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My father is 89, my mother is 87 with dementia. My father has a difficult time getting around without his walker or cane. They live in a 3 story home with their bedrooms on 2nd floor. My father refuses to put my mother in a home because he expects his children to come every night to put my mom to bed and make sure they have a meal on the table. My mom can't dress herself, she is wearing depends that my dad does not change for her until one of us shows up @ dinner time. We then have to make sure she has eaten for the day and taken her pills before we bring her back up to bed @ 6:30 PM. She can't remember how to brush her teeth, she eats very little, and she will remain in bed sometimes until we get there and get her up to come downstairs. They have a dog that is deaf, that defecates and urinates thru out the house so they have us put puppy pads down all thru out the house. My father insists he can take care of her with our commitment every night and if we can't he states that we are selfish and just thinking of ourselves. My sister lives up the street and she is able to get there every night but it is taking a tole on her. There are just 3 of us in town and no other help comes in because my father refuses to pay for it. He can move to a home at this time thru the VA and take my mother with him but doesn't know what to do with the dog. They do not have enough money to put my mom in a home with out my dad having a lien put on his home to pay for my mom if she goes to a home and he stays at home. How to we convince my father that it is time for her to get more help that we can't always provide with out him making us feel like we are just being selfish.

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Perhaps the dog gets lost? Of course you look for a no-kill shelter before the vet, so don’t let’s get into that one again. It sounds as though the dog is a major complication in the lives of at least three people, and there are good options without it. Three people count more on my scale than one deaf incontinent dog.
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NYDaughterInLaw Jan 2020
This is just horrible!!! Dumping an old dog in ANY shelter, kill or no kill, is just plain cruel. At least have the guts to give the dog a peaceful end at the vet.
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Take your dad to visit the VA home ASAP.

Take the dog to the vet and get it checked. If the dog is in pain, it's time to put the dog out of misery. If the dog is not in pain, take the dog into your home (crate the dog in a comfy and easy to clean space with regular walks) and bring the dog to visit your dad at the VA home.

Recognize that your father will not change because he doesn't have to change. You and your siblings are enabling his current living situation.

Also recognize how very, very fortunate your father is to have access to a VA home.

Your father is not thinking clearly - either because of the situation with your mom, his own cognitive decline or a combination of both - but, you and your siblings must be rational and act in their best interests and in your own as well.

Caregiving must work for everyone involved. It's time for you and your siblings to be the adults. Be gentle yet firm and resolute that "things cannot go on the way they are now, dad".

Your parents' needs are only going to increase. Do not let the VA home opportunity pass your family by.
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disgustedtoo Feb 2020
I would also recommend enabling the move and assessing/taking care of the dog. Another option that might be possible, if they initially balk at the move, is that VA does provide some in-home care.
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Taking care of the dog sounds a lot easier than taking care of Mom and Dad. If the dog’s care is all that stopping him, heartily encourage them to move to the VA home, and assure him the dog will be well cared for and can visit. Our elders have a special bond with their pets who have grown old with them. My Moms concern for her dog trumped her own care for herself. Now that I have just lost my elderly dog, I understand better how she felt about hers. So take that roadblock away in a kind way, and help them move on.
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I'm not sure what is wrong with your father. He may not be thinking clearly, but,I would react immediately to protect the mother's welfare. I'd seek legal consult with an attorney and inquire how to get guardianship of your mother, so you can decide where she receives care and get it for her. You can ask about what benefits she might be entitled to as well. The requirements and policies are complicated, so, I wouldn't try to sort that out alone. A professional would be able to advise you and answer questions about what she qualifies for. There are special provisions for married people with one person continuing to live in the home.
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PandabearAUS Jan 2020
This is good advice and you should take it
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My idea is to call APS. Ask that they investigate the situation. Your Dad is neglecting Mom. Allowing her to sit in her own urine and #2 will cause problems with her skin breaking down.

If Dad has money he needs to use that for her care. Medicaid will allow assets to be split. Moms part will be spent down and then you can apply for Medicaid. Dad will keep the house and a car and his part of the assets. When Mom passes, then a lean will be put on the house. Dad can continue to live it it. This is just basic info. Each state and situation is different.
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Your dad is the selfish one. No loving parent forces their adult children to take care of them at any expense to their offspring.

I am a dog lover, but fouling all over the house is a deal breaker. He obviously can't even let the dog in and out.

Can you and your siblings agree to stop propping up this really bad situation? It is going to take all of you to say no more.

Your dad is also neglecting his wife, leaving her in bed in her own waste is detrimental to her wellbeing in many ways. One meal a day is not sufficient nutrition, she is probably dehydrated as well.

It sounds like your dad is not all there cognitively, time for extreme measures.
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Based on what you have posted, I would say it is more than time. Your father is neglecting his wife, as he is no longer capable of living independently, those of you who are running over there every night are actually part of the problem, you are setting up a false front, a lets pretend situation.

Ask around see if a family member will take the dog, thus eliminating this as an excuse.

He is fortunate that he has the VA as an option, time to take advantage of this option. Who has their DPOA, whoever it is should step in, if necessary call APS, do whatever it takes to have your mother properly cared for.
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Your father has 100% unrealistic expectations, including the expectation that he's capable of caring for his wife who has dementia & has needs that go way, way beyond his capabilities. He, most likely, is suffering from dementia himself, based on your description of what's going on in the house right now.

At some point, a parent's wishes have GOT to be overlooked and overridden. The parents sometimes become the children and the children must take on the role of the parents; we see that ALL the time here. Yet the children are afraid to say No to the parents, because it goes against everything they're taught. "Respect" for a parent includes allowing them to have the right to do what they want & to live how they'd like, right? No, wrong. At this point in time, and with this level of disease and dysfunction, someone has to step in and deem their lifestyle to be unfit and no longer safe. They have to be placed in a safe environment, such as Assisted Living, for their own good, because they are no longer capable of making sound decisions.

It is what it is. We children do what we have to do to ensure their safety and that they're eating and being cared for properly. If he is able to move into a VA home and take your mom with him, then that is the easy answer here. One of the children can take the dog and bring it by for visits once in a while.

Your father can call you 'selfish' until the cows come home, but you know that is not the case. He is no longer able to think clearly, which is obvious. This is what you tell yourself. If he was able to think clearly, he'd SEE and he'd KNOW that the living conditions he's subjecting himself and his wife to are dangerous, unsanitary and it's only a matter of time before both of them fall & need hospitalization. At that point, the choice will be REMOVED from him and they will HAVE to be placed, like it or not. That's how our system works.

He can do things the easy way or he can do things the hard way. Most of the elders choose 'the hard way', unfortunately, and wait for The Crisis to occur and for them to be forced into placement. Let's hope you can convince your father that making this decision on his own is much better than having it made FOR him.

Wishing you the very best of luck with this difficult situation. I had one myself and my dad was forced into Assisted Living after a hospitalization and rehab stint.
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Isthisrealyreal Jan 2020
Lealonnie, I think that my parents can do what they want. I found that they have all the rights, the law is behind them and against me trying to force them to do something that they don't want. I am all okay with that, but that is a double sided coin, I too can make my own choices. Propping up their bad choices is not something that I am willing to do. They may fail and become willing, but right now it is a flippin runaway train and I have moved out of its path.

I understand the laws, I know that people have institutionalized others for evil reasons, but it is so far the other way that it is mind blowing and frustrating, especially when you just want to help them be safe and cared for. Grrrrrr!!!
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"He can move to a home at this time thru the VA and take my mother with him but doesn't know what to do with the dog"....

Take the dog into one of the siblings homes.
Place Mom and Dad in available VA home **together**, providing caregivers to come in for Mom.

That is my solution, and I am sticking to it. It looks so much easier looking in from the outside.

Because if people wait, I have seen families destroyed, divorces, elder abuse, no medical care provided for one spouse, and exploitation by adult children with their own issues of incompetency. (bipolar, failure to become self-supporting).

Do it now, imo.
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Alicew234 Jan 2020
We are going through something similar. Unless her dad is demented too, he probably has POA over his wife and he gets to decide where they both live and whether or not to hire care. The children have only two options: Abandon their mom to his "care" or Keep helping her. Either way, eventually, there will be a crisis and things will have to change.

It would be great if elderly people would hear their children when they say "we can't do it anymore." But many of them do not.
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Isthisrealyreal, very true,
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On my DHs advice, I stopped doing it, and it worked! I was running like a wacko chicken, when my DH said "Stop! You cannot keep this up; tell your mom you'll come once a week, and not do the shopping at all the stores anymore, before it kills you." He was right; I hadn't realized how bad it was, though I dreaded her calls... So, over the last 2 years, the Lord has provided a village of people to care for her! It would be nice if she could afford AL and keep her cat with her, but she can't, so all this help keeps her going in her apt - her SW has gotten her approved for Medicaid LTC; if the situation becomes untenable, plan B will be implemented. For now - it's all good!
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disgustedtoo Feb 2020
I didn't have anyone to "warn" me, but when I first realized mom was having issues (repetition of statements/questions were the first inklings) I started researching. It is best to know what you are up against before it actually happens! Some of the stories related were scary (having to deal with BM in disposable while out shopping!!!)

A combination of factors ruled out me caring for her, either in her place or mine. I did what I could to keep her longer in her own place, but she was making that difficult. Primary gates to me providing full care were her inability to do my stairs, no way to handicap my bathrooms, my inability to support her weight, my cats... There are other reasons, but the biggest is her weight and my bad spine! There are days when I can't stand up straight, lift anything even like 10# and/or inability to bend over!

Glad you had a wise husband AND sensibly listened to him!!! Sometimes we can't see the forest for the trees, or get sucked in slowly and before we realize it we are in too deep!

You could check around - some ALs (even MCs) will allow small pets. Mom's place had a dog (he really wasn't appropriate, too big, needed room to run!) and a cat, which stays in the person's room. If not, can you take the cat in and maybe bring him/her to visit mom, after she moves to AL?
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If he/they can move into a VA facility and the ONLY thing preventing him from doing so is the dog...I am sure some family member will take the dog and even bring it for visits. The time to move them is NOW! Spaces do not open up often in VA facilities so if you can take advantage of that now do so.

Stop the daily visits to help them out as difficult as that sounds if you keep doing for them there is no reason for them to change where and how they are living.
You can move a bed to the first floor so mom does not have to go up stairs. That will make it safer and easier for her. As a matter of fact your dad should probably be sleeping on the first floor as well. Safer and easier for him as well.
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Wow, sounds like way past time. Just start doing what needs to be done and don't ask, don't respond to his arguments. He's probably got dementia too.
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What I really meant to say: This is madness. How is it that no one outside the family has noticed this situation--no doctor, no mail carrier, no neighbor, no friend of the grown sons and daughters? It's the same as if a kidnapper kept her chained in an attic for years! Next the family is going to hear an attorney say that they legally can't act in place of their father--well, who is going to notice if they do??? No one has noticed this situation developing for years! Maybe the father was abusive when the kids were young, and even now, when they are in the same room with him, they become terrified children again inside. That is one of the few rational explanations I can think of. Every member of this family needs intensive medical and psychological help, starting with elderly mother, starting now.
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worriedinCali Jan 2020
No one has noticed the situation because the family is putting on a charade so that dad can continue to believe he is taking care of his wife in their home. They are all working to take care of the mother.
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It might be a good idea to call APS for mother, not father. Father’s POA shouldn’t over-ride APS finding that your mother is not receiving adequate care. It’s not a case of convincing father to change his mind. Father will tell APS about the family care, APS should check with you, you all need to say that you cannot continue to provide it, and you don’t think it is adequate anyway.

One small verbal thing to think about – s/he ‘moves to xxx', don’t say that “you put them in a home’.
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Alicew234, you are correct, it will be really hard to step back and let things get bad. However, it would only take one day for APS to intervene. The conditions that will be existent in the situation when the adult children stop propping it up will set APS into action. If they come in and find a filthy nasty mess on this ladies bottom they WILL do something now. You can't expect them to help when you are taking care of everything, they are overwhelmed by their jobs and have to act by priority of need. Someone being propped up doesn't have a need, the caregivers do and APS doesn't give a shake about the caregiver.

We are talking about days to change a situation that could escalate for years before these caregivers finally break and they will because the situation is beyond what the family can handle. So we do the very hard thing now to stop the hard things from continuing daily.

No one ever said any part of this would be easy. Change never is.

Ckirsch, be sure and make it very clear to APS that they can go to a VA home, this will help them get both of your parents the care they need. You could also give dad the ultimatum, you either get your head into helping mom get the best care available by moving into the VA or the state gets involved and then she goes wherever they choose. Make it one or the other, no other choices available.
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Alicew234 Feb 2020
I don't know. In our case, the caregiver refused to let the APS people in and they closed the case. But if Ckirsh lives in a state that is more aggressive in protecting the elderly, that might work.

In our case we had to wait for the crisis. A fall lead to a hospitalization. Discharge to rehab turned into a "No safe plan of discharge home" and a permanent nursing home placement. The patient is well cared for now.
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I just wanted to clarify that she is still capable of her bowel movements but she will sit in her depends until one of her daughters comes to change it for the evening. She hasn't had any accidents in them so far but she just sits in the ones from the night before most of the day until we come to help her change them. The other thing she is doing is she forgot how to spit after she brushes her teeth. Not sure how to get her to do this, we are afraid she will swallow or choke. Any advice on this would be helpful until we can make the arrangements to get them moved. I wish I could convince them that it's time for the dog but they refuse and my brother POH and my sister POA after my father are refusing to do anything but pick up after the dog. My hands are tied so I will continue to help them the best I can. Aging Resource is assisting us in the next steps. Thank you all for some great advice.
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BeckyT Jan 2020
Ckirsch1979 Are you sure the dog is incontinent? Or is it just that your father can no longer let the dog out on a regular basis? It would be best to determine before you decide what to do with the poor thing. Someone may decide to take him, if he’s happy to go outside. That would be one hurdle handled.
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It's just me with my Mom; there are three of you? Lucky and blessed! I would start a GoFundMe drive to raise money to make up the money difference. The suggestions below are valuable; I will heed them going forward.
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disgustedtoo Feb 2020
Based on OP's post a day before yours - she doesn't sound lucky or blessed:

"...my brother POH and my sister POA after my father are refusing to do anything but pick up after the dog."

Sometimes having others is detrimental, not helpful.
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It sounds like they are at the point where they can't take good care of themselves, particularly your mother. They either need an aide to help with cleaning and cooking, dressing, etc. or need to move to a home. Their dog also sounds elderly. Is it possible to convince your father that it's time to move to the VA home? If not, speak to a social worker and see if you can get assistance to get an aide, or maybe family members can be paid for this work through government programs. I always remind people to make sure that the paperwork is in order for power of attorney for financial and medical decisions, a will, etc. It's very difficult for people who have lived in houses to move to assisted living homes--the space is much smaller and there are schedules and rules. But sometimes this is the best option when people are totally dependent on others, like your mother. Can your father make this sacrifice to accommodate your mother's needs?
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I agree with those who believe this situation needs to change.
Botton line: in what situation will both parents be safest?
Staying put is not the answer. If they have the VA home as an option, they are very fortunate. With luck there isn't a long waiting list.
You and your siblings have helped your parents, but their need for a higher level of care/ assistance is becoming more dire.
Although difficult emotionally, in time you will never regret assisting them to relocate to a safer place.
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ASAP
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I figured I would add on to my previous answer.
Bottom line it is time when...
The care falls to other members of the family, when spouse can no longer care for spouse.
When safety becomes an issue. This could mean...
If the caregiver may be injured caring for the care recipient
If the care recipient may become injured by or because of the caregiver.
If the caregiver is not safe themselves due to health or mobility issues
If the care recipient is not safe due to health or mobility issues.
If the house is not set up to safely care for the care recipient.

Unfortunately it often takes a catastrophic event for spouse and or family members to realize that a change has to be made. And many times if it comes to that it may be too late.
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I suggest a free caregiver support group in your area. They would have the info you need for your area. The situation unfortunately is common. The big issue, to me, are the stairs and minimal care for your mom. If your Dad is anything like mine... good luck. Try to set up Community Medicaid (CM). Meanwhile, Dad should arrange the home/finances for protection against Medicaid. CM doesn't have a look back and they will pay you guys (if you want) to care for your mom in the home.
Good Luck
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If you get the community Medicaid they will pay for a live in caregiver.
You should rearrange the home so your Mom can sleep down stairs and the aid(s) have the room(s) upstairs. When the home becomes topsy turvy this might be the push your Dad needs to make a real change rather than the catastrophic inevitable fall. Take control don't let Dad make you fell guilty.
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cetude Jan 2020
Depends on the State. Florida Medicaid will not pay for a live in caregiver. They cost too much. They just pay for nursing homes or adult daycare. That's it.
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Do something soon. We had the same situation and nothing was done until they
broke their hips in the same year. It was a blessing in disguise. I found a Elder assist service that helped me to do a separation of assets so my mother in law could go to skilled nursing. She was never strong enough to walk again and needed help with daily living. Medicaid approved her and they cover everything now. Her mind is good and she has thrived. We even got her cataracts done! My father in law has dementia but could care for himself until she left. He had fully recovered from his hip surgery but his dementia had worsened. We were able to get him assisted living in the same facility and his small income covers the bulk of
his expenses. Recently we got him a small VA pension. This has not been easy but, I'm here to say that there is hope if you use the resources available. Its been 1 year and the difference in both of them is remarkable. They spend every day together and when we visit we are able to enjoy them. Don't wait until its too late. Start doing your homework now. My sister in law lost years of her life trying to care for them. Wish we would have stepped in sooner.
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AnnReid Jan 2020
We had a similar result with my mother, who “bloomed” in the 5 1/2 years she was in residential care.
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Having gone through a very similar situation with my MIL for nearly 10 years, I can offer this: you and your siblings HAVE to be united on your decision. If not, it will be miserable... I say this from experience because it was a constant fight about what was best for mom and dad, who was feeding them, who was cleaning, who was taking them to appointments, who was called in the middle of the night when she fell... the list went on and on; those were stressful years for everyone.

If your parents are both determined to stay, however, you all must then give them some rules, starting with having a bathroom installed somewhere on the main floor (at least a half bath) and that they move their beds to that floor, too... even in a small house, you'll find a way to do this. It's just too dangerous for them both to be climbing stairs in their conditions. And that they have some kind of regular in-home nursing to help with bathing and medication management.

Pick up the phone and start calling every agency you can think of for financial aid and medical assistance... you never know until you ask.

They say you're being selfish because they're scared... nursing homes, for their generation, is where old people went to die with nurses in severe white uniforms forcing medication on them. Newer facilities aren't like that but you won't convince them of it.

I hope you and your clan can come up with something that works for all of you.
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Ohhh my. First of all the dog has to go. It is a trip and health hazard to the elderly. I'm surprised your folks did not fall yet with a three story home and it makes me wonder how they maintain that especially with that dog pooing/urinating all over the house -- they can sell the house, and be put in assisted living facility. Or, have them live with you.
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C1john Jan 2020
You don’t just kill a dog like that. There are plenty of rescues that can foster the dog until a home can be found. How horrible to kill a dog because it’s deaf and it’s owners are old. That’s terrible advice and cruel.
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Seems the dog needs to be placed with somebody else that can provide "doggy hospice" since loss of bowel and bladder control is usually a sign of close to death. Of course, it may also be that dad just doesn't let the dog out.

Realize that dad is manipulating everybody but that the situation does not provide adequately for anybody's needs. Dad probably needs some help with his ADL. Mom definitely needs help with most of her ADLs. None of you appear to want or are able to be full time, live in caregivers. Seems either they need full time caregiver(s) or to go into a facility that would provide the care they desperately need. Dad may be concerned that his children will not visit them, he will be separated from his wife, and that there are not enough finances to cover costs.

Do your research. Talk to home health care agencies. Talk to a VA representative about VA residential facility care and dad's finances. Talk to your siblings after you have gathered all information. Then talk to your parents about their options. Dad may need to realize that Adult Protective Services would remove them from their home if the situation does not change - and then your parents would not have choices.
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The VA has a program where they will send an aid to the house most days for 2-4 hours. It’s quick to enroll in and can start almost immediately as opposed to other government solutions that take a lot of time and paperwork.

Does your father go to the VA for his medical care? because that makes it even easier.

I told a friend about this for her husband and they had help within 2 weeks and it’s all free. I believe she was even able to request a time frame. She chose morning for bathing and getting ready for the day.
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The VA will not come and take care of your mother - they will come to help take care of your father.

You need to set up a bed downstairs for your parents - they should not be going upstairs at all.

I lived in the livingroom with my DH for 1-1/2 years when he became unable to get into and out of our bed. I bought 2 sleepchairs and we both lived in the livingroom. I took him to the bathroom when needed and assisted him with his urinal right there in the livingroom. It was an act of love for me to tend to his needs and I'm thankful I was able to be there for him. However, he was 30 years older than me and that helped a lot since he was already 96.
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