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My dad is bedridden, full care, but has retained his mental faculties. Mom had a stroke 6 weeks ago and is now home. She is physically strong but confused about everything. (cannot prepare food, use a phone, etc) I lived there for 6 weeks, and have arranged care 4 days a week during the day and now have moved back to my home and returned to work.


They really are not safe and need 24-hour care. They have the finances to pay for in home care, but dad does not want to pay. They have refused POA, and he insists they are fine alone. We have been arguing about this daily for 4 weeks and he is very stubborn. I feel guilty leaving, but I should not have to give up my life and job, when they are able to pay for care. Is there a way to force them to pay for in home care? They do not qualify for Medi-Cal.

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Good Lord, she was discharged HOME? Did the hospital realize that she was expected to return to being his caregiver?

At the least hint of an emergency, call 911. And yes, call Adult Protective Services and their local Area Agency on Aging tomorrow.

The conversation you need to be having with dad is "If you don't get yourself an eldercare attorney, A POA and the proper in home care for you both, the state of (fill in the blank) will gain guardianship and take ALL of your assets and put you in a home of THEIR choice. You can do this the hard way or the easy way, Dad. Your choice".
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What a dreadful situation for you to be in, my condolences. When stubborn parents refuse in home help, what can you do? Nothing, really, except call APS for a wellness check and let them evaluate what's going on and make the call. It blows my mind that your father would expect his wife who's had a stroke and is confused to be his full time caregiver while he's BEDRIDDEN!! Absolutely ridiculous.

Hopefully APS will pay them a visit asap, see what's going on and determine they need placement, BOTH of them, or at least 24/7 in home care.

Barring such a determination from APS, you'd have to wait for a crisis to happen to one or both parents where they're sent to the ER and then rehab, where rehab refuses to release them back to independent living. That's another way a stubborn elder gets forced into managed care or into getting in-home care against their will. Or they're hospitalized and you let the social worker know they're an 'unsafe discharge' and require placement, at which time the SW would get busy finding them a spot in residential care.

Wishing you the best of luck with a very difficult situation. Sending you a hug and a prayer this all works out.
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Caregiverstress Mar 1, 2022
I'm afraid this is what it will come to with my own father. His personality is such that he would never ever allow in home care or be placed in AL. No way. It will probably come to him having some sort of accident or a second stroke and ending up in hospital. From there as POA I will have to say he does not have anybody to care for him 24/7 and they will make the call. It's a heart wrenching situation for everybody.
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Stop arguing with them about it. Tell them in plain language that there will be 24 hour care in their home or you will be making a call to APS.
Explain to them what APS is and that they are at-risk vulnerable adults. If they continue to be stubborn about it, the state will place them both in a nursing home against their will. They will go ahead and do this whether they agree to it or not and there will be nothing you or anyone else will be able to do about it.
Tell your father that care is not going to be free for him or for your mother and that if they want to remain in their home, 24 hour homecare is their only option.
Stubbornness has a way of getting cured when there's a real threat of nursing home placement.
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againx100 Mar 1, 2022
Sometimes you have to do the tough love thing.
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He is bedridden because he can't walk or feed himself, etc, but he still is thinking straight most of the time. I finally told him I would not manage his bills, pay caregivers, etc, without POA. I told him I will do everything in my power to give them the best life they can have. He finally relented today. What actually convinced him was me telling him what would happen if the county took over and made the decisions about their care. I am piecing together in home care, with me still spending every night and weekend. I am realizing elderly can be in so much denial about their loss of function. I guess it is really hard to let someone else take over your life. Hard time for everyone. I also contacted an elder care attorney to see when they will qualify for Medi-cal to help.
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BurntCaregiver Mar 5, 2022
GenJohnson,

I am happy to hear this. The only way to deal with the stubbornness is to just speak plainly and tell the senior exactly what's going to happen if it continues.
It is hard for people to give up control of their lives and to allow hired help to come and do the things they've always done for themselves.
It's certainly easier on a person when they can stay in their own home and not be put in a care facility. I've done in-home caregiving for almost 25 years. I became like family to clients who were among the most stubborn to accept help in the beginning.
What I found is the best bet for most people in need of round-the-clock care is to hire two caregivers who split the week. Or one who will work weekdays and one on the weekends.
Try looking on care websites. If your parents have day help you can also hire someone for 'Sleep Duty' and it's less expensive than what you'd be paying the regular caregivers.
'Sleep Duty' is a person who comes in to stay after hours. They pretty much are just so the elders aren't alone at night. They don't usually do care. They get up a couple times in the overnight and check on the clients or take them to the bathroom. That's about it.
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They are scared of having a "stranger" in their home. Hire someone local for a couple hours twice a week on a "trial" basis, and say it's your friend. Once they get used to the company and the help, they will begin to see the value there. Your Dad will appreciate the help. This is the roundabout way to "force" them into it.
My Mom always said," I don't need anyone". I ignored her and hired someone I really liked that I felt was a good fit, and eventually they both fell in love with each other. My mother used to say she's "like a good friend"!
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stuckdaughter Mar 3, 2022
Not OP but, thank you I am going to try this tactic with my terminally I’ll, disabled, defiant, “I don’t need help” mother. The only problem is that her health status and complete isolation from anyone aside from my father (her full time caregiver who also has a full time corporate job that pays for the health insurance) has forced a lot of people out of her life. I would feel guilty asking anyone to put up with her negativity and opposition. Perhaps a neighbor would be helpful for me. Thank you for this recommendation.
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Is Dad mentally competent? Really? Bedridden with Parkinson's or it from another reason? PD effects brain too, not just mobilty & speech.

I saw a case similar last year. She was bedridden. He was able, driving, heating meals but with some memory issues until Boom he falls & # hip. Full delerium in hospital, relatives called. They disclose the Mom is at home, left unattended - panic ensues.

Call to Human Services (our APS). Mom taken into emergency NH care. Emergency Guardianship applied for. Dad discharged to rehab. Then either home (if able) or into care also.

Was a sh*tstorm basically. He was confused, she was unable & those adult kids clueless.

But this OP has the brains & strength!

Best of luck (((hugs)))
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Since he is mentally competent, you can not force him to do anything. The hardest and best option is to step back. You need to allow him to see for himself that they need more care. Continue to be firm in your position on what you will do to help them.
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dear OP,

hug!!

sending lots of compassion from me, to you (and your parents).

it’s verrry frustrating/exhausting/angering/worrying, when one clearly sees LOs need help (and possible solutions to make life easier, are X, Y, Z)…but the LOs fight us, every step of the way.

a friend of mine managed to convince her mother to get 24-hour in-home care by saying, “Dear mother, don’t you want me to sleep at night? I lie awake every night worrying about you. I go to work the next day, totally exhausted.”

another friend convinced her mother by getting someone else to convince her of in-home care. (many parents don’t want to listen to their adult children).

——
a side-note on in-home care…if possible, it’s good to check that the hired people are good, honest people (sometimes one can only realize the truth after they’ve worked some time, caring for the LOs).

one needs luck, perseverance, in finding good, caring, trustworthy caregivers.
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I would speak with an eldercare attorney for advice on what can be done and how. I would report them to adult protective services who will come in and investigate. And you should give them an ultimatum. This nonsense stops now and they either get help and a caretaker and do the right thing or you walk. Let them reap what they sow but you live your life and keep your job. And stick to it. You may have to get guardianship if a POA won't work. You need professional advice.
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My thoughts:
Your dad is of sound mind, so you can't "force" him to do anything, even though he has physical challenges.

However, your mom sounds like she is not of sound mind, and your dad is not physically able to provide care for her.

What you can do is call Adult Protective Services and have them come to the home and do an independent assessment of the situation. If they find that mom is not receiving adequate care and supervision, and that dad is incapable of providing it, they will likely offer dad two choices. 1) Put mom in a facility or 2) Pay for in home care, since he is not physically capable of providing it.

If, on the contrary, APS deems they are both capable to function and/or make decisions on their own, then go about your life as usual. You should not have to sacrifice your job or your nuclear family because they make bad decisions.
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BurntCaregiver Mar 1, 2022
Clarakate,

If the father is of sound mind his daughter cannot force him to do anything, but APS can and will.
Even if he is considered of sound mind he is a bedridden invalid. That makes him an at-risk vulnerable adult. They can force him into care.
They can put his wife into a care facility as well. She is not of sound mind. Their care needs cannot be met by part-time caregivers a few days a week coming in.
The OP needs to level with the father and tell him plainly that this kind "stubbornness" often results in nursing home placement. This will very likely bring him around and make him receptive to the idea of having 24 hour homecare.
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