Father with dementia in nursing home, sister wants to bring him home

[Anonymous]

Anonymous wrote:And practice self-care. There are so many things you have no control over - all you can do is the best you can. I imagine your dad appointed your sister POA when he was well enough to do so; these were choices that he made. They may have been terrible or misguided choices, but they were his and it’s what precipitated the situation he’s in.

Thank you. My siblings had a call with the social worker and nursing staff yesterday. They were quite clear on the level of care required. And its a lot. I know they have experienced my sister's instability, but I'm not sure there is any more they can do, other than be candid about the enormity of the level of care he will need. The decision to appoint my sister as POA is another ugly event, but at the end of the day, even after experiencing her actions first hand, he did not make the change to one of his other children. And you are right, that decision affected both my mother at the end of her life, and now his. It's hard not to have that in the back of your mind and just say "oh well, live with your decision ", but he is still my father and is a feeble vulnerable old man. I still want the best for him, and I don't think this is it. I have to accept it and pray it doesn't go down the same ugly manner as my mother's death. As much as I want to prevent my father from the same fate, I fear I don't have a choice.

[Anonymous]

You probably don't have much of a choice, OP. And that is not because you don't care or can't be bothered -- it's because he agreed to a setup that led to this.

And that does not mean he is a bad person or that anyone is celebrating the result of a bad decision. It's just the fallout from a process that began farther back, and it is what it is.

[Anonymous]

I have a friend who basically started counseling families to avoid problems like yours. I’m so sorry you are suffering through this - and I hope your father doesn’t suffer as a result of your sister’s issues. She may enjoy the drama that will ensue but focus on your dad and not your sister and hopefully that will get you through this. So many of us will endure the same challenges. Sending good thoughts.

[Anonymous]

Anonymous wrote:

Anonymous wrote:And practice self-care. There are so many things you have no control over - all you can do is the best you can. I imagine your dad appointed your sister POA when he was well enough to do so; these were choices that he made. They may have been terrible or misguided choices, but they were his and it’s what precipitated the situation he’s in.

Thank you. My siblings had a call with the social worker and nursing staff yesterday. They were quite clear on the level of care required. And its a lot. I know they have experienced my sister's instability, but I'm not sure there is any more they can do, other than be candid about the enormity of the level of care he will need. The decision to appoint my sister as POA is another ugly event, but at the end of the day, even after experiencing her actions first hand, he did not make the change to one of his other children. And you are right, that decision affected both my mother at the end of her life, and now his. It's hard not to have that in the back of your mind and just say "oh well, live with your decision ", but he is still my father and is a feeble vulnerable old man. I still want the best for him, and I don't think this is it. I have to accept it and pray it doesn't go down the same ugly manner as my mother's death. As much as I want to prevent my father from the same fate, I fear I don't have a choice.

Nursing home SW here. If the requirements for discharge are met, then they might discharge him. But if the family member who is primarily responsible for the resident at home demonstrates instability, as you say it, or otherwise questionable behavior that might affect the resident, that is definitely considered. If you are on the contact list, they should be able to speak with you. And even if they can't, you can still speak with them without them having to divulge any medical information. If the facility decides discharge will not be safe, and your sister decides to take him anyway, they will probably have to report it to APS. And if she does take him with a "safe" discharge and you don't feel it's safe, you can call APS too.

[Anonymous]

If she can care for him at home he will likely get better care. Duh.

[Anonymous]

We brought my mom home....as was her wish. It was work, but we made it work. She died in her home with family. No regrets.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You and your other sibs need power of attorney over him. Who is in control?

The sister that lives with him is POA over financial and health decisions. I would go into that topic, but the almighty judging queens on this board would pick it apart and go off on my about whatever it is I say. Gosh, it's nice to know so many people have wonderful families that all act completely normal in a time of crisis. Mine isn't one of them. I could write a book about what it was like with this same sister when my mother died. It was hideous, and stressful - and unnecessary. But this is how she rolls.

I’m sorry, but you just sound nasty.

[Anonymous]

It doesn't sound like you want to do anything but whine about it.

Try to get POA ...Excuse why you won't
Have him be near you...excuse why you won't.
Try to take charge of the situation...excuse why you won't.

Just seems like you want to sit up on your high horse and vent about your sister's decision without actually doing anything. Which is fine, but don't think it makes you a good person.

[Anonymous]

Anonymous wrote:And yes, my sister's decisions have notoriously been bad ones. When my mother was dying she insisted that she had 247 hospice care lined up at no cost and insisted that was correct even when we questioned her. My mother was brought home on a stretcher into her home and was there 2 hours before she finally realised that this was not the case. Since it's hard to find available beds my mother was placed in the nastiest nursing home In that area and died 2 days laterl. Alone.

Does Hospice in your parents area include an at-home service?

[Anonymous]

OP, I am sorry for both you and your sister in this situation.

It sounds like you are very upset and are missing important information and making a lot of assumptions.

You really can’t be in all of the provider conversations if you are not there. You don’t need POA to be physically present and to contribute practically to your father’s care. As troubled as you sound, you should consider going to your father’s town and attending these meetings while holding your fire. Get a handle on how the system of elder care operates. Do not challenge your sister’s POA or pressure anyone to do or not do anything. Take the time to learn. You’ll feel better and have more peace.

[Anonymous]

Anonymous wrote:...

My sister is hell bent on bringing him home because she promised him she would. He asks to come home but honestly I don't think he knows what that is anymore. My siblings feel it is a mistake bringing him home. I live 200 miles away, and while two other siblings are nearby and can help, it seems that skilled nursing is the better option. We would have to have someone be there overnight (he tries to get out of bed and has fallen multiple times) and the rest of the time it would be up to my sister's who are in their 60's. Yes, we could bring in extra help, but after adding up the expense of in-home care, plus the stress on the family (my sister that lives with him is very unstable and volatile), it makes more sense to put him in long term care, where he has 24/7 skilled care. Has anyone else had to deal with a situation like this? He is 86 and as you can see, has multiple health issues. How do you go about convincing someone to leave him where he is - which he seems to be happy with most of the time? I don't know if she is doing it to alleviate her own guilt (and trust me, the way she conducted herself with him before all of this happened, i know I would feel guilty), but the situation just doesn't seem safe for my father.

Is your father with it enough that you can get him to say he’d rather remain where he is and not go home? Otherwise it seems that your sister is not going to change her mind particularly if she sees herself as fullflling his wishes and her promise (which she could feel is her duty as his POA.). Barring that, since your sister seems to have executive function difficulties, helping make sure the appropriate amount of home care is set up seems like your best option.

[Anonymous]

Lots of projections on OP, good grief.

OP, if this discharge is happening no matter what your concerns are then all you can do is address any practical issues that you can - setting up the home and services yoircdad will need for as safe a discharge as possible.

It would be beneficial to get a local geriatric care manager involved to assist both your dad and your sister; they act as a case manager on the realm of elder care services and support, and they are also skilled in handling the often-thorny family dynamics, resistance, etc.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have elderly parents and they live near my brother. Siblings and I have always held the opinion that the boots on the ground gets to make decisions. Your sister is the one who is looking after your dad and she gets to make the decision. Sorry.

Do what you can to make her life easier. Emotionally, the quality of life for your dad will be better if he is at home. He is probably near death. Let him be surrounded by loved ones. Let him not be with strangers. The aim is not for him to live longer. The aim for him is to live happier even if it is a shorter life.

Thank you. This is very helpful. I will continue to do whatever I can to support her. I guess that includes taking all of her verbal abuse even when we all do anything we can to support her. She's doing the work, so I guess that's what I deserve. Unfortunately it's ripping apart the family, and after years and years of taking it from her and still continue to love her, one day that love might be gone. You can only abuse the ones that have been there for you so many times.

OP again - and just to add, his quality of life won't be better. She screams at him when he spills something, threatens to have him removed and put in a home if he won't get up and go to the bathroom himself, and then usually tells him to "F off". Everyone wants to make this about my poor sister, but as I have said, I could write a book about what life has been like for the rest of the family since she moved in. At the nursing home it's peaceful, he socializes in the dining room and has a routine. The same cannot be said when he gets home. But I guess I am just a deadbeat that had the nerve to not live by my parents, so good luck dad!

This sounds like a terrible situation. I’m really sorry.

If you want to override your sisters decision (she has POA, so she gets to make the decision), you’ll have to get an elder abuse organization involved and take her to court to strip the POA.

I’m really sorry you’re going through this. It sounds awful.

[Anonymous]

Anonymous wrote:If she can care for him at home he will likely get better care. Duh.

A 60 year old woman, living alone, caring for a 90 year old man with severe Parkinson's and dementia, who cannot really walk, sounds like he will get better care? It sounds like a path to one of them getting injured.

We were in this situation with my grandmother. We kept her at home. We had daytime help with her as my parents both still worked outside of the home, but were not in a position to afford 24 hour care. She would insist on walking around with her walker even though she was not steady on her feet. She was not a small woman and would end up falling even with one of us literally next to her, and depending on who was home, we would sometimes have to call an ambulance to help lift her. One of the falls resulted in her passing.

Was she happier? I really can't say. The dementia affected her personality, she was constantly agitated, didn't really recognize our house and kept asking to "go home" and trying to leave (she'd lived with us for decades at that point). She also stopped recognizing my dad (her son in law of over three decades at that point), thought he was a different person every time she saw him, and constantly accused my mom of bringing home a series of strange men to rob her. I don't know if being in nursing care would have been better or worse but perhaps she wouldn't have fallen.

[Anonymous]

OP here. To 10:34, thank you for suggesting a geriatric care manager. I think this person could hopefully speak to my sister and actually be heard, as opposed to the siblings trying to address it. Sometimes it's easier to take when its an outsider telling them what the reality is than it is hearing from a family member. I will definitely look into that option.

To 10:57, you probably are one of the few people that truly understands what our reality is. I am trying to keep everyone's best interest at heart - my sister that lives with him and my sister that is nearby. They are at odds as to what the best decision is for my father, and I am in the middle. I have repeatedly told them that I will support whatever they decide, but they are the ones that will live with the day to day reality of the condition my father is in, and what the level of care will be. My father has fallen just as your grandmother - and no one has been able to get him off of the floor, so paramedics have been called just to get him back into a chair. In the past he has broken his pelvis, hip, wrist, collarbone and hand - and that's when he was pretty steady on his feet. As for wanting to come home, I think my father is in the same boat as well. A social worker once told us that with dementia patients tend to say they want to go home not because they miss the place, but that they miss that particular time. It's a way for the brain to protect them and let them think that if they just got home, all of their problems will be solved. Every time one of us talks to him he is in a different place than where he actually is.

So this is the dilemma. Concern for my sisters mental health when he comes home. The cost of providing 24/7 care that could potentially drain anything my father left for us, but in particular how by not having that money will affect my sister's future. Concern for my father's well being if he does come home. The last thing I want is for him to come home and after 2 days its decided that its too much and he is bounced back into another nursing home (and there is a real potential that it won't be the one he is in now, which has been outstanding). Its not easy to ring up a nursing home and find an available bed. I appreciate all of the comments (not the nasty ones, which I suspect are from people who have NEVER dealt with aging parents with dementia) and have concluded that I will continue to help with anything I can from here, whatever is decided.