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My 89 year old grandfather recently
moved in with my Uncle full time. He had been back and forth between his own home and my Uncles since my grandmother passed away 3 years ago but his health continued to decline to the point where it was not safe to live independently so he agreed to sell his house and move in with my Uncle. Since then he has been hospitalized multiple times. Most were related to pneumonia and his PCP recommended a swallow test to check for potential food aspiration leading to pneumonia. My grandfather said he didn’t want it done so my uncle did not push it.



Then my grandfather fell getting out of bed. My uncle was at work and his significant other did not check in on my grandfather all day, claiming she believed he was sleeping. When she finally looked in on him that afternoon, he was on the floor and not moving so she called my uncle who called 911. She wouldn’t even go in the room to check on him. He was hospitalized with fractured ribs and admitted he fell trying to get out of bed. He had been on the floor for at least 8 hours.



Recently my Gpa was hospitalized for an infection that doctor said was related to a dog bite. My Gpa said my Uncles dog bit him and that he bites him and my Uncles sig other frequently but my Uncle denies this and insists the dog only scratches him when he excitedly jumps on him. He doesn’t seem to understand the dog jumping on my Gpa and scratching him is also a concern and could lead to serious injury.



During a recent visit with my Gpa (he lives about 4 hours from me) he seemed very depressed and I could tell he is beginning to mentally decline. He also is considerably weaker and has lost most of his mobility. He can still get up out of a chair on his own but cannot walk more than a few steps. I inquired about PT as I know his PCP had recommended this in the past but my uncle claims my Gpa refused it so he didn’t arrange it.



I truly believe my a uncle is trying to do his best to care for my Gpa but I think he is overwhelmed and is not capable of pushing my Gpa to do what the doctors recommend to keep him at his best. He is also reluctant to manage his meds as he claims my Gpa gets very frustrated that everyone thinks he is an invalid. I just don’t see this working out for much longer so I offered for my Gpa to come stay with me. My husband works from home so he would never be home alone and my husband has happily agreed to help care for him. I also have my Mom, a nurse, 10 minutes away and she is willing to help out with his care. I have a strong medical background and can help manage his meds and medical care. And I have a safe home free of obstacles that could cause him to get hurt, including a walk in shower.



Unfortunately my Uncle became very defensive when I offered for him to come stay with us. He said he is just fine where he is at and basically told me to mind my own business. I just want what is best for my Gpa and feel this environment is not the best option for him and that his care needs are being unintentionally neglected.



What should I do? How do I know if this is not a safe environment for him? I appreciate your comments and suggestions.

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You say that you want him to be kept "at his best."
Honestly, at 89 (I say this as an 81 year old retired RN) the days of "at his best" are now over.
Other than a dog bite I don't see evidence of any abuse at all, and the whole story there is kind of muddled and unknown.
Then you mention "seemed depressed".

In none of this do I see your 89 year old grandpa as having passed into a dementia that is severely compromising his ability to make decisions of his own. I think your going ahead with this without passing it by his son, who has for some time now been his caregiver, may be a mistake. Best way to handle this is the steps you have TAKEN already being 1. and 2. A decision whether you want to take on 24 hour care, and all in household are agreed it should be done. That out of the way, step 3. is to go to Grandfather and his son with this offer that you can take on his care either full time or part time.

I am hoping you have carefully considered all this caregiving would entail. The path, the trajectory for an elder is downhill. Things could get very dicey indeed; are you and hubby prepared for that?

So I would speak now with grandfather alone, and with grandfather and his caretaking son. I would make the offer if that is your intention and then I would allow them to consider it together.

Wishing you the very best, however the decisions are made. I hope all will be included in them.
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JeanLouise Nov 2023
Well said.
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If you call APS on your uncle, plan for him to be very angry and upset. Your grandfather may be seriously angry himself, this is his son you'd be reporting, after all.

If this were me, I'd go visit grandpa again and lay eyes on him myself to see how he's doing. Talk to him, ask him if he's happy living with uncle? Does he want to continue living there or would he prefer to move in with you? Feel him out.

Elders get pneumonia all the time and it cannot be blamed on anyone. Lying on the floor for 8 hours w/o being checked on, however, is a problem. So are dog bites if that's what's happening. If he's refusing PT which is quite common, and refusing medication management which is also quite common, you will run into the same issues uncle is dealing with. A stubborn elder is a stubborn elder. We'd all like to think we can ride in on a white horse and save the day, but it doesn't always work out that way, especially when we don't have all the details.

Your uncle and his SO likely feel that they are doing everything in their power to care for grandpa, at their own expense...literally and figuratively. Now you come along questioning their ability in properly caring for him, questioning them inappropriately etc, which gets their defenses up. Outsiders always seem to know better about what the elder needs than those who are working hard to care for them. Tread lightly and take uncles feelings into consideration here, that's my advice. You don't know for sure that negligence is involved, so it's better to approach the matter as what does grandpa want at this juncture?

Good luck to you.
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I can read that you have concerns & you care.

But I can guess that suggesting G'Pa move in with you instead could come accross as *a take-over*. That your Uncle may be insulted that you are questioning/challenging his care. You could appear as an overstepping *do-gooder*.

Keep the communication lines open but change tack.
ASK if Unkle is Ok? Needs any help? If so, what help does he need to care for G'Pa?

Ideas: Be involved by visiting (when convenient to you & Uncle). Stay for a weekend (nearby hotel) & bring some joy, bring treats or take G'Pa out to lunch Make weekly phone calls to G'Pa. Send small gifts. Set up an easy video-chat system.

Stay within the boundaries of a Granddaughter would be my top advice.

"I have a strong medical background and can help manage his meds". OK. But you are not G'Pa's Doctor or Nurse - stay within your scope as a relative.

While it is nice your Husband & Mom have said they can/will help, be very careful you are not overstepping as no-one has the right to volunteer for others. Check you are only volunteering for you.

Best of luck with this tricky situation. It can be hard to watch from afar when you care deeply. But the downsides of overstepping must be weighed up against speaking up. The aim is for G'Pa to be comfortable, a tug of war in the family will not achieve that.
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Your uncles home is not the place for grandpa. I don't think your uncle is intentionally trying to harm your grandfather, but clearly they do not understand that he needs care...not just a place to sleep. He needs active care... someone fixing his meals and helping him eat, help getting up in the morning and getting dressed, help with meds, help with bathing, someone paying attention to his cognitive and physical changes, etc. In other words your grandfather needs to be in a facility with 24 hr care. If his home has already been sold, he should have the funds to pay for it and once that runs out he can apply for assistance.

I also get that sometimes the elderly can get a little cantankerous and refuse care. Your uncle needs to tell him that he cannot let him live in these conditions without appropriate care or he could get in trouble. He needs to tell him whatever it takes to get grandpa to relent and accept care. Grandpa cannot be getting dog bites and lying on the floor all day long with broken ribs. If he still refuses, Adult Protective Services should be called.
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JeanLouise Nov 2023
It’s my understanding the so called dog bites may be due to elder’s paper thin skin and the dog inadvertently scratches. My DH ADORES our beagle and yes, on occasion when DH is cuddling the dog, he scratches and we apply a band–aid. No, he’s not being ravaged by our dog. This beagle brings him great joy.
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It sounds like your grandfather is being neglected and you should call your states’s APS to investigate his care.
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Omg, you have to call aps given that he’s laid on the floor for eight hours and has dogs mauling him!
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JeanLouise Nov 2023
I do hope that was hyperbole
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You're right to be concerned about Grandpa. I understand why you'd want to make sure he is safe.

The problem is that you want to care for him in your home. That is almost never a good idea. Taking care of someone his age with his issues would be a huge job. You can't imagine the disruption of household, marriage, social life, etc. that this would cause. Of course you're willing, and you want to help, and there's no one else, and your husband agrees, and your mother's a nurse, and so on.

Husband works at home. Grandpa will increasingly need more care. Husband may not be so agreeable when he finds out how much there is to do for such a patient. Mom's a nurse. Is she going to run over every time husband needs to get Grandpa to the bathroom? Because it takes two people to get him there? How many months or weeks will she want to continue doing that? These are only a couple of examples of what you'll be facing. It gets progressively worse. Like who will change Grandpa's diapers when he becomes incontinent?

Look for care facilities where Grandpa will be safe and comfortable with 24/7 professional caregivers. You all, including Grandpa, would be better off.
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Ask Grand Pa " if he would like to go to a assisted facility near you with people His own age and social activities ? " And go tour some Places near By .
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If you do not have legal authority / documents to manage his care ... At the very least, contact the Adult Protective Services and tell them what you've told us.

The uncle may have his own issues with dementia or inability to care for his - brother? (I don't know the relationship here. It is your uncle's father? Or perhaps it has to do with MONEY ... the will.

As I now read all that you and your mom can do, I would advocate to get him to your place asap. Hire an attorney to help you sort through all this.

You could also contact his MD although if you are not on his records - authorized to receive information - they will not tell you anything. Or, your mom, being a nurse, might be able to do some research / investigating.

If I were you, I would make a trip there - I do not know where you live - and see for yourself. I don't know where you are physically located in relation to where your grandfather is located.

When there is money involved (a Will, a house), family relationships certainly seem to change. If your uncle is legally handling things - they may be little you can do.

Thank you for caring enough to reach out to us.
It is horrendous when a loved one is mistreated as they age.

Gena / Touch Matters
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You have to call APS. Please be an advocate for your grandfather’s well being.
If everything that you’ve said has happened at your Uncle’s house is true, this should be investigated.
Your uncle may not have malicious intent so definitely have a conversation with him about your observations and concerns and let him know that your grandfather should be re-evaluated by a Geriactric Dr. To see where he is physically and mentally.
This is so tough and I hope you and your uncle can work together to find the best solution of care for your grandfather but you have to step in when you see neglect.
I wish you and your family well.
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