So, I've returned home and need to deal with the fall out from the Adult Day Care nonsense from last week. I seriously experienced a sense of dread on the plane ride home, as I knew I would have to figure this all out.

I HAD to make the decision to pull Dad out of the Adult Day Center, and he seems miserable. Dad told me that due to all the stress from Monday's situation, he had a bathroom accident, and he thinks that he was kicked out of the ADC because he "lost his bowels". This ticked me off even more because I am sure the driver (that left him) was yelling at him. She yells at everyone.

That's the story stuck in Dad's head, and nothing I say convinces him otherwise. I'm tired of repeating that everything is OK, and I kinda snapped at Dad this weekend. I was like "let's just talk about something else." When he started up again, I just wouldn't respond to him at all and THAT upset him.

So... what now? I REALLY don't have time to deal with this, but it seems like I'm going to have to take time off work to straighten this out.

Who should I talk to? Hospice? The ADC Director? The Driver? The VA Social Worker? The Assisted Living Place? All of the above?

Where do I start? I want to REPORT the ADC guy, but is that necessary?

I HATE that I'm the only one that ends up dealing with this despite my futile efforts to delegate. Somehow this all ends up back in my lap that's WAY too full.... Yuck.

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About the overwhelming guilt: I think sometimes we have way too high of an opinion about our own power and capabilities.

Your father's lung disease has taken something away from Dad, and will continue to do so. Unless you caused that disease, unless you have secret powers that no one else does to cure that disease, you are not responsible.

Guilt serves a useful purpose if it reminds us, "Oh, I did something wrong. I won't do that again!" But what have you done wrong in this situation?

The notion that you have/should have power over your father's disease is really not realistic, and kind of arrogant, don't you think? You don't have any special powers that the rest of us lack. We would ALL like to ensure that our loved ones lose nothing as their diseases progress. But we can't, and you can't either.

Feeling sad, frustrated, helpless, angry ... all these seem appropriate. But overwhelming guilt? That just doesn't fit the situation. Please, let yourself off that particular hook! Watch your self-talk and be more accurate in how you describe your feelings to yourself. "I feel so helpless! I wish I could turn back the clock to when Dad was well," instead of, "I'm a terrible daughter. I should be able to fix this."

I don't mean that caregiving has no impact on quality of life. Of course it does. And you are doing your absolute best in your caregiving efforts. That is enough. It has to be. None of us can do better than our best. Having an impact is worth striving for. Having control is not possible.
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Is there some way you can utilize a geriatric care manager to help relieve you of some caregiving responsibilities/coordinating?
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Thankfully, the social worker at Hospice stepped up and coordinated a meeting between Dad's care team manager and the ADC director. I think Hospice is probably trying to cover their behinds as well.

I was so stressed over everything, I took yesterday off and laid in bed in my pajamas all day. There was so much I should have been doing (still haven't unpacked from my work trip, dishes in the sink, etc.) but I just didn't care. I actually think a day of nothing helped. I even turned off my cell phone.

I just decided to let it go. Dad is out of the ADC and he won't go back. He keeps complaining that he's bored at the ALF and he keeps biting the staff member's head off when they try to encourage him to participate in activities, but there's nothing I can do.

He does have one buddy at the ADC he's going to miss terribly, so I would like to try to get his contact information so the fellas can stay in touch. Otherwise, I'm doing the best I can. It's nowhere remotely near good enough, but I have to focus on work. for the ranch house. My lease isn't up until September, so I have time to make a decision (in case the VA option doesn't pan out). I haven't completely ruled it out...yet.

Why do I feel like I took something away from Dad? The guilt is overwhelming...
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Nor can you control or micromanage everything as well.

You’ve been discussing stopping ADC for awhile. Glad to hear you’ve made the decision to do so.

You will never know the details of what happened last week. I too would have been livid if my dad was waiting for transportation and not returned home until 8:30pm. I understand you want your dad to go to ADC but it clearly isn’t working on many levels and for months. Let ADC go. Your dad will adjust and may even be relieved he doesn’t have to cope with what appears to be frequent issues with the ride to ADC.

I am an ex dialysis nurse. The majority of patients used county transportation. The drivers are given a strict route to follow daily. If one patient is delayed for whatever reason, then every person on that driver’s schedule gets behind. It was important for your father to be in the lobby and ready to be picked up at a certain time. This often did not happen. If there is any blame, it would be the ALF, IMO.Drivers cannot leave other vulnerable seniors waiting unsupervised in a running van to go upstairs and fetch your dad. IMO it is an unreasonable expectation. 

Now fortunately you have narrowed you dad’s care down to the ALF & Hospice. Let’s see how this works because it may be the golden ring.

As for making someone “pay” I would ask the nursing supervisor or whoever was responsible to complete an internal incident report. This will document your concerns. But at this point & hearing about it as a third party that wasn’t actually there, you can’t say factually what occurred.

I would definitely stop ADC as it’s been a nightmare for your father. I am sure he gets stressed out on those days just hearing the staff discuss oxygen tanks, being late, driver stress, and now the poor guy had an accident. Maybe he will branch out at his ALF & participate in more activities, which you have said was one of your goals as well.

Moving both of you into a ranch? Oh please don’t do that. Although you’ll be in a better position in controlling events, for you it would be added stress. Your job performance would suffer, and you would really have no life.

Hang in there!
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Newsflash: You are not responsible for EVERYTHING!!!
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"I'm even thinking about just giving it all up, finding a two bedroom / two bath ranch style house to rent and moving in with Dad."

Well. I hope you are merely toying with the idea in idle moments. In my best Joyce Grenfell voice: Tiny. Don't do that.

I feel for you on the what to do about the series of shortfalls in standards and performance.

That driver. The VA pays this person to transport veterans, note, to and from services to which they are entitled, note. She needs a serious attitude adjustment, and/or retraining, and/or more support and better conditions at work. Probably all of them combined. But unless and until the VA does something about it, not only your Dad but also other elderly people who are, we're supposed to suppose, if anything *more* entitled to consideration and respect than the average, are being treated like fussy, naughty little nuisances.

The trouble is, it is extremely difficult to report concerns like this and be sure that they will be understood as one intends, handled in the way one is aiming for and therefore achieve the desired outcome. And in any case, even if it worked, it isn't going to help your father because he won't be using this service any more; so it really isn't your problem. It's just still a problem, and it still annoys.

As for the ADC Director... Well. He'd probably blame the ALF. They'd blame him right back. And it probably is six of one and half a dozen of the other. And who has the authority to knock their silly heads together? You could consider drafting a summary of their co-ordination - ha! - over the time your father has been the subject of it, sending a joint report to both organisations copied to the VA, and recommending that they sort this one out between them.

But haven't you actually got better things to do with your time? Maybe one night if it's still keeping you awake you could relieve some tension that way.
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Thanks countrymouse. You're right. I'm just in my emotions (still). I want the incident at least documented. The ADC director seems to have dropped the ball and other vets could suffer.

As for Dad, I'm hoping he forgets about the bathroom accident. I wish there was something I could say or do to assure him that no one is angry with him. He keeps repeating "I tried to do everything right". I'm not sure if it's genuine or his old Narcissistic way of pushing my guilt button, but BOY IS IT WORKING!!

I'm even thinking about just giving it all up, finding a two bedroom / two bath ranch style house to rent and moving in with Dad. It seems like the attempts I've made to reduce my stress level have backfired, and I'm just tired of spending money to only have to deal with the stress anyway.

I could save money and cut out all the middle men. I just don't know....

Dad programmed me well, huh? I feel responsible for EVERYTHING!!!
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Garden Artist... the short version:

Dad (who is in ALF) was going to an Adult Day Center (free service through the VA) that provided transportation to and from 3 days a week. Their driver was TERRIBLE and kept being rude to ALF staff, most likely taking her frustrations out on Dad.

Dad is on 24 hour oxygen due to advanced COPD and he also has dementia. He is also under hospice care. Essentially hospice, ALF, ADC and driver can't coordinate and communicate effectively (too many folks involved) and last week, my Dad ended up being left at the Adult Day Center until nearly 8:30 PM. I was on a work trip and ultimately think I would NOT have known had I not called to report the rude transportation driver...

It's a matter of reducing the matter of people involved, but I just want someone to PAY for the stress everyone was caused, and I think this all at least needs to be documented.

I'm just sick of it all...
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Tiny, I hope this doesn't sound like a silly question, but why do you have to get this sorted out?

You've made the decision to stop having your Dad taken to the ADC. It will take him time to adjust. Because he's down anyway, he is also having false negative thoughts about it - that he did something wrong (he didn't), that that's why he can't go to the ADC any more (it isn't).

The thing to do is to let him settle, and for help with that try flattering the ALF staff - Dad could do with a little extra tlc, I'm sure he'll do better now his daily routine isn't disrupted, you'll be great at getting him engaged with activities here, I'm sure you'll be able to reassure him, blah blah blah.

But last week's shenanigans were last week. Do they really still matter? Did anyone do any lasting damage for which they're obviously culpable?
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Tiny, I don't recall seeing the day care problem thread, but I do have some thoughts about handling complicated issues with providers. Delegating is another issue.

Your father is probably embarrassed about the bathroom accident, but I wouldn't think it's a cause for dismissal from day care center. He isn't the only one who faces this issue, but I do understand that it's embarrassing for him. I'm sure it's embarrassing for everyone who deals with it.

Whatever happened at the day care center, were you a witness to it, or are you getting your information about any incident from your father or from someone else? If you weren't there to witness whatever happened, when you call (and also address the driver issue), say something to the effect that you have grave concerns about an incident(s) and would like someone to investigate and respond.

Also indicate that you'll call back (a) in a few days (b) a week or so get an update on the investigation status. You gently set the time you'll call them so they can't "drop the ball." If they get feisty, you can ask them when you could expect to hear from them.

This way you don't make ANY accusations, but instead shift the burden to them to investigate the incident. If your father was at fault somehow, you can decide then whether or not you want to also raise the issue of how could the situation have been handled better, so that you don't have to find a new day care center. Again, you shift the burden to them, but you retain the right to make any final decisions. But they do the leg work to investigate.

If your father can't go back to this day care center, I don't see any other choice but to find another one. Have you tried any of the Jewish centers? I have little experience with any day care center other than just having briefly toured one, but I do know that in this area they have a strong outreach program and extend services, as well as compassion, to anyone of any faith.

You are in fact the person to deal with this on behalf of your father, but there's no reason why you can't involve others, such as the day care center staff, in doing the ground work of researching whatever incidents occurred, and leave the decision making to you (which can be good or bad). Just make sure you set follow-up times so the issue isn't dropped.

In the meantime, you might do some research if you can find it on incontinence related issues in the elderly. Perhaps if your father realizes he's among millions of others facing the same issue, he won't feel so bad. Easier said than done though.

And take it one step at a time; what are the priorities now besides your sanity and work? Is there someone to care for your father during the day?
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Were your ears burning??? I was just talking about you on another thread, where another successful business person is being driven to distraction by her parent's "support" team.

What's occurring?
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