My father is 86 years old, he will be 87 years old in 4 months. His wife died 2 years ago, and I, as well as, my husband, sister and brother started to help him. His wife was a hoarder and we removed 60 tons of stuff, we sold 5 of his propeties, they had not prepared for retirement, we dealt with 12 renters, and cleaning up the 5 properties. When we found him he weighed 128 lbs, and had no food in the house. We removed over 200 mice and rats. We got his BP under control, had his cancer in his nose removed, had his Parkinson's dianosed. He got up to 151 lbs, and was doing wonderful. My brother moved into his home, but he could only be a companion and 1st responder because he is disabled, blind and double aputee. My sister is 70 years old, and she cleans his 2800 sq ft house, and my father has a cather she has been trained to flush, we have a visiting nurse come to the home to change the cather. His drivers license was suspended by the DMV, and we sold his cars. He has fallen and had a brain bleed, so we replaced the carpet with hardwood floors, and we have made a lot of changes to the house, for safety, handrails, etc. Back in January we started the conversations about going into a assistant living home, he just said NO. I live out of state and I handle all his bills, bookkeeping, accounting, insurance, and keep the books for the one rental he has left. We now have a standing medical order from his doctor that he can not live alone or take care of himself. That he also needs skilled help, and we are unable to provide him that care. He can not afford for someone to live in his home as a caregiver. We have found a wonderful Assisted Living Facility, and even though he is still sharp in the mind, he can not take care of himself, and continues to fall as his Parkinson gets worse. He will not even consider going to see the facility let alone move in. We are lost, my sister and I do have Power of Attorney, both medical and durable, what can we do? We would love it if he could see the whole picture, but he will not.
lostfamily's dad is refusing to move. His mind is still sharp. I don't think you can legally force someone to follow doctors orders if they are still competent. This general issue has arisen before here regarding mentally competent seniors refusing to comply with treatments their doctor has ordered. You can lead a horse to water but you can't make him drink.
I have read of others who simply take their parent for a drive and stop at the home and, as you did, explain this is their new home. My mother would not buy that nor would lostfamily's dad, from the sounds of it. In my mother's case I suspect she would, like lostfamily's dad simply refuse to move. What then? For now she is well enough off, and has been given "home care" in her ALF for life, but, one day that may not be enough. I totally agree as DPOA you have to act in your parent's best interests. So far my mother is considered competent. She would pick up on any subterfuge (she is a bit paranoid anyway) and resist it.
In some instances here, people have been advised to wait until "something" happens to convince the person that they need better care. No caregiver is comfortable with that, but, at times, it seems to be the only alternative, as seniors -even seniors with illnesses, but who are deemed competent, have the right to make decisions for themselves, even bad ones.
You are fortunate that your mum made the transition so easily. My mother has walked out of hospitals before being discharged, and would likely walk out of a facility if she didn't want to stay there, contact a lawyer, and rage about being kidnapped. She has done that already to a hospital who simply put her in a geriatric ward, after she took herself to the ER with electrolyte imbalance, when she was in her nineties, and got an apology. I think we are comparing apples and oranges.
The ALF should be well able to handle the arrival. In my moms case (dementia) she was happy to go with me and I stayed to visit, showed her her new room etc. The staff made her welcome. I hugged her before leaving and told her I would be back again later.
I came back that evening and again each day. Everytime she asked when she would be going home, i explained that this is now her home. That I work and my husband works and we can not be with her during the day or give her the help she needs. This is now her home and because they care for her, we are able to come enjoy visits with her.
My sister and I selected a place that is an Adult Family Home for dementia and all the way through to hospice. She should not have to ever move. However, if she does we will do what is in her best interest as lovingly as possible. As the DPOA I do what is best for mom, no matter how much easier it would be not to have to - as I feel it is my duty as her legal decision maker. There is a reason for the POA. It is in place because Mom can not make her own decisions. In view of that, I don't need Mom's 'buy in' and if someone is waiting for a 'buy in' after the doctor says they need full time care, then they need to recognize that not acting is doing potential harm. If they can not act, they need to have someone else that can named as the POA. It really that simple.
Just as you would not allow a small child to live in an unsafe situation, as POA you cannot let your loved one either.
My neighbor handled the situation much the same way. They took the Mom to a new ALF and while she is still unhappy about it - she will adjust.
I love my Mom very much. Enough to make the tough decisions I have to for her safety. That is who she raised me to be.
Therefore lostfamily's question is very valid. How can we convince someone to do what is clearly in their own best interests? (In the orange case, we don't have to convince them, in the apple case we can't act without their cooperation.)
I don't know the answer. :( I think it often is some kind of crisis that finally convinces the loved one that he or she must accept help. Or in the case of dementia, the person clearly becomes incompetent.
Lostfamily, if Dad can afford ALF, could he afford some in-home care instead? Or would he have to sell the house to move to ALF, and use the proceeds to pay for his stay? Does he have assets in addition to his house? I wonder if he would qualify for Medicaid (or could use his assets other than the house for his in-home care until he did qualify.) Mediciad isn't going to cover in-home care that winds up being more expensive than a care facility, but the Elderly Waiver portion of Medicaid may cover significant help to keep him in his home instead of a nursing home. It might be worth looking into. That is how my 92-year-old mother is managing to stay in her apartment. My sisters are keeping a close eye on her, and it may be necessary to move her to a nursing home before long. But as long as what she needs is "assisted" living, she can get that assistance right where she has spent the last three decades. It's a thought ...
palebluedot ((((((((((((((((((hugs)))))))))))))) I am sorry. Your situation, like lostfamily's, is not easy. However the Elder Waiver that jeanne mentions may be worth looking into.
Yes, 24/7 care in a private home is prohibitively expensive for most middle class elders. Did you say he is not cognitively impaired? He was in on the cost discussions, he doesn't want to pay what skilled care would cost at home, and yet he refused to consider the more economical alternative. Hmmm ... What does he propose?
Wait ... I can guess. That his 70 year old daughter cleans a 2800 sq foot house for free (and continues cleaning it when she is 75, 80, etc). That family members empty his cath bag. That family members do his laundry. And change his sheets. And make his meals. And drive him around. All for free. Hmmm ... again.
What if you stop trying to convince him what he should do, but instead you tell him what you are/are not going to do? I have no idea if you could pull this off, or what the outcome would be, but what if you tell him your sister is retiring from cleaning any home but her own, that he is going to have to figure out how to get his meals, that if he spills his cath bag while emptying it he'll have to live with the urine smell, etc. etc. And if he can't do a decent job of taking care of himself, you will get authorities involved to assess his living conditions and they will determine where he needs to be.
Because when I really think about it, why should he want to change anything? He is comfortable right where he is, and the price of all the care he gets is certainly affordable. Going to ALF would be an improvement for all of you, but not necessarily for him, right? Now that the mice have been evicted and there is food in the house, he's got it better than he's had it for years! Why on earth would be agree to change?
But of course, you can't keep it up. I understand that. Your enormous efforts can't go on forever. But have you made that aspect of the situation perfectly clear to this man who is "still sharp in the mind"?
You've spoiled him. Totally understandable and probably appropriate at the time. I'm not blaming you or criticizing you. But seeing it in that light may help set the tone for what has to happen next.
My heart goes out to you and to your sister, and to your father, too. I hope this can be resolved soon.
Manager, they may be able to help us. If that does not work, we may have to go to court so that we can protect him from himself. I will keep everyone updated, and hopefully how we handle this may help others.
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