How do I get my husband to accept in-home care? He fights it every time they are scheduled to come.

Like others have mentioned, it depends on the resulting behavior. If he becomes physical or aggressive, like my mother, caregivers may not want to come. But if it’s just agitation, or verbal refusal, then it’s not a choice. Just like when my kids needed to go to daycare, or be left with a sitter, or have to do something safety related that they didn’t want to… it’s not a choice or up for discussion. You, sad as it may be, are the decision making adult. End of story.
Physical violence is a whole other issue.

Dear Helen, My FIL is challenging as well (putting it mildly). The doctor prescribed a low dose of Sertraline (zoloft) to calm him. It has helped his agitation and anxiety. He’s definitely easier to manage. He can still be disagreeable and yell at times, but much less so. Sounds silly, but to get him to shower, which is one of the biggest hurdles, we promise him a sweet treat or a mid-morning nap afterwards. I”m sorry for what you are going through ….as caregivers, it’s so very hard to see loved ones in this state. Make sure to take care of you as well. Marie

Hi Helen, I am sorry for what you are going through. My dad had frontotemporal dementia and passed a month ago, following four months in home hospice. He was on a lot of Seroquel and Trazodone (calming drugs for his form of dementia) and had lost at least 40% of his body weight due to rejecting almost all food for months, and yet he was still generally uncooperative with the aides and nurses. He didn’t like the cleaner my mom had come into the house for 3 hours once per week either. His general approach was to try to hide from them all and refuse to do whatever (shower, allow them to change his sheets, etc). He was not physically violent though, thank goodness He accepted one male nurse better than any of the others and would generally allow this nurse to take his blood pressure, measure his arm circumference, etc. this nurse would sometimes try to cajole or bargain with him. Like say “next time I come, we are going to shower. Can you shake hands on this?” Once or twice it worked. He also fought against wearing Depends and would remove them whenever he got the chance. Toward the end my dad lost strength to stand on his own, yet he kept falling every time he got out of bed. Then he wanted to be left lying on the floor in pools of blood or his own waste. The nurses and aides would tell him he couldn’t stay there and insist on transferring him back to bed. My mom was resistant to the overnight aides but even when we did have them, my dad would wait until their back was turned and slip out of bed and fall. The last time he ended up injuring himself so badly that he had to go to the hospital to check for concussion and then to a SNF. Before he entered the SNF, his hospice nurse (the one he liked OK) gave him a rapid Covid test. My dad was mad as hell about this and yelling about how it was an invasion of his privacy and he couldn’t believe such a thing could be allowed against his will. He was also furious about being in the SNF. He ended up getting aspiration pneumonia 1-2 days after he entered there and died a couple of days later. Which my mom and I consider to be merciful. I was also very grateful for the morphine they gave him every 2 hours the last 48 or so.

I know many on this forum would say he should have been placed months earlier and I offered it as an option but my mom was adamant to keep him at home as long as humanly possible.

So I am sorry I don’t really have any advice, but I do have heartfelt sympathy! I truly hope it all plays out better for you. But I also feel like we all (me, my mom, the hospice staff) did the best we could. And I am sure that you are also. Best wishes to you.

Q1. What level of refusal does he have?

Does he grumble but accept?
If so, I'd explain the help is for YOU. To help clean etc.
Explain. Then ignore the grumbles.

Does he verbally fight the idea with you constantly?
I'd drop the topic. No longer discuss it. Avoid any mention in advance if this riles him. Eg No mention that tomorrow aftenoon X is coming.

Does he physically stop staff from entering your home?
That will need immediate intervention & discussion about aggitation & mood with his Doctor.

Q2. Can he cancel the service himself?

If yes, instruct staff they work for YOU. Only YOU can cancel.

If not, then it is more about changing your own mind set. About letting go of 'convincing' & towards 'arranging'.

I've been told it can feel *foreign* or wrong. Feel like *telling* instead of *asking*. Can feel like an abuse of your power as a caregiver. Yet, too much control given to the person lacking reason ends with abuse of the caregiver. They become enslaved (of which I have read a few posts today already head that way).

See what others have to say on this. Dignity of choice, consent - these things do matter. It's an interesting topic. Har far can someone go when refusing their own care?

Cover is right.
Take your husband to visit a nursing home. Tell him that if you cannot care for him at home, and he cannot be managed at home, he will have to go to in-facility care.
If he has severe dementia this "threat" won't work.
And if that's the case then it may be time to acknowledge that you cannot yourself go on managing his care in the home.
I am so very sorry. This is very tough and very sad.

Easy, take a visit to nursing facility, and tell him this could be your fate.

I think the best way to get your husband to accept in home care is to tell him that the person(s) that are coming are coming to help you around the house. Make it about yourself and not him.
That has worked for several folks I know like you who had husbands who didn't want any in home care. Over time the husband became comfortable with this person being in the house and would eventually let them help him also.
Best wishes.

Hi Helen, I did home care for a few years ago. We would often have clients like that mostly male that would refuse help

If the caregiver company works well with you they may find the right person that clicks with your husband.

There was one male client that wouldnt let anyone in the door. But they kept sending some there, and then they would leave. One day one of the paid caregiver showed up and he was at the door refusing to let her in.
Then he said before you leave can you help me get the remote unders the couch.
He let her in and they bonded.

Sometimes it's about the right timing. Often it's about the right person.

I was sent to a NH to watch over this lady that was vilant, while they found her a better place , for her needs. We bonded and she said I had a calming effect on her. Her brother was visiting and she picked up something to throw at him. I said stop she looked at me and put it down. Because she trusted me.

Other clients I didn't bond with I couldnt help . So they would send me somewheres else

Best of luck