I'm the son of a difficult 88 year old dad. He was diagnosed with mild cognitive impairment in 2017 (not officially dementia), but I'm pretty sure it would be labeled worse than that now. I'm one of 2 sons, but my sibling is across the country so I'm really the only involved family around for my dad
We have had a difficult relationship all my life. My dad is an unpleasant narcissist. I could'nt wait for the day I graduated high school and could get out of the house. After that, our relationship as I have been an adult improved, we would usually talk by phone weekly etc. When my dad reached age 65, he said he would move to the same town as me, but keep his distance and "not be dependent on me" but wanted to be near me in case of emergencies or for help with things. His house is 1 hour away. He is a loner. He divorced my mother 30 years ago in a nasty divorce. He has no local friends, a couple of elderly family members within 2 hours. A couple of friends across the country he can call. But essentially, other than me, has no one locally to help him. Over recent years, he has been declining, and stubbornly was living at home for too long. After the inevitable happened, a bad fall with fracture in August, then after hospitalization, surgery and rehab hospital, he has been in an assisted living place 15 mins away from me for 3 months.
I have been hoping over the past 3 months that he would get used to it and stay. However, he gets in arguments and shouting matches with the staff, has not made friends with any other residents, has created conflicts, has "fired" some staff from taking care of him, and only allows 1 caretaker to help him with bathing. I'm surprised they have'nt tried to tell me that he is not a good fit there and ask that he leave! The place is not full, so I don't think they want to lose a resident so they are fine keeping him. Since he continually says that he is not happy there, we have looked at a few other ALs, but he has not found any he seems to like, and then recently stated that he wants to live at home, either returning to his house or buying a small house near me.
If he returns to his house, I have told him that since its an hour away, I could only practically come on weekends. He would need to get at-home help (ideally 24 hours) via an agency or private. However I fear he either will not find anyone to his satisfaction, or will hire someone who he soon will clash with and fire, or they will be tired of his ways and will quit. It will be very hard retaining caretakers. If he buys a house near me, its closer to visit, but will be a lot of headaches on me and the same issues with finding and keeping a "satisfactory" caregiver will remain.
Should I give in to his wish and let him move back home or buy a home, even though it likely will be a huge increased stress and time-suck for me? Or should I stand firm and essentially require that he stays in AL? If so, should I flat out tell him that, or just stall things and say " we can consider possibly moving home later on, but it will take time to think and research", something to that effect? Me and my sibling have POA. I need to formally get him back to his PCP and neurologist to get a clear determination from them that he can't/ should'nt make his own decisions. I'm not sure if they will but I will see what they say
Thanks for any comment!
-Strugglin' Son
They all want to go home, wherever they think it is.
Get him tested, use that as a response, "When the doctor says in writing that you can go home, we will consider it, until then you will stay where you are at"
Dementia is a progressive disease, he will get worse, and eventually and end up in memory care, that is if he lives long enough.
What you are experiencing is quite normal with a stubborn, spoiled elder who does not consider anyone but themselves. He will continue to act the way even if you move him to a home, he will not suddenly get nice, doesn't work that way.
Don't cave to his demands, you will regret your decision. Read around here there are more than enough posts to help you understand what you will be getting yourself into.
Sending support your way.
Don’t offer your services on the weekends if he does move out. You will regret it.
He is 88. He’s going to require more care as time goes on.
Have you considered having his cognitive abilities checked for his current condition? That’s where I would start. Then you will have more accurate information for each of you to process.
Even if he refuses to believe that his mental capacity is impaired, you will know the truth.
You are not responsible for his care. It will cost him more money in the long run if he hires private caregivers. You deserve to have a life of your own.
I understand that you want him to be well cared for. Continue to be his advocate instead of being more involved with the hands on caregiving.
What do you feel about the care that he is receiving? Does it seem appropriate to you? What doesn’t he find satisfactory with his care?
Facilities see people like your dad on a regular basis. Ask them if there is anything that you or they can do to help him adjust.
Wishing you and your father all the best.
This is known as anosognosia.....which is a person's inability to accept that they have a condition that matches up with their symptoms or a formal diagnosis. Commonly found with mental illness and dementia.
Have dad tested again with a mini cog exam like a MoCA or SLUMS test and see what his score is. Then the doctor can tell him he needs to stay living in AL who hopefully has a Memory Care available too.
Do not allow an angry elder with dementia to dictate to YOU where he should live! As POA, your job is to keep him safe 24/7. If he's angry and not speaking to you as a result of keeping him in AL, all the better. The silent treatment from a narc is truly a blessing.
Even if you wanted to care for your father and you had a great relationship, his health and cognitive abilities will sink. He will require more and more care, time, and effort. But you don't have a great relationship.
Can he even afford 24/7 care if he went home? It's THOUSANDS of dollars a month. Even if he could afford it, you've stated he is hard on caregivers and they will quit. It will get difficult fast to replace them. And you don't want to be the one to take their place.
Frankly, he (and YOU) are likely better off to sell his house and use that money to pay for his care. And believe it or not, strugglinson, you matter too. You deserve your own life.
This could go on indefinitely.
Then, there are the middle of the night needs/wants/tantrums/falls/panics.
Those also could go on indefinitely.
Save yourself.
Leave him where he is.
He has had a life.
You deserve one, too.
He wouldn't be able to manage his own home caregivers, so it would all be on you. Every problem at his home would be your responsibility. The water heater quits, the caregivers don't show up, he hasn't bathed in days and he's hungry. What do you do? (Hint: it won't be what you want to do that day, ever.)
Home care is a pie-in-the-sky lovey dovey idea where everyone is going to be happy so Pops can be where he wants to be. Except that it isn't. And Pops isn't going to be happy anywhere. As far as his buying a home close to you, NO. NO NO and NO. It would run you ragged. Who would be responsible for all the work it takes in buying and moving him to his new home? Maintaining it? Not him. YOU.
At this point, in assisted living, he's as good as he's going to be. Don't let him push you around, and good luck.
Was he caregiving his own Father (or Mother)?
Was he trying to work full time while doing 24/7 care for anyone?
Why does he think YOU should be his caregiver slave? If he yells at medical personnel now, he will be 10x worse to you.
You said you aren't even that close, so why are you "obligated" to sacrifice the prime of your life to an angry, PIA senior, who obviously needs 24/7 care?
Listen to the excellent advice that has been given here.
So now I would like three solid big reasons TO do this from you, remembering that this is an unpleasant, narcissistic man with dementia that is progressing.
I am eager for your response, and ready to be convinced.
PS, son: I would make it very clear to Dad that moving home is unwise and unsafe and that you will not participate WHATSOEVER in his care when he does so, but will supply him with numbers of help for hire, and emergency services. Do not enable poor decisions.
What would be three reasons to follow his wish? Well now I see that these really are not great reasons:
1) Some degree of family pressure from extended family to "make him happy, let him have what he wants"
2) general family expectation to "look after your parents/elders, let them be as comfortable as possible"
3) Religion does state, (not that I'm that religious anyway), eg ten commandments " honor thy parents, love and respect them"
Well, from the answers and this forum I'm learning that there 3 reasons are not good ones, and the counter arguments would be:
1) If the family wants me to do the work to set him up in a house, well, where are they to help!! easy for them to dictate this and not help out!
2) So what? Also, who is to say in his condition he really would be more comfortable at home? And, as someone asked, did my dad go out of his way to look after his elderly parents - nope.
3) This is probably the key lesson to me. Doing the right thing for my dad and keeping him safe is "honoring and respecting " a parent. The ten commandments don't say " let you parents do whatever they want even if irrational". Also, I'm starting to learn that what keeps him physically safe and does'nt grind me into the ground with burnout is also respecting parent in addition to respecting myself.
Let me know if anyone has further comments into my new insights. thanks all.
Frankly, if he doesn't like being around people, he's probably better off in AL where he can retreat to his room than having workers in his home around the clock.
Has he ever been seen by a geriatric psychiatrist? It sounds like he's had lifelong depression.
Even if he saw them, he would refuse any prescribed meds most likely, we would need to force them .
The medical and psych eval are needed and then you work with an Elder Law atty to get that POA changed to a DPOA. You have to make the decisioms for his best living situation, not him and the DPOA will allow you to do that. It's not an enviable position to be in, to say the least and you may wish to consider handing it all off to a professional,m esp given the history you speak of and your dad's unsociable nature.
Best case, imo, would be a facility that will accomodate his increasing care needs and that is Medicaid eligible so that once his estate is spent down, he can remain in the facility and not have another move.
As one who has spent literally thousands of hours on my parents estate and Mom's NH care over the course of over 3 yrs, If I had it to do over, I'd have handed the works over to an elder care agency and looked in on Mom, spending my timebeing the loving daughter and losing the nightmare of the myriad estate issues.
You're struggling at this juncture, my advice is to get out from under it now.
She especially likes "abusing" the button when a male aide is her aide for the shift, definitely if he is a new hire.
The reason that you and your dad have an "improved" relationship is because you do not live with him.
Stand firm, he remains in Assisted Living and possible move later, as the dementia requires a different level of care, either Memory Care or Skilled Nursing.
My father in law has dementia , still hides in his room except for meals , is nasty to the staff etc . It’s been 19 months . He kept asking us to move him , we took him on many tours , he didn’t like any of them because he kept wanting to go to independent living but he can not.
Leave your Dad in assisted living where he needs to be . Like my mother and father in law , your father does not realize that he can not live on his own . He needs 24/7 access to staff and supervision for his safety .
We tell my FIL that he needs to be where there are nurses . Your father is only going to go down hill from now on with dementia and become more unreasonable . He will need more help than you should take on .
I had such an ordeal getting my mother out of her house and the only reason we got father in law in assisted living when we did is because the guy was in shock over his wife’s death or I fear we would still be trying to get them out of their apartment . She had dementia too . Once you get them placed , don’t take them out or it will be like a dam breaking.
bring the staff treats when you visit.
i forgot about seriquell and Ativan. Talk to his doctor.
get a plastic dimestore ball
snd toss gbd ball to him. Engage in activities sling Ruth staff. Bring his favorites. Music good and milkshakes. Party like it’s 1999.
Play the music upbeat and happy loud. Trwats6. If you get him a hamburger and milkshake bring enough for people to share..
ensure with a milkshake is good. Make it fun. He starts yelling or complaining, turn up the music have fun
NO!!!
DO NOT!
"Should I give in to his wish.."
Sure! Of course.
Mmm, yes Dad. Sure, uh huh. You do that Dad. Let me know when you have moved.
Dad can wish, plan, scheme, plot. It's his life afterall.
The only assistance you need to give is a little "mmmm" or "uh huh" here & there.
Listen for a set time.
Change the subject.
Stay out the visit - or leave.
Repeat.
PS if Dad could live independantly, HE could arrange it
In spite of that - my response to your question is a resounding HECK NO!
We have struggled with my FIL nearly every day since he was moved to the SNF. It has not been easy.
But that being said, it is still 1,000x easier than what we would be dealing with if we were still trying to take care of him at home.
I think if you are REALLY considering this - you have to be brutally honest with yourself. You need to sit down and make a list of pros and cons. And the cons list needs to be a list of every possible thing you can think of that could possibly go wrong. Even if it is completely stupid or unreasonably stupid.
I suspect when you do - you will realize that the cons - even potential ones - will outweigh the possible pros.
Additionally - you have to account for the great unknown.
I'll give you a TL:DR reason from my experience. We had been considering ALF for my FIL for a while. For the social aspect as well as the bump in care. He was at home with my SIL and we were starting to notice that he needed more care than she could provide. He was adamant that he was not leaving his home. We knew at some point home care would become impossible and wanted to look into step up care. He dug in his heels. Physically he went downhill.
Then we got to crisis management and went into a series of hospital-rehab-home cycles. And his physical condition deteriorated so much that we literally could not bring him home. And we had to SCRAMBLE to find a SNF (NOT ALF - he didn't qualify). That is not an effort I am ever going to be anxious to revisit if I can help it.
The unknown, the rush to find somewhere that could take him, the planning and anxiety, managing his anger about not being able to return home because he refused to come to terms with it, all on a very short timeline under emergency circumstances - rather than being able to do it on our own terms - on a relaxed timeline. Never again. It was completely unnecessary.
Your father WISHES to go home. But what does he NEED?
You have already said that he lived at home alone for too long. And that was BEFORE he went to the ALF. 24/7 in home care is astronomically expensive. How long can he possibly manage that before he has to go back to ALF or SNF? How long will taking him home be sustainable? Are you just putting a band-aid over an infected wound that is going to fester and need to be surgically remediated in some crisis type of emergency? Because I can promise you that isn't fun for anyone and that just makes it terrible for you and it makes it confusing, infuriating and agitating for your loved one.
Trust me when I say - unless you just don't have any other choice- leave him where he is. He isn't being kicked out. The facility has behavior management and remediation. They are trained to work with different types of residents.
Now, to your point - you SHOULD move forward with getting a checkup for your dad. It would benefit you and the facility to know where he stands mentally and physically to best assess his care level. He may need 24/7 care now.
But please, my friend. Consider what he NEEDS. Everyone WISHES to be home.
this is a key one: "Your father WISHES to go home. But what does he NEED?"
Can he move out of the facility without your help? No? There's your answer.
We on AC seldom agree together for an ONE approach, but the responses here are pretty unanimous.
You haven't been back since asking your question. Many new posters don't know how to respond, but if you look to the right lower end of any response you can respond to us in that way, or simply make a new "answer" to your question.
Once again, you gave us so many reasons why NOT to do this.
Can you give us 3 reasons why you might consider it?
And again, if your Dad is competent enough to make his own decision I would tell him you won't be participating in his in home care.
What would be three reasons to follow his wish? Well now I see that these really are not great reasons:
1) Some degree of family pressure from extended family to "make him happy, let him have what he wants"
2) general family expectation to "look after your parents/elders, let them be as comfortable as possible"
3) Religion does state, (not that I'm that religious anyway), eg ten commandments " honor thy parents, love and respect them"
Well, from the answers and this forum I'm learning that there 3 reasons are not good ones, and the counter arguments would be:
1) If the family wants me to do the work to set him up in a house, well, where are they to help!! easy for them to dictate this and not help out!
2) So what? Also, who is to say in his condition he really would be more comfortable at home? And, as someone asked, did my dad go out of his way to look after his elderly parents - nope.
3) This is probably the key lesson to me. Doing the right thing for my dad and keeping him safe is "honoring and respecting " a parent. The ten commandments don't say " let you parents do whatever they want even if irrational". Also, I'm starting to learn that what keeps him physically safe and does'nt grind me into the ground with burnout is also respecting parent in addition to respecting myself.
As for doing it himself - there is no way he could manage going back to his house or a new house on his own. And no family is around locally who could help him, or even if they are distant, would want to help him. The only way is if I help him and I spend a LOT of time helping himSo , if I say no, there is not much he can do except complain. Thanks - good point. He was declared unable to make decisions while in hospital but its a very good point that I need to get a statement from his doctor that he CHRONICALLY cannot make his own decisions and needs 24/7 help.
Let me know if anyone has further comments into my new insights. thanks all.
If Dad is in a facility he is safe . You do not have to answer Dads calls all the time . You can call back when it is convenient for you . If you don’t respond to all his calls they will decrease .
Tell him he needs to ask the staff at the facility when he needs something. Only intervene when necessary .
The lack of insight can be profound.
My mom was not a narcissist and she was very pleasant. But helping to manage someone else's life is work.
You and your brother need to decide how much time you can devote to providing for dad, outside of real emergencies. How about you each call once a week to chat, and visit on alternate weekends?
All other calls from him go to VM. The facility calls if there is a medical emergency.
Tell dad to "write it down". Have dad keep a list of what he needs or wants. Bunch those tasks so you're not running after items every day.
Try this for a few weeks.
This is how to rid oneself of guilt imho. Guilt is attached to thoughts - if you change those thoughts the guilt is extinguished (or at least fades).
Those extended family.. 'backseat drivers' I call them. Drive the car yourself, sit there & shutup, or get out & walk 😁
I very much like Barb's suggestion of a weekly list. My husband & I work this way, as do other relatives.
Sometimes you find ALL the needs/wants/whims are presented to you as Emergencies eg Come now /I need it today/right now! Sometimes the requests fly in via the backseat drivers.
This is why you (of sound mind) must *triage* the requests. Making a list can help eg Action status: now, later, much later, never.
Otherwise every missing sock can be an 'emergency'.
If push comes to shove, one way to deal with this is to give him a taxi voucher and his keys so that he can move back to his house. If you want to be extra kind, you could leave some groceries. But that’s it! If he wants to be independent, that’s what independence means. Yes, it is possible to do that, and it is fully justified. Meanwhile, keep his place open at AL.
"HONOR YOUR PARENTS"
Here is the thing - What makes them think that just because you aren't making his dreams come true to stay at home for the rest of his life - that you aren't HONORING him? I mean there are two ways of looking at honoring. It is either about respect/esteem or about fulfilling the obligation of a contract.
Respect just means that you have regard for someone's wishes and you have great admiration for them. Contrary to popular belief it does NOT mean that you have to do everything they want or tell you to do. You aren't dishonoring them by not granting their wishes. And you ARE actually honoring them by ensuring that they are in a safe environment where they can receive the care they need.
As for the other - fulfilling an obligation - you are only legally bound to fulfill contracts and even those have loopholes. And I know that we often feel dutybound to keep our word. But often we make promises that we shouldn't and they are impossible to keep. Things like death bed promises to one parent to keep the other parent in their home for the rest of their lives for example. You feel cornered and make a promise. But that's a promise people often feel obligated to keep - that they just can't honor.
The BEST way that you can honor your father is to figure out what is best for him and make sure he gets that - probably in spite of himself. THEY don't always see it that way. Other family members don't see it that way. People want to use "Honor your parents" as a way to guilt adult children into doing what THEY want.
I really don't think that is what that was intended to do - I think it has been twisted to be what people want it to mean instead of what it was intended (not to mention people almost ALWAYS forget the rest of it - which says not to provoke your children to wrath LOL!!)
Anyway, all that to say, I agree with the answers given here. You have found a safe place for him to be taken care of and that is honoring his needs.
You visit him and that is honoring him. It’s sad when our parents become unable to accept their situation and adjust to a new situation. And assume that their grown children will take care of their needs, forgetting that they have lives, too. My dad also placed his mother in AL and then SNF. He didn’t visit her as often as I visit him. But he has forgotten all of that.