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Dad is 88 and he gets around fairly well. He forgets to take meds properly even though I obtained Pillpack. He is as stubborn as stubborn gets but still in a frame of mind to say HELL NO I WONT GO. He eats what he can which isn't a good diet and he has gout attack once every 6-8 weeks literally. He wants to work in his wood working shop which mostly ends up with an injury of some kind. His driving, don't even get me started.


Mom is 84. In late 2019 she had Kyphoplasty (back surgery) and it left her paralyzed. That outpatient procedure took her from hospital to Skilled Nursing, talk about unprepared. Soon after being in the Skilled Nursing (SN) she asked my dad, her husband of 52 years to please come live there with her. He without hesitation said NOPE. Broke her heart & mine. Fast forward to March 2020 COVID and we're locked out of the SN and she is left to fend for herself (so to speak) I continued to advocated for her care. Now I have to do it by phone.


My kids are grown, left home 2017 and the same week I resigned my full time job, Dad has a heart attack I'm left to care for him. The following year he contracts Sepsis, the following year mom trips over a tree root and shatters both shoulders then 2019 with Paralysis....it has been non stop and I don't fool myself....it's not going to get better. Age attacks us all, no one is immune, SADLY my day will come too. November 2020 I was able to obtain Medicaid waiver and bring mom home......CLEARLY I had NO IDEA what I was jumping into.....All I could think was how lonely she was and ONCE AGAIN my dad "gets" his way of NOT going to be with her in the SN.....We live in Texas and this past week was a REAL EYE OPENER and Burn out hit bigger than the storm did along with emotional damage.....Dad & I got into it....He just will not even entertain the possibility of living anywhere else but HOME. Well....my home which is on the same property to the Home I live.


I am dealing with both parents and while physically mom is worse off, Dad seems to be my bigger challenge. My whits are nearing the end.


My sibs are not in a position to be of much help VERY little. I don't think it's fair that the ENTIRE family be expected (DAD) to DO and care for them...or ARE WE?


What & How are the conversations to have with him that might help persuade him to even CONSIDER assisted or nursing facility? Mom is more than willing to return to the nursing home...provided DAD goes with her. I dont think that is an unfair request of a Husband of 52 years. WHAT IS WRONG WITH HIM? Does he not love his wife? That eats on me as well.....


I appreciate reading all areas of caregiving....It's helpful to know that there are others that are dealing with one or the other & both

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I am confused as to the living situation here. Your parents live on your property? Or you on theirs? Separate homes?

You are not going to be able to convince your father to go into a facility, as it appears he has not been declared legally competent.

What you CAN do, though is to refuse to participate in his care. Who makes the decisions for your mother?

It is indeed unfortunate that all the care has landed on you. Please understand that it doesn't have to be this way.
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If dad has a sound mind, and that definition is pretty loose, he’s able to make his own decisions, even the bad ones. He has the right to refuse to move even if it’s a bad choice. I hope you’ll get your mother back in care you feel good about, and accept his refusal to change. Also, don’t rescue him or come to his aid and provide help to him. It’ll help him see his need for care, even though it may take a major event to force change
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LittleOrchid Feb 2021
You are so right. I would add only one thing: do not further enable bad choices by "helping" to bring the quality of life at "home" to your own wishes for his welfare. Visit, be pleasant and cheerful, but refuse to do any of the work of keeping and maintaining a house and yard. When it becomes too much for him, he may change his mind. If not, it is his choice, not yours. As much as we would like to, we cannot force our preferences on able-minded parents, even "for their own good."
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You have been "assumed" and "defaulted" into the caregiver role, which is unfair. I don't think you're going to change his mind. Therefore with that as a reality, what is your goal for yourself in this situation?

- who are your parent's PoA?
- has he ever had a cognitive exam that is recorded in his medical files?
- is he actually living in your home? I'm a little confused about that...

1) you won't "reason" him into leaving so please don't exhaust yourself trying. You should *tell* him he is moving out, not *ask* him. Stop giving him a choice.
2) if no one has PoA for him this is a whole other level of problem that will eventually kick in
3) if he won't leave your home you can legally evict him.

What are you willing to do to regain your sanity?

Can you move your mom to a care community that as a continuum of care (IL, AL, MC, LTC)? He can have an apartment on the campus if he doesn't want to bunk with your mom. The question is can they afford this? But the goal is for him to get out of your house. I don't envy you. You won't be able to have it both ways (him move out AND him doing it voluntarily). I wish you all the best.
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Love for better or worse but that doesn't mean one has to go into assisted living just because a spouse does.
Your Father doesn't feel like he needs assisted living at this time and he probably doesn't so why should he.

Would you want to go into assisted living just because your husband did?

Most want to stay and live in their own homes where they are familiar and will be their happiest.

You should let them stay in their own home and see about what kind of help you can get come to their home.

Beleven me Assisted Living places are mostly not always as they're presented to be.

You give up everything and have to do what someone else tells you to do and when. Not Fun at all.
My 96 yr old Dad made it plain that he never wanted to leave his home.
He lived by himself til he was in his 90's.

He had his fall alert and Nest Cameras where he could be watched from a cell phone or computer 24 7.

At 94 he had a priblem of not being able to urinate which ended in a 4 day Hospital Stay and dementia and a Cathiter.

I hired 24 7 Care Givers which is very expensive and using up all his saved money but he gets to stay in his own home.

Nown I'm considering hiring a Live In because it would be half the price and his money would last longer.

He says he's going to live to be a hundred.

The only thing that Dad's Health Insurance pays for regarding his Care is with a Home Health Service, he gets a Nurse come twice a month to check on him and change his Cathiter.

He also has a Nurse Practioner come once a month.

Dad's Ins doesn't pay for anything else.

They would pay for putting him in a Senior Home but my Dad would be miserable and probably not last a month.

You should see what your mom and Dad's Insurance would cover regarding In Home Care.

If they don't have money and on Medicare then they usually will give up to 40 hrs a week Care and you can even get paid yourself to take care of them.

Find out your resources.

Prayers
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gdaughter Feb 2021
Just had to add that my aunt is in an assisted. Went from a private small home in a suburb and initially liked it for a month or so, but the honeymoon was over in a short period of time. Rent continually escalates for the same level of care all while the food remains dreadful or worsens. Residents, their family members are too gutless or unskilled or aged to take some action. Rent includes food, and no way to opt out. In my aunt's case she is eating sometimes the dessert, and more often than not it goes down the disposal. Of course some of this is due to COVID isolation. She spends a fortune on her rent and then still spends great amounts not only for junk food but for shelf stable items. There are PA announcements daily that I would find absolutely intolerable. I can understand someone not wanting to live in that environment.
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Please get your father evaluated by his primary care doctor and ask for a referral to a neurologist. He may have dementia (there are several types) and the neurologist can check to see which one he has (sounds like frontal temporal lobe problem with his difficult behavior) - and also test for "mental competency." If dad is deemed mentally incompetent, then he does not have the ability to make sound judgments - sounds like he is already there from your post above.

In the meantime, your father needs somebody to give him his medications, make sure he eats a healthy diet (for his multiple health challenges), and supervises him whenever he wants to putter in the workshop. It does NOT have to be you.

Time to call a family meeting. Make a list of all the are care tasks for your father and all the care tasks for your mother. List the amount of time it takes to complete each task. You may be surprised how much time it takes to care for both of them. Consider which tasks you can reasonably handle while making sure to care for yourself and your family: 7-9 hours of nightly sleep, 3 healthy meals at a reasonable pace in a stress free setting, "time off" to take care of your own health needs, and "time off" daily as well as weekly to nurture your soul doing things you enjoy in relationships you value. At the family meeting, explain that you can NOT do all the care tasks for both mom and dad alone anymore. Show the list and ask other family members for help. Help can take many forms: caring for parents for a period of time, taking care of household tasks, paying for help... Also consider asking friends and members of your faith community for help as well. If you can not get enough "free" helpers, you will need to investigate paid help. Home health aides through a reliable agency can fill in the gaps but usually are paid for privately (unless mom and dad have long term care insurance). Many long term residential facilities also have adult day programs - see if that is available where your live. Otherwise, your parents will need to go to a residential facility so that their needs can be met.

You will have more luck moving dad into a facility if his behavior issues are addressed. Even if your decide to keep everybody at home, addressing his behavior issues will make life easier. A neurologist or geriatric psychiatrist is probably the best health care providers to address these issues. Treatment usually takes the form of medication, but developing a consistent schedule and coping strategies for behavior "problems" can help make dad less anxious, less agitated, less controlling, and less outburts.
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It sounds to me like the whole family isn't expected to take care of dad and that it's pretty much only you doing anything for him and your mom in the nursing home.
As for not thinking it unfair to ask your father to live in a nursing home when he doesn't need to, well it is unfair. Extremely unfair. There's nothing wrong with him for not being willing to confine himself to a nursing home for the rest of his life. It is not for you to judge how much he loves his wife. He would not have stayed married to her for 52 years if he didn't love her.
You're suffering terribly because no one is helping you with your parents. You and all your siblings need to get together and decide upon some homecare help for your father. Of course, he will be stubborn about it as most elderly people are, but if you and your siblings are united together about it, he will accept outside help if he understands that you will not be doing everything for him and he'll end up in the nursing home himself because he'll get sick the way he's going.
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Just a few ideas based on what I had to do.
My mom is now 90 and a half, and been in the nursing home for about two years. She has dementia which is pretty bad now, but wasn't at the time. The only way she would go to the nursing home is with Dad, but Dad doesn't need SN care even though he's 94 years. They had been living with us for about eight years at that point. At the time of her entering the home, we explained to both my parents that I was going on a vacation with my husband for a week and that we wanted them to be well cared for while we were gone. We didn't want them to worry about caring for the home or whether the aides "would take something" while we were gone.
We repeatedly explained to Mom that this time she and Dad would be on different floors of the nursing home because Dad would need help so that he wouldn't fall (a problem he was having), but she would need different help with using the toilet, getting dressed, etc. I laid on the guilt and told them we knew they loved us, knew they understood we need a break from our demanding jobs, and wouldn't want us to worry about them. I explained that they could see each other as much as the home would allow; Dad was actually on a rehab floor while we were away, Mom on a dementia floor. Dad understood he would be coming home after our return, but that Mom would not be.
When we returned, we went to the home. I gave Mom some excuse why she couldn't see Dad that day, while my husband took him home. Dad has been home since; Mom still thinks he's on the other floor of the home.
This passed November, they are married 66 years. Dad is willing to be in a nursing home, but so far, no need. Mom is asking to be home -- part of missing us due to COVID, but we get video-conferences twice a week. Dad has not gotten on the video-conference or come to a visit with Mom since he's been home. Mom and her family were deserted by her Dad, so this really bothered me, until very recently when a therapist started helping me understand. Dad doesn't speak about the situation -- except occassionaly he'll tell a doctor, he hates the situation, but doesn't know that there's any better solution. He still reviews her every monthly medication list, and demands that she get the specialist appointments her insurance entitles her to. After every video conference, he wants a report from me on how she is. When Mom was home, she started hitting and kicking at him, if he didn't respond to her every demand immediately. She'd started trying to do the same to me when I got home from work.
That's when I had to change the promise I had made to them,and more importantly to myself. Instead of telling them, I would always care for them and not place them in nursing homes (we lived through my grandparents and uncle being in them), I started telling Mom she would stay with us as long as she wouldn't hurt anyone, even herself. It's a hard, but necessary, message. And many places won't take someone in if they become too aggressive, so it's a real balancing issue as to the timing.
Anyway, thanks for listening to me vent. And I hope this gives you some ideas on how to "do the impossible", that so many of us now have to face doing every day.
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This is a rather complex problem and a lot of good advice here. I suppose all decisions regarding aging parents are complex. One must respect the wishes of your parents even if you disagree with them. They are adults, not children and you really can't tell your father what to do if he is competent.

From the point of view of an older person, myself, now 70, I have given considerable thought to what my/our next move might be. We love our home and will stay here as long as we can. I find work in the gardens peaceful and exciting in turns.

Nevertheless, if at some point my husband needs more care than I can give him, I would absolutely move into assisted living with him. Our dedication to each other is such that I cannot imagine not living with him. Granted, I am not sure he would make the same decision. It is a somewhat easier decision for us than it might be for some as we did make investments in our youth that would allow us to move into a somewhat nicer facility than Medicaid would provide--though certainly not top end.

Not everyone would make the same decisions as I might. It is perfectly alright to allow your father to remain at "home" as long as he can maintain himself and his home and visit his wife at the residence where she can be cared for. He may change his mind after a few months of living alone if nobody pesters him about it. He may not. Let him be and see how it works out. You will all be much happier without trying so hard to over-manage his life.

Try to be at peace with the idea that in such complicated matters there is often no "best" or "perfect" solution.
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"WHAT IS WRONG WITH HIM?"

That made me chuckle...

Some ideas of why could be;
1. He's a MAN. So always right, right? (Sorry guys for being sexist I'm sure some of you are flexible, gracious individuals).

2. Dad is fighting to keep control. Like 4 year olds do. MY WAY foot stamp stamp.

3. He has (un DX) vascular dementia & no longer has good judgement or planning skills

4. Fear. He is scared of change.

A social worker once told me it takes at least SIX times to have the conversation about moving/future needs for *reasonable* people to get it. For stubborn people... well... you may run out of time... or they never do. (They die fighting with their boots on in their own homes).

I'll be back once I read all the replies.
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Prayers sent for this most difficult of situations.
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