My mom died 5 years ago. My stepdad was a practicing physician but he was going into the office so infrequently that he did finally close his practice. He stays in bed for hours, if not days, at a time.

I know he is depressed...all his close friends have passed. His daughter lives 7 hours away. She calls but in all honesty is more of a problem as her dad will tell her things like we aren’t feeding him.

He’s Catholic, so I thought perhaps the priest could offer him some guidance. He told the priest we made him wait hours between meals! I was mortified. What is happening is he frequently takes Lorcet or Percocet PRN. He then refuses to wake up for meals or wakes up only to go back to sleep. Both of these meds and Halcyon are prescribed. However, I never really know if or when he has taken any of these meds. He also takes his blood pressure medicine irregularly. However, attempts to use a pill organizer have not gone well. Meds get skipped, he’ll double up on meds...and that’s just maintenance meds. Pain medicine truly is prescribed PRN as is the Halcyon.

Bob has complained to his biological daughter (who lives 7 hours away) and the priest that we don’t feed him. He asked the priest if he could arrange Meals on Wheels. I would arrange meals to be delivered, but Bob often does not hear the door, hears the door but won’t get up to answer it, or sleeps through the doorbell or knocking. I explained he would have to get up and sit up in the family room if he would like meals delivered, because at lunchtime, frequently all of us are at work. He then asked if we had food in the fridge!

I explained we always had food in the fridge, but schedules were such that we all make lunch on our own. I did ask him if there was something he wanted us to keep stocked for him, and he named some things we had. I made sure to buy him things he named he would eat that we didn’t have.

It really boils down to he wants all meals brought to his room all the time. I’m worried this isn’t healthy for his heart. He often wears adult diapers so he doesn’t have to get out of bed to urinate. Or he keeps multiple plastic urinals around his bed so he doesn’t have to get out of bed. He has a walker and a cane, and I know his knees really do bother him. We do have a wheelchair, but he has problems transferring from bed to chair.

He did have a short stint with PT following a hospitalization. He is capable of doing bed to chair transfers. The PT suggested short walks around the inside of the house and outside weather permitting. However, Bob continues to stay in bed to the point that I think he has some muscular atrophy.

My husband and my daughter feel as if we should make him meals but insist he come to the table to eat. I think we are fighting a losing battle unless an impartial third party suggests he needs to regain some strength and recover some mobility or he really needs to go to an orthopedic doctor.

I do feel very sorry for him...until he tells someone we haven’t fed him when in reality he slept through a meal, refused a meal, or got hungry at a time when we were all out of the house and no one was at the house to bring him something to eat.

I could go on and on...but I think you get it: An older man left with no contemporaries who does have chronic knee pain but won’t go to a doctor.

Am I enabling? Or should we concede he’s in pain and is depressed and let him slowly atrophy away?

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I would get him to a doctor. I know you say he won’t go, but it’s time to insist, by whatever means necessary. Trick him, lie to him, tell him there’s no further care by you unless he goes, whatever, this man is far overdue for a complete checkup. And make sure the doctor hears the whole story of what’s been going on. It’s the only way I see that you’ll get a clear picture of where to go from here. What you’re doing isn’t working for him or you, time for a new plan, starting with a complete exam
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How did he come to be living with you? I think that it may be time to reevaluate that, it really sounds as though he would be better off in a facility where his meds will be handed out properly and he will be prodded to get up and move. He will also have the opportunity to be with other people and to take part in any activities that take his fancy. As a retired doctor I imagine he can afford it.
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If he won't go to a doctor how is he getting pain medication? This is a red flag considering the regulations on narcotics.

I would put a small fridge and microwave in his room and keep foods he wants right there. That would handle the false accusations.

He may be getting beyond home care, you could tell him he needs to get up or you need to start thinking about alternative care.

Using incontinence products and urinals from laziness would be a deal breaker for me.

Maybe call his daughter and tell her that he is in serious need of motivation, could she take him for a while or come stay for a couple weeks and see if she can coax him?

Something has to give.
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