Father should be in nursing home but I can't do it

Mav2126 · May 28

Hi - I have a father who keeps falling and going to the hospital. I think he would be better off in a nursing home. He also has dementia and no short term memory. My dilemma is he is absolutely 100% against going to a nursing home. He literally cried in front of me saying it is not what he wants to do. I have requested strategies on this forum and besides trying to be empathic and understanding to get them to go (which I don't think ever works with someone with dementia and stubborness). The other strategy told to me on the form is to "trick" them into going into a nursing home. This goes against every fiber of my being. I am sorry but I was brought up to never tell a lie and I can't go against my moral code. So that leaves me back in a untenable situation with a father who is too much to handle and rapidly wearing away at my own mental health. This could go on for years. Ugh.

H1235 · May 28

You are the adult in this relationship now. You are the one that can reason and weigh options and consider all the many pros and cons of decisions. He is not capable of doing this. He is vulnerable and needs you to keep him safe and cared for just as he did for you when you were young. I imagine there were times you didn’t want to do something but because it was what was best for you your father made you. It was probably difficult for him too, but he did it. If you have to be honest, then just tell him what is going to happen, period. I would not give him days to stew about it, I think that would be cruel. By telling him where he is going you may not be able to get him in the car. A moral code is about more than lies and truths. It’s about doing the right thing for the people we love. In my opinion.

SusanB-dil · May 28

I understand.

Could you at least look into adult daycare through the week?

There comes a point where it really is just too much. You've probably seen posts that say that caregiver burnout is very real. His reasoner is broken. If you do find a place you think he might like, you know there will be care for him 24/7. Something very, very few of us would be able to continue. I see a lot of times where a LO really does settle in just fine. You'd still be his advocate. That wouldn't stop. At least consider it a bit more, both for yourself as well as for him.

ARIL · May 29

I understand also. I too balk at suggestions about tricking my parent.

I wonder if it would help for you to reframe this for yourself and your dad somehow. You can talk about “trying this out for a little while to see how it goes.” You can talk about trying it out for you. You might also be able to involve the doctor more directly.

It does sound as though you need to allow yourself to imagine making the hard decision and reminding yourself that this is not abandonment. (It’s very far from that.) How would destroying your own health benefit your father?

Do continue to think about it. Are there any half-measures that could help a little: day care, respite, hiring an aide part-time?

I wish you well. There is nothing easy about any of this.

Quilting brings calm · May 29

I’m trying to figure out why you keep jumping straight to thinking he needs a nursing home when you’ve described him in prior discussions as being in the EARLY stages of dementia. You’ve mentioned the falls. Does he have medical issues that require a nurse to see him every day? Wound care, tubes, shots, etc? Because if he doesn’t - he’s not going to medically qualify for a skilled nursing home.
He will qualify for AL or MC. Although those are mostly private pay. These days a lot of them look like apartment complexes with individual apartments or rooms. Activities, meals, housekeeping, laundry, shower help, medication management. Pkease determine the level of care your dad needs, and go tour places without him. Discuss his needs with the director, find out about costs etc. Have a plan B in place. Whether you want to or not.

There are lots of discussions on these forums about placement and what worked to get the person there and what didn’t. However given that you have already been discussing it with him and are meeting resistance - I suggest you try this: The next time he goes into the hospital, ask to speak to a patient advocate/ social worker. Explain your living and financial situation to them - repeatedly voice that he is no longer safe in your home and you can’t take care of him. Your best bet is if they pursue placement and arrange for direct transport from the hospital to the facility.

You have not mentioned your mother lately. What is her current situation?

cdgbdr · May 29

When he goes to the hospital, have a placement arranged from there. If he's frequently falling, odds are that at some point there will be an injury that requires that care.

harshedbuzz · May 29

A couple of thoughts—

You describe his presentation as "mild"; you mention he's struggling with the computer of late. My own dad was in the early-moderate stage of dementia when I assumed the role of tech support. The repeated questions driving your BSC are a stage 4 behavior per DBAT. It would be highly unusual for a person at that stage of dementia to go into a SNF unless there was some other medical need that required the support of skilled nursing. Someone if stage 4 would normally be more appropriate to a MCF assuming he's ambulatory and self-feeding and doesn't have skilled nursing needs.

If both parents have dementia, placement together might be a good option.

Does he have some other medical issue that is at the root of his falls? If there are, could they be improved by making the home safer or adding PT to improve strength and vestibular issues. We did 4 months of PT after my mom had 6 months of serial falls— I sent her for bi-weekly PT and made draconian cuts to her shoe collection. We also made some adjustments to help with her vision issues. She hasn't had a fall in over a year. Knock wood.

I can appreciate it's difficult to place a LO who doesn't want it. You could hire and supervise in-home caregivers assuming he can pay for it. If your parents didn't want to go to a nursing home, but didn't save vast amounts of money or invest in robust LTC insurance, they made a wish, not a plan.

Realistically, it may not be able to honor a wish without the plan to make it a reality.

As for your feelings of exceptionality, it's not as if the rest of us were raised by wolves. I'll assume you didn't intend the sanctimonious tone. The way I was encouraged to think about this next step— You aren't ripping dad out of his home and into a facility, dementia is.

I hope you find a way to keep dad safe without losing yourself. If he doesn't have any life limiting conditions beyond dementia, you could be looking at a decade more as caregiver.

HB

Father should be in nursing home but I can't do it

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