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

[Anonymous]

Anonymous wrote: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.

OP here - I am involved in all of the calls, as I stated in my earlier post. Due to COVID, these calls are done on the phone. I have only missed one, the one this past Monday. Otherwise I have been on every single call involving nursing homes, specialists, doctors and nurses. I feel I have a firm hold on what is going on, and have all of the information needed and am far from making any assumptions, but thank you for your advice.

[Anonymous]

Anonymous wrote:

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.

If she has POA and has made up her mind there is really nothing else for you to do or say. I agree with you that she’s making a mistake but you can’t control her.

Unfortunately, I think this is the answer.

Will she listen to anyone else - like an eldercare advocate? I don't know if this is an alternative, but family mediation?

I am not judging you, but from some of your responses it's clear that there is a lot of tension/history in the family. I'd be very honest with yourself - will you talking to your sister get you anywhere or do you need to step back and let someone else do it?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Here is the truth: in-home care is only better if you can afford a truly 24/7, attentive, type of care. It requires SERIOUS MONEY but also watching the paid caregivers like a hawk, so commitment on the part of the relative, even though they may not be doing the actual caring.

Can your sister provide that?

If she cannot, then for the patient's own sake, they're better off in a nursing home.

No, she cannot. She becomes overwhelmed what a bill comes in and needs to conference the rest of in rather than make a call to whoever sent the bill. She's overwhelmed when my father hasn't made it to the bathroom and she has to clean it up. She's overwhelmed that she had to set out breakfast for him, which consists of a package of instant oatmeal. She was overwhelmed with keeping him on a low sodium diet, which BTW, was the original reason he was sent to the hospital - his legs were swollen up to his knees. They literally drained gallons of fluid out of the man.

Is he competent enough to revoke the POA and healthcare POA that are currently held by her? I mean, this is far beyond a disagreement about what's best for dad. It sounds like it's objectively bad for dad to stay with her due to neglect. I'd get her off that POA even if I had to take her to court to do it.

[Anonymous]

Anonymous wrote:You wrote that post thinking it makes you sound better. It actually makes you sound worse. I'd LOVE to hear your sister's side of things.

+1
That was basically incoherent

[Anonymous]

Within 48 hours of returning to live with her, he will be back in the hospital. He likely needs a two person assist anytime he seeks to stand up and move. Her back and her mental health will be destroyed trying to do this.

[Anonymous]

Anonymous wrote:Within 48 hours of returning to live with her, he will be back in the hospital. He likely needs a two person assist anytime he seeks to stand up and move. Her back and her mental health will be destroyed trying to do this.

+1. And HIS mental health.

[Anonymous]

Anonymous wrote:Father went to the hospital in January and my sister who lives with him thought it was appropriate to have him go to rehab for a couple of weeks before returning home. Since then, there has been multiple hospital stays for various things (UTI, low oxygen, etc). Sister decided she was unhappy with the first rehab center, so after the second hospital stay moved him to a new facility. After another hospital stay she moved him once again, where he currently is today. Unfortunately, as is common with elderly, all of these moves confused him greatly. He was already showing signs of dementia, but it has now reached the next level. Many times he doesn't know where he is, or he is at so-so's home visiting, etc. Recently he asked where my mother was and why wasn't she visiting (she died three years ago). Some days are good days, and you can carry on a basic conversation - i.e., what did you eat for lunch? Did you do PT today? In addition to the dementia, he has worsening Parkinson's disease which leaves him shaky and unbalanced. He is very weak and can only walk (aided by a person and a walker) about 30 feet. He is frequently incontinent. He has trouble swallowing (Parkinsons) so his food needs to be basically mush and they need to thicken his water so he doesn't choke. His recent hospital visit they discovered MRSA, so he has a PICC line for 4-6 weeks of antibiotics, which would need to be flushed by my sister at least once per day. The Physical Therapy department at the nursing home says he has reached a plateau, and they don't push him because of his COPD and two aneurisms in his heart that could explode at any time. He cannot bathe or dress himself.

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.

So your father hasn't been living at home since January? And he has a PICC line, can't swallow well (so high risk for pneumonia), and can't perform daily acts of living without assistance?

[Anonymous]

13:28 - that is correct.

[Anonymous]

He hasn't been home since January, so your sister isn't living with him at the moment. He actually sounds pretty miserable from your description. In addition to catching MRSA which is not uncommon in hospital or rehab settings, he's confused, weak, stressed. So I guess I don't understand why not bring him home where he might fare better cognitively and therefor physically? And maybe you can drive the 200 miles twice a month and help out? And your other sisters can help out as well?

And before you lambast me, I take care of my 86 year old parent, work full time, and have three kids. So I know this is not easy. It's incredibly challenging. But I'm not hearing a lot of solutions coming from you, just how problematic your sister is because she won't do what you think she should.

[Anonymous]

Anonymous wrote:

Anonymous wrote: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.

OP here - I am involved in all of the calls, as I stated in my earlier post. Due to COVID, these calls are done on the phone. I have only missed one, the one this past Monday. Otherwise I have been on every single call involving nursing homes, specialists, doctors and nurses. I feel I have a firm hold on what is going on, and have all of the information needed and am far from making any assumptions, but thank you for your advice.

I understand that you are on zoom calls, but that is a very different thing than being physically present and responsible for the elderly person, your father in this case. Have you shared your concerns with the social worker? They would be responsible for raising concerns with APS/ law enforcement if the stress shown by the caregiver was putting your father in danger. Please accept this with the sincerest of concern. It is typical for non POA family members to make allegations against POA and financial circumstances often are a source of contention, but nothing you have written in this thread rises to the level of adult endangerment or exploitation. There are conversations between your father, healthcare providers, etc. that you are not privy to. The pandemic makes this much worse, and if your father’s facility is as restricted as you say now, that may be why a move out is being considered.

[Anonymous]

OP - sorry some posters are jumping down your throat. I have toxic family members and know how manipulative they can be, and how they can take and take and take and still complain that they haven't been given enough.

I agree with the PPs that say there isn't anything you can do at this point, and it's because of everything leading up to this point and not because of anything you did or didn't do right now. If you suspect your father's medical condition will be neglected, the best you can do is visit often and document it so that his doctors require that he be readmitted to a professional facility.

[Anonymous]

Before my father died, he was in a memory care unit for about two years. One sibling kept advocating for him to live at home but was not volunteering to be the person to provide the 24/7 care he needed or even coordinate it. I refused to consider it because I knew it would fall on me and I was unable to provide that for my father. The other sibling would periodically say she wanted our father to live with him but when I told her to carefully consider if she was capable of providing him with 24/7 care (she is a working single mom to a young child), it would be dropped for a period of time. I also believed that as someone with dementia, he received the care he needed in the facility. Of course, I wish he could have spent his last couple of years at his home but it simply was not a safe option because of the level of care he required. I guess it was fortunate that my siblings talked a good game but weren't willing to do that work themselves. In summary, I understand your position on where your father will receive the best care.

I should add that I also have a difficult sibling and I assume there are reasons other than caring for him that your 60+ year old sister lives with your father. From your description, I would be concerned of elder abuse and would not hesitate to call the authorities if you see any evidence of it. Taking care of a parent with dementia 24/7 without help is extremely hard and would test the emotional well-being of a well adjusted person. Unfortunately, your sister sounds like she already had issues that make her a very poor candidate for this task. I am sympathetic to your situation and I wish your family the best of luck. You should start preparing to have the court appoint a guardian for your father and be willing to step into that role yourself and assume more responsibility for the care of your father.