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He is 82 years old, lives independently, and has had home health care and physical therapy periodically, but when that runs out he does not continue with the home exercise plan, so he atrophies and his mobility suffers. He has diabetes but continued for years to eat whatever he wanted. He stopped caring about bathing. He doesn’t like to wear clothes or underwear. I have actually seen him walking naked using his walker and defecating while walking to the bathroom. He refuses to wear pull-ups. I suffer from depression and have taken a high-dose anti-depressant for years. Sometimes even with my medication I have bouts of depression where I don’t function well and don’t want to get out of the bed. My siblings are aware of this and so far have not come in to rescue me from having to deal with my father. My siblings also have resentment towards him for the way that he has refused to eat healthy refused to exercise and now refusing to wear depends, clothes, do physical therapy, and when he’s had help he has refused to let them give him a bath. It’s infuriating mind blowing and exhausting mentally. He is the first thing I think about when I wake up and throughout the day and the last thing I think about at night. I am also a grandmother to two beautiful boys ages six and eight. My daughter has mental health issues and struggles like I do. Unlike me, she is unable to stay employed for very long and I’m constantly worried about her and her situation.

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You must realize that there is something wrong here. If you can not handle getting him placed, then call APS. The State can take over but be aware you will have nothing to say about his care. You also won't have responsibility of him. Tell APS that you cannot care for him because of your own health issues. Do not allow them to tell you there is in home help for him. There is not enough for 24/7 care. By allowing the State to take over, he will get placed quicker than you could get him placed.

You need to take care of you.
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No you do not have to visit your father.
It does not sound like your father should be living alone.
Once he is no loner participating in his care plan you (or other family member) could report him to APS or to the Elder Abuse hotline. What he is doing is Self Neglect.
If your dad does not have dementia (diagnosed or undiagnosed) it sounds like he himself is dealing with mental health issues.
Have you expressed your concerns to his doctor? Is his doctor aware of his living situation?
Take care of YOU first.
If he does not want help, refuses help you can not force him.
NOW if he is diagnosed with dementia whoever is POA for health or his Guardian can place him in a facility where he will get the care that he needs.
(If no family member wishes to take this on the court will appoint a Guardian and he will become a Ward of the State.
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JuJu212 May 2022
Thank you so much. I agree. Self neglect and yes he does suffer from anxiety and possibly depression too. Getting old is depressing. Seeing him not care about his hygiene is so sad. He was once a very handsome, strong and well groomed man. My brother got his good looks and I’m not exaggerating he is gorgeous too, but he didn’t inherit my Dads gluttony and lazy streak. My brother is 59 and in great shape and eats healthy. Also very active and meticulous with grooming and keeping his house clean. He doesn’t like my Dad at all because he let himself get obese, diabetic, and barely mobile.
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Dad has long since passed the stage where he needs to be living in 24/7 care.

Uncontrolled diabetes is a mess to live with. I know, as my 70 yo DH refuses to control his.

Time to look into places for dad. Unapologetically so. Someone who walks around naked smearing feces on the walls--does that ring even remotely OK to anyone?

We tend to look at out LO's 'oddities' of behavior and just think 'well, that's the way they are' where if we heard of someone else doing this, we'd be appalled.

I doubt your dad cares about your depression. His level of dementia is pretty bad if he feels that naked living (with kids in the house????) is OK.

Make placing dad a priority. For you, as much as him. We were in the process of placing my FIL (very similar 'bathroom' habits were the tipoff he was NOT ok) when he developed the final pnuemonia that took his life. My DH wanted him to move in with us. I stood firm and didn't even entertain the thought.

He needs to not be the first thing you think about, nor the last thing in a day. What will happen to him and your family when you shut down completely?

I hope you have some support--looks like your sibs are well content enough to let you handle it.

My heart aches for you--I also suffer from depression and it's a daily battle. Take care of you, first. And taking care of you means dad has to move.

He actually will be healthier and probably happier living with other older people and a NH will force him to be cleaner and more compliant. It's for his own good, really.

((Hugs))
MidKid
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JuJu212 May 2022
Thank you for your kindness and compassion. I think that is where we are headed. A nursing home for him. To clarify, he lives alone in an apartment. My Grandkids live with their Mom, my daughter and I live alone and am content to do so. I’m introverted and need quiet, alone time to recharge. I grew up with a suicidal, mentally ill Mother, and Dad has terrible anxiety. I have inherited both depression and anxiety but if I cope by not watching the news or reading sad articles, getting out in the sun, eating healthy, exercising and taking antidepressants. I will try not to think about my Dads situation so much and I think that eventually he will end up in care somewhere. Hugs and gratitude.
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There is enough on your plate. Your father should now be moved into care where someone can oversee the day to day care of him, and you can visit when you are well and able. He has had a life, and for you to give up your own for him isn't right. I will seriously consider placing Dad so that you can put things in a better priority. First comes you and your own health. Secondly, when you are well and able you can hope to support your daughter and her children. Then you can visit Dad. You likely already have mental health followup and if you do not, that is priority number one. Have your therapist help you in working out a plan that prioritizes things for you. Many many people suffer from mental illnesses, depression, and etc and lead very quality lives with a tuneup here and there, and with good mental health support. You can do so as well. Let them help you comb out a path forward. Best of luck to you.
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JuJu212 May 2022
Thank you, your words and support mean so much to me.
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If your father is walking around naked on a walker and crapping himself as he goes along, he is not living independently.

What do you expect your siblings to rescue you from? You do not live with your father nor are you his caregiver.
Obsessing your thoughts day and night about your father and driving yourself to mental exhaustion amounts to absolutely nothing. It does not help him or you. It is a dog chasing its own tail until it collapses from exhaustion.
If you are able to pull yourself together long enough to make a phone call, put one into APS and tell them he is an at-risk, vulnerable senior living alone who needs help. If picking up the phone and making that one call doesn't exhaust you too much, call the police department in the town he lives in and ask them to start doing wellness checks on him. The cops and APS will handle your father and get him the care he needs.
If you think and believe there is reason for you to feel guilty for not seeing your father, then there is. You alone answer to your own conscience. No amount of validation from others changes that.
Don't use having depression as an excuse to hide behind. If you do not want to see your father or help with his care, you don't have to. Own it though and accept whatever guilty feelings you may have over it.
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Unfortunately, depression runs in the family. If visiting him makes you more depressed, cutting down the visits or stopping them seem logical and reasonable. No need to feel guilty. I would do the same thing if I were in your shoes. Obviously, your father can't live "independently". Something will have to be done to place him in a facility more adequately for his care. Work towards this goal with the rest of your siblings.
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I would get dad on social services radar. He needs more help than can be reasonably expected from you or any other family member. Call the local council on aging or even Adult Protective Services and report the situation as you’ve explained here. Don’t discuss any of it with him. He needs a safe living environment and you need peace of mind. Accept that this is beyond your control and get others to help. I wish you peace
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JuJu212 May 2022
Thank you and I was already wondering if I could report him to APS so that he won’t blame one of his kids for trying to get him help. I think this is a good idea. Us siblings are going to talk Tuesday and I will bring this up. Thanks!
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JuJu212: Your father is completely unable to live independently. Your dialogue confirms that. He needs to be placed in a managed care facility.
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Please get your father admitted to a hospital. Ask case management or social services to place him into a skilled nursing facility. He is unable to care for himself and his needs are beyond your abilities (and beyond what most family members can handle). Then, focus on your health. You can only be an asset to others when you are healthy.
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Trying to help someone who refuses help is a very hard situation.
Sounds like he is likely to end up in ER sick enough to require the 3 consecutive nights that trigger eligibility for SNF rehab at a nursing home. Check his particular insurance, though..details vary widely.
Once in SNF, he may be more cooperative with rehab - so he can go home again. You need to be clear with hospital and SNF that he can not return home safely.He's likely going to be very very angry with you and everyone else.
SNFs sometimes tell you a resident who needs to have custodial care (live in the nursing home) that you have to find another facility as they don't have any available beds for that care. A bed is a bed is a bed.
He doesn't sound like he will have any interest in or cooperation with efforts to move him to assisted living or memory care, and his care needs may exceed what they can provide.
Do not stress over this - don't need to do any of this until he is in ER. And no matter how long he is there, UNSAFE DISCHARGE is the magic term. He needs 24/7 care and family can not provide and he refuses hired CGs.
For now, be gentle with yourself, let him do his thing...and just be ready to pick up the pieces when it falls apart. Some of your siblings might be willing to assist with the tasks like Medicaid application and cleaning out his apartment, once it is clear that they will not be asked to do hands on care.
APS may visit him, but he can refuse services, and they can't force him unless he is clearly demented and doesn't know what to do if he cannot manage minimum safety for himself. Someone who know to call 911 in an emergency is 'safe enough' in many cases. It's ok, they can assess him again with a future report.
Take good care of yourself and the grandchildren.
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