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My father was put in a NH for rehab now it would be in his best interest to remain long term he is only 77 years old, over past month he’s had a sudden decline in his health due to multiple strokes and severe heart failure and dementia. His body is extremely weak, and is mostly required to use a wheelchair for safety instead of his walker, his mind comes and goes, and relies on the nurses to dress, bath him. Sits sits around with his head slumped over all of the time and does not have any desire to walk around and socialize. He wants to move with me but I’m not physically able to care for him with all of his needs. I feel so guilty about this, he does not want to stay at the nursing facility and I worry about what he’s going through and struggle with the decisions I have to make for his wellbeing because he does not think he’s that sick. What do I do to accept the right choices without feeling so very guilty.

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You HAVE to think of yourself and YOUR health. The majority of us with elderly parents are no longer spring chickens ourselves, therefore unable to do the lifting and pulling that is frequently necessary in the daily assistance of a bed bound or wheelchair bound person. One is practically BEGGING for a back injury when they take on this job alone at home. The majority of people do not have hospital beds, hoyer lifts, lift chairs, etc. and rely on muscle. And do not even get me started on the soul-crushing stress!

Frequent visits to the NH at random times will help keep staff on their toes and tending to his needs. Believe me, they KNOW which patients have family members who are involved.

Let go of the guilt and do the best that you can.
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Reply to XenaJada
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Tina, yes, this is so hard but you are not alone! Many have gone before you and many will post that you should not move him into your home. You are absolutely correct in seeing that his medical needs cannot be met at home by you. Often the older generation has a concept of NHs being just horrible and today that is less the case. Shop for a reputable local one. Take your own pictures to show him how nice it is. He still won't like it, but there really aren't other choices. In-home care for him would be just as expensive and a burden to manage. I hope you have his durable PoA and that he has the financial means necessary. If not, come back here for further insights. May you receive peace in your heart that this is the best decision for the both of you.
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Reply to Geaton777
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I’m sorry you are feeling the despair so many of us feel when the decision comes down to this. My father also was placed in LTC or NH once he couldn’t rehab enough to walk again. His ALF would not take him back. Did either of us want this outcome? No! But as they say, it is what it is. He has come to terms with it now.
He hated it, yelled at me for putting him there, it was all my fault etc. etc. Make sure to get him an assistive lift chair so he can sit in that to watch tv and get him out of his wheelchair. The squeaky wheel gets the grease and believe me, I and my sister squeak loudly when we see things that aren’t right at his NH. Do not accept him just sitting in his wheelchair, slumped. Tell them you want him in his recliner or the bed after meals.
For those that think a NH placement makes life easy on the caregiver, yes in some ways it does. However, you still need to visit, assess his care, and manage his things.
This is the time you will find you have to think with your head not your heart. I wish you the best.
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Reply to Harpcat
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Please do not feel guilty. His level of care has become far beyond what you can manage and it would unsafe for him to remain at home. You are doing the best thing for him by placing him in a facility.
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Reply to dragonflower
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He is better off with 24/7 care and will need two people to move him. If he continues to ask to live with you, place the responsibility on him. Use it as a motivation for him to work at getting stronger by participating in facility activities and restorative therapy. If he get strong enough, you might be able to take him out for a ride in the car or lunch out. That activity which is a form of occupational therapy will be beneficial to him and a physical reminder for you about the reality of caring for him. Please don't feel guilty. There are many ways in which to help him be the best he can while in facility. I encouraged my dad to attend restorative therapy by going to the class with him. He actually enjoyed the class and began to attend (most times) on his own. I did see an improvement in his physical and mental well being and he could feel it too.
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Reply to lynina2
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RoyaB19 Feb 25, 2020
Excellent advice. Provide a goal and see if he can get motivated to reach it. Definitely taking him out when possible.
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None of us want to be in the position your father is in, but should it happen to me, I will not expect my daughter to kill herself trying to keep me at home.  It wouldn't be fair to her.  It is a lot to bring someone with his needs into your home.  I am sorry your father's health has declined to this point and he is only 77!  By todays standards, that's not that old.  You can feel sad for him but please try not to let the guilt eat you up.  That is what these facilities are for.  Your due diligence is finding one that is clean and safe and hopefully close by so that you can make sure they are doing what they need to be doing for him.  Get him what he needs, visit as often as you can.... that is what you can do for your father.  Running yourself into the ground is not the answer and it will not change his situation, it will only worsen yours.
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RoyaB19 Feb 25, 2020
Thank you so much for saying this. I’m about to enter my parents into assisted living for the second time and of course I’m feeling guilty because it will be different from what they have now. But what they have now is not sustainable — for me.
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Hi! We recently placed my grandmother in AL Memory Care. She doesn't want to be there and wants to go back home, so I can totally feel your pain as you face this decision. It's so difficult to be in this position, because what you know is a logical and sound choice is directly in conflict with your desire to make your LO happy. The staff at our facility and my gramma's doctor helped us come to peace with this by telling us that our first duty was to provide for Gramma's physical needs. Her preferences can surely factor into things where and when we can accommodate them, but the physical needs come first. It is really pretty straightforward.

Your guilt is normal, but completely unhelpful to both you and your dad. In placing him where he can get the best care possible, you are really showing an amazing amount of strength and love. And continuing to be a constant presence, overseeing his care in the facility and making sure he gets the best of what's available is also a gift of love that you are able to give every day - but in a way that doesn't destroy your own health and wellbeing. I hope this helps you.
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Reply to gmadorisylove
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cherokeegrrl54 Feb 25, 2020
Very helpful advice to us all. Thank you...
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They are better off in a NH when their care needs can be met more easily there, or when the caregiver is stretched so thin that compassion has died and care suffers as a result.
The nursing home had lifts to help place my mother in her wheelchair without risking strain or injury to her or her helper, a big sauna tub where she had her baths twice weekly, a dining room to offer a varied menu, RNs immediately available and doctors on call as needed - in all these ways the care she received was superior to anything I could give her at home.

You mention your dad is sitting slumped over in his wheelchair - this is something I see often and it drives me batty. If he is going to spend the majority of his days in a wheelchair please consider having him fitted for a higher end chair that can give him both comfort and support - one with a headrest, stability backrest, pressure relieving seat cushion (consider a ROHO), tilt in place so he can recline and rest there.
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Reply to cwillie
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My rule of thumb is if they can't move around their living quarters, cannot get up from a chair or bed alone, cannot toilet themselves, or have dementia issues that are dangerous like leaving stoves on or wandering outside aimlessly; it's time for a facility.
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Reply to HelloImMinsu
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I have been exactly where you are. I will tell you... I wish I had done it all sooner.
My health has deteriorated over the last 7 years, with both parents declining and like your dad, not wanting to go to a facility.
We went through bad caregivers, hospice at home, scary times when electricity went out at their home (I’m an only child living 2 hours away) many, many rehab stays. My words of advice: let him be in the nicest facility you can afford.
There will still be oodles of paperwork, meetings, etc. but you can go back to somewhat being his daughter. Enjoying one another.
For me, not having to worry when caregivers would not show up, when dad would get confused and try to stand, caregivers bickering, a wheelchair not working, etc. has been a life saver.
I love my parents so much, and I know you love your dad. My body had taken a blow from the years of trauma and constant worry. Chronic disease and living through cancer treatment along with the caregiving was devastating. Turn the day to day care over to a facility where you will not be constantly worrying about what’s go to happen if a caregiver does not show up, or takes money or does not fold the laundry.
I'm sure your dad would rather make sure he still has his daughter alive and visiting. I may be projecting, but I remember feeling that guilt, and want to share a bit of my story to show not all facilities are awful. My parents have been making friends, love the food, are always clean, and enjoy the activities. You’ll make the best decision for you both.
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