Anonymous wrote:This is OP - thanks for the kind words and advice.

He will be released soon into home hospice care. It gives me some comfort that there will be someone there to help, however I don't know how many hours a day he'll have support.

If your dad has Medicare only, hospice does not usually provide a caregiver/aide (or does he have long-term care insurance too?) but there will be regular nurse visits, and they will manage equipment (like a hospital bed, oxygen, or anything necessary for toileting). They will likely bathe him a couple times a week, as well as order appropriate pain medication to keep him comfortable. If your mother becomes a barrier to his safety or comfort, they will hopefully observe that and address it.

This is OP - thanks for the kind words and advice.

He will be released soon into home hospice care. It gives me some comfort that there will be someone there to help, however I don't know how many hours a day he'll have support.

Prepare yourself for the fact your dad will likely want to remain with mom and you may become the family villain. I have seen this play out over generations in my family and in friend's stories. The caregiver spouse becomes downright abusive and doesn't want the one receiving care to go to a facility. Change is scary and often the one being abused is so afraid of the unknown that they chose to remain with spouse. This played out in my family with verbal abuse even doctors noticed and it played out in my friend's family with outright physical abuse. The mom, who was abusive to her children as well, would fly into a rage and beat the father who was ill.

Adult Protective Services is all there is, really. You or the social worker (or both) can make a report and explain the situation. If your dad loses capacity to make his own health care decisions, and they feel that your mom is a threat to his health and safety, they can go to court to become guardian of person and property. But it sounds like he’s still able to make decisions, and defers to her, for better or for worse.

APS can check in on them from time to time and intervene with your mother when necessary, in a way that family might not be able to do as effectively.

If your dad’s condition deteriorates and he’s unable to discharge home effectively, the rehab social worker will have a very frank discussion with your mother. But again, if your dad has capacity, you may have to make peace with the precariousness of things.

Make a report to Adult Protective Services as well as hospital social worker.

https://www.cdc.gov/violenceprevention/elderabuse/resources.html

https://eldercare.acl.gov/public/resources/topic/Elder_Abuse.aspx

I'm so sorry you and your family (siblings and dad) are experiencing this.

Been there. Let the hospital social worker know the situation. The problem is a lot of people chose abusive situations. If he is deemed competent and denies there are issues, it will be difficult. So make sure you emphasize safety concerns, not just mom's attitude. The problem there is that they can promise they have people coming to upgrade next week and it's a lie. You can also get adult protective services to check on things. They vary in effectiveness and there can be a delay in them coming out.The reality is most places just want to protect themselves in documentation and they cannot do that much. If your dad protects mom and insists home is safe, SW may just sign off. It's complicated and disheartening, but you try your best to protect dad and be there for him.

Oh one more thing, they have to protect his confidentiality, but not yours. One doctor confronted mom that I had concerns about her behavior with dad. That set off a major rage session at me. The doctor was protecting himself and I get it, but I had asked him not to say anything.

Have you/will you talk to your dad one on one? If he's mentally competent then he can make decisions or put plans in place on his own/with your assistance. What does he think?

D.C. Death With Dignity Act of 2016

D.C. Law 21-182

ACT 21-577

Effective February 18, 2017

Can you hire a home health aide a few hours, a few days a week? They can help with bathing and do light housekeeping (which may be appealing to your mom)?

Anonymous wrote:

Anonymous wrote:Talk with hospital social worker. And call Adult Protective Services if you think there is Elder Abuse. Also try the local Department of Aging.

This.

And keep reiterating that his home is not a safe environment (and come up w/ any/all evidence you have of that.) Repeated falls, inability to care for himself physically, inability of partner in home to provide a safe environment - all of that is important language to keep using w/ the hospital. They are obligated to discharge to a safe environment so you can make it evident that some sort of rehab or residential facility is required - even if only for the near term. Then you do the same thing w/ the staff of the rehab/care facility.

Frame your mother as unable to care for him (not unwilling - that she can argue with more effectively). In reality, you may not be able to do much - depending on how effective your mother is and whatever she advocates for, but at least you can know that you tried.

Also, if your father is mentally competent then you really are limited. If he can advocate for himself effectively then they will listen to him.

+1. Adult Protective Services

Anonymous wrote:Talk with hospital social worker. And call Adult Protective Services if you think there is Elder Abuse. Also try the local Department of Aging.

This.

And keep reiterating that his home is not a safe environment (and come up w/ any/all evidence you have of that.) Repeated falls, inability to care for himself physically, inability of partner in home to provide a safe environment - all of that is important language to keep using w/ the hospital. They are obligated to discharge to a safe environment so you can make it evident that some sort of rehab or residential facility is required - even if only for the near term. Then you do the same thing w/ the staff of the rehab/care facility.

Frame your mother as unable to care for him (not unwilling - that she can argue with more effectively). In reality, you may not be able to do much - depending on how effective your mother is and whatever she advocates for, but at least you can know that you tried.

Also, if your father is mentally competent then you really are limited. If he can advocate for himself effectively then they will listen to him.

Talk with hospital social worker. And call Adult Protective Services if you think there is Elder Abuse. Also try the local Department of Aging.

Have you spoken with the hospital social worker?

I am the oldest of 3 children and have been estranged from my parents for nearly 7 years due to physical and mental abuse largely on the part of my mother. She likely has NPD and BPD but doesn't believe and therapy or meds and remains undiagnosed and a threat to many around her. One sibling live across the country and, while not fully estranged, has done everything in his power to separate himself from her. Other sibling is geographically close to my parents, but is young and wields very little power or influence.

My dad (early 70s) was diagnosed with prostate cancer a few years back and then Parkinson's about a year ago. His health has been declining for some time now and she has refused to acknowledge it or get him the help he desperately needs. Apparently he's been showing signs of Parkinson's for many years but her refusal to act led to a significant delay in diagnosis and the treatments that can come with early identification. He falls regularly and has been in and out of the hospital. Doctors have said that the Parkinson's will kill him before the cancer, which seems to be under control. In recent weeks he's become completely incontinent and is hospitalized again after a bad fall. She only recently consented to getting him a walker and refuses to install bars/seats in the shower, provide him with adult diapers, etc. He's also experiencing significant mental decline and has bad, and sometimes, good days.

It's clear that he cannot return home at this point but she refuses to look into a long-term care facility claiming that it will bankrupt her. My dad worked hard his entire life and has investments and retirement accounts that I believe can cover the cost for a while, as it doesn't seem he's got too much time left. My mom is too caught up with herself (poor me, poor me...) to do anything and it almost feels like her unwillingness to act is abuse.

My dad is far from perfect, but deserves dignity and much better care than she can help provide. What are the options in this situation? If he make it though the current hospitalization it will be 30 days of rehab and then back home until the next 911 call. She is not physically or mentally able to handle it and I feel so powerless.