Hi, I'll try to be brief with my backstory: I have been living with my husband, Don, for 8 years and his father, Ron, has been living with us for 5 of them. Ron was in a nursing home for a couple of years before hubby pulled him out so "he wouldn't have to die in a home." Don and I only make around $15K a year combined, so you can imagine how nice of a (state-funded) nursing home it was. Five years later, Ron shows no sign of dying, and as Don works longer hours than I do, I end up taking on much of Ron's home care.
Ron is overweight, diabetic, and suffers from unpredictable drops in blood pressure which can cause him to fall or experience brief periods of time where he's "out of it." He has trouble feeling, which results in him knocking lots of things over and dropping lots of things without noticing he has done so. He won't wear his hearing aids or glasses. Diabetes has claimed many of his toes so he is none too steady on his feet, but he won't use his walker and frankly, there isn't really enough room in our 2nd-story walkup 900-square foot apartment to maneuver a walker or wheelchair. He has broken two toilets so far from sitting down on them too hard and rocking them back and forth as he gets up. I recently purchased a toilet aid with grab bars and a raised seat for him, but he finds it difficult to use due to his weight. No matter what I try, there is always a big mess in the bathroom and a quarter-inch of (water? urine?) on the floor waiting for me when I get home from work each day.
I wouldn't mind all of this and I wouldn't be complaining if Ron was someone I loved. But he's not a loved one. I don't even like him. But I'd like to. I think my job would be much easier if I could perceive him as a human being with a personality instead of an inconvenient lump of flesh. He just makes it so difficult. He spends all day and night in his room, watching TV or playing computer games with the door shut. He must be prodded to bathe or even wash his hands after going to the bathroom or before coming to the table. He resists getting haircuts and fingernail trims. Sometimes his undergarments fail and he wets the bed, and he never tells us when this happens. He offers very, very little to the conversation at the dinner table, even when asked conversational questions. He doesn't have any hobbies or seem to have any interests, aside from the occasional day out with his lady friend. He refuses most offers to take him somewhere, and when we do get him out of the apartment he doesn't seem like he's enjoying himself. It's like he just suffers through it and is grateful to get back to his room, never mentioning the outing again. I don't really think he's a danger to himself, as he is still doing fine mentally. He's left the coffee burner on a couple of times but heck, my 26-year-old sister has done it twice, too. He doesn't use the stove or anything.
I want to love my father-in-law, but I'd settle for just liking him. What can I do to change my attitude towards him? I'm having trouble seeing him as a human being; Don tells me stories about Ron's younger years and it's like hearing about a completely different person. Ron isn't stupid, I'm sure he realizes how I feel about him. I must sound like a broken record, "did you wash your hands," "did you have some trouble in the bathroom there, you know you really need to let me know when that happens," etc. Am I wrong in thinking we should be holding him to a higher standard, demanding more of an effort? Or is this just how it is, how it goes? Is it just an attitude problem on my part? On Ron's part? On both of our parts? And how do we air this? Don and I have had a few family discussions with Ron, but the problems are still happening just the same as they ever did, and I wonder if Ron feels like he's being ganged up on. How can we prevent that? We try to be as kind as we can be, but it seems to have had no effect.
I'm sure you take good care of him and don't let your personal feelings get in the way of caring for him but trying to hold him to a higher standard is just going to increase your resentment toward him.
But washing hands before dinner or after using the bathroom aren't higher standards. They're very basic standards that should be upheld and as a member of a household this man should see to his personal hygiene for as long as he can.
After 5 years of living with you, if you don't have loving feelings for Ron by now I don't think you're going to.
Does hubby feel the same way?
Have you asked Ron if he would prefer to live in the nursing home.
It sounds as though there is some depression involved here with on. Does he get regular Dr visits?
I can understand why the toilets get broken. He really can't lower himself gently and cant use the grab bars on the side of the toilet, also as a sever long standing diabetic he probably has some neurological problems too. i don't think he means to pee on the floor but once he has plonked himself down to poop he cant manouver back far enough to get his penis in the toilet so on the floor it goes which he may not even notice. Of course i don't know how your bathroom is laid out but if there is a wall in front of it putting one or two bars very securely on that would enable him to lean forward and haul himself to his feet without rocking the toilet. That is much easier than trying to lever yourself up with hand rails. If he can't reach behind to wipe properly you can buy long handled devices to hold the paper and extend his reach, also provide wet wipes. You are absolutely right in requiring him to follow personal hygiene and if he needs cueing so be it. As far as showering is concerned I would feel that is your husbands job. He can approach it in a matter of fact way but insist. he is living there and these are house rules. He will need assistance. Any obese person does so hand that over to hubby. As far as cleaning up the bathroom is concerned just accept that as part of life and have the supplies habdy and make it your first job when you get home. If you have never loved or liked Ron I am afraid that is not going to happen now but understanding why he behaves the way he does may make it more tolerable for you. You say he is mentally alert but my guess is that he is at the very least extremely depressed and feels trapped. He may prefer to stay living with you but if he was previously well adapted to life in a nursing home that could be a better option. You could still take him out and have him home for week ends but leave it up to him. Because you love your husband does not mean you have to feel the same way about his father so there is no need to feel guilty about that.
Question, did father-in-law ask to leave the nursing home? Maybe he was actually happier there, being around people all day. If the place had a central dining hall, he probably enjoyed going there and sitting with friends from the nursing home. Plus he had co-residents who were around his own age, thus a lot to talk about.
Surprised your father-in-law's lady friend hasn't tried to get him to take better care of himself, or is she similar in that respect?
I would quit asking him "if" questions about the bowel and bladder accidents, and just either remind him what he is supposed to do instead, or supervise him more.
It is hard to say if trying to improve his diabetes management and diabetes related care will do much or him at this point either, but it might be worth a shot. If not, well, lower your expectations, and then lower them some more. He possibly hasn't got it in him to do a whole lot better beyond the very basics and at some point he won't even have that. Sitting and playing computer games is the easiest and most comfortable thing for him to do, so he does it as much as possible...it's not good for him, but there is a time for trying to change a person's behavior to something healthier and a time for letting things go. Not quite clear which this is for you guys!!
How old is Ron? Does he get any monthly check that could go towards a board and care? Does he have Medicaid? Is he by any chance a veteran?
I hope that your husband and you together can find Ron a pleasant place to spend the rest of his life.
There are a lot of good suggestions above. But I would like to add a crazy suggestion: try making your time with him (at least part of that time) something that YOU enjoy. For me, that would mean reading aloud to him. the kind of books like: adventure, travel, etc. Or, do you like to play cards? to do jigsaw puzzles? draw? play board games? chess? backgammon? write letters to politicians (I am grasping at straws here..but that could be funny).
But you get the idea. I say this because i have had to change the way that I interact with my mom. I CANNOT STAND having conversations with her (all the repetition drives me over the edge). So, sitting and talking is out of the question. So, I DO things with her. Take a ride, play cards, go to exercise class, etc. These are the things she likes at the moment. They are "low conversational" and more bearable.
Might something like this be worth a try? Afternoons, turn on the soaps, play cards????
The whole notion of "I won't put him/her into a home" is antiquated. The homes are safe and professional. He will get food, meds, personal care, and be at peace.
THEN, you can visit once in a while, turn on the soaps, and play cards.
Often caregivers can't see the forest for the trees. Things get progressively worse until they are absolutely horrifying, but it happens so slowly that the caregiver takes it in stride. For example, I had come to accept my mom getting taken by EMS to the psych ward because she was living at home alone with dementia and the neighbors would call 911. I'd come by after work and on weekends, but it wasn't enough. Eventually, I put her in a nursing home which she loves.
But getting back to your question, one thing that struck me is to say to you that this is not "your job." I, too, come from a generation that believes in taking care of our elders. But when they need more care than we can provide, it's not good for them or us. Your dear father-in-law needs to be in a skilled nursing facility where they will bathe him, change him (and his sheets), monitor his eating and his meds, and provide activities and socialization.
You mentioned that you had tried a nursing home before. Try a different one. This time, look up nursing homes in your area (within a 30 minute drive, or whatever is reasonable to you), call the admissions office, and schedule a tour. While you're there, pay attention to the intangibles. How do you feel? What's the vibe like? Do they residents appear to be clean? Happy? How does the place smell? Do the aides appear kind? Patient? Is the facility clean? Look at the activity schedule. Are there at least 2-3 activities a day? Pay attention to how you're treated. Is the admissions person understanding? Respectful? A friend told me "the better the neighborhood, the better the nursing home." There may be some truth to that.
I understand that finances are an issue, but every nursing home accepts medicaid. You don't have to go to a bad one just because they have an available bed. Shop around.
Do some more research. I think you would feel a lot better if you found 3 or 4 great facilities and put your father-in-law on the waiting list. This does not mean you have to take the bed when it comes available, it just means that you will have another option available to you, which you desperately need. Perhaps if your husband saw a clean, well-run facility, he would realize your dad would be better served there than at home. So find a few for him to see. You don't even have to tell your husband you're looking, just quietly begin researching.
For example, my mom is on medicaid and she has a private room in a clean facility where the meals are delicious and the staff is caring. There's been some talk on this site about people on medicaid not being accepted at certain nursing homes, but my mother get into hers on medicaid. Maybe because it's a larger facility in an affluent neighborhood, where there are others to balance her out. Maybe that's a strategy you can use. I don't know. Just keep trying. You're not under a time constraint, so start now.
Another interesting point you made is the emotional change that happened in your fil. He needs a complete medical work up to determine why this happened. He could have a treatable condition that is affecting his personality and you need to find out now. That could have caused his depression, which could have caused his weight gain, when could have worsened his diabetes. Have you looked into why he is incontinent? If your sister is 26, I'm guessing your dad is somewhere in his 60s. Is there an underlying medical cause or is it his weight? Of course, you DON'T have to answer that, I'm just throwing out possibilities.
Please start with his primary care physician and see if you can get to the bottom of his behavior. If he has a treatable, organic reason for this, and gets a good prognosis with treatment, he may not need to go into a nursing home, but the way things are now, he does. He definitely does. Good luck to you.
In some cases, though, Ron is not aware of the trail of destruction he leaves behind him. A couple months ago, after using the toilet, he smeared feces on all the light switches, door knobs, and furniture as he made his way through the apartment to go out and smoke. Then, on Halloween, as my husband and I were about to leave for a party, Ron voided his bladder on the kitchen floor, shuffled through the mess, and sat down outside. He was wearing a diaper but I think he is just too obese and clumsy to put it on properly anymore--it has happened before. Again, I don't think his mind is going, he just can't see, hear, feel, smell, or move very well.
For some reason these last couple of incidents have really gotten across to my husband (maybe because he was present when they happened) and we are looking at nursing homes that will be better equipped to deal with Ron's physical needs. I know I, for one, have tried my best.
My relationship with hubby is actually pretty awesome despite all the clean-ups. I am one of those women who actually enjoys being a domestic diva, cooking and cleaning. I think he has finally come to understand the scope of what I've been dealing with these past few years, and realizes that so much body waste cleanup just isn't within normal household cleaning paramaters.
Good luck with this move. and hugs!
But good luck to you!