Moral Dilemma - Fight with mom to arrange for better care for dad or give up the fight

[Anonymous]

In a nutshell, fully mentally capable dad has had precipitous physical decline and now requires private pay home health caregivers for bathing, etc.

I have been closely helping dad since he hospitalized 2.5 weeks ago (a full week staying with him in the hospital, coordinating care, pushing for rehab referral, etc.). Before I arrived, he in terrible shape completely bedridden and in pain.

Mom is declining mentally but has no diagnosis. (Brain tumor survivor so it could be that.). Still very active physically and has an active life. Has a large dog that she spends most of her time taking care of. Has shone herself unable to prioritize dad over dog (i.e. go to dog park instead of picking up pain meds for dad). Believes she can handle alone since "she cared for her dying father 60 years ago." Does not respond to rational thinking - generally oppositional and arrogant (that's without the mental fog).

Mom is resisting my guidance on plan for dad as he is discharged in the next few days. She thinks he will be fine just sitting in his room while she does her normal life. Believes caregiver will steal, pillage, etc from them and resists hiring someone. Also resisting hospital bed recommended by PTs because she doesn't want her furniture rearranged.

I am at my breaking point dealing with her. I feel like it's A LOT for me to be handling this situation for them (flying in, getting dad to hospital, etc.) and now I have to fight her on every point. Exhausting and demoralizing.

Moral dilemma - do I break some eggs, railroad mom into hiring appropriate caregiver and possibly hire case manager? Or let her try it "her way" and see what happens. Dad is a cheapskate and resistant to spending money though they have significant savings and own their home. A stoic who will not self advocate, and controlling in his own way. (That's how he got in such tough shape - denial of pain). Any thoughts would be great. I have lots of kids who need me right now and though I am happy to help my dad, I am enraged that my mom is making it so difficult.

[Anonymous]

I would break the eggs. I had a similar dyanmic with my parents and my mother would have literally let my dad die before she inconvenienced herself in any way. My only regret was not getting involved sooner and when I did get involved, I told her she was done being in charge of the situation and I told her straight to her face she was harming my father. It's elder abuse.

It's also an option to call Adult Protective Services on her. Get your local jurisdiction involved. They'll assign a case worker who will check on them.

[Anonymous]

Op, I think you act. As if your Mother didn't exist. Take this a far as you possibly can, doing, arranging, whatever YOU think is best. Quit asking, and just act. IF she truly steps-in and wreaks the plan -- well, if Dad is mentally capable, the final say-so is still (legally) his.

I'd stop talking, speculating, and just do.

[Anonymous]

OP, does your dad agree with your plan? You toss in that he's a cheapskate and stoic sort of as an aside... but what are the chances your mom's plan is actually the one your dad also wants? You will be more likely to succeed if your dad is on board and agrees to the level of care you think he needs.

[Anonymous]

This is a very tough situation. I hope you can at least get your mother to stand down and/or your father to stand up to her. I suspect she is just completely overwhelmed more than checked out or selfish, but the end result is the same.

At the same time, I suggest you monitor your own emotional involvement and investment. Your mother and father are adults with their own dynamics as a couple. You can’t make them change, and I can tell you from experience that no matter how much you move heaven and earth to make the ends move on a solution, they (or one of them) will wait until the last possible moment, when you are fully invested and nearly exhausted, and then “move the ends” to frustrate the plan and create chaos.

I think what I’m saying is you can propose solutions and you can even push some, but the less personally invested you are in the final outcome the better, for you and for them.

Hope it works out.

[Anonymous]

Anonymous wrote:OP, does your dad agree with your plan? You toss in that he's a cheapskate and stoic sort of as an aside... but what are the chances your mom's plan is actually the one your dad also wants? You will be more likely to succeed if your dad is on board and agrees to the level of care you think he needs.

This was my question too. If NEITHER of them want these interventions, let them be. I understand that you’re right, that it would be better for them objectively, but it’s not your job to inflict what’s best on them.

[Anonymous]

Agree w/ the limits of your options if your dad is intact cognitively and doesn't want help. Then you're kind of stuck.

Otherwise, use the discharge folks at the facility where he's staying. They can only discharge a patient into a safe setting - so you can talk candidly/directly w/ them about the limits of your mother's capabilities. Don't sugar coat it - be very clear about what she will be unable to reliably provide. Things around immediate physical safety and medication management are especially relevant.

You're in a tough spot, I'm sorry. I couldn't get my parents to do what I thought was best and it's hard. In the end I took some small comfort in knowing that I did my best, knowing that I can't force another adult(s) to do anything, and that at least they were able to manage their end of life on their own terms. It's small comfort, but some nonetheless.

Good luck OP.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, does your dad agree with your plan? You toss in that he's a cheapskate and stoic sort of as an aside... but what are the chances your mom's plan is actually the one your dad also wants? You will be more likely to succeed if your dad is on board and agrees to the level of care you think he needs.

This was my question too. If NEITHER of them want these interventions, let them be. I understand that you’re right, that it would be better for them objectively, but it’s not your job to inflict what’s best on them.

OP here - thanks for all the thoughtful advice. Dad does want more help and is questioning mom's ability as a caregiver, so he is generally supportive of my efforts. He is wondering if he would be better alone at a nursing home than trying to go home with her in charge of his care. He has very limited mobility and will need lots of help with transfers and bathroom stuff.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, does your dad agree with your plan? You toss in that he's a cheapskate and stoic sort of as an aside... but what are the chances your mom's plan is actually the one your dad also wants? You will be more likely to succeed if your dad is on board and agrees to the level of care you think he needs.

This was my question too. If NEITHER of them want these interventions, let them be. I understand that you’re right, that it would be better for them objectively, but it’s not your job to inflict what’s best on them.

OP here - thanks for all the thoughtful advice. Dad does want more help and is questioning mom's ability as a caregiver, so he is generally supportive of my efforts. He is wondering if he would be better alone at a nursing home than trying to go home with her in charge of his care. He has very limited mobility and will need lots of help with transfers and bathroom stuff.

I mean - have you thought about discharging him to a nursing home? That seems like the smoothest path if both of you are concerned about your mom's capacity.

[Anonymous]

I’m a former lawyer but have been a hospice caregiver for the last almost decade. I’ve seen lots of setups for in home care, and the good ones all required a very serious commitment on the part of the family members in residence, especially as decline progresses.

Without someone really paying attention your dad could suffer skin breakdown leading to bedsores as he becomes more and more incapacitated. At his present stage he already belongs in a hospital bed for his safety and comfort and for the safety and well-being of his caregivers, too. A traditional bed is a nightmare for caregivers to navigate a body that cannot fully participate in transfers etc.

Given that your mother is more concerned about the placement of her furniture than she is in creating the safest most ideal home care situation for her husband and his caregivers, and more concerned about the dog than she is in his comfort as well-being as he ages in place, I would say this is a bad situation for your dad unless you remain highly involved or hire a care manager to do it for you. He may be very together mentally, but that doesn’t mean he will suddenly have the emotional means to counteract your mom’s nature. A neutral person is best involved, or at least a concerned child, when the person needing care is in a marriage that appears at best description neglectful.

I’m sorry for your experience, it is very hard caring for aging parents in best circumstances nevermind when there are dynamics like this in play. Your mom sounds very narcissistic; if that has been the case all along I’m sorry you endured that yourself growing up. Narcissistic parents are a gift that never stops giving.

[Anonymous]

Anonymous wrote:I’m a former lawyer but have been a hospice caregiver for the last almost decade. I’ve seen lots of setups for in home care, and the good ones all required a very serious commitment on the part of the family members in residence, especially as decline progresses.

Without someone really paying attention your dad could suffer skin breakdown leading to bedsores as he becomes more and more incapacitated. At his present stage he already belongs in a hospital bed for his safety and comfort and for the safety and well-being of his caregivers, too. A traditional bed is a nightmare for caregivers to navigate a body that cannot fully participate in transfers etc.

Given that your mother is more concerned about the placement of her furniture than she is in creating the safest most ideal home care situation for her husband and his caregivers, and more concerned about the dog than she is in his comfort as well-being as he ages in place, I would say this is a bad situation for your dad unless you remain highly involved or hire a care manager to do it for you. He may be very together mentally, but that doesn’t mean he will suddenly have the emotional means to counteract your mom’s nature. A neutral person is best involved, or at least a concerned child, when the person needing care is in a marriage that appears at best description neglectful.

I’m sorry for your experience, it is very hard caring for aging parents in best circumstances nevermind when there are dynamics like this in play. Your mom sounds very narcissistic; if that has been the case all along I’m sorry you endured that yourself growing up. Narcissistic parents are a gift that never stops giving.

Thanks so much for this advice. I hate to send him to a nursing home given his cognitive state. I'm afraid he will just give up and die. If he could make it to his hip replacement in July, there's a chance his quality of life could really improve. I will think hard about hiring a care manager.

[Anonymous]

For myself, I once made the decision to not interfere. It could be better if I did, but I would spend so much energy that nothing would have been left for my kid.
For dad (the surviving parent) I decided that I gently nudge but if it doesn’t go any further - it’s whatever.
I think you mom may be secretly tired of your dad and doesn’t want to invest much into his care. Of course people never admit it but it happens more than you think.

[Anonymous]

2 choices: Caregiver or nursing home. Get the hospital social worker involved. Tell him/her about your mother’s plan. Sometimes, hearing the news from someone (especially the doctor) has more impact. After spending 2 weeks in the hospital, your dad will need help regaining his strength. Good luck.

[Anonymous]

If your dad is directly requesting a different situation than what your mom can offer, try to help him get that. Maybe start with in-home care because it's the least disruptive.

In a way I hope that your mom is passive in allowing changes to take place. My mother was passive about all but the basic care for my dad, but when I proposed or tried to initiate change she would get so aggressive and agitated. She'd yell at me saying I was accusing her of being negligent of him. My dad reacted by siding with her because he wanted to keep the peace.

I did what I was able to while I could. He was comfortable enough, but I still would have loved his last months to have been better.

Good luck, OP.

[Anonymous]

I wanted to add, please remember to take care of yourself, too.