My father has been assessed by the VA. They were helpful in getting a new pair of hearing aids, New Walker, etc. they also did a home assessment. We already had grab bars and ramps, so house checked out. We have had Lifeline for past three years, so even if no one is at home, if he’s ill or if he falls, he can reach someone, although typically he’s never alone for more than 1-2 hours. He’s ambulatory. He told the VA worker that we won’t bring him food. But when the VA worker queried him, it came out that meant he would often wake up and then yell for someone to bring him food. At times, that happens when we’re at church or at a grandchild’s ballgame. But often we are at home and he just can’t hear us, so he’ll yell, or call, or do a group text to get someone to walk a sandwich or bowl of cereal back to his room. If we know we’re going to be out of the house, we try to get him to eat before we leave, or will tell him we’ll bring him something after church, etc. but he often will drift off and lose track of time and think we’ve been gone longer than what it’s been.
We do try to get him out of bed for 30 minutes once a day... usually at supper. However, it’s getting harder and harder to get him to rouse. The VA worker told us to make him get up and walk around. I just don’t know how to make someone get up who just refuses to do so. It’s sad...but also embarrassing when he tells people we’re not feeding him. He will also call on our phones... even if we’re in the house... to bring him food. Even if it’s after we’ve gone to bed, or we’re in church, or if he forgets that we’ve gone out of town and one of our kids is staying at the house with him. (We don’t leave him alone except for short periods.) I know he sometimes forgets... but sometimes he doesn’t, and then it’s aggravating that he expects my husband or me to be at his beck and call. Especially after the VA worker encouraged him to be a little more self-reliant.
Sorry for venting. I know some of it is just not always realizing what time it is. And some of it is due to limited mobility. But it’s a vicious cycle of not moving, then feeling stiff. And there is also elements of depression, too. But he won’t even go out for short drives.
Thanks for letting me post.
A couple of thoughts for you.
Does your dad qualify for in home PT or OT? Sometimes our parents may listen to a stranger , better than family .
When we go out sometimes we'll leave a small snack, just in case, crackers, chips, cheese sticks, grapes. A note stating "dad we'll be back by 6 o clock, in case you're hungry before then, we left a snack and water"
Good luck.
Is it possible for the doctor to order occupational and physical therapy at home? They will make him move, build up his strength. Is he afraid of falling? If he doesn’t move he is losing muscle mass.
Don't worry about venting on here, it's encouraged on here. That is what this board is for. I do hope your situation gets better for you.
Your suggestion about the visiting PT is great, and we need to investigate that for sure. It helps a lot to have outside people encourage him...especially since he is actually my step-father and, at times, will play his bio-daughter against me...even though his bio-daughter lives seven hours away and does none of the caregiving. But can you imagine how mortified I felt when he told her 1) that we had taken his car from him (He had a stroke and was told to stop driving.) and 2) we weren't feeding him. Sigh. Having unbiased outside professionals coming into the house is a great suggestion for all of us.
How about telling him that he will be having meals with the family in the kitchen from now on? So, breakfast time, someone tells him it's time to eat and if he needs assistance, get him up and going and eating at the table with the other people in the house. Same for lunch and dinner and maybe snacks or whatever.
Do you have any in house assistance? If so, this would be great for them to do.
This could also cut down on his hounding you for food all hours of the day and night, etc.
I can tell you what we'd do at work, where our aim is to encourage self-reliance and confidence in people so that they can manage for themselves. We would encourage your father to get out of bed, and if he chose not to we would leave him to it. If it went on for long, his eating would become the first priority and so he would be brought food; but not without prompting him to go to the kitchen to get it, or at least to the table to be served it.
I can tell you what they'd do if your father were in residential care: they would absorb him into the facility's routine, and without actual "force" being applied he would find it very difficult to resist being got up, helped to dress, and helped to walk or be wheeled to the facility's dining room and lounge(s) - all on their timetable.
But you are not running a nursing home, and neither are you prepared to walk away and let your father shout himself hoarse, and that makes your task especially tricky. What is the typical daily household routine?
The other thing that troubles me, I don't know if you've already looked into it, is that your father's heart disease and stroke history make vascular dementia a strong suspect behind some of his ways - especially the losing track of time, the belief that you're starving him (my mother once said mournfully "are we having supper today?" literally as I was clearing the dining table after her three-course dinner), the loss of initiative and motivation, and the loss of social skills such as not being rude and demanding.
Before you make any radical changes, then: has his mental state been assessed by an older age psychiatrist, neurologist, or any other specialist in dementia?
Yes, my father has been assessed by a neurologist...the neurological hospitalist, the neurological PA, and then his regular neurologist. The only limitation they put on my father was his right to drive. I see cognitive decline, but my father was a practicing physician, so oddly enough, any medical event or visit seems to bring out the best in him.
Because he insists on managing his own medications (and his bloodwork indicates he is taking his medications as prescribed), I sometimes think that on those days that he is really hard to rouse, he has doubled down on a painkiller that is prescribed by his neurologist PRN. This breeds another vicious cycle of sleep, confusion, constipation...and I'll just leave it there, because it kind of gets messy during those times.
We have suggested putting him on the waiting list for the Veteran's Home in our area as I think he would become more engaged...but because he is still ambulatory and there has been no mention from the cardiologist, neurologist, or primary care physician of a need for a nursing home (or even in-home care), things just putter along.