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My dad has end stage Heart Failure. I live with my husband in Nicaragua & I flew back to Canada at the end of October when my dad was rushed to hospital. Dr.'s told me it was best if he moved to palliative care. My dad categorically said no. Also, my mom doesn't drive, is illiterate & outside of housework & cooking (her forte) she has never had to deal with daily living issues or finances. I had set up a part-time housekeeper/grocery shopper for them when my dad couldn't drive anymore. My mom suffers from some arthritis in her hands but at 84 years old, besides some memory problems, she also seems to have bouts of depression/anxiety/anger that are triggered several times a month.


The waiting list for nursing homes is over a year & my only other choice was finding a senior's home where we could have home care services & government run home palliative services. In a whirlwind affair, got my parents moved to top of the line senior home while my dad was still in hospital. I postponed my trip back home to Nicaragua to get them set up.


Once he was stabilized he moved to the Senior home with everything set up for him. Oxygen, nurses visiting & home care to help with certain things. Home care sends different women & each had a learning curve on what to do. There was a lot to iron out. I postponed my trip again. I wasn't going to leave until I felt everything was under control. Now everyone knows how many details there are to moving, changing addresses, POA, banking, government, etc.


Shortly after my dad coming home, a week or so later, my mom calls in a panic & said she called the ambulance to take him back to the hospital. Once again in the hospital we went thru explaining to my parents either my dad stayed in hospital palliative unit, or at a hospice, which they refused. My mom can't be alone, she can't do anything on her own. So dad came back home once again. I postponed my trip once again.


Then the tears began again with my mom. She hated the food. Over the weeks while my dad was in hospital, I often ate with my mom at the Senior's home dining room. It was all quite good. She often sat with other folks & ate but the minute my dad came back, they began eating in their apartment because my dad didn't feel well enough to make it to the dining room. They practically stopped eating. There are activities, shuttle bus, entertainment at the Senior home, my mom stays in the apartment with my dad 24 hours a day.


A week before I was suppose to fly back home she announces that she refuses to continue living at the Senior's home & wants to move to Nicaragua with me. I was shocked at first. The plan was that after my dad died that yes, indeed she would come live in Nicaragua with me but now she wants to do it right away. I postponed my trip back home once again. The logistics of bringing my dying father is enormous. Yes, he could live perhaps a few more months or he could pass away in a few weeks. They would save a lot of money, the senior home is very expensive. It would be easier for me to take care of them in Nicaragua. (I'm the only living child left & I'm 65, my hubby is 75 & needs me too). I don't have the heart to put my dad through this but my mom is adamant she won't stay.


How can I convince her to wait it out for my dad's sake? She cries & is depressed daily now. I've been here now for over 3 months, do I just stay month after month until he passes away & leave my husband alone longer? They are both old school Europeans where they expect the child to do all. I am burnt out from the stress of it all & can't think clearly anymore.

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If she is truly old school then she should believe she has a Duty to stay by her husband's side, if she refuses to honour that then what is going on is more selfcenteredness and manipulation than it is old world values.
I get that she feels lost and alone when you are gone because she is losing both her husband and her main support (you), is there any possibility of finding someone who can be your mother's companion - paid or otherwise - who can help her through the next few months??
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Carebuni Feb 2020
Yes, that is exactly what I've been thinking, is finding a paid companion while I return to my husband for awhile. The only problem is the financial situation. The Senior home is very expensive. They have only their government pension & a bit of savings that will not last long. Paid home care is also taking a small chunk. Even if I find someone to come 3 to 4 times a week to take my mom out, keep her company, it will be worth it.
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Your mother is clinging to you because she can't cope and she's frightened.

Old school European? What type? Are there any support groups, church groups, clubs that could reach out to her? Have you discussed with the seniors' home management how they might support her as your father's primary caregiver during this terribly difficult time?

The thing is - just suppose you did take her to Nicaragua and leave your father being cared for in Canada. She'd eat her heart out from thousands of miles away. You'd end up shuttling her back and forth, I expect. Bringing your father to Nicaragua sounds like a nightmare on stilts, for him and all of you. She is GOING to have to stick it out; you can't be there all the time; you need allies.

An open-ended commitment to staying until your father passes away is not reasonable. Your husband comes first, and besides you have a life to be getting on with. You can't stay in suspended animation for what could be months.

What does your father say about it all? And, not criticising just asking, what is his main objection to palliative care?
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Carebuni Feb 2020
The Senior home management has been trying to help out. We had meeting with the Chef, made list of foods they won't eat. They're going out of their way to help accommodate. All their long time friends have pretty well died out. There is no family except me, There are a few of my friends that have known my parents all their lives & do come visit once in awhile. My parents are not religious. European community is very small here.

My father's objection to palliative care is he doesn't want to go somewhere where people are dying.


I'm going to call the Dr. tomorrow and ask for a family counselor or psychologist to come talk to my mother.
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I'm sorry for your dad's prognosis. I am thinking that the airlines may not even permit him to travel if he's that sick, so I would check into that option before going much further. Ground-based medical transport would be exceedingly expensive and be too hard on him. Your own husband is the priority, and this is easier said than done knowing your father is so ill and your poor mom is not coping well, understandably. When my stepFIL went into rehab after a fall, it became crystal clear how much cognitive decline my MIL had but we didn't see it because of all the other issues. This may be what's happening. As a short-term solution do you think it at all possible to hire a bi-lingual "helper" for your mom? Here in the states we have in-home care agencies and you can talk to the agency owners about her special need. There are many bi-lingual citizens and if your mom only needs a helper, driver and companion (nothing "medical"), this would be at the least expensive fee level. Maybe if you can mitigate this situation with your mom you may feel better about going back to your hubby at this time. I wish you much peace as you sort through options.
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I think you cannot convince her as she is used to making the decisions. I think that this time it is you who must make the decisions and live with her ire. Sorry, but it should be done. There are their expectations, yes. Tell them you are sorry and apologize for being unable to fulfill their expectations. There really isn't any other answer unless you want to continue this, and believe you will be able to. It will be very difficult and you will have to be honest.
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Peanuts the OP says her parents are in Canada, if her father is a citizen or landed immigrant then he is covered under provincial medicare which will not pay for care outside the country and the likelihood of any private insurance company providing coverage is pretty much zero.
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My stress level dropped when I got my aunt, 'dad's sis" and my mom in same facility.... about a 2 minute drive from my home.

I believe.. sorry.. that your stress level would drop if your parents were within a 5 minute drive from your home... SO
Do your homework.. look at assisted living places near your home.. See if it feasible and affordable and if both your parents n hubby, knowing , dad, can leave this planet within a few minutes, are okay to move to be close to you....
Just Look.. See If There Is Anything Close To YOU To Move Your Parents Near You...EVEN IF DAD IS GOING TO LIVE THERE A FEW DAYS....Shoot, you already spent more months where they are living, anticipating the death of dad...
It will be an adventure.. possible a one way trip for both of them, but if you are their only child.... why not...Will yoour mom be okay with the move..even if her hubby is gone? She will be close to you...
that is what counts...
My thoughts.. /// sorry...
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JoAnn29 Feb 2020
She is in Africa, them in Canada. No way is she going to be able to fly a dying man to another Country. I would think there are Visa's maybe shots. Passports and then getting permission for a permanent stay. Then there is Medical. Canada is socialized medicine. I would just ewait till Dad passes and then deal with Mom.
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This is such a sad situation. I can’t imagine moving him. Of course it is sad for your mom too but I feel your dad must take priority. Have you spoken to the social worker at the facility to see what recommendations she may have for your mom?

Best wishes to you and your family in this truly difficult situation.
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Seems you have a good situation lined up for your dad and he is dealing well with it. Your mom seems to need more attention. I suggest getting a doctor's appointment for your mom.... and probably a referral to a psychiatrist, or geriatric psychiatrist if one is available. She is not coping well with all the changes: impending death of her husband, lacking skills to manage in the country is lives in, anxiety, maybe depression... A doctor could evaluate her physical and mental health and prescribe therapy and/or medications to help her now. Moving in with you may come sooner than later since she is coping so poorly with all the changes.
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Yes, I believe that's the route I'm going to go, try and find a companion. The hard part will be getting her to accept staying with my dad till he passes.
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PALLIATIVE CARE AND HOSPICE, here as I know it... They Come to you.

My aunt cannot walk, so they have a nurse come to them - palliative care, once a week...

Hospice.. comes more often, has someone come to her a few days a week for bath.. and a nurse to check her vitals... Mom graduated 3 times...\\

palliative care and hospice do re-evaluate...

Check with your area, see if their insurance transfers over to your area, and ask them about these services...

You are burnt out.... Take your parents close to you... Look into assisted or senior living... check into it..// Then make your decision.. But while you are in Canada.. check about these in home cares... palliative or hospice... I may be wrong... they may differ from one country to another...
Good luck

GN
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