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Father in law is very difficult to communicate with and will not consider assisted living, even though he is not able to care for his wife or himself anymore. We are unable to take them into our home. and the other son is zero help.. Any advice?

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hardm1970: Perhaps you should speak to a social worker in their locality's COA (Council on Aging).
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hardm1970, welcome to the forum. For many of us here, we had to wait for a medical emergency, 911, hospital stay, rehab before we were able to place a parent into senior living. With dementia, it would be Memory Care if the parent can afford to pay the monthly rent.

My own Mom was very stubborn, she still felt she could manage the house even though she and my Dad were in their late 90's. Their house had a lot of stairs, Mom refused to downsize. They both became major fall risks. My Mom refused caregivers. Dad on the other hand welcomed them, but Mom won the argument.

So I just had to wait for that medical emergency. It came with a major fall my Mom had. She spent her final days in a Nursing Home as it took a village to help her.

Dad hired caregiver to help him. Later he sold the house, and moved to senior living as it was less expensive then 3 shifts of caregivers, plus he was around people of his own generation, which he enjoyed. Oh how he missed the love of his life, but he knew my Mom would never live in senior living.
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Sounds like Adult Protective Services needs to evaluate him and maybe applying to the court to intervene and get both placed in safe accommodations. Has he filed his final wishes papers and health directives? If not, an Elder Law Attorney can sort through all of his issues and advise.

Perhaps meeting with a Geriatric Psychiatrist who can evaluate and medicate may help the transitions.
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Be sure who is the assigned POA.
Speak frankly with the PCP attending his wife and him.
Safety is a number one issue in all care giving situations.
It sounds as if safety for both of them is a concern and, you are right to address their decline and changing needs. Enlist their physician help, referrals to case manager, your and/ or their clergy for support in all the areas of need for them and you/ the family .
Expect the present cg/ fil to be resistant, perhaps even angry; he is grieving the changes but most likely will not see it this way without some help; he like all seniors , some more than others, grieve deeply the loss of independence and, this often is expressed as anger or " non compliance".
If all else fails , you can always tell him ( if he can comprehend) that for both his and wife's safety you will have to call APS ( Adult Protective Services) and report the situation in the home, if he refuses to cooperate with you/ the family/ POA towards changes needed. He may not understand the ramifications of this; so do try the physician, case manager, family meeting, faith support route first.

Practice your self care....take care of yourself!

Best regards
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Hire full-time or live in cate takers.
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NorcalAE Nov 2022
My step sister hired FT caregivers once it became clear my Dad's dementia and alcoholism made him unable to care for her mom. Once the FT caregivers started, Dad agreed to move to assisted living. He hated having a strangers in his house all the time.
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Evaluation by doctor for mental competency, physical ability, and probably need to show pictures of current home environment if hoarding or very unclean (house might be condemned). Usually older generations will respect authority of a doctor. With a statement of mental incompetency, then family, person with POA or a guardian ad litem can "make" decisions.
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Isthisrealyreal Nov 2022
I have to say that APS couldn't have cared less about my mom and stepdads filthy hoard.

Told me people can live anyway they choose, as long as they had food, water and electricity there was nothing they could do.
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Start with an ombudsman or social worker for advice on living arrangements ASAP.
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I agree. When my Dad was no longer able to care for Mom, who had Alzheimer's, SS came in very handy. Dad didn't have dementia, but he wasn't strong enough to lift Mom, and she frequently slid off the sofa ( she was very short). SS was very nice. But made it clear to Dad that she need more care. He elected that they both go to AL. We found a place with both memory care and AL. It was very traumatic for us all, but none the less went smoothly. It's a very difficult time to get through, but they will settle into "jail", as dad called it, and adjust eventually.
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Will he accept in-home caregivers? Consult with a local social worker or senior counselor for advice. Much will depend on his finances. If he will have them, lock up all of his valuables and personal papers, especially financial statements. Better still, ask if you can take over his finances and have all statements and bills sent to your address, or set them up online and paperless (best). Has he (and his wife) set up Powers of Attorney for medical and financial matters? If not, try to get him to do this asap, while he is still able to sign legal papers. They also need living wills with their advance medical directives, wills (if they have assets - a house, a car, etc.). All the best to you and your family.
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They both need SNF placement for their safety and wellbeing. You can facilitate this with the POA, etc. if they have one in place. Otherwise, you have a lot ahead to gain the legal footing to make these decisions for them.

I encountered it often when an RN case mgr working in Home Care that distant family was unaware of how tenuous their parents' hold truly was on safety and we had to call family meetings to get things moving and get the elders placed.

Wishing you the best in all of this.
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If no one is their PoA then you should call social services for their county to discuss options and strategies.

When we were in a somewhat similar situation I was blown away at how helpful the social workers were. They got guardianship of my stepFIL and into a facility so that we could then help my MIL. It may not happen overnight, and things work differently by state and county but I would start there.

If someone IS the PoA this person needs to step up and make decisions whether your FIL likes it or not. It make require a sneak maneuver to remove your MIL while he is out on an errand with a family member. Hopefully FIL is not her PoA.
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Caregiverstress Nov 2022
The problem is that POA does not always give someone the right to place an individual in care. It mostly gives you financial authority. Even with POA you often have to petition the court for guardianship or conservatorship to take control of the person. This is a lengthy and expensive process and fraught with emotional trauma so most people don’t go that route. A friend of mine looked into doing it for her mother and instead opted to wait for an event that would trigger placement. She kept calling APS to do wellness checks and eventually APS took control by taking her mother to the ER after a fall and from there they “held” her while her daughter found her placement where she was transferred to. Once there they would not let her leave as she lived alone and it was unsafe to let her go home. Another reason not to live with your LO or let them move in with you. A social worker told me it’s much easier to get them placed if they live alone. If you say they have nowhere else to go and you refuse to take them the hospital will work with you to get them placed.
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