My dad is 88 and has been in a skilled nursing facility (SNF) since beginning of September 2021 due to frailty and weakness. Then he got an infection and needed IV antibiotics. He has had a wound since July 2020 and I've been taking him to wound care weekly since then. (This is the 2nd time he's gotten an infection requiring skilled nursing/IV antibiotics). He is not diabetic but this wound is taking its sweet time healing.
I work part-time and go over to dad's every day and fix his meals, clean the kitchen, do his shopping, take him to/from doctors (of course on my days off!) We have a housekeeper doing light housework once a week. Anyway, he is being discharged on Monday Oct 25 because IV antibiotics are done. Per the SNF, he needs assistance to do just about anything. Toileting seems to be the biggest thing right now and I'm sorry, call me selfish but I do NOT want to have to clean up after dad's BMs. Seriously. It's a very tiny bathroom (my childhood home) and there isn't much room. Dad's a big man. He called me this morning to let me know he's had 2 BMs and DIDN'T EVEN KNOW IT. ugh.
Any words of advice on this subject? Dad had been using Depends and a guard. At the SNF, he's using adult diapers with tabs. He hasn't been able to smell things for a long time and dribbles but can't smell it. Of course when I get to his house, I CAN SMELL everything. ugh. and now these BMs that he doesn't realize he is having. Plus the doctor ordered barrier cream and of course that has to be applied after he is cleaned up. Dad also has lost fine motor skills - if he drops anything on the floor, he can't pick it up. He can't use his hearing aids because they are too small and he can't feel them. So, of course, I end up speaking very loudly and repeating myself most of the time. Oh. In August 2019, one of his knees buckled and ever since then, he sits in a wheelchair because he's so afraid he will fall. He had been able to transfer just fine, use the bathroom just fine, take a shower just fine but in the last year, he's lost 50+ pounds, nothing tastes good so he doesn't eat, and had been getting weaker and weaker. Thus the SNF. Home PT and OT will continue, so I am *hoping* he can get back to doing things himself, but then again, that is probably wishful thinking.
A long-term facility is probably going to be required BUT I had quit my FT job, moved in with parents when mom had Alzheimer's. They paid me $$. Mom passed in 2019. Of course, I didn't know until it was too late to contact an elder care lawyer and so now I'm screwed because if dad goes to a long-term facility, I will have to pay some $25K after he spends down all his $$ before Medicaid would start covering.
Anyhoo, my brain hurts. Advice or words of wisdom are greatly appreciated. I really don't want to hear "your dad is lucky to have you" or "you are blessed to still have your dad around". Thanks.
Tips from the trenches - get by express delivery -
a good sized bin with a foot pedal and plenty of liners that fit it properly
plenty of toilet paper
a bulk pack of dry wipes
a bulk pack of wet wipes
a bulk pack of disposable gloves
disposable aprons - cheap and would at least stop you despairing if he backs into you unexpectedly
at least two plastic basins
more towels, face flannels and muslin cloths (such as old fashioned diapers used to be lined with, only you'll use them for washing because they can be boiled and sterilised)
find or buy a sturdy table to put kit on
a big laundry basket
you can get clever laundry bags that unzip themselves in the washing machine, saves you handling soiled clothes or bedlinen, debatable whether worth the money and/or plastic waste.
short of an OT visit - have a good look round the bathroom, bedroom and other key rooms and just mentally figure out your basic routes and basic procedures. This will help you spot if you won't be able to reach the bin at the critical moment, for example, or will need three hands to pull out a wet wipe.
GOOD LUCK!!! I will be thinking of you, brave soldier.
I do have disposable gloves but a disposable apron is an awesome tip! I did purchase 2 packages of cloth diapers a year or so ago because they were on sale. I'm not sure WHY I actually bought them but now I am glad I did. Need to figure out WHERE I put them, though!!
I have a whole list of things to do today since it's my day off and I pick up dad at 2 p.m. I have MILES TO GO before I can sleep. So, I will now add a bunch more stuff to my list of things to get! One place I'm planning to visit is a rather large medical equipment type place. I ordered some tabbed briefs online but they won't arrive until Thursday, so hoping I can get some there, as well as look at other items that might help.
Since Dad's been at the skilled nursing facility for 2 months, I haven't been over to his place too many times, so need to go over this morning to (1) clean up the kitchen (2) determine what food I need to purchase to start making his meals again (3) I'm not sure what #3 is but I have #4 thru #gazillion in my head. Said list also wakes me up in the wee hours of the morning and plays on an endless loop forcing me to just go ahead and get up at 1:30. ugh. LOL.
At this point, I've replied to several ladies thru care but no one is replying back. So, I'm pretty much resigned to the fact I will be doing all this on my own. I just hope I don't end up having to move in with dad. After mom passed away, her room became the 'let's just put it in there' room and that will be a major chore to clear out. Also, my apartment lease goes thru July 2022 so I will still have to pay rent.
I just took on a new schedule at work this week so now I will have Monday thru Thursday off work and I will work Friday - Sunday 3 a.m. to 8 a.m., so I could actually move in with dad as he will be sound asleep from 3 a.m. to 8 a.m. on the weekends. I. Just. Don't. Want. To. Do. This. Of course, I know full well this will probably be my fate in the not-too-distant future. When I was caring for mom, I still kept my apartment and would take a couple of breaks each day because I had cats to care for (they have both since passed, too) but although I no longer have the cats, I think I will keep my place so I'll have somewhere to escape to if I do end up moving in.
Anyhoo. Thanks again for your suggestions! They are very much appreciated. I will be asking OT for some hints and suggestions as well since they *should* be starting up again this week.
It does indeed seem as if you are trapped because of that $25,000 you were paid without a contract for taking care of your mother.
But do make a contract for NOW, and run it by an elder attorney. And make sure ALL the tasks you do for your father are in the contract. Be generous with your rate of pay, and make it the equivalent of what you will/would pay outsiders to do.
Are you POA/HCPOA?
I suppose we all have our preferences, strengths & weaknessness. We can be stretched but ultimately have to decided ourselves when "I can do this.. I think..." crosses the line into "Nope, can't do".
Are BMs that line for you? (No shame if it is).
Everyone has a limit!
A Dr I met once found his line - administering regular suppositories for his MIL w Dementia (who no longer recognised him) & would lash out in fear.
The 'Acts of Service' folk may be great with a hoist, wheelchair, cleaning & bathroom duty. But prefer not to sit in the garden drinking tea, holding hands, listening to the same stories on repeat.
Others are big on 'emotional support' or bring gifts but will run from physical labour.
No judgments here about not being willing to clean up incontinence or about not wanting to become a caregiver.
You don't want to do it and that's okay. Your father will probably have to be placed in a care facility or have live-in caregiving service.
In the meantime, hire some CNA's to handle his personal hygiene care.
I quit my job and moved in with parents to care for mom (and dad) and now that she's gone, I no longer live there but do go over every day after work to cook dad's meals, dole out his meds, take him to/from doctor appointments, clean the kitchen, do the shopping, etc. I got myself a part-time job so currently I'm providing this care without compensation. So, I'm still his caregiver but now that he is unable/unwilling to do his toileting, someone will have to do that and I really don't want to be that someone! Currently looking for a CNA to handle his personal hygiene care but I think I'll be "it" until I find someone. Not looking forward to it and honestly, I don't know how to do it. Mom could still walk with assistance and she was a tiny thing so it was easy for me to handle her toileting. She rarely had any messes so I guess I got lucky then. But looks like my luck has run out. lol. smh. whaaa. :o)
Many forum members recommend getting a bidet toilet seat.
Try to get him to the toilet when he is most likely to go and leave him there several minutes, most adults are fairly regular and tend to go at certain times - I always figured even the occasional success was well worth it.
I need to look into the bidet thing. My question would be - how do you dry off after using a bidet? Does it have a dryer built in? Or would you need to use a towel?
Dad claims now he is having BMs and not even knowing he had them! This has started happening this past week while he's been in the skilled nursing facility (since early September). Prior to the SNF, he was able to toilet himself at home so it's new to me and ... well ... just ... ugh.
My line manager called to demand to know why I was so late on my round. I don't say boo to a goose, mind you, but she certainly heard what I thought of whoever decided that client only needs a 30 minute call in the a.m.
Sorry! - that probably won't cheer you up much, but I was hoping maybe at least your Dad knows to wait for help?
Get a home assessment done. Get a wheeled commode (if he's a really really big man, there are bariatric ones). If you have any such thing as a reablement service in your area, ask for a referral from the SNF.
On the plus side, another lady is doing so brilliantly she doesn't need us at all any more.
And then again, in a flabbergasting first for me, the client I was accompanying to the bathroom to clean his teeth, who walks haltingly and lop-sided with a tripod stick and has the effective use of only one arm, announced on our way back to the living room that he was ready to go out in his car now, and despite my vocal concerns - "you worry too much," he said - got in his car and drove away. Leaving me standing there in his yard open-mouthed, except I was wearing a mask. I rang my shift leader who laughed a lot and said "well he's got capacity, you couldn't have done any more." I rang the client's wife, who said this was normal for him, I was to shut the door and make sure the dog stays outside.
It's been a very. long. day.
I'm hoping you'll get support coming in to help with toileting, personal care, dressing - activities of daily living, basically - and see how it goes from there. If they're worth their salt you may see more progress than you fear.
It's been a very long week for me - since I found out just Tuesday that Medicare is discharging him Friday (yesterday). I am having dad private pay thru this weekend as I was hoping I could get something lined up when I have to take him home on Monday. And I'm working this weekend. yay me. so far, I don't have anyone or anything lined up - except me. joy.
Thanks again for your comments!!