Any ideas for communicating the need for respite visits to a patient who thinks he should still be fine home alone?

How do you trust a caregiver from outside??? I need the respite. I've been 24/7 for my husband for 7 years now with no outside help from his family or friends. How do you find someone you can trust in your home when your spouse is legally blind, has a profound hearing deficit and is an amputee.

Maybe you can try the opposite. Tell him she is the one in need of care. Tell him she thinks she is coming to clean but it is really so he can keep an eye on her. In this stage, we use whatever works with my mom. She had her first companion visit two days ago and she insisted it wasn't necessary so the caregiver told her she didn't feel safe being alone and it was ok with my mom, she would like to stay until we got home. Mom bought it and admitted she would rather have the company too.

I suppose if Mom is going tomorrow, it's already occurred. I would have left your phone number or neighbors number for her to call. How did it go?

If she is there for 2-3 hrs, I’d try to make a list of fulfilling items. Cooking. Cleaning (sweeping & mopping, dishes, his towels- not too excessive but maybe an hour of cleaning). That should total 2 w/the cooking. I agree with the “lie”- “She is there to cook & clean”. That is the “truth” with a twist. This is a journey and if your mom starts receiving the help now, she will be far better off than burning out. Good luck

Simple. Lie. My wife was very, very anti respite. Her kindly Dr. agreed that I could use the health care provider insurance as a threat. "Either you accept in-home visitation and help for both you and your husband or we may no longer provide you with health coverage". I didn't even have to type it up; rather just pretended to be on the phone with the insurance provider. Worked like a charm and now she is very comfy and happy with her care giver.

heatherf: Perhaps you should go with the premise that 'the individual is there to help your wife.' Don't say 'to give her a break' as that may lead to an acrimonious tone of your father.

IMHO, I think this is more of coming to accept your dad's diagnosis and prognosis than it is how long someone might need to clean the house. Coming to accept that your dad is in need of more than your mom can provide is hard, but something you and your family should work toward quickly to try to catch up and stay in front of this disease.

Until then,
Have people coming and going as often as possible - if you keep him at home, then this will become the norm and you might as well start it sooner rather than later.

Get your father, and mother, acclimated to someone being there often. With opportunities for your mom to step out - perhaps for a short walk, to do yard work, or go to the store. But, you can't go from zero to 100 because it is necessary now, you need to still take the incremental steps if you want your father to not be too agitated.

Realize that your father may never come to agree to these changes. Aggrement or acceptance is not necessary, reducing his anxiety over it is. And give strategies to the respite person to reduce his agitation: don't talk to him, don't sit down, stay in a nearby room, motior but don't hawk over him, keep busy, etc.

Finally, work with his geriatrician to understand what the future holds for your father, create a plan of care and then decide the best place for that care to occur. The disease only becomes harder, you can't prevent it, you can only prepare for it.

If your dad’s dementia is accelerating to the point he can’t be left alone he won’t remember if the “cleaning lady” already dusted the room an hour ago. She could just cruise around with a swiffer in her hand and act like she is really working hard. Can she do some laundry and change sheets when she’s there? That would keep her busy. Also when I took care of my dad I got a camera I could monitor him with from where ever I was. I didn’t ever leave him alone except to go out in the yard and do things so that was helpful in knowing if he was looking for me or what other things he might be up to and also to monitor when a caregiver was with him.

Why not stick to the story that she is there do help your mom with the cleaning? Does she come every day, or just when your mother has to go out? Try to find 2-3 hours of work for her so that she really is helping your Mom. Have your Mom make a list of things she can fill in with, if she runs out of the regular work, such as laundry, cleaning the inside of the refrigerator, dusting book shelves, kitchen shelves, etc.

I started having non-medical caregivers from Seniors Helping Seniors go into my mother's home for a short time before she went to assisted living (spouse is no longer living), I just planned to be there at the beginning of the first visit to meet the caregiver with mom and did not discuss payment specifics with mom. I insisted that the same 2 people go to the home every time. After a couple visits Mom actually liked having the people come to visit and became very friendly with them. Though I initially just wanted someone with my mother I decided that it was absolutely ok for me to want someone to go in to take some responsibilities off of me in addition to socially interacting with her. I did find that I had to very specifically list the things I wanted the caregivers to do but in the end decided I wanted someone to go in around dinner time and do things like empty the dishwasher and make sure my mother had something to eat for dinner. It is really ok for your mother to have someone provide some assistance that benefits her and takes some of the burden aside from just getting out of the house for a minute. I'm not sure if hospice will help with light housekeeping and meal prep but those services may be really helpful to your mother. The best approach my just be to not make a big deal out of it and indicate the people are coming in to do some help around the home.

Good Morning,

In all honesty most men don't like "strangers" coming into their home. They prefer the wife and/or daughters do everything. I have heard this scenario from all of my friends, "I'll be nice while she's here but happy when she leaves".

When you have two aging parents, it's a juggling act. If you have your father's primary care physician (PCP) do an assessment and be up front and say look, dad can't be left alone he thinks everything is fine.

You could just do one morning per week for four hours. Find some place in the neighborhood, usually nurse practitioner's in a doctor's office know more about this stuff than the doctors do. Try to find a "Medical Model".

Some provide transportation but I drive mother to and from since she has to go to the bathroom after her morning coffee and I don't want her to feel pressured.

If your dad was a Veteran there is $$$ available for this along with a million pieces of paperwork to fill out. It's not a given.

I have my mother go one morning a week for Physical Therapy, Speech Therapy a continental breakfast and hot lunch. There is an RN on duty at all times and activities. Some people are totally out of it--it's sad. I think if my mother attended more than that she would decline but I need a place locally so I get my errands done with some peace of mind so I won't come home and find Mom on the floor.

There is a fee for this along with a bill from the insurance company for Speech/Physical Therapy. As I write this my mother is out in the hallway on her UpWalker Lite.

Your internet/phone provider can put a camera at the door with a sensor. If dad should leave you get a text with a photo. A lifeline button comes in handy too.

You could explain to dad that these places exist so you won't have to go a nursing home. They can remain in their home longer if they participate.

I'll leave you all with a laugh--when my dad was living I said dad why don't we all pitch in and get mom someone to clean the house as her Christmas gift. He responded, "No, your mom likes doing it". They say men and women are different, I agree.

Turn it around. It helps Mom knowing someone is there, makes her feel better and this person will do the housework too and give mom a break from that. Warranted or not Mom is consumed with worry when Dad is alone so having someone she trusts there gives her the piece of mind to do and enjoy the things she needs to do.

Check out this incredibly affordable 24/7 non invasive remote monitoring system that seniors are very receptive to have in the home, which provides safety for the senior and peace of mind for the family when the senior is home alone.
https://www.seniorshomeservices.com/monitoring

If he's a Veteran, there may be visiting options available. When my father was eligible, there were no "visitors" available in his area, but if there were, I would have taken advantage of that resource.

The Jewish Welfare Federation offers a variety of assistance; even if you're not Jewish, it wouldn't hurt to find out what might be available in terms of friendly visits.

Our county also has friendly visitors, paid for through county funds.

Also, if you're involved with a Senior Center or religious organization, there may be options for friendly visitors as well. They don't have to clean; and I don't think that they're paid. They just drop by for a visit.

Are there any neighbors who could drop by for a quick visit, especially if they have dogs and your husband likes animals?

These might be ways to acclimate him to visitors while his wife is gone, then gradually add someone who does light household work once he's gotten used to, and hopefully accepted, visitors.


The other thing I would focus on is his safety at home. Does he have a life alert pendant? If not, I would seriously consider getting one.

Have throw rugs or any potential fall objects been removed? Have grab bars been installed in any area where he might be vulnerable walking on his own?

The line that sounds best to me is ‘I have to go out, she’s going to do some cleaning that is being a stress for me now, I have to pay her for a minimum time, if she runs out of jobs she can sit with you and watch TV – that’s OK with me. She’s nice, you can talk to her till I get back'.

Depends how you intro the staff member, how much Dad retains of that & his attitude I suppose..

The truth is light cleaning & friendly visiting so I would try that first.

Here is *Jill* a new aquaintence working for friends & will be visiting us too. All have a cuppa together & social chat to build trust the first time/s before Mother pops out.

I see the issue of *Jill* is our cleaner, as 30mins after dishes & a sweep Dad may be confused to why she is sitting down watching the tv with him...

What I found is whatever the story, what you want is *this is happening* undertow. Be careful who gets the power to hire/fire. Sounds a bit mean 😕 but if Mom is kind hearted & gives Dad the power, he may cancel. The help is for both - to help Dad be safer & allow Mom to leave the house with less worry.

So a confident manner is essential. No "Is this ok, Darling? Are you sure?"

My LO keeps trying repeatedly to cancel the 'help'. Why? Because wants caregiver - in the same room 24/7. This is unrealistic (but insight to this is diminished).

Doctor advised: When reasoning is lost, just arrange what you need to.

Best of luck! May it work out well.

What is wrong with telling him the truth, which is that mom has to go out for a while and that (insert name) is coming to help mom with some chores and make sure he’s comfortable? So what if he’s mad? Will he throw a tantrum? Who cares? He may not remember much of it for long anyway. He doesn’t have to know she’s being paid. Caregiver could offer to help him do a jigsaw puzzle or water the plants. His getting mad needs to go to the bottom of the list of worries. The main thing is that dad is safe. I realize this situation is new to all of you, but you’re dealing with it and he’s not allowed to call the shots now because he’s not in his right mind and never will be again. PS I hope mom has a wonderful time.

I would tell him that she is a friend or student or intern just coming by to tidy up and be around.