back pain. The doctor diagnosed him with bulging discs probably about 9 months ago and prescribed a series of injections to ease the pain. Dad has not gone back to get the injections. If he would get the injections, maybe that would reduce his pain and improve his quality of life.
It’s so difficult for me to go over there and visit my parents in the facility. Watching both of them decline has been excruciating. But especially watching my dad has been unbearable because I really believe he could improve if he would just do what the doctors etc recommend.
I know it’s his decision. But is there any recourse for us here? This is incredibly difficult.
At least they are in assisted living , and not living unsafe at home .
Get some instant oatmeal, bread for toast, whatever they like for breakfast. Tell your mom to do what she pleases, sleep in and eat when she likes.
Your father long ago chose the way he preferred to live his life. You, mom and siblings stepped in and rescued him. Then it happened again and again and on and on. This is your family dynamic. Push, pull, push, pull. This is not meant to be blaming because it isn't your fault, but: Dad controlled you and the family by his behavior, and that might have been helped by family counseling when you were a child. Now it's too late, and the push-me pull-you continues because that's the only way you know to relate to each other. He controls, you react. He controls, someone enables.
I believe that if dad were in enough pain, he'd go get the shots.
How tall is your dad? Look up his BMI. Although this is no longer considered a valid indication for body weight, it will give you an idea of the level of alarm his current body weight might be considered a huge problem.
He has lost how much weight over 7-8 years? What did he lose this last year or last month? I’m asking you to put these things in perspective so you aren’t wringing your hands over the wrong things. Your dad is 90. That’s a good long life. Everything he has done hasn’t been all bad or he wouldn’t be 90. If he has no appetite or doesn’t enjoy his food, there a medication for that. But if he eats “enough” to pretty much maintain his weight as it is, then not a problem. If he eats a lot and is still losing, that’s more of a sign of a problem.
My dad had back issues and would get up in the middle of the night when his back hurt and play solitaire on the computer. He also could have had shots but after discussing it with his ortho he decided he would rather have pain than deal with side effects of the shots. He didn’t have dementia. Those were his choices. Your dads walk may actually be the only thing he does to help his back. My dad spent his day creating things in his wood shop. That’s probably what aggravated his back but again, it was his choice.
Going to the dining room instead of eating in his room is, perhaps, the only exercise your dad gets. You don’t mention your mom being unhappy about going to the dining room. Many, many people sleep after eating. It is a cultural thing in many countries to rest after eating. Eating and digesting food slows the system down. He gets drowsy and falls asleep. At 90, for sure allowed.
My advice to you is treat your anxiety. Especially before going to visit. None of us want to be “shoulded”. If ought to, should have, must do, any of those come out of your mouth, bite your tongue and enjoy that they are so agreeable as to be living in managed care. That they leave their room. That they have each other. Soon enough those won’t be the norm for them.
Reflect on your own life choices. Have they all been perfect?
Remember we can’t change others, only ourselves.
I’m sorry for your distress. Losing our parents and watching them decline is hard. I apologize for “shoulding” you. 🥹 Feel better.
Your father is tired and shouldn't be forced at this point to do things that he doesn't want to do or that will only prolong the inevitable, which is his death.
Instead call hospice today and have them come out to do an assessment on him, and let him live out his days in comfort and peace, without being poked and prodded by any more doctors.
He deserves that much don't you think?
Unless he becomes mentally incompetent, you can not take over POA. When he does becomes mentally incompetent, your mother has that authority as long as she is mentally competent. If both of your parents are not mentally competent, per doctors evaluation and signed statements in their charts, then you and your siblings will share that responsibility.
I think it is Alva I can thank for this quote "not everything can be fixed".
Sometimes just spending time together, holding a hand, listening.. is all you can really DO.
But it shows love which can be felt.
It is horrible watching a slow motion decline.
So sorry for the stress that you and your family are dealing with.
We cannot make others do what we want them to do. They have to want to do it. So sorry for you and your brother.
I would not concern myself so much with the weight. Being of lower weight can actually help one live much longer. My own partner is 123 # at 84 and gets only complimented on how clear and healthy his arteries are, and told not to worry about his weight. We don't anymore. It is also normal to sleep more with age.
Your father is now in the last stages of his life. He has battled a cancer and he sees a doctor for pain care help. It may be wise now to think in terms of palliative care and Hospice for extra help and support in this, his final stage of life. Be certain all advance directives are in place. Speak honestly with a Palliative care or good Gerontology specialist about the final stage of life and how to make it the most comfortable you can until the end comes.
I am sorry; now is the time to concentrate on suffering and comfort care and pain relief. Both Palliative and Hospice can help a lot with that.
Asking about pallative (serious illness) hospice may give you some other options. IF they cannot take your dad on, they may have suggestions. A possible independent evaluation in their living space is worth the call to Hospice to ask. Be sure you are there with the evaluator to ask questions - like "now what" and "what options should I explore" etc.
Find out if there is in-home nurses in your area - RNs and PAs that come directly to the facility/house rather than going to a doctors office. They can prescribe pain meds appropriate to the circumstance AND tell you what has to be done in an office while giving ideas specific to the living situation.
The most difficult thing for me is taking a parent to a doctor's office and made to wait in a room for 15+ minutes, no compassion for the situation, and told to do more whatever...just treated as a machine. Nurses are SO much better. Hospice nurses are AMAZING on giving information in a situational way. Pallative care could be just right.
AND hearing "don't go to breakfast" from "an authority" might just do it for that item. Use all the ideas you can.
Big hug.
"This is exhausting for me ...'
Your answer: "He just refuses to listen."
Yes, it is excruciating to watch your parents decline due to self-neglect.
You say you know 'it's his decision' although I sense you don't get this in your gut / in your soul. For years, you've wanted him to be a person he isn't - a person who cares about their self / their health and well-being.
I sense that one 'reframing' or shift in how you are thinking is for you to decide to let go. Realize what you can and cannot do (for years, if not decades) ... stop having this internal fight going on inside you - tearing you apart emotionally and mentally, and it will affect you physically, too.
You cannot make a person do anything, as you know.
You can only change how you relate to the current situation / circumstances.
Recourse:
* Meditate
* Exercise
* Be present and accept what is
* Have others visit (give yourself some distance from situation)
* Evaluate your own health and how you want to be - and how to achieve this.
--- I believe the first step is you deciding to let go of what you want / would have wanted for your dad (and now your mom, too) and cry ... feel sad ... and then stop thinking about it and refocus on what brings you some inner peace and joy.
Gena / Touch Matters
With your Dad's multiple health issues it may be time to have the doctor make a Hospice referral. You can contact Hospice yourself as well. Hospice does not mean your father is going to die immediately. The new Hospice is not God's Waiting Room.
If your Dad is in a lot of pain and is not wanting to aggressively manage his conditions, Hospice will provide comfort care services for him to manage his pain. They can see him at his apartment.
When a person has dental pain that affects eating, weight loss also changes how the dentures fit. My Aunt had this issue, and actually ate softer foods without her dentures for comfort. Also as someone ages, their food intake can diminish due to not being as hungry.
Have an open discussion with your Dad about what is going on and what he is feeling. Let him talk without judging or pressuring him. He won't accept nagging if he is anything like my husband.
Your profile name says it all: you want the best. Unfortunately, you can't make someone else want, or do, the best for themselves.
So, please take the advice of others here, including Gena/TouchMatters and RetiredBrain - change your way of thinking about this problem and look after your own wellbeing, especially your mental health.
You say that you know this is your father's decision, and yet you haven't really accepted this. Acceptance will help you to find peace.
Someone else said that pain relief patches could bring relief, so let your dad know about this and try and encourage him to bring this up with his doctor, as it's less invasive than injections.
However, don't bang your head against a brick wall if your dad doesn't take up your suggestion. This is his life and he has to deal with it in his own way (providing he has competency, of course).
Finally, many people sleep less during the night, as they get older, and tend to take more naps during the day. Your dad isn't unusual in that. So, stop worrying about your parents being night owls and going against their natural rhythm.
It's great that your parents have a routine and are walking to breakfast every morning (although I'm very surprised at how early it's served).
Not moving, not leaving their rooms, and not going into social/communal areas would be far more worrying. If it were me, I'd be encouraging my parents to do this for as long as they can.
I have chronic pain, due to problems with my spine, and I know that the worst thing is to give into it and not move around. My joints and muscles seize up, making walking (or doing anything) difficult.
As far as stubbornness goes, anytime you try and persuade your dad, don't nag because he'll just dig his heels in! Always frame things so he feels that it was his decision.
I also use the "drip-feed" method with my stepdad, as it takes him a little while to get his head round an idea. Then, when he adopts the new change, he thinks that he came up with it himself.
You can not control another person's life. You can only control what you do.
In your last sentence, you say, "I know it's his decision." "But..."
Your But says you don't want it to be his decision, or you disagree, and you want to control the situation. Your stubborn father is not likely to change now.
Make a helpful suggestion to him, then let it go. He may or may not follow it.
Instead of allowing yourself to feel angry or upset, and instead of fighting with your parents, simply allow yourself to enjoy time with them when you visit.
Let them complain. They've earned the right. Your dad is old, he hurts, and he doesn't have much life left. Let them complain, and try this: Just listen. You don't have to try and fix it. The best thing you can do is try and re-direct attention to something more cheerful. Focus on the good things still left in life.
He is not totally exhausted because he is getting up early, he is sleeping throughout the day, that would alleviate that issue. He is old and old people are tired, yet, many have a hard time sleeping because they don't burn the energy they have or do anything to wear them out daily.
My dad would eat and be sound asleep wherever he sat down after leaving the table if he wasn't able to be active.