My 103-year-old parent refuses care other than from his children. How do we find a balance?

Introduce a caregiver SLOWLY.
Have one come over, introduce your friend "Gail"
Gail can help you change bedding and do laundry on Monday.
Gail can help you do some cleaning on Wednesday.
Gail can help prep some dinners for the weekend on Friday and all of a sudden you need to run out to get potatoes for the stew you are making. Gail can stay with FIL for 30 minutes to an hour while you run to the store.
The following week Monday is the same but Wednesday you have a "dentist appointment" and will be gone for 2 hours.
Friday you are going to meet a friend for lunch and will also be gone 2 hours.
He will get used to "Gail" and be more accepting of her.
The other option is to find an Adult Day Program that he can go to. They typically pick up in the morning, the participants get a snack and a lunch. Maybe an afternoon snack as well then the bus/van returns them home at the end of the day.
A program like that is good as it is consistent and it sounds like he likes routine.

In different circumstances we told my dad, living in his own home, that there was no choice, either he have a helper in home part time or he move to assisted living. We stated this very firmly, though we really had no power to make it so. For whatever reason, I guess our firmness, he believed us. We hired a part time helper despite his insistence of “I don’t want anyone in my house” Thankfully, she was experienced and very good at her job and she quickly turned him into a believer in her skills. She became very valued by him and we were grateful. Don’t make it a choice and back away when necessary

Some posters have had success with introducing a carer gradually. She comes in as ‘your friend’, and talks with you and him together. ‘Her mother recently passed, and she is at a loose end’. Third time, you ‘have to slip out for a while’, and she is prepped to do something he might enjoy. Then you extend gradually. It might be worth a go? It’s probably not as quick as you hoped, and it is too expensive for some people to manage, but you’ve done so much that you may be willing to take it a bit slowly. Good luck, Margaret

My mom resists having caregivers but I'm burnt out, busy with watching grandkids (which I LOVE and will not give up for any reason!) and want to have my life back. So I did not ask her, I just did it. And, yes, she pays for every penny of it. She gets pissy about it sometimes and I tell her it's this or she'll have to live elsewhere because I can't/won't do it all. It's an on going battle but it's imperative that I have my grandkid, kid, hubby, me time (not in that order but still).

You’ve tried the conversation, it appears: it didn’t work. Get moving! Because you can’t do it all, nor should you have to! Do what you need to do, and say - gently but firmly - this is how it’s going to be.

My suggestion would be to take a different approach to the conversation. Instead of asking him to agree to outside help, why not go ahead and arrange for the help you need and then tell him you have engaged part time help... not for him, but for you?

In truth, the help *is* for you, and I do not say that in a critical way.

Another suggestion is to actually be there with the new caregiver as your FIL is getting to know them. Hopefully, even with his limited ability to learn new skills, he will become familiar enough with them that he isn't frightened the first time you leave him alone with them.

Good luck to you. You sound like a wonderful, loving family.

Grandma1954 has it about right, whether it is "Gail" or "John.". Begin to introduce outside help, perhaps introducing them as there to help YOU. You may go through a few care workers before you find a real " fit" especially with current shortages in the home health field, but the goal is to find someone your FIL accepts as a helper.

Just be honest and upfront with him, and then give him the choice of hiring outside help in(with his money of course)or tell him that you will have no choice but to have him placed in the appropriate facility, as you guys can no longer continue the 24/7 care that he requires, as it's just too much.
I would venture to guess that with those being his only 2 options that he will welcome with open arms outside help coming in to assist him.
Good luck!

With short-term memory impairment I personally think it is unproductive to have any discussion with him that he won't remember, but if it gives you a clear conscience, then do it but have no expectations of him recalling it. And certainly don't bother telling him a second time.

Do what you think works best for both parties (him and his caregivers). If he is still active and mowing the lawn, etc. it may be best to have aids come to the house and maybe someone over night. Maybe consider an adult day care. Him wanting you to be around 24/7 is called Shadowing and is a characteristic behavior of dementia. You won't ever be able to get him "reassured" that he is "safe" so do what you need to so you don't burn out. Have the aid(s) keep him physically and mentally busy during the day so that he sleeps through the night. Having in-home aids 24/7 will eventually cost more than a facility.

In any other situation I would recommend AL for all its healthy social exposure but at 103 and him having great mobility and activity level... I'd say it's ok to preserve that by keeping him home, if possible.

If you decide to transition him to AL then you can use a therapeutic fib to get and keep him there: The house has a dangerous gas leak / infestation / broken a/c or furnace, etc. You have to go to a temporary apartment until it is fixed. Most facilities are familiar with going along with this type of strategy.

Your profile says he has depression so I would recommend this be discussed with his doctor to see if meds would be an option, and it *may* "help" the shadowing.

Can you present it as something that you need to do for you and your husband, so that you can have breaks? Some men prefer male aides, especially for bathing and dressing. What about a transitional period when you bring in aide(s) and also are there at the same time while your father in law adjusts to the aide(s). You'll also have a chance to see how the aid works with your FIL. If you will have "strangers" in his house, lock up his valuables and personal papers, especially financial papers, or better still, remove them from his house and keep them at your house. Maybe it's time for your FIL to go paperless. Are you handling his finances? If so, this will be easier. In time, as he gets used to the aide(s) he may be OK with having an aide. Does he need 24/7 care? If so, he'll need to have aides in shifts for the times when you cannot be his caregivers. Is his financial situation such that he can hire in-home aides? Connect with a local social worker to discuss his options. Medicare/Medicaid cover in-home caregiving in some situations. At 104, and with dementia, he should be entitled to some benefits. His doctor may have to prescribe in-home caregiving if it's for Medicare. Hopefully all of his paperwork is in order with setting up powers of attorney for medical and financial matters, having a living will with his medical directives, and a will (he has a house, so he has assets). If he doesn't, and his dementia is still not far advanced, he may still be able to sign legal papers. All the best to you all.