Why does my 89 year old dad want me to make the decision on how his living arrangements are going forward? Shouldn't he be involved?

I came to the realization years ago and 2 years into it that I must make the decisions now on their behalf because they are incapable. It’s painful and requires more work. And for me there’s been constant adaption, there’s no set-and-be-done with it magic solution. I had to take my mom’s car keys away after she got lost for 4 hours in the city, dented it, and I got a call from the police. Sadly, it was the 2nd time. I believed incorrectly that she was still capable. She wasn’t. If they are incapable or unwilling, then assume the role and do the best you can making decisions on their behalf.

Obtaining a medical Power of Attorney will help in extreme circumstances (medical decisions when they are incapacitated, ER visits, financial matters escalate, or other family members begin to meddle in decisions).

Take care. Blessings.

If your dad is almost blind and needs help with almost every aspect of him living "independently" then he really is not independent.
What would happen if you were to stop helping him. For example you break a leg and can not drive for 8 weeks. You hurt your back and can not drive or bend or lift anything for a while. Your car breaks down and you can't get to him for a while.
If you have someone come in to assess him take yourself out of the equation so they get a good idea how independent he is.

I am sure that he realizes that you living 4 hours away can not continue to care for him in the way you have. His care will become more involved.
If he is agreeing with Assisted Living then he is relying on you to find a place that will be a good "fit" for him.
The big question is do you find a place closer to where you are living or do you find a place close to where he has lived all this time. I am sure he has friends and is involved in his community to some degree so maybe locating an AL near where he currently lives is a better option. This way he does not have to change doctors either. It would mean that if he needed help at any appointment you would have to go and it is 4 hours to him, several hours with the doctor appointments and another 4 hours home. That is a full day and if he has several appointments it might be several days away from your family.

Your dad sounds very reasonable with no dementia.
Yes to your answer about having a professional assess him. It’s good for a baseline even if he doesn’t qualify now. If I were you, I would have his doctor order a home health assessment to see if he qualifies.
A couple of people have mentioned Home Health but made it sound doubtful he would qualify. Check it out for yourself.
The HHCare that is covered by Part B of Medicare for intermittent nursing is for folks who need less than 24/7 nursing care but could use help with their pills for instance. Being blind I would assume he could use help with that. He may have other comorbidities that qualified him as well. The fact that he goes out to lunch once a week is NOT a disqualifier. People go out to doctors appointments and to church. That certainly does not prohibit eating out. The nurse that comes once a week needs to have something to do for him, like the pills, check his vitals, etc. once the nurse is approved she can order a home health aide who will come in to bath him, give him a shampoo, shave him, etc. My moms and my aunts also stripped the bed and remade it, would put the sheets on to wash. This is a great help, gives them a bit of company and keeps an eye on their health. They keep a log in the home where they record his vitals and any notes. This is very handy for you then to notice how he is doing. Most doctors like to see this info as it tells them much more about a patient than the 10 min they see them in office.
I do believe that regionally these services might be slightly different as we get differing opinions on the forum. I am telling you what I have personal experience with. He can also have this service in an ALF. Check this out for yourself.
I lived three hours from my mom. It really helped her. I was two away from my aunt. She still uses the same service she had at home, now has them for hospice in a NH. She’s had them at least 10 years now. She’s 97 now. Good that he has no problem microwaving food, Neither of my LOs did either when they first started with HH but things change and over the years they had to have more help. So know that what you set up for today will have to be adjusted as his health declines.

Your Dad is willing to give up control because he no longer trusts himself to make all the the correct decisions in his life. That is a good thing.

However, you now have the opportunity to help him move his life into a new direction. First, get involved with his medical. Find out all the medications, vitamins and herbal supplements that he uses. Find out his sensitivities. Note his food and drink likes and dislikes. He needs a medical advocate.

When the opportunity arises, understand all there is to know about his finances. What he owns, how it is titled. Call Social Security and get on his list of authorized people to talk to them about him. What health care he has, what are his deductibles, etc. If he allows it, get a user id and password so that you can review his bank balances. Does he have a pension or life insurance? Understand how he pays his bills.

I suspect you already know his "routine." Meet the people that he hangs out with. Meet the people that he trusts like his barber, his banker, his "hangout" group, his doctors.

Talk to him about his hopes and his future. Regardless of whether he goes into assisted living or not, knowing these things will help you make decisions for him in the future. I believe he wants to live, however, getting someone to help take care of those details is like having a trusted partner who will help you live the life you want to live.

You might want to consider moving closer to each other. On the other hand, depending upon where you live, living an hour away might be close enough to keep a "loving" watch over his activities.

Whatever you do, do NOT invite him to live with you in your home, or agree to move into his home. You both need your physical and mental space. This becomes extremely important as he ages and you continue to take care of him.

NewToThis2022: My late mother, a legally blind woman, also lived alone until she could no longer do so when her blood pressure plummeted and I had to move in with her to provide care. Your dad may require managed care facility living.

This is a good thing if he recognizes he needs help and is giving you decision making ability!
My dad is not blind, but was otherwise needing help in the same way, and refused to get ANY help, not even a housekeeper, until he fell and literally broke his neck....

Yes, getting an assessment would be a good idea. Get some experts to come in and let you know what is needed. Then you can look at costs of assisted living, versus staying at home and getting all the help in. From what you are describing, going to Assisted living would likely be lower cost to get all the help and safety needed. But its good to do the analysis. If he is reasonably willing to consider leaving the house and going to assisted living, consider that a victory and major plus!

Yes, you may get help to come in to do your dad's chores and help with his hygiene or move him to assisted living. I see that he gets to his favorite restaurant once a week. Can he walk there or take public transit? Rideshare is an option.

I think your father sounds like he needs more than an AL facility. He probaby needs a long term care facility or nursing home.

Homecare may be an option for him to. A live-in caregiver.

Yes..

Sounds as if Dad realizes he needs help .
That’s half the battle already won . Many of us could not get a parent to even consider accepting help at all . I do hope he is willing to go to AL , he sounds as if he would adjust well . Talk up the positives to get him over the hump of worrying about the money .

It's not uncommon for older adults to seek support and guidance from their loved ones when it comes to decisions about living arrangements. Your dad may trust your judgment and value your input. However, it's essential to involve him in the decision-making process to ensure his preferences and needs are considered. Talk to him and ask about his
thoughts, concerns, and preferences regarding living arrangements to ensure that his expectations will be met. One thing I can suggest is to check some retirement living options together, that’s what me and my mom did when we were looking for a reputable retirement living in Canada (https://seasonsretirement.com/) that offers assisted living. Hope this helps!

Sounds like he really trust you, and that is very sweet!

I agree with Lea whole hardily. Adding that it must be hard living alone. An AL would give him some socialization.

I recommend too that you contact your County Disabilities dept and see what resourses are available for Dads blindness. He maybe able to get help in learning how to do daily tasks.

I am pretty sure Medicare does not pay for CNAs on a daily basis. A Dr can order "in home" help usually after a hospital stay. This is usually Physical and occupational therapy and an aide in included for bathing. This is about 3x a week. It depends on the in home service if you can get an aide for a longer period. But this service is temporary. There is "intermittant" care but as the name says its intermittant. You would need to find out from Medicare what that entails. Medicaid does have "in home services" that do supply aides but Dad would need to fit the criteria income wise.

With dad being 89, nearly blind and owning a home thst requires all that upkeep, to me it's a no brainer that he'd be much better off in Assisted Living. Especially if he's not upset at the prospect. His health will only decline from here and then what? Then you're faced with a potential crisis where you MUST move him to managed care. If the crisis is bad enough, he may bypass AL altogether and require Skilled Nursing! Head off disaster now and place him where he'll have services available at his fingertips, along with 3 hot meals a day, friendships, outings, activities, help with showers, etc.

He may have trouble making decisions at this point in his life and defer to you for your input because he trusts you. My parents did the same thing.

Best of luck to you.

I think this is up to you, completely. Your Dad is happy with his situation. I don't know if he is in any way cognitively impaired; he may not participate in any "decisions" because he feels perfectly OK with how it is, given his age. And he may have little understanding that this is at all taxing for YOU with a little cognitive disconnect. He can only know THAT if you tell him.

I would start with an honest sit down. Tell your Dad that daily spending the four hours is wearing on you, and impairing your ability to handle your own life.

Only you can decide just how much it IS affecting you, and how willing or unwilling you are to continue with this daily. And only you can tell you Dad how it has to be, because from his own perspective he of course likely wishes to pass in his own home.

Short of honest discussion I cannot imagine how you come to conclusions here.
I wish you the best.

I'm not so clear on what your Dad wants you to do?

Arrange all the services & help for him to stay where he is? Or find him a new, assisted living location?

Is he trusting you to do what's best, to 'take the wheel' so to speak. Has decision making or planning become burdonsome for him?

You could get help to come In and do chores. Contact elder services - Medicare will Pay for a CNA ( certified Nurse assistant ) and they Can bathe him and do light House cleaning and Laundry , meal On wheels can come and bring Food , he can qualify for Physical Therapy and a grocery shopper . His doctor can also write a script for a VNA Nurse to check on Him .