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My 80 year-old father-in-law has become wheelchair bound in the past 2 months, due to a spinal tumor. He has always lived independently in his own home but now he is unable to care for himself. He can't even get out of bed or go to the bathroom without help. However he is refusing to move to an assisted living facility. He wants to keep living alone in his home by hiring live-in-aides that he can't afford long term. We have been helping him find and hire live-in-home aids, under the assumption that he will eventually move to an assisted living facility. Live-in-aids are extremely expensive, and he will run out of money in just several months at this rate. We showed him the math but he refused to listen. He is sound of mind but unable to deal with reality. When his money runs out, I fear that he will end up alone in his home in a dangerous situation. I imagine he will probably call 911 out of desperation when this happens. My husband and I will probably be called and questioned why he was left alone in an obviously unsafe situation. I fell trapped into enabling my father-in-law down a path of destruction. He is destroying not only himself but also his son and 2 year old grandchild. My husband has taken so many days off work to help his father that I fear for his job. He is our sole bread winner, and we have a 2 year old child with special needs. Even finding home aids has become next to impossible because my father-in-law insists on being lifted from his wheelchair to the commode; he refuses to use a diaper. It is very hard to find strong male aids who are able to lift my father-in-law. I have spent countless hours on the phone trying to find home aids. Then my father-in-law fires them because he doesn't like their personalities. I can't keep doing this anymore. Is is OK to stop helping him? He is of sound mind and financially independent from us. Will my husband and I be charged of elder neglect if we stop helping him?

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It sounds like FIL is going to run out of money ... with at-home care, or in long-term care of some kind. Before he runs out of money he will need to apply for Medicaid. Medicaid can help with in-home care until it exceeds the cost of placement and then help with placement costs.

So, start the process of applying. He may be broke before you get that all ready to submit!

For as long as he remains at home it sounds like he needs not only an aide but also a life device. No one should be expected to physically pick him up unaided!

Rather than turn your backs on him, I suggest getting an agency involved. Personally, I'd call his county Human Services Department and ask for a needs assessment. (That's what we did for our mother.) Be sure to be there during the assessment. Parents are apt to exaggerate their skills and abilities!

Human Services can explain the options, explain what help FIL is eligible for or will be eligible for when his money runs out, how to apply for Medicaid or any other program he might qualify for, etc.

During this process make it abundantly clear that YOU WILL NOT be providing the hands-on care. You certainly have your hands full with other responsibilities.

This is a good CYA approach for you, and also the kindest thing you can do for FIL. (It should probably be his son who does this, but whatever works best for the two of you is OK.)

Good luck ... and keep us informed on how this goes!
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Does he have POA's and other documents in place? If not, yesterday was not soon enough. As long as he is competent he has the legal right to make his own, right or wrong, decisions. Your hubby need to establish firm boundaries by telling dad what he is willing to do and what he is not going to do. Has he filed for Family Medical Leave Act at work? By law the employer has to permit him a certain number of hours away from work, without pay, to assist with medical needs of immediate family members. If he doesn't have that in place he needs to do that immediately! It will protect him to a certain point, but establishing boundaries with dad is equally important, if not more so. Providing for his family, you and child, is his first responsibility.

It is very difficult for many of us when a parent becomes incapacitated. We feel like we have to step in and help. Our responsibilty for parents is to find them appropriate care, that is where it stops. When dad calls for help son needs to tell him that he will not be able to now, but he can when it works for hubby. Or setup a schedule of when he can offer assistance. No more than what he is willing or able to do. At this point, hubby is enabling dad and he needs to stop.
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Why are you finding HCA's for your father? Why is your husband taking more time off work than his employer is comfortable with?

These are the sorts of things you need to stop doing. FIL wants to manage at home with outside help? Then FIL can make the arrangements, with as much assistance only as you are happy to offer. If he can make it work, good for him. If not, HE - not YOU - will have to think again.

Two other points:

What kind of spinal tumour? Is FIL thinking he won't need any kind of help for very long? Might he be right about that, or is he depressed and therefore unreasonably pessimistic? Perhaps ask his primary doctor to clarify his prognosis - to your FIL at least, to you with your FIL's permission.

I don't want to overreact, here. But. This bit: "Even finding home aids has become next to impossible because my father-in-law insists on being lifted from his wheelchair to the commode; he refuses to use a diaper." There is no other way to say this: I am revolted by the notion that your continent FIL should just accept being forced to soil and wet himself because he needs assistance to transfer. There is absolutely no need for the aide to be lifting your father. Hire a hoist.

Finally, I know you must be upset, and I understand how frustrating it must be for you to see your husband struggling to help his recalcitrant father. But take a step back and a deep breath. Your FIL is not destroying his 2 year old grandchild. You and your husband together must make the decisions that are best for your family, and let your independent, mentally competent FIL make the decisions that he thinks are best for him.
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One important question is whether or not your husband will step back from all the caregiving for FIL. Will he? I have seen on this site so (too!) many instances of people who won't enforce strong boundaries with the elder.
Wil FIL get ugly if your H doesn't run to his father when he calls? How would your H deal with this?
And, lastly, my pet peeve -- are there other sibs or family members who can help make decisions regarding FIL?
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If FIL is a Veteran there may be services that can help and depending on when (if) he served it is possible that some ailments may be classified as service connected and that would get him more help and possibly money to help pay for care. Contact the VA or your County Veterans Commission office they will help answer questions and help with paperwork.
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