Need some advice dealing with elderly parent...

[mattl]

You guys have been helpful in the past when I needed to vent, I know a number of people here are or have dealt with an elderly parent/relative.

My dad is 93, has CHF, kidney failure and early to mid stage dementia. Been in and out of the hospital with CHF. Mood swings are increasing and he only hears what he wants to hear. Pretty common I guess even in people who are not that age. Anyway 2 years ago he was cleaning gutters and fell off the ladder, shattered his left leg. Was no solid bone left Dr. put in a rod and pins, one at hip other at knee. His bone growth was rapid and in 6 weeks he was healed.

Problem is that the Dr. left the pin at my dad's hip a little too long and it irritates the bursa. We've tried all the possible remedies, but to no avail. The Dr. explained to my dad the situation a few months ago and said that surgery is the only cure, cut the pin off or remove it, but with my dad's health problems surgery is not an option. My dad does not recall this and insists I take him back to the Dr. Basically he wants to yell at him and sue him. My brother and I have both told my dad repeatedly this is not going to happen. The Dr. did the best with what he had to work with, and I understand that. My dad mentioned suing this Dr. to his family Dr. and he was told if he sued then no Dr. would ever take him as a patient, and he would drop him. Part of the problem is that at the time he broke his leg his weight was 165 lbs. now it's 114 lbs, so there is little tissue to cover the area and the pin really protrudes. So my dad gets fixated on that and the pain.

Just got into it again today and he gets very angry yells stuff at me,calls me names, refuses to take his meds, pouts and on and on. Assisted living is not an option, you can't reason with him so what do you do? How do you short circuit an argument with a person suffering from dementia? If I walk away or leave he stews and the minute I return he starts all over again. Bah.

 

[jamman_98]

Here's my input

My 83 year old dad suffered a stroke in January 2008. To say the least, he was a handful. Very moody and quite unreasonable. I finally blew my lid with him in the hospital. He could not understand why I was mad. We made up. Sometimes you have to just be the parent and put your foot down on things. This is hard because you are torn between being the child and a parent. In the end, you have to make some tough decisions whether your dad agrees or not. Sometimes a 3rd party/person can help mediate tough situations. In my case I had 3 Drs. tell my dad he could no longer drive because there was no way he would listen to me. I wish I had the right answers but just remember that you can only do your best. Love him for the person you know he can be and not be bitter when he's angry. Make sure you have all the legal stuff taken care of too. My dad has been gone 6 months now. I know I did the best I could for him. I wish you much luck and prayers.

Joe
jamman_98

 

[maytagbear]

Oh, mercy, mercy.

Does this take me back.

Ma had degenerative arthritis in the spine, CHF, multi-infarct dementia....and a whole raft of other conditions. The last five years were bad. The last two were not pretty.

I got through with a support group for care-givers every Sunday. Sometimes I had to hire someone to come in for the two hours, making sure it was the same person.

Make your life as simple as it can be. I used telephone banking a lot. I had a cleaning lady. In those days, there was a pharmacy here in town which delivered--and we used them.

If there are any members left of your Dad's social network in decent condition, ask them to come...even once....Ma's friends were heroines and heroes.

My sister was not as helpful as I would have liked, but she was as helpful as she could be. She lives in Minnesota. She'd come down for a long weekend two or three times a year, and when she couldn't, she sent money, which I used for the respite care-giver. Good help is not cheap.

However, the last three months of Ma's life were in a decent nursing home. I was there every day for at least 4 hours....often having dinner there.

The horrible thing with multi-infarct, is that some moments they are their old selves. My mother was an educated, exceptionally intelligent person (I wish I were half as smart), but sometimes she was just a very large baby.....and wilt multi-infarct, they can go from one state to the other in a day or less.

All of this happened before I had any sort of internet connection, and a lot of the time, I felt exceptionally alone. I am glad that you have told us.

My email is in my profile.

Best of luck, and try to remember that you are doing the best and the most that you can, and don't beat yourself up.

Lawrence/Maytagbear

 

[paulg]

Dementia

My mother had dementia as her health failed. Tough time for anyone.
My two cents though: Simply put, my sister and I had to take over the thinking for her. Discussing medical options logically with a patient suffering from dementia no longer worked in our case. Perhaps your doctor can make a diagnosis justifying mood-altering medication to make him comfortable with life - leg pin and all. If he won't take his meds, perhaps they can be secreted to him in a clever way. Think ahead - things can get worse so be prepared. I was fortunate to know a psychologist who had a side-specialty of dealing with the psychological troubles of the aged. If I were you I'd search one out - if not for him but for you.

 

[pturo]

Matt,

It is difficult to be the the child and the care provider at the same time. You will have to incresingly give up your position of a child of the parent to the provider for the parent, making them the child, which they won't like.
Pretty much, you are the parent now of a child who needs looking after, but is rebellious.
Having old friends and connections does help, I have found, where strangely the elderly seem to behave and revert back to days when they had some control and reason.

It is not easy, but you are doing the best thing you could possibly be doing right now in your life.

 

[jeffg]

For reasons I won't bore y'all with here, I've reached the conclusion that medical care in the U.S. jumped the shark at least 30 years ago, and probably earlier than that. So I have to buck the general trend in this thread.

Your dad is the one in pain, not his doctor. If this doctor won't perform the surgery, call around and find one who will. Go out of state if you have to. As long as your dad understands the risks, the choice is his and no one else's.

 

[bajaespuma]

Been through this now twice.

Is your father taking Aricept? Is a full-time companion a possibility?

 

[perc-o-prince]

Is your father taking Aricept?

From what I remember hearing, Aricept is more of a drug to make the family of the patient feel better (they're on something), rather than doing the patient much good.

Rich certainly knows more about this than I do, but we dealt with his grandfather's dementia for about 6 years. Don't argue. Period. It upsets him but upsets you more. There's a book called "The 36-Hour Day" that Rich and I have both recommended to people dealing with this. You'll gain a lot of insight as to how to deal with him.

As far as what to do re: the pin and pain, I would see what a pain clinic has to say. It's clear that your father's GP doesn't understand the condition your father's in, and has made some interesting "threats." Get rid of the GP, find another who's in tune with geriatric issues, and find a local pain clinic.

And, know that both Rich and I send our best wishes in this difficult time.

Regards,
Chuck

 

[wiskybill]

Good advice above.....

My story,

Dad passed away last year 2 days before Christmas at 88 years from CHF. Mom is still in decent health for being 86, but has mild dementia. She couldn't live on her own or take care of the house.
So, being the only single member of the family, there are 6 of us, I moved back home to stay with mom.

Moving back to the home I left 38 years ago has not been easy.

I was already a parent and grandparent of my own kids, and now had to take charge of mom and all of her affairs. I'm basically on duty 24/7 with little help from the rest of the family, but mom gets to stay in the home she and dad bought before I came along.

My experience has been that "change" is very difficult for someone with dementia, and for someone that has always been in control of their own life. I now have to be her memory, as well as my own.

The beginning of the year was very difficult to say the least. It's a lot better now.

Mom can be a real handful at times, but I'm glad she's still with us. We have had some intense moments, but after the apologies are said she replies "Let's just forget it happened,.... I probably will."

My best advice, explore every avenue you can to deal with your dad's pain. Surely someone somewhere can find him some relief, and that will probably help some of the other issues.

Hang in there,
Bill

 

[mattl]

Thanks...

I appreciate all your support.

I know a lot of issues with my dad are related to his loss of control over his life. As I have posted in the past, he never really was an adult, at his best emotionally he was 13 or 14, now he's 3 or 4. My mother often sighed and muttered about wishing to be married to a man, not a child. When she died I inherited the task, so I've been the adult in the relationship for quite some time.

I actually agree with the family Dr., there is no reason to sue anyone. The Dr. did make an error, but he is a good Dr. and admitted it to us, and I don't hold it against him. I'm exploring what other options there are. If surgery could be done with a spinal block or some other method short of general anesthesia, it might be an option. I don't think my dad is in any way capable of making a rational decision on surgery anymore.

He is on a low dose of Exlon, we had tried increasing the dose but at the higher level he became very aggressive and even more argumentative. so this level is a fair balance between helping him cognitively and helping me by keeping the aggression in check. Unfortunately he and I share the same genetic predisposition against anti depressants and a very similar depressive state, mono polar, rapid cycle. To date I've tried about 28 various drugs to treat my life long battle with depression, one worked for 8 months, but now nothing, 60-70% caused an increase in depression the rest no effect. The couple we tried for my dad put him in bed for days with a severe depression, so at this point I don't even want to attempt any of that class of drugs.

It's been a rough 4-5 weeks. Late Oct. his CHF was getting worse, he fell a number of times because he was so weak, wouldn't go to the hospital. finally got him in, he spent some time in CCU then the remainder of 2 weeks on a med. floor. Got totally loopy and didn't talk for a week, just gestured. His Dr. fed him breakfast a few times and noticed a swallowing disorder, and twisted my arm to have a feeding tube put in. I kept telling him it was just part of the hospital psychosis, but he prevailed. When we got him home the speech therapist gave him the all clear to eat, no problem. He is still tube feeding since nothing tastes good to him, plus it keeps him away from salt and too much fluids.

At this point he's now able to function on his own for a few hours so I can get out a do things. I need to finish up the house I've been working on, but with the market they way it is, I don't see it selling until things straighten out.

 

[sudsmaster]

I think the time may have come for you to petition a court to be granted conservatorship for your dad. You should already have power of attorney (or durable power of attorney). You may need to consult a lawyer to help you get these legal papers in order. If he's already incompetent, though, the conservatorship should take care of the power of attorney as well. I'm not a lawyer but my brother is, and we both got power of attorney for our mom some years ago when it became evident she was not fully coping on her own. I think he now has conservatorship, not sure.

Power of attorney means you can make legal decisions for him as long as they are in accordance with her wishes. Conservatorship means you can make decisions for him in his best interest regardless of what wishes he may express. It sounds like this is where your dad is at now. You'll probably need a doctor's statement supporting evidence of his dementia etc.

Most women will probably tell you that all men are essentially boys. I think they are probably right. The so-called second childhood is just a temporary lifting of the act that society forces on most men to act "grown-up" when inside all they want to do is fight, play and have fun. Obviously some of us cope with the realities of modern life better than others. Dementia is another matter, and at a certain point the grown up child has to make parent type decisions for the parent. It's not easy, esp. when the parent starts blaming the child for their problems (just like a real child may blame his real parents for things out of their control). And of course the guilt trip can be extreme until you step back and realize that your parent is now the child in the relationship and as such not the one to be making decisions for the both of you any more.

Whew.

Been there.

Still doing it.

 

[alr2903]

MattL, JeffG is giving you good advice, only your dad can pilot his life. My parents are gone, Vicious prostate cancer got Dad, i had to make many decisions including restarting chemotherapy that he had decided to stop, it was given as "palliative chemo". For Moms heart disease she made all her decisions known, living will, the whole nine yards. she selected the procedures she wished to try, That does not mean i didn't run interference behind the scenes during her care. I would do it all for her again. Make SURE your dad understands the risks, he is elderly and in pain, he ought to be honery. I hope you and your dad can find someone to make him more comfortable. Best of Luck to you & your Dad. alr2903

 

[toggleswitch2]

Get yourself today's equivalent of valium, and ear-plugs. Pray for patience (for both of you). Also, get one of those electrified pet-training door-mats that zaps anyone standing on it, and put it in front of your bedroom door to at least get 8 hours off per day. *LOL*

~I know a lot of issues with my dad are related to his loss of control over his life. As I have posted in the past, he never really was an adult, at his best emotionally he was 13 or 14, now he's 3 or 4. My mother often sighed and muttered about wishing to be married to a man, not a child. When she died I inherited the task, so I've been the adult in the relationship for quite some time.

I've had one of those as a partner. It's a lot of work and frustration. On the other hand their thougthts and love are pure and it is impossible to stay angry with them, even if one can't have an adult interaction /conversation.

I pray that you get through this intact and remember only the good when your dad has transitioned. Your enormously good deeds are seen right now and will be rewarded, just as sure as the sun will rise tomorrow.

PEACE and comfort to you both. AMEN!

 

[polkanut]

A durable Power of Attorney for Health Care is essential also. This will allow you to make health care decisions for your dad without anyone second guessing you, and going behind your back to contradict you.

 

[seeitrun2006]

Dealing with aging parents also

My 75 year old Mom started having dementia symptoms late 2007. It became full blown in June 2008. Luckily my Dad is still living and is in reasonable good health. When all this started my Dad who is 79 years old was still working driving a dump truck. I have 3 younger brothers and 1 younger sister. Dad would not quit work to take care of Mommy. My siblings would not help do anything. I had to take over all of my Mothers healthcare issues. When my Mom and Dad would go to the doctor my Dad would NOT ask the Doctor questions or tell him what was going on with Mom. I started taking her to all her doctor appointments. The docs were able to get her on the right meds and things started to improve with her short-term memory loss. My Daddy got laid off in late September so he is able to stay home more. He didn't work because he needed money. He worked to stay away from home to deal with Mom. Until September I was about to litterly start pulling my hair out plus it was starting to effect my health as well. I got ZERO support from other family members. They thought I was putting more drama into it then what they really thought was going on. Until Mom starting improving with the meds did anyone start to see she did indeed have a problem. Plus during this time I also helped get my sister into rehab for alcohol abuse.

So for now my Dad is taking better care of my Mom. Mom's memory has improved a lot also. I go by every Tuesday to refill her meds and check on things. I hope she continues to improve. My sister will be sober 2 months as of December 9th!

I know what you are going thru! I wish you best of luck with dealing with this.

Peace and blessings!
David

 

[mattl]

Wow

I guess I'm not alone!

I do have power of attorney and do make the medical decisions. I consult with my brother and a number of my cousins, so I do have some family support. My brother has told me he wouldn't put up with it and if it was him he would have put my dad in assisted living long ago. I know that would amount to a death sentence.

Luckily we have a very large home so we don't have to interact if I don't want to. It was funny last night, after him yelling at me that he didn't need me and so on, he comes walking into a room where I am and says "No dinner tonight?" I told him he knows where the refrigerator is and there was still plenty of turkey and sides left. He opted to go to bed hungry, oh well.

I guess it wouldn't be so bad if he didn't play mind games, he is very passive aggressive. I've been lucky in that when my mom died there was nothing left unsaid, and it was a good of a death that is possible with cancer. I was angry with my dad for a lot of years, and at first we barley talked after my mom died. Now the anger is gone, still lots of frustration, but I know who he was/is and understand him. It doesn't make the dementia part any easier though.

 

[brisnat81]

Hi Matt,

We went through a similiar situation with my Mums mum about 10 years ago. She went into hospital to have a sun spot removed and ended up cut from the ankle to the chest. It took over 9 months for her to recover and she could never go back to independant living again afterwards. So she was in her mid 70's lost her freedom and her whole life changed overnight.

We took the path of having her try to live with two different families over 3 years, and it didnt work for anyone. 18 months in, she was diagnosed with early stages of dementia. She stopped doing things for herself, she was always angry, we were always frustrated and it just didnt work out for anyone.

We had the discussion with her and all decided that it would be best for her to move into an assisted living centre. She agreed as it had reached the point that she hated living in someone else house and could see the relationships being damaged. She had 2 rooms, her own bathroom, and they prepared all her meals, changed her linens, did washing etc for her. The change in her demeanor was almost instant. The stability and routine helped her lots, she knew when everything was going to happen, and because she was early stage, she still had her faculties and got a real sense of purpose from helping other people out. She felt usefull again. It reached the point where we could take her out for the day and she couldnt be late back, because she had games, or puzzles or someones birthday to look forward to.

It wont work for everyone, but with dementia the stability offered by a home can really help their mental state and give them that sense of security. We just couldnt provide that level of routine in a normal household.

Luckily for us, we didnt have to see the dementia progress, she made it another 3 years before lung cancer took her in her sleep.

 

[rp2813]

Matt, assisted living wasn't something any of our family wanted to do for Mom, but the huge cost of in-home (not even skilled) care was going to cause her to lose her house. We had no choice. As much as she wanted to live out her last days at home, it became too dangerous for her as she needed help getting up and down the couple of steps leading to the only shower she could use, and eventually the caregivers couldn't bathe her anymore as she had become virtual dead weight for them to lift.

While we had to sometimes keep on top of the skilled nursing staff, they were over all very good and always reported to me any changes they were making in her care. Keep in mind that these facilities want to keep their beds occupied to maintain a revenue stream, so they aren't in the business of promoting the wasting away of their clientele. We advised after one emergency outing to the hospital that we no longer wanted her to be sent out. I had to go and sign something one night because they called to say they might have to send her to emergency again, and that there was no order saying they shouldn't. Once she developed pneumonia, they triple checked with me to make sure we didn't want her in the hospital. We looked at quite a few facilities before settling on the one we did. I was impressed with the amount of caring and concern the staff had for all of the people in there. When you think about it, they wouldn't be in that line of work unless they had those traits.

So when the time comes, do as Lawrence has so wisely advised and don't beat yourself up over it if you have to put your dad into a facility. He will be better off and receive the care he requires. You'll still need to play an active role, but you'll be relieved of the day to day responsibilities. I definitely needed anti-depressants to help me through the entire process.

After it was all over, so many friends of my mom called to tell me what an excellent job I did and what a good son I had been to see her through this. While I felt I had failed her in so many ways, other people had the exact opposite opinion. I see no reason why it would be any different for you. You are doing the best you can in a situation that no one can ever be fully prepared for and while the ultimate outcome may be predictable the route there can be anything but.

Again, don't beat yourself up. You ARE doing the best you know how.

Ralph

 

[iheartmaytag]

Matt,
First you have realized by chatting with the group here is that you are not alone. As more of our "boomers" age the sandwich generation is growing as well.

I hope you have found some good advice here on the board, as well as were able to vent. May I also suggest that you seek out resources from your local Area Agency on Aging.

In your area area 4, Valley Area Agency on Aging is located in Flint, MI You can reach them by phone at 810-239-7671 or 800-978-6275. Speak to someone in I&A (Information and Assistance). They can help you with in home services, respite, specialized transportation, counseling services, and caregiver support. You may not need, or want all of their services now, but it is ok to gather information so you will have it when the need arises.

I have attached their website information. I work for a counterpart in Kansas so would be glad to help with some more specific questions, however, services depend by region and state to state; hence they would be your best contact.

http://www.valleyaaa.org/

 

[mattl]

Thanks again!

Got to say thanks again, all of you have been great. It's surprising to know that so many here are or have been through a similar situation. Thanks for the link.

My dad's insurance has been helpful too. The case worker calls every few weeks to make sure all is well and we are getting what we need. They or the hospital put me in touch with a social worked who explained all the various things the county has set up for elderly people. This program is NOT income based, they can come out and clean house, shovel show, cut grass, even play cards, I was told generally it's limited to about 15 hour a week, but it can be more if needed. We don't need that now but it's good to know it's there. I did pass the info on to my 83yo aunt who lives alone.

It's been a rough week, I am avoiding him and not talking to him, as he is doing with me. I'm available if he wants something, but I'm getting sneered at at the moment. Oh well.

Went out and got a Christmas tree yesterday, about a 30 mile drive to get the big tree, stopped and visited some relatives, had a nice time. So I am getting out. As much as I try to avoid it, it does get to me. Tues, I didn't accomplish anything, sat around, spent too much time online. I know better, but...