What if parent refuses a care home and you are unable to care for the parent?
I’m guessing I need to contact an elder attorney but I’m up late thinking about this so I thought I would ask everyone here. My father lives in our guest home. His balance is poor. He had his first major fall and broke 3 ribs. He is starting to get up and about and so far has not developed pneumonia thank God (yet is still refusing to use the walker I gave him). He has dementia, but does not recognize it. He said he would only go to a care home if he were bedridden. Plus my sister is telling me he needs to live out his years in his own home...so convenient to say when she’s not the one he lives with. He also has a hard time managing new medications, and becomes argumentative, telling me the Doctor never gave him such a medication when I know they did.
He is refusing a caregiver (my sister was willing to pay for one temporarily) because he still feels quite capable. I have health problems and am not able to take on extensive care. He is on a limited income so I know he can’t afford full time caregiving anyhow. I have heard you can’t force anyone into a care home. My brother n law thinks he is not ready for one anyhow and says You can’t do anything more for him, he has to want help. Wouldn’t I be accused of neglect? Do I wait for another major fall where he needs rehab and do a hospital dump? My father has a new Doctor. On the day he saw him he was having a better day so I don’t think the Doctor suspected dementia but I didn’t want to bring it up in front of my father, I was dreading the stress. I will call and let the Doctor know the neurologist did diagnose him with dementia, and he’s refusing to see her again, but perhaps he can test him and document it as well. Perhaps he can have him tested to see if he’s incompetent?
I would feel so bad just leaving him over there waiting for something bad to happen. So I’ve really been bending over backwards to help and the stress is causing me to have more seizures. But what do you do when they refuse care? I really had no clue what I was getting myself into by moving him in. I should have read the comments on this forum before making the decision. I thought it would be so easy to keep him here a few years and help him here and there and move him into a home when the need arises. When is it ever that easy on anyone? Right? Never mind all the stress he’s put me through these past 5 years, even if he didn’t mean to.
"I would feel so bad just leaving him there waiting for something bad to happen".
Take action independent of his wishes. Take charge. Don't wait for more damage to convince you. You're just afraid of taking charge, don't blame you one bit, but you gotta.
My old mom refuses the walker all the time but she gets her old bones up & out'a the chair. Up & out'a the chair is my charge....no walker is hers.
You appear clear about what's needed, you just seem unclear about how to be firm. It's not your dad's choice anymore. And that's Okay.
2. EVERYONE “refuses to go to a care home”, but he has already had one “major”fall, and you have realized that he is having balance difficulties. At some point, SAFETY is more important than anything else. Do your research NOW before matters reach a crisis. Find the most pleasant Assisted Living residences in your area, and vet them out. “Our”residence has a nice display online, and it’s pretty accurate too! Belligerent LOs (mine!) often do better in settings where their care is given by on-relatives.
3. You may research specialists in geriatric assessment on your own, and slip a note to Dad’s doctor asking him if it might not be time to update Dad’s original assessment. Look for a GERIATRIC SPECIALIST in neurology, psychiatry, psychology, social work. Ask the new physician to recommend an examiner as well.
Mood stabilizing medications are tricky with balance issues, but it sounds as though he may need something to help him adjust to his situation.
4. People who are identified as “fall risks”, FALL! MY LO had TERRIBLE FALLS in her hundred + year old home, and she HAS had falls in her AL, BUT NOW, THERE IS A PROTOCOL IN PLACE, and her falls have been much less dangerous to her.
5. You and your sister need to work as a team, BUT EACH OF YOU NEEDS TO HAVE THE SAME AUTHORITY IN DESIGNING THE BEST FUTURE FOR HIM, WITHOUT GIVING UP YOUR OWN.
Be pleasant, FIRM, and prepared for THE CONVERSATION with your sister and brother-in-law, AND DO NOT BACK DOWN.
There are no ”right” or “good” or “perfect” answers- between you, you BOTH need to find out as much about his present status as possible, address his prognosis, and act on your mutually developed decisions.
Sometimes, “the best WE can do”, done with love and compassion, has to be enough.
I agree with others who say if your sister is opposed then she must move him into her place. But moving your dad around will only worsen his dementia (you can send articles to your sister about this). And, no once can be "assumed" into caregiving, like your sister is trying to do to you by proclaiming your dad should live out his remaining years in his own home. Best to try to convince her that a facility is the wisest and most humane plan. Otherwise, you are correct in seeing that you are just waiting for a profound accident or medical emergency. Stress upon stress.
If your dad has humble financial means, then get him into a great local facility on private pay and don't worry about the cost (make sure the facility accepts Medicaid). Once his funds have run down then apply for Medicaid. Make sure prior to this that he is not gifting money or assets and no one is gifting him, either. The Medicaid look-back period is anywhere from 2.5 to 5 years, depending on your state. I agree with others who have suggested a 2-hr consult with an elder law attorney/estate planner is a smart investment before making any changes in his care.
No one likes the thought of leaving their "home" (although Dad is not in his home, he's in yours). No one enjoys transitioning their parent into a facility. Nothing about what is coming will feel good. But the goal is to do what is in your dad's best interests AND doesn't cause his PoA/caregiver/family collateral damage. I wish you peace in your heart as you work to make his finals years as good as they can be, for you and your family.
Again, hope that was a typo!
Perhaps, giving your father a choice of a caregiver or a placement in an appropriate setting? Maybe no third choice at all.
Perhaps, your father would be willing to listen to those choices from someone other than you. My mom took such news from my husband, better than she did from me.
Best wishes.
Are you the POA? For Financial and health?
You are such a good writer, and you are valued here for your voice, and given you ARE here, I know you know what the story is, what the options are, and yes, you are so right in that it is never easy with any of these issues.
You say Dad is now in the guest house. That is exactly how I would leave it for right now, with Covid-19 absolutely raging across the country. And I would step away as much as you are able. I would see if, instead of a caregiver, your sister would pop for someone to come clean once a week, and perhaps shop to get together things he might like to heat up for himself.
And yup. I would WAIT.
And yup. I would do the dump.
I would cry, I would accept the grief. I would accept my own judgement of myself for doing this and I would not discuss it with others. So that I don't have to field THEIR judgement as WELL, because quite honestly, why add to an already full plate? I would tell the sister when he ends in hospital, which he will soon enough, that he cannot come back home. Sorry. Can't. That you KNEW all along this is where this was going, and now it is there.
You have the documentation with a neuro eval of dementia to go a long way, you have your own history so that when you tell the social worker he cannot come back you have all you need to do that. If you are not already POA then she can get you emergency guardianship likely with a phone call to the local judge, and she can get him placed and hopefully the vaccine will already be making the rounds by then.
I am sorry. I tried to put myself in your place, and that's where I ended up. I cannot see another way.
I wish you the very best. Please just keep us here updated; we care about you.
I cannot see
While it's a lovely idea to live out our last years in our own home, it is not always safe or possible.
If dementia is involved, supervision becomes essential. So in-home help or move into care will be the real options to choose from. Living with family can work for some, as a middle step. More (non-family) help is usually required eventually though.
I'm thinking your sister may benefit from some education on dementia.
My youngest sib prefers to not see any signs of dementia, appears to believe 'it's just aging' or 'that's just her'.
Neurologist reports will detail what areas are showing reduced function & can explain how this will translate into real life skills. Eg short term memory : did I eat a proper meal today? Leaving the gas cooker on or burning dinner. Judgement & planning : going out in the snow without a coat. Or at night.
Can he cook, dress & wash?
If so, for now, concentrate on celebrating what he can do for himself but get more 'eyes 'on him for safety. Some ideas that others try are to introduce a weekly housecleaner, use an occasional meals delivery service, regular family visitors, check in phone calls morning & night.
If so, your Father may be truly UNABLE to see his care needs (lack of insight). Look up 'Anosognosia' on the forum.
Your sister, however, may be UNWILLING to see (denial). This may be to protect herself from the reality that is approaching.
Being a team with family will be so helpful. I hope you can find a way to work together.