My father has severe osteoarthitis and had 3 strokes. He cannot get out of bed by himself and deals with incontinence so he is in LTC. Since being there he is largely in denial that this is his new life. First he was hoping tramadol might be the fix that gets him to walk, that didn't work. Now he wants hip replacement which we are looking into. But even with a hip replacement, I'm not sure that it will be enough for him to walk again due to the damage done by the strokes.
Do you ever give up trying to find "solutions"? How do you help your loved one come to accept this as their new reality?
'Just working on it' may not always be completely accurate, but it is kinder ❤️
If HE doesn't give up finding solutions then YOU don't give up--my personal opinion as an old retired RN. This is an individual decision. UNLESS your father is deep in dementia, this is his decision to make.
If doctors agree to the hip surgery then let him "go for it" because what is there really to lose but his life, and he is already unhappy and frustrated with that leaking away from him one piece at a time.
Your dad isn't going gently into this good night.
Myself I would choose the end of life cocktail as soon as possibly I could, and wouldn't let them replace much of anything at all on me. I don't mind death, but I sure have no courage for the losses of aging on my doorstep now at 82.
But that's me as an individual, and despite his losses your dad wants to fight on.
Your Dad is s/p strokes. He is at risk because of that, and because surgery would necessitate his being off blood thinners, which could kill him pretty quick or injure him more than already he has suffered. He needs to fully understand that.
So this comes to
1. Individual right to own decision
2. Whether or not dementia is involved (and this therefore must be YOUR decision)
3. Measuring risk
Attend doctor meetings with him if he will allow that. Do the pro and con thing with the doc. Speak about the dangers of anesthesia at a certain age. Be certain he understands the risks.
As RNs we were taught to always follow the patient's lead. Especially so far as not robbing of hope is concerned.
With all the losses of aging for some people, hope and daydreaming of a better day is about all that's left.
Good luck.
I want to encourage the OP to factor in her needs while supporting Dad and be clear to him what she can and cannot do to facilitate the surgery and recovery.
After a trip to the ER and an MRI of his brain, I had to tell dad his tumor was growing and that was causing his mobility issues. That nothing could be done medically about it, it was too dangerous at his age. But he could still have years ahead of him, it was not a death sentence.
Dad died 19 days later. He lost hope and gave up. Hope is a very important thing to have in your father's life. I destroyed my dad's hope by taking him to the ER that day and getting such a diagnosis. Let your father have his visions of walking again and going back to his apartment. It hurts nothing but helps him tremendously. So what if it's all a dream? Dreams keep many of us alive.
You told your dad that he could have years left to live, it was not a death sentence. You show such love for him.
My dear friend chose to die because she was ready to go along with her body's choice, in the room of her choice, with her loved ones.
We love her and are inspired by her.
I continue on, in ever-growing amazement at the immensity of all of
our lives, and our capacity to feel so much compassion for and support from one another and our world.
Maybe you didn't destroy your dad's hope and he chose to go on his journey.
It was, however most kind of you to share it with us as a possibility to be aware of.
Thank you.
Sending much love.
At this point the denial is most likely a coping mechanism and you should go with what he suggest and tell him he should ask the doctor. I wouldn't spend much time tryi.g to convince him because it could possibly add stress anger and resentment. My advice is nod and encourage his range of motion exercises. Good luck. and if it is too stressful during visits, it's okay to take an break from visiting to maintain your mental wellbeing.
Sometimes we caregivers just need to shake our heads up and down and go about our business, we cannot fix them or convince them that there is no cure.
I have used the line " When your doctor gives us a release letter that you can go back to your apartment we will consider this option, until then you will remain here".
I know several people who had hip replacements (they were all 60 and older) and it is the "easier" of the joint replacements in terms of PT and recovery. He has to be able to do the PT post-op or he won't benefit from the surgery. Will the other hip eventually need replacement?
I would consider breaking down the goals reach in phases for him to reach. EG: If he can recover "enough" from the strokes (cognitively and physically) then he can be assessed as a candidate for the hip replacement (and his doctor does this).
Then, he has to understand/agree that he will be in rehab for a while (Medicare 3 weeks?).
From rehab he goes "temporarily" to AL where he will need to continue to be able to get to his PT appointments and do them faithfully or they will drop him if he doesn't progress. Once this happens he either stays in AL or moves back into LTC.
Once he successfully completes his PT (as assessed by the PT), in order to leave AL he needs to "prove" he can do his ADLs to his doctor (not you), and only then could he leave the facility.
Maybe you have this discussion with his doctor in the room so it's not your plan but what is "medically required". He can still have hope, it just needs to be in baby steps and realistic -- and you need to decide your own involvement level. Maybe put it in writing, so he can review and ponder it when you're not there. I'm rooting for him to go for it, as long as he is realistic.
See All Answers