Mom has had early-onset Alzheimer's for three years. She has miraculously fought its progress despite very poor short term memory. Recently her long term memory has been slipping. Time is short. This is going to get harder soon.
Dad is disabled with chronic back pain. He takes a mild common RX pain killer that he regularly goes off of due to its negative side effects. For years he has done this, going off it at the most inconvienent times like on vacations. Then he becomes grumpy, more depressed, and talks compulsively about his pain. Everyone is sick of hearing about it, especially because he isn't treating it. Then he apologizes and bashes himself. Rinse and repeat for years.
He is also depressed. It runs in the family. I have tried sensitive sitdowns and sarcastic barbs to get him to get onto antidepressants and try other pain killers. His response is evasive, his tone guilty. He says he will, but he never does. I got him a new doctor once and he missed the first appointment, clearly feeling guilty. Then he hemmed and hawed for a few weeks and never went.
He is terrified of negative drug side effects. Any drug we mention that is working for somebody we know, he looks up its side effects on the Internet and then refuses to try it. He'll say he's going to ask his doctor, then he never does. I tell him the last thing he should care about at his age in his situation are side effects. I tell him he's going to die from depression and suffering before any medication side effect kills him. He claims he is trying to stay alive longer to help Mom. Yet he's not helping Mom being this way.
What should I do? They cannot afford assited living and it's too early for that anyway. We have a chance to move them in with us for a few months, the point being they need to rent their place to save money and we want to enjoy what little quality time Mom has left since they are out of state. Despite what you read above, they are easy to live with (we tried several weeks recently), aside from Dad's grumpiness and refusal to treat himself.
It has reached the point where I think dad is failing in his duties. He is not taking care of himself or making good decisions for the both of them. Maybe this is just him aging. He seems overwhelemed by his life and Mom's situation. Despite her diagnosis, our constant impression is that she is doing better than he is emotionally and in many ways intellectually. But I think this is a side effect of his years of failing to treat his pain and depression.
I was thinking I could make it a requirement of them living with us that Dad try new pain killers and, hopefully, antidepressants. I think that is only fair given Mom's situation and the sacrifices we are making to help them.
What would you do?
Here are some of the issues that may occur. (They may seem petty now, but, trust me, once you're actually thrust into the situations I mention, they will quickly seem overwhelming.) With elderly parents in your home, none of you will have much privacy. Do you have both a family room and a living room? If not, the living room will probably become your parents' domain, rather than a place for your husband to sit and relax. If your parents have hearing issues, the TV will be blasting day and night. You mentioned that your dad is disabled with back pain. Will he be able to get in and out of the bathtub/shower on his own? If not, someone (you? your husband?) will have to assist him every time he wants to bathe.
How much time do you have available for medical appointments (and how easy will it be to find new doctors for your parents in your area)? You will find that specialist appointments multiply like fireflies in the summertime. How is your own back? If either parent uses a walker, you will have to lift it at least twice during the course of every doctor's visit.
Who will come and stay with your parents if you and your husband want to run errands together or go out to dinner? What if you want to go away overnight?
I know that all of this sounds really negative, but it truly is important to think through all of the issues before taking a step of this magnitude.
Moving them in with us in a stop-gap measure. Without my intervention, by the end of this year they will have run out of savings and been unable to pay their mortgage. They would be forced to sell their house. Dad really is unable to deal with this or make decisions to avoid it.
We had them here for a month recently. Mom did repeat herself sometimes and forget things, but by far the bigger stress for my wife and me was my dad. It even was stressing Mom. But overall there was a sense that life was easier for them here and Mom was much happier being around the grandchildren. Her dementia at this point is largely only noticeable on short-term memory loss and associated minor confusion.
I am willing to risk her declining rapidly in the months they will stay with us. I see it as precious quality time before that happens, and a way to prevent bankruptcy for them. If she declines to the point it becomes too much for us, it will certainly be too much for him, so we will need to seek Medicaid options. Assisted living is not an option with the only asset they have which is limited equity from their condo should we sell it.
We are locked into a lease here until mid-year 2017 and to me this is the best and wisest move. I think it will greatly increase the chances of dad taking better care of himself if I'm there with him as he goes to doctors, etc.
Not sure if it would help with your dad, but I printed out an article from online regarding depression and back pain. It listed how back pain, headaches, nausea, muscle aches, digestive problems, hot flashes, and dizziness are often symptoms of depression. It was text book of her symptoms and it let her know that I wasn't making this stuff up.
Also, taking care of a person who has dementia can be extremely stressful. I'm not sure how much time you spend with your mom, but the dementia can cause so many changes that include, repeating, poor hygiene, being grouchy, false accusations, etc. Your dad may be in over his head and afraid to say anything about how this is really too much for him. With his age and illness, I would not consider him a proper caregiver. He may protest, but he may ALSO AGREE with you and be glad that you put your foot down.
Why not ask him and your mom what options they think would work, if you mom is still able to process what she's going through. She may not realize what is in her future. I'd try to get some viable options to get dad some relief, which doesn't include watching mom 24/7.
I'd see an Elder Law attorney about their fiances and what the money situation will tolerate. Ask about Medicaid down the road. Some states cover the cost for Assisted Living for some conditions and based on certain qualifications. Check your state.
Are you the appointed Durable Power of Attorney for both of them? I'd address it immediately or it could be an issue to act on their behalf.
I think that the vast majority of people of this site would say DO NOT move them in with you. If you read enough of these threads, you'll see why. No matter how wonderful your mother is, dementia changes people. It's much more demanding than you can imagine. Plus, all issues will become magnified. It's not just about losing memory. It's much more, like constant repeating, making false accusations, hiding things, poor hygiene, resisting care, etc. Each person is different, but it can be very stressful. If you really feel compelled to move them in with you, I'd do intensive reading about dementia and what you can expect.
Your Dad isn't taking care of himself probably because your Mom use to do all the household duties which means taking care of everyone else. My Dad was that way, he always relied on Mom for everything and when she passed he was so helpless around the house. Can't blame him, Mom ruled the inside of the house.
As for your Dad taking pills, if he is pill sensitive, it can be very difficult for someone to try antidepressants or tranquilizers. Those ads on TV don't help blasting the more common side effects.
Your Dad needs to do what I did, have the doctor give him the smallest dose possible, and cut that in half, try it for a couple of weeks. One will know quickly if there are any side effects, but DO NOT read what are the side effects otherwise the mind will make you think you are having those side effects... if there are actual side effects, it's easy to get off and try the next family of medicine.
Then take a look at the other spouse, who appears worn out.
Conclusion: The first spouse described is being well taken care of..
It may not always hold true, but worth a look-see.
Do not move then in with you..
Take separate vacations.
Start with the housekeeper, and gardener. Ask them to keep an eye on your parents and call you if there is anything unusual.
Make plans for assisted living near you.
You sound like you really care, and will make a good support resource for both Mom and Dad. I agree with Cmagnum, stop trying to manipulate Dad to take care of Mom-(not his words). But good advice.