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My dad is 87, caring for my mom (who turned 89 today). He's in fairly good health, but she suffers from dementia (short-term memory loss, mainly) and has mobility problems. My dad has arranged for round-the-clock home aides to be with her at all times, but in recent months things have gotten more difficult.

Last month, Mom developed a lung infection which sent her to the hospital for five days. The time in the hospital bed severely impacted her mobility problems, and her physical therapist recommended she spend time at a rehab center (in a local nursing home) before trying to return home. Right now, that's where she is. She begs my dad to take her home every time he visits her (he visits two or three times daily), and she seems to be more and more disoriented. The nurse practitioner at the facility doesn't want to release her (even though she has been making good progress with her physical therapy), and now they're claiming recurring concerns about her lungs and breathing.

Dad is completely depressed. I live five hours away, which makes it very difficult for me to be much help. We talk on the phone every few days, but today he sounded worse than I've ever heard him.

Would a geriatric manager be of help to him? Are there ways he can bring her home safely? Money is not an issue for him -- part of me worries that the nursing home knows that and is keeping her there longer than necessary (but that may be my own frustration talking). Anyone out there experience anything similar?

How can I help Dad deal with this?

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Again, thanks for your responses. Perseverance, your situation with your mom sounds very much like my own. My mom developed a lung infection, and they were (and still are) concerned about pneumonia -- she is on oxygen on-and-off, and her blood oxygen level is too low (thus they won't release her to go home).

Our family situation is difficult -- Dad won't consider an assisted living facility (and my sister and I have both researched places near us that might work for both of them). He is able to afford full-time, round-the-clock nursing care for Mom at home, and many of the nurses have become friends (another reason why having Mom in the nursing home is difficult for Dad -- his daily support network is gone). It's also the reason he won't consider moving in with either me or my sister -- his nursing staff wouldn't be able to come with him. If we lived closer, it would be much easier to spend more time with them. As it is, my sister and I each visit every few weeks. He's more animated and seems less depressed when our husbands come along, too -- and that's harder to arrange.

Sylvial, my dad seems to be suffering from the same kind of depression as your dad. He has health issues of his own, but puts off getting help or going to a doctor. He won't ask for help, and when we offer it, he generally rejects it. This weekend my sister and I just ignored him and went anyway. At first, he didn't seem pleased -- but I think by the second day he was feeling more relaxed, so it was good we were there.

And no, neither my sister nor I have POA, and my father has made it clear he doesn't want us talking to their doctors (or to the nursing home) without his presence. He was a big-deal attorney in NYC for decades, and he wants full control over everything in his life -- this, of course, is why it's been so hard on him caring for my mom, since he's not in control at all.

The other "issue" is my brother, who lives about 25 minutes from our parents and doesn't work. He also doesn't visit or call except rarely. It's been frustrating for my sister and me. I've talked with him about it, and he says openly that he can't deal with them.

Again, thanks for all your help and support. I'm glad I found this website. It's good to hear from others who are going through the same thing . . . and surviving!
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Why is your dad coming to see her so many times a day? That's enough to depress anyone. He either should be staying there with her for longer periods of time, or not visit quite as often. If she's disoriented, then part of the problem could be seeing him come and go off and all day long. It's confusing to say the least. How can she get acclimated to her new surroundings, when he keeps popping up all the time?
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There is a lot to sort out here. At least you are 5 hours away and not 15! Does dad have moms POA to get info on meds that might be making things worse? can you get consent to check on that? By "things" I mean both the confusion and possibly the lungs, which could be due to trouble swallowing. Not sure how much a case manager can do without being able to delve into the medical issues, but its not a bad idea. Will the doctors or nurses talk to you at all?
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Thank you all for your comments and understanding. The nursing home has suggested that Dad not visit so often -- and I've tried to get him to at least take advantage of the time he has now (he's been dealing with her at home for the last 10 years, with no real break at all to be on his own or get out of the house). But I think this situation defines him now.

And yes, I'm not sure Mom actually knows what home is at this point. Her memory is in and out, and sometimes the place she's thinking of isn't the place they actually live now. And I do think if he would just visit less often she might adjust to the new environment. But that thought terrifies him. He doesn't want her in a facility; he wants her at home -- and he wants things to be the way they used to be (unfortunately, "the way they used to be" was over ten years ago).

As for his depression, he's dealt with this for his entire life and has refused any help (won't see anyone -- my husband is a therapist and has tried to convince him to see his doctor about medication, but he has refused). Of course the things causing his depression are very different now.

I do appreciate all of your help, and it's good to know that we're not alone. I'm visiting him (and Mom) tomorrow (along with my sister) and we'll see if there's anything we can do. Thanks again.
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A carbon copy of my mom and an dad, this so sucks. My dad is still depressed, after mom's death October 2012. Mom went to assisted living three years ago, dad could not take care of her if he tried, lack of mobility and not accepting her medical issues were huge, she almost died under his care. As a family, we kept his back, best decision we made to put mom in skilled nursing, but he is still messed up mentally. Can somebody lend some help to problem. My heart goes out to you kacunnin. . .
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Dad saw mom at Country Care three times a week and complained about the drive (10 miles one way) go figure. They do the visit for lots of reasons, guilt, missing the person, it's what they are supposed to do. These are the reasons I have experienced.
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Tell him it is OK, not to visit so often. She may not know what home is, even if she was able to be released. Then, he will really have a problem. Also, he needs to see his own doctor for the depression. Good luck. He has to feel awful.
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My mother has dementia and my dad was her primary caregiver for years.. He passed in his sleep on christmas night 2012. He used to tell my mom , do you know how hard it is to watch you loose your mind? I feel he was very depressed, going through his belongings we found his blood pressure medicine that he purchased from walgreens still in the bag never opened. I really feel he gave up. We visited weekly and never realized the progression of our mother until living with her. I think as hard as it is for your father the respite care is very good for him. I feel that my fathers life was cut short due to her illness and him not asking for help. It sounds like your mother for right now is needing skilled nursing due to her illness.. I never realized what that meant until I was a caregiver and my mother has reached the point of skilled nursing. I have a very deep respect for my dad after living with my mother for the last six months.. I feel like it almost killed me. I hope things getter better and you are not alone. I wish I could have done something more but my father was also stubborn and brought her home when we were all against it. Good luck and keep your chin up.
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You are entering into the new phase of your parents needed care.

There is a lot unsaid in your post. How often do you and/or your sister spend quantity time with your parents? Have you recently spent more than one week with them? I ask this because it is easy to be deceived by a phone call or a couple hour visit every few months when it comes to really understanding your parents level of need.

My Mom is 78 and has dementia. Along with dementia comes difficulty swallowing and often lung infection because food goes down the wrong pipe. Fluids begin to accumulate and then oxygen, a nebulizer, and/or meds are needed - eventually morphine. Pneumonia is a real threat.

Your dad visits her because he is LONELY. He doesn't want her to pass without him. He sounds like he really needs YOUR support and guidance. Are you and your sister prepared to bring him into your home? Can he go into an assisted living facility near you? Your Mom may also be able to move to a NH closer to you.

Do you or your sister have POA and their health directive?
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The only other suggestion is to get adult protective services involved. Your hands are tied (by the likes of it, what a relief) with your father. He will need to reap what he sows. He sounds extremely prideful. The silent but belligerent type. One who probably didn't care for his elderly parents....

Do what you can and be content knowing that you did.

May you find peace in this situation.
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