Three years ago my husband and I moved my dad in our home. At that time he was able to do everything for himself and was driving. Things have gone downhill in the past year. He was diagnosed with onset of dementia. He now doesn't drive, needs help getting around with a walker, is wearing diapers and depends on me for other daily needs.
I am an only child and my husband is wonderful with his help.
Here is my question... my husband and I would like to take a vacation and my Dad is not cooperating. I was going to take him to respite care... NO. I was hiring in-home care... NO. He wants to stay home alone and I have a pet sitter that will just check on him. He is in fear someone will hurt him.
I don't know what to do next and I don't want to deny my husband a weeks vacation either.....Help.. what do I do?

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Your house. You decide who lives there, who stays there, and what services you hire to run it.

Have you got as far as actual enquiries about the in-home care option? I should talk to a reputable agency and explain what your father's needs are, and that he is used to having only your support. A good agency will be very familiar with this sensitive issue and should have invaluable advice for you. You want to talk to one which offers 'aging in place' services, so that they have a good understanding of the house-and-person combination.

The point to make to your father is that this service is for you and your husband, so that the two of you are able to enjoy R&R as a married couple and recharge your batteries. You don't need his permission to take your break; and you don't need his permission to insist on cover for yourselves while you're away.

The caregivers will, it's true, need his permission to assist him. But befriending, encouraging and reassuring vulnerable elders is all part of the skill set that you're paying them for.
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Dattwood Jan 2019
Thank you so much for the encouragement... I needed that.
We transitioned my grandma into fulltime care. You may be past this point but it's something I am facing a second time as my mother declines.

When possible, don't help in ways that a facility or caretaker would and the facility or caretaker will be their better option and you will not develop expectations that crush you.

After she cracked ribs in a fall and didn't tell anyone for a week, we enrolled her at a facility which flexibly let her visit away from the facility. So, with a lot of cajoling, she would go for a social event with other elders and would end up staying overnight when she got tired rather than wait the 30 minutes for a pickup and half hour drive home. An hour seemed like a long time to wait when she was tired. We did not wait there with her as a valet service.

Eventually, she became fearful of going home because that meant being alone more often and chose to stay longer and longer. Even in her incapacitated state she began to avoid a trip home to get something or spend a weekend at her house. Her house seemed too complicated and scary. We helped set it up that way as we did not make being home easy for her. Her sense of home became attached to the facility.

We didn't make it easy, not in a cruel way, but things like if she didn't like that the dishes were up high we agreed and discussed how it wasn't a problem at the facility. We didn't move the dishes into easier reach and she didn't think to ask. If the laundry piled up we only did washing for her during her facility visit. "Oh, looks like you have chores building up, take a day off and I'll do things here."

It was so relieving when she stated she no longer felt happy at home and the facility was where her friends and sense of safety was.

It ended up that she would live for about 15 more years and was total unable to care for herself. It would have been a nightmare to try and make her home wheelchair accessible and safe for someone who was medically fragile and was panicked by leaving for appointments.

By the time she was too medically needy for the facility and moved to a 24/7 medical care facility she was too far gone to notice the change and she was used to the routine.

I suggest to anyone to transition while your loved one still has the faculties to participate in the transition and is struggling with self-care so that the facility is a relief to them.

Once you are expected to help with toileting and feeding your life will be totally on hold.
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AnnReid Jan 2019
My mother suffered as long as I can remember with severe agoraphobia and crushing anxiety. Our experience with her placement was similar to yours, and she functioned far better after placement than she had at home.
Very well stated.
In my experience, the hardest thing in the caregiver’s world is making the mental and emotional shift from expecting reasoned judgement from the LO to (rightly) denying them the right and opportunity to decide for him-or her-self.
As long as you have researched the respite site and you are satisfied with what you have found, his “no” doesn’t count.
I was an only, and I am now one of two POAs for my mom’s youngest sibling.
Take my word for this- not having a sibling to help may be less of a nuisance than having someone else involved who does nothing but get in your way.
You are SO fortunate to have a husband who honors you and his FIL by stepping up.
Treat that husband right and arrange for a refreshing week away, and treat Dad right by finding the situation for him that YOU are prepared to trust, and present it to him without an alternative choice.
Trust me, I’m sure that out of your concern, you WILL make the choice that is the best available to you.
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Dattwood Jan 2019
Thank you so much for this feed back. I think that everyone agrees that it's not his decision. I'm going to go check out the RC and see what it's all about.
Since your dad is afraid someone will hurt him that is the issue that needs to be worked out.

Whether he goes to a respite facility or you have someone come in to care for him, get him used to it before your vacation. Take him for an overnight at a respite facility, let him see it's not so bad. Or start having someone come in now from time to time to let your dad get accustomed to it. You and your husband go out for part of the day and let your dad get acquainted with a caregiver knowing that you'll be back in several hours.

And if your dad agrees to stay home with a caregiver while you're on vacation ask the pet sitter to check in on him anyway since that person is someone your dad already knows.
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Dattwood Jan 2019
Thank you very much..
Do what you want to do, not what you feel you should do. They never want to move; they never want to make any changes, and they become very set in their thinking that it is just fine for you to sacrifice all. Change is very hard for them but this is necessary. I would put him in a respite care facility; no drama, just state that this has to happen. He would not be the first person who went to respite care; if possible, yes, have him do an overnight but don't try to talk him into it saying it is to see if he likes it. He needs to stay there if he likes it or not. They will help him transition.
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You can ease him into it as best you can but get the help. It isn't his choice unless he want's and is willing to participate. While the stance is firm I wouldn't present it that way, at least not right off the bat. I would say this vacation is important to both you and your husband, things have changed since dad first moved in (he knows this) and you aren't able to handle it all on your own anymore anyway so how about testing out some people just to see how it might work. Bring someone in for a couple hours at first, you stay as well being part of the care/day using your instinct about how to balance stepping back. So the goal is to be there (making dad feel secure) but having the care person doing all the work while making it feel natural, then you have them for say 4 hours and you stick around for part of the time and then run out to do "errands" for some of it until dad gets to know the new person and relax with them a bit. Then they come for several hours while you go out or you do something for the day and he stays alone for whatever stretch of time he already does, on one or the other end of the time and the care person is there the rest of the time (so dad is alone during either arrival or departure). Dad may still not like the idea or want it but without making it a fight he has to know he doesn't have a choice in whether or not you are going to get outside assistance but he can have control over who it is, how it works etc. Including if he can't cooperate with having someone there he can choose to go to respite, you could even visit a respite option so he can choose between that and having someone come in. Right now your letting him hold you hostage and that needs to change (learned that the hard way) so even if you need to enlist his doctor to be the one requiring that he not be left alone for more than 2 hrs (whatever the number is or never if that's the case) or maybe even requiring that a professional come in and "asses" him at home. That typically happens after a hospital stay, VNA comes in for a period of time but a doctor can order that for some medical reason (a good doc can find a reason) and they will come in 2-3 times a week at least, maybe more if they find he needs more and that might get him used to having people come in at least. Then the situation can be that he either get's assistance at home or he needs AL or something giving him the option again but not the option to care for himself. I don't know the exact answer for your dad and your situation of course, these are just ideas but some form of them, whatever works for you is what I would try, what we did do before fighting with him about it because that will make him did his heels in more and he has the ability to do that until he lands in the hospital of course but if you can avoid that trauma by taking away the choice of weather or not there will be outside care without Laying down the law, so to speak, this process will be far easier on all of you. Not saying it will be easy or smooth sailing but easier than what you have building now. No if ands or buts in your mind though, you will go on this vacation and you have reached the end of being his sole caregiver and that is all out of love for him as well as yourself and the rest of your family. You are doing what is best for him here as well as everyone else, don't loose sight of that, you are operating from a very loving place. No guilt! Good luck.
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Dattwood Jan 2019
Thank you so much for all the support. I'm going to visit 3 respice care places to see if I think this would be best.
What Bobbing is true. There comres a time when you have waited too long and they don't adjust as well.

This is not Dads decision. This is yours. I personally would not set up 24/7 care in your home. Dad probably wouldn't call to tell the agency someone didn't show up. Call around to the NHs and ALs. Some have respite care. That way Dad is fed and taken care of and safe. You can enjoy your vacation.

Don't ask, tell Dad you are going away and you have made arrangements for him to stay in an AL (I would go this way) for the week. You will pick he up when you return. If he says no, say sorry Dad but hubby needs this vacation and as his wife you are going along. And he needs to go to the AL so u don't worry about him and can enjoy the trip.
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Dattwood Jan 2019
Thank you it gets harder to separate myself from being is only child to his caregiver.
It's your house, your way of doing things. Go on your vacation and do put him in a facility. If you go for the home caregivers, you run the risk of them showing up late or not at all. With a facility, someone is always there. If your father pitches a fit, just say that you and your husband pay the mortgage and taxes on the house, you make the rules.
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Dattwood Jan 2019
Thank you so much!
Tour a few places that you think would be good for his respite care.
Pick 2.
Take dad with you to do a tour as well.
Tell him you are going on vacation and that he can choose one or the other. If he does not choose you will.
Pick one.
Get all the paperwork you need to get done. He will most likely need a TB skin test and a recent physical.
Tell your dad that you are leaving on vacation on........whatever date and that he will be going on his own vacation.
Do not let him guilt you into not going.
I think you should also think of this respite stay for him as maybe a permanent possibility. It is going to get more and more difficult for you to care for your dad. Might be something to think about and talk about with your family while you are on vacation.
(If your dad is on Hospice Medicare will cover the respite care. )
By the way if your dad is a Veteran the VA may also be able to help. Just another avenue for you to explore.
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Judysai422 Jan 2019
I would also add to the explanation that YOUR doctor told you that YOU need a vacation...And HIS doctor said he CANNOT STAY HOME.

Then when you get home, start exposing him more to in home help so you both get used to it for the future.
Praying your week off is a cruse. . Dad will know you cannot be reached for his issues back home. Thinking you'll be interrupted continuously while trying to relax while away. . To the point you'll have to cut your vacation short. God Bless you for your care and concern. (might even tell a white lie ~ that that's what you'll be doing. )ENJOY THE R & R ~
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