95yo Dad Not Accepting His Cognitive Decline

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:He's 95, so think hard about what senior community is appropriate. He's not going to be there for decades and his needs will likely increase rapidly. Memory care doesn't sound like a good fit yet, but he also doesn't sound like he can't be fully independent. It may be tough to find something that fits his needs.

If he was a lawyer, can you use the line "This is associate work, let me do a first pass and I'll report back." Then take the time to walk him through what you did, if he wants to hear it.

I just posted, but these are good points. He needs a CCRC where he can easily move along as needs increase. He doesn't need memory care now, but in the next few years he may and you don't want to keep doing major moves. I disagree with the part that it may be hard to find something that meets his needs. There are people in assisted living with very minor needs and the next year they have more needs. The more independent folks in AL tend to hang out with eachother so it doesn't feel like you are among people with greater needs. Before you know it, you need all that AL has to offer.

He has money. They can afford care at home. That is usually better than being institutionalized especially during COVID. Op does not need to convince her dad to move into assisted living if he wants to stay home.

I don't agree with you here. First, home caregivers are going to get very pricey very quickly if he starts to need 24/7 care. Second, it absolutely depends where you were living and what the facilities were like w/r/t nursing home death rates during the outset of covid before vaccines. We're not living in the same world now. Sure, absolutely, being elderly is a huge risk for covid -- but in my mom's independent living community she just moved to, their vaccine rate is almost 100% and people are not dropping like flies anymore.

Also, being alone is a huge risk factor for life-threatening issues like falling, not to mention it exacerbates mental decline to be alone and not with other people. My mom almost totally isolated herself in her single-family house for most of the pandemic to date and we saw her experience terrible loneliness (by choice, she didn't even want to get together outside for a long time) and experience further hearing loss and decline. She was so depressed, too. We managed to get her into a great place by truly herculean efforts on my family's part and it's like she has a new lease on life. She's making friends and has like fifty times the daily social interactions she used to.

Keeping your parent at home all by him- or herself is not necessarily a kindness if they are lonely and isolated.

100% this. There are communities where he could have his own apartment but still have access to a dining room for meals and programs for socializing and access to doctors at the facility. Such a setup would be far superior to staying alone in a SFH with a rotating staff of caregivers.

[Anonymous]

This is a very common challenge for adult children. It is rather amazing that you are just facing it now. Still, of course, very difficult though. I would suggest you not try to handle it on your own. There are professionals (like social workers) who have expertise that would help you. If you identify a quality placement for him, they may be able to give advice on handling the transition. Otherwise, I would suggest a gerontologist or someone who specializes in working with this population.

(The Alzheimer's Foundation has a toll free national helpline. When I called it was staffed by social workers who were knowledgeable and supportive. This was despite the fact that my mom did not have an official diagnosis of Alzheimer's). Good luck!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:He's 95, so think hard about what senior community is appropriate. He's not going to be there for decades and his needs will likely increase rapidly. Memory care doesn't sound like a good fit yet, but he also doesn't sound like he can't be fully independent. It may be tough to find something that fits his needs.

If he was a lawyer, can you use the line "This is associate work, let me do a first pass and I'll report back." Then take the time to walk him through what you did, if he wants to hear it.

I just posted, but these are good points. He needs a CCRC where he can easily move along as needs increase. He doesn't need memory care now, but in the next few years he may and you don't want to keep doing major moves. I disagree with the part that it may be hard to find something that meets his needs. There are people in assisted living with very minor needs and the next year they have more needs. The more independent folks in AL tend to hang out with eachother so it doesn't feel like you are among people with greater needs. Before you know it, you need all that AL has to offer.

He has money. They can afford care at home. That is usually better than being institutionalized especially during COVID. Op does not need to convince her dad to move into assisted living if he wants to stay home.

I don't agree with you here. First, home caregivers are going to get very pricey very quickly if he starts to need 24/7 care. Second, it absolutely depends where you were living and what the facilities were like w/r/t nursing home death rates during the outset of covid before vaccines. We're not living in the same world now. Sure, absolutely, being elderly is a huge risk for covid -- but in my mom's independent living community she just moved to, their vaccine rate is almost 100% and people are not dropping like flies anymore.

Also, being alone is a huge risk factor for life-threatening issues like falling, not to mention it exacerbates mental decline to be alone and not with other people. My mom almost totally isolated herself in her single-family house for most of the pandemic to date and we saw her experience terrible loneliness (by choice, she didn't even want to get together outside for a long time) and experience further hearing loss and decline. She was so depressed, too. We managed to get her into a great place by truly herculean efforts on my family's part and it's like she has a new lease on life. She's making friends and has like fifty times the daily social interactions she used to.

Keeping your parent at home all by him- or herself is not necessarily a kindness if they are lonely and isolated.

100% this. There are communities where he could have his own apartment but still have access to a dining room for meals and programs for socializing and access to doctors at the facility. Such a setup would be far superior to staying alone in a SFH with a rotating staff of caregivers.

I can attest to this. My mother insists on aging in place. She is rotting into hostility, depression, isolation and resentment. This was a vibrant and social woman. She buried her head in the sand as her own elders aged and refused to think about things like social isolation. She just figured we would make our lives revolve around her as she acted like the matriarch. I am being pulled in many directions right now and am dealing with my own illness and she is livid that I don't do enough to cater to her which just pulls me away more because I want to live for my children and husband and spending time around her literally leaves me bedridden some days. It is like drinking poison. The rare time she would finally get together with a friend I saw a much better side of her.

Socializing is vital to brain health and not just socializing with people you feel you can boss around of hired help paid to be nice. You need to be forced to use social skills and get social feedback from peers and adjust accordingly. My mother had diva tendencies before, but dad and her friends called her out and she listened. She doesn't listen to adult children.

It is so, so, sad because she is alienating neighbors too. The biggest gift you could give him is to find a really nice assisted living with a memory care, nursing home and rehab. Friendship and socialzing makes life so much more amazing.

[Anonymous]

I have mixed feelings about these responses. It is clearly easier for children to have professionals care for their aging parents.

My mother's ONE expressed wish in old age was to die at home (where she had lived with my father, the love of her life, and raised her children). The nursing homes we visited were VERY depressing. Full of people who were in cognitive decline, half of whom were moaning or crying out that they wanted to go home. The staff had too many patients to attend to, and did not seem particularly fulfilled shall we say.

So, I get both interests, and have a hard time labeling one party selfish over the other.

Aging is just very difficult. I am not sure that increasing life expectancy in a society that is not set up to support old people with compassion is a good thing.

[Anonymous]

Let that man be. He is going to die soon! Let him live his life as he pleases until then, even if he is not cognitively all there. If he misses a doctors appointment, who cares. If he accuses debt, who cares. He probably has a couple more years left before he croaks.

[Anonymous]

Anonymous wrote:This is one of the many things that has done me in over the years with trying to help parents/inlaws.

First off, you are very fortunate that he accepts any help, he isn't raging or tantrumming at you and you and your siblings are on the same page and able to work together. My sibling just feeds my mothers delusions and gets financial rewards for it.

He needs a full assessment and I would just let you know you and your siblings want it for peace of mind and won't be letting up until he gets it. I would also get him to accept an aging professional visiting and assessing every few months so that you all can leave him alone and stop worrying.

Those are some first steps.

It really is so frustrating and challenging, but like I said, the fact he went along with anything means he is a lot more compliant than the elders some of us deal with so I hope he stays that way. Also, if you have siblings who aren't going to take advantage of him financially you are a step up.

Where do you find an "aging professional" that can stop by to assess every few months?

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is one of the many things that has done me in over the years with trying to help parents/inlaws.

First off, you are very fortunate that he accepts any help, he isn't raging or tantrumming at you and you and your siblings are on the same page and able to work together. My sibling just feeds my mothers delusions and gets financial rewards for it.

He needs a full assessment and I would just let you know you and your siblings want it for peace of mind and won't be letting up until he gets it. I would also get him to accept an aging professional visiting and assessing every few months so that you all can leave him alone and stop worrying.

Those are some first steps.

It really is so frustrating and challenging, but like I said, the fact he went along with anything means he is a lot more compliant than the elders some of us deal with so I hope he stays that way. Also, if you have siblings who aren't going to take advantage of him financially you are a step up.

Where do you find an "aging professional" that can stop by to assess every few months?

Google geriatric care managers in your area.

[Anonymous]

“It’s ok to lie” is the best advice given to me when my mother was in a similar situation.

She never admitted out loud she had Alzheimer’s so when it reached a point where she could no longer live safely at home (we had two home caregiver steal money, so sad) we told her she was just visiting us for a few days and moved her in to our house.

In your Dad’s situation I’m not sure where the lie would fit but if there is a point where you reassure him of one thing while doing another (for his best interest) it’s ok.

[Anonymous]

Anonymous wrote:I don't think there's an answer for you. A lack of insight into his condition is a feature of the disease.

This. It's called anosognosia and it is common in people with dementia and people with mental illnesses such as bipolar disorder and schizophrenia. It's not denial - it's a lack of insight. A person can be told by their medical provider that they have dementia, but the part of the brain that would process the information is no longer working as it should. So the person insists that there is nothing wrong with them, which makes it much more difficult to get them to accept help. My mom is a perfect example. She is in the middle stages of Alzheimer's and she continues to insist that she's perfectly fine.

https://my.clevelandclinic.org/health/diseases/22832-anosognosia

[Anonymous]

One, look into hiring a geriatric care manager--they know the steps to go through and how to talk about this stuff.

Two, do not get into power struggles over this stuff. Don't argue and expect him to accept your POV. Instead, maneuver the conversation the way you want it, stop asking permission, start lying. My advice having dealt with a dad in denial hostile to all change. It's scary for them. You are acting in his best interest. Also seconding getting him to wear his hearing aids. This makes such a difference.

[Anonymous]

Don’t get him “care” or “help.” Suggest he hire an “executive assistant” to handle his business affairs. This is language that he’ll understand and will preserve his sense of dignity.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is one of the many things that has done me in over the years with trying to help parents/inlaws.

First off, you are very fortunate that he accepts any help, he isn't raging or tantrumming at you and you and your siblings are on the same page and able to work together. My sibling just feeds my mothers delusions and gets financial rewards for it.

He needs a full assessment and I would just let you know you and your siblings want it for peace of mind and won't be letting up until he gets it. I would also get him to accept an aging professional visiting and assessing every few months so that you all can leave him alone and stop worrying.

Those are some first steps.

It really is so frustrating and challenging, but like I said, the fact he went along with anything means he is a lot more compliant than the elders some of us deal with so I hope he stays that way. Also, if you have siblings who aren't going to take advantage of him financially you are a step up.

Where do you find an "aging professional" that can stop by to assess every few months?

Google geriatric care managers in your area.

This, but be careful. If they are a service that allows you to age in place, they will push this at all cost. They sell you the moon, when in reality, they just contract with many places. They tell you they never have no shows or issues. I guess we were the only ones and so were the other people I met through a caregiver support group. Imagine that. So my point is, interview first and if they say they do what the parent wants that sounds lovely, but most parents want to stay at home even when it means constant falls, total isolation and you having emergency after emergency.

Re:nursing homes person described. That is an extreme and it's nursing, not memory care. We saw beautiful memory care facilities with cheerful staff, plenty of sitting areas and even a Gazebo where you can enjoy nature and lots of activities including adorable sing- alongs (which my uncle LOVED).

[Anonymous]

Anonymous wrote:I have mixed feelings about these responses. It is clearly easier for children to have professionals care for their aging parents.

My mother's ONE expressed wish in old age was to die at home (where she had lived with my father, the love of her life, and raised her children). The nursing homes we visited were VERY depressing. Full of people who were in cognitive decline, half of whom were moaning or crying out that they wanted to go home. The staff had too many patients to attend to, and did not seem particularly fulfilled shall we say.

So, I get both interests, and have a hard time labeling one party selfish over the other.

Aging is just very difficult. I am not sure that increasing life expectancy in a society that is not set up to support old people with compassion is a good thing.

Many of us wanted to honor our parents (even difficult ones) and do exactly what they wanted. After enough years, emergencies, elder tantrums, caregivers quitting or stealing, ingratitude and siblings ordering you around and your own stress-related health issues from trying to balance things you burn out no matter how many books you read in the tub or nature walks you take. People are living a looooooong time in a horrible state. in the end, after all you did nobody remembers or cares and worst of all the parent you did it for hates you either for not being good enough, or putting them in a facility or not being there for 1 of many emergencies because you had your own emergencies. Save yourself a horror show and find the best place possible to age where they must keep up those social skills. Friends/connections/interacting with people who won't put up with nastiness is vital to brain health. Also, you must preserve your own health. Some elderly will eat their young even once loving ones if the empathy totally erodes. We have learned a lot on the over 10 years we have been at this. Your parent may hate you for a placement, but my parent hates me after many years of sacrifice when I just couldn't take it anymore. She hated me throughout. The thank yous went away after year 1 and when I set boundaries I occasionally got a sarcastic thank you, but that turned into outright abuse and I had to step away.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have mixed feelings about these responses. It is clearly easier for children to have professionals care for their aging parents.

My mother's ONE expressed wish in old age was to die at home (where she had lived with my father, the love of her life, and raised her children). The nursing homes we visited were VERY depressing. Full of people who were in cognitive decline, half of whom were moaning or crying out that they wanted to go home. The staff had too many patients to attend to, and did not seem particularly fulfilled shall we say.

So, I get both interests, and have a hard time labeling one party selfish over the other.

Aging is just very difficult. I am not sure that increasing life expectancy in a society that is not set up to support old people with compassion is a good thing.

Many of us wanted to honor our parents (even difficult ones) and do exactly what they wanted. After enough years, emergencies, elder tantrums, caregivers quitting or stealing, ingratitude and siblings ordering you around and your own stress-related health issues from trying to balance things you burn out no matter how many books you read in the tub or nature walks you take. People are living a looooooong time in a horrible state. in the end, after all you did nobody remembers or cares and worst of all the parent you did it for hates you either for not being good enough, or putting them in a facility or not being there for 1 of many emergencies because you had your own emergencies. Save yourself a horror show and find the best place possible to age where they must keep up those social skills. Friends/connections/interacting with people who won't put up with nastiness is vital to brain health. Also, you must preserve your own health. Some elderly will eat their young even once loving ones if the empathy totally erodes. We have learned a lot on the over 10 years we have been at this. Your parent may hate you for a placement, but my parent hates me after many years of sacrifice when I just couldn't take it anymore. She hated me throughout. The thank yous went away after year 1 and when I set boundaries I occasionally got a sarcastic thank you, but that turned into outright abuse and I had to step away.

Thank you for saying this, PP. So many adult children feel obligated to honor the wishes of their elderly parents at all costs, even sacrificing their own physical and mental health and the needs of their own families. This benefits no one and only causes resentment. I learned the hard way that I cannot provide the 24-7 care and supervision that my mother needs. I was not willing to quit my job and put my school-age children's needs and my marriage on the back burner to provide for her every need. Not all elderly parents are pleasant and easygoing - some are very difficult and abusive and the cognitive and physical decline only make it worse. Every family has to make eldercare decisions that work best for their particular situation.

[Anonymous]

I wish someone would create a shadow web for seniors like those pretend villages in Holland where people like your dad and mine could go “online” and pay bills and manage their finances but pretend.