I live far from my Dad. Yes, I visit, but taking care of all his needs is not an option. I believe he expects me to drop what i'm doing and fly down there. Or he thinks he can manage along. In the past i've arranged for substitute caregivers's and he's refused to let them in. I am stymied. He cannot stay alone. Would he somehow have to be removed from the house against his wishes? How dreadful! Maybe I need a local agency with a professional who can manage the situation-either call him and gently but firmly tell him what's necessary, or go to the house to talk with him and reiterate his options, or arrange to have him taken out of the home if he refuses to cooperate. Im tempted to say, "Fine, this is his choice. He believes he can stay alone. I won't interfere. I won't demean him." But really, that's not an option. As far as explaining to him the need for a caregiver, I could use help with the words. Please offer me kind, firm words. My Dad is still a forceful, domineering, scary man. I get tongue-tied! Thank you.
I would try to win his confidence in the substitute aide. It is important to have a few aides who are acceptable because it is not that unusual for an aide to need time off for a variety of reasons (sickness, sick children etc). Often even live in aides have family issues which will require time off outside of a scheduled time off. Agencies are supposed to have acceptable replacements but I found that do can be a problem when push comes to shove. I had a retired LPN who would help at those periods so I could maintain my work schedule.
I found my father would become concerned when the regular aide was not available on short notice. He was more at ease when the part time aide who he knew arrived even though it wasn't as good as the regular aide who he really enjoyed. Consistent care givers are really, really, really important. The 6:15 am call from the agency saying the aide could not come, was a scary call for me as well as my elderly father.
I wish you well. I would try not to tell him he has to accept an aide who he isn't comfortable with and does have confidence in. Also since he may need a nursing home in the future, I would not threaten him with nursing home placement prior to his need for it. I know the aide coverage issue is a rough one to handle particularly if you are arranging it from a distance, but your dad will
probably come around if reassured. Having consistent home health aides and substitutes is vital to keeping the elder in his/her home.
Just do the best you can. I really know how difficult this type of problem is, having lived with it myself.
Elizabeth
"I remind him that he may not die but end up in a wheelchair or paralyzed and then his activities will really be cut short and he may not be able to keep his home." I used that logic on my father about seat belts in my car. I told him he could take it off only at highway speeds, but that he had to wear it around town to prevent non-fatal injuries. Stubborn old coot!
There sort of is an implied threat that if he doesn't be sensible he may find himself in a position to not be able to stay at home. He may not like it, but it is for his own good. I believe you can respect his wishes and still gently put your foot down. Best of luck! My struggle is trying to convince my own father that he - after two back fusion surgeries, two knee replacements and a couple of surgeries due to complications from the other surgeries (!) - can't climb up on his roof and clean out his gutters. I think he thinks well, if I die doing what I want to do, then so be it. I remind him that he may not die but end up in a wheelchair or paralyzed and then his activities will really be cut short and he may not be able to keep his home. My mother is still alive but all she does is screech at him and that makes him more determined to get out of the house and work in his very large yard! In the end though, who knows? One of his doctors told him "well, I can fix your knee but I can't transplant common sense". In the end they are adults and they will unfortunately have to live with their consequences. Didn't they one day teach us the same thing?
PatatHome01
You could also explain it as (if he is on medicare or priv. insurance) "Dad, I know you don't really want a different person here, but your insurance / medicare says that you MUST have someone come visit on these days, or they may stop paying for the caregiver to come out at all." A bit underhanded, but it's worked well for me with my mother. =)
Another option would be to actually speak with his regular caregiver, and explain the situation (she probably already knows) and ask her if she can have the substitute come out WITH her a couple of days, to get to know him and so he can see that she's harmless. It might be that he is scared she will be 'different' from his regular one, and not know the routine or how he likes things done. If his reg. caregiver can bring her with, it's let her show them how he likes things done, and give THEM a chance to get used to HIM as well!
I hope this helps!
I've hit "the wall" recently where I had to "take over" or be "taken down" with caregiver burnout. I told the "stubborn, domineering, difficult step-parent" that I needed to step in as the decision-maker to protect this person. Before I've been asking them to still make all the decisions for their well-being. It isn't working. Surprisingly, the time was right and the person said "ok". We are working toward downsizing a large house, fixing it up to sell, and then they move on to an independent living situation that offers "continuous care" - - which means as physical or mental needs shift (in their 90s now), that more services are provided. Look for a facility that is NICE, and takes a percentage of income vs. buy in - unless you are well financed. I was in shock what assisted living or retirement communities want to charge elderly or their family members. (Try like $135,000 - $150,000 to "buy in" then another $2000-$2700/ month on top of that!)
Finally found a nice place with a waiting list what wants 30% of income and includes everything. A wait list we can deal with -- - if needs increase before the name comes to the top, this person knows his only option is "the bone yard" as he calls "assisted living places". He described the ones where he went and looked - "wheelchairs lined up and parked and people waiting to die."
Get a Social Worker, contact "Council on Aging" (nationwide), VA Services (if your person is a Vet), and even turn to local churches for help.
Above all - - if he does go into care - watch out for clauses that obligate the family to pay the bill. That "clause" is buried sometimes 18 pages in to like a 25 page contract. Don't get stuck signing a contract without a lawyer looking it over and explaining it to you. They will sure try to make you sign and not take a copy with you.
Don't buckle! Get legal counsel. Know your rights and protect his.
You need an elder care lawyer.
Those admitting contracts - they don't protect residents' interests - they protect the companies that own the facilities.
Good luck!
If you have tried "Dad I want you to allow another caretaker in, so you can stay at home. If not you need to go to respite care at the nursing home," I don't know what else you can say.