How to decide how much guidance to give my dad about his very strict and specific diet?

If your dad has a sound mind he’s capable of understanding and choosing to follow or not follow his prescribed diet. It’s not on you to attempt to coax or make him do it. Bow out and let him be the responsible person for his eating habits

Your dad has a lot of health issues most of them affected by his diet. You didn't mention dementia or cognitive decline so it appears that he has his marbles and can make his choices. However, heart surgery can certainly affect his mood and his brain function in general so he may have some confusion. and he is facing decline.

I would suggest sitting down with him and talking with him about the food issues just once for now. Be sure he understands the consequences of his choices as well as he can. I wouldn't say he couldn't eat anything - that's his decision, but rather, if he asks, say that, for example, the amount of salt in potato chips could elevate blood pressure, or that dessert has syrup in it which raises blood sugar i.e. keep it as information for him to make his own decisions. Even remind him that when he is on his own again he has to make the decisions.

It sounds like he is worried about going back to living on his own. Can you talk with him what kind of support he needs to be independent again? Or is it time to consider for assisted living where there is some support built in? Good luck. These times are difficult.

Having a meal plan to follow is a lot easier than trying to figure things out as you go - a lifetime ago when my mom suffered her first heart attack she worked with a dietitian who went over her normal daily diet and then helped write a weekly menu plan that was similar but better, has your father been able to do something like that?

So, the crux of this is: is it DOESN'T UNDERSTAND or is it doesn't WANT TO?

This sounds very much like my mom, who was diagnosed with Mild Cognitive Impairment, once we realized that she was not simply being stubborn or wallowing in self-pity. She REALLY no longer comprehended stuff like ingredients, instructions and planning in general.

I think getting a comprehensive neuropsych workup, including tests of cognitive ability and executive functioning would be helpful in planning how independent your dad is going to be able to be.

I agree with Barb, get a Neurological work up. After a long stay in a hospital and going under for surgery, it could have caused some mental decline. My Mom at 80 allowed my 18 yr old nephew to come live with her. He has a neurological disorder, scoliosis in his back with rods, and joint contracture problems. His neurological problem effects his ability to reason. Even so, my Mom believed him over me. And I could not reason with her. Why, because she was in the early stages of Dementia. I figured it all out after it became apparent.

With all your Dads health problems he should not go home. He needs to be in an AL where his diet can be monitored and his meds too. You don't say how old he is, but with stage 4 kidney failure his days are numbered. Yes there is dialysis but thats hard on the elderly. I had a 70 yr old friend who chose to stop his dialysis. So when it comes to his diet, I would be lenient. Let him enjoy some things he shouldn't have. My Dad liked peanut MMs. Mom gave him a serving size every night. For some reason they never raised his sugar.

My DH has had many health issues that have come with 'a special diet' attached--

I learned the hard way that no matter what I cooked--what I said--what I bought to have in the house, etc., he did just what he wanted and that's that.

He is a type II diabetic and doesn't follow by any means a diabetic diet. He is a liver transplant patient and doesn't do much more than take his one anti-rejection med.

When he had a heart attack a few years ago, he actually blamed ME for it--told the doctor I was 'too good a cook' and that had caused his HA.

Doc said he's NEVER heard that excuse before.

He doesn't check is blood sugar. He doesn't wear his CPAP, he does what he wants and eats what he wants.

It doesn't matter what I do--he is a big boy and can make choices and changes. It's not up to me.

Tell him that while he lives with you and you are responsible for the cooking you will be following the diet given for him. Period. Tell him that when he gets well enough (and following the diet will help this happen sooner) he can go home and make his own food choices.
Tell him that you are happy to help him arrange a nutrition consult for him through his MD.
Your role is to do as you feel is correct in the confines of your own home and to let your father do as he wishes when he is on his own and independent. It's really pretty simple. It involves a whole lot of standing your ground. So slab some cement into those boots. I sure do wish you the best. Soon enough he may dislike you so much he leaves. And that will be a good day.

If you're the cook, you're in charge! Tell him that for starters. If he doesn't like your cooking, inform him that he can leave anytime his doctor okays it. Then send a note to his doctor that you can't handle this anymore.

His move-out date needs to be discussed NOW. If you think it's stressful already, just wait. The last thing you need is a full-time patient on your hands. It appears that when he goes home, he'll still need help. That could be an aide who cooks for him according to his prescribed diet, which gets you off the hook.

Sad to say, crabby old men only get worse. There is no celestial magic that turns them into little rays of sunshine.

I’m in a very similar situation. Dad’s got CHF due to inadequate management of his diabetes. He’s got no other health issues other than being legally blind from a childhood accident. He has received excellent medical care from his team of doctors. All he has to do in order to live a decently comfortable life is follow the salt & sugar restrictions & to get a little physical movement. My mother was a professional chef & my career was in the destination health spas here in San Diego. I know how to create balanced yet tasty meals & snacks. You’d think I could manage his diet… But no.

I truly believe that few people comprehend the difficulties in battling sugar/ processed food addiction. No drinking or smoking, just addicted to cookies & soda. My dad has had full on screaming tantrums with nurses for not getting what he wants to eat. He has berated caregivers & I don’t want to get into what he says to me, his daughter, when he doesn’t get his way.

His diabetes has caused his bladder to stop functioning, putting him on a Foley catheter for the last 6 months while he waits for a pubic port surgery. In the meantime the urethra is splitting open. His feet are in the beginning stages of developing ulcers. It’s only a matter of time before limbs start getting amputated. I’m doing everything I can, making countless sacrifices to manage his diabetes. I test his sugars 4 times a day & have advocated for a continuous glucose monitor. But all he wants is cake & fried foods. His doctors & I have explained the consequences of his choices, but he doesn’t care.

It’s infuriating & insulting because I watched my mother battle & die from breast cancer a few years back. She did everything she was told to do & still suffered & died. My father has the opportunity to live & see his grandchildren grow up. But he’d rather have chips & candy than man-up & fight for his life.

And, to add insult to injury, these Assisted Living & Nursing Homes won’t follow the diet restrictions because it’s inconvenient & expensive. Oh, some they *say* they do, but they don’t in practice. I caught staff giving him chips & candy while at SNFs. Several facilities that I’ve interviewed have straight up stated that they do not accept patients requiring special diets. And don’t get me started on the lack of diabetes care…

I’ve been struggling with him for about a year now. It is his choice to participate in improving his health or not. I’ve told him when he chooses to not participate in his health care in a positive manner then I’m left with no choice but to place him in a facility. I’ve made too many sacrifices for him to do otherwise. I’ve been explaining to him the consequences of being placed in a facility. His health will very likely decline, we will have to sell his home to pay for the care, and what freedom he currently has will be further diminished. I’m currently in the process of trying to find a facility that will accept him. Not much luck so far. But I can no longer fight for someone that refuses to fight for themselves.

Sorry for the long response. Your question was an excuse for me to vent. Just know you’re far from alone in your struggles. No easy answers when it comes to addiction.

From your profile:

About Me
I'm a writer, artist, and teacher taking a semester (hopefully not more) to care for my dad while he recovers from a long hospital stay and heart surgery surgery. Additionally, has stage 4 kidney disease, diabetes, emphysema, and hypertension. 

What your father wants is to have his cake and eat it too, but he can't. He wants you to wave a magic wand over steamed chicken with veggies and have it turn into Mac and cheese with a milkshake on the side. Except you're not a magician and dad's a grown man now, imposing himself on you and griping about it at the same time.

Your father has spent a lifetime acquiring and practicing unhealthy lifestyle habits which brought him to where he's at today. Having more issues than Newsweek. You didn't create these issues, he did, together with a knife and fork and many cartons of cigarettes. He's now had heart surgery to repair some of the ensuing damage. But to keep himself alive a bit longer, some changes he'll have to make and accept of his own free will.

HE is the only person who can change these unhealthy habits, keep his diabetes in check, etc He's expecting a magic pill to DO it all FOR him w/o any hard work and sacrifice. And blaming you bc a salad doesn't taste all yummy-in-the-tummy like the Big Mac and super sized fries that brought him to this ugly place to begin with. There are no free rides in life, dad.

I'd give dad a move out date when you'll be escorting him back home. If he proves to be unable to manage his life independently, you'll be happy to help him find a managed care senior facility of some kind.

Some things in life are just not fixable and an old man set in his ways is probably #1 on the list.

Thanks, everyone! You've given me a lot of great ideas and I will think them over! We met with a nutritionist today so I had some reinforcement.💜

Hopefully we can teach an old dog some new tricks haha.

I have two things to say about your father:

1. You cannot change his habits.

2. He has so many health issues he needs to be placed into a facility.

You love your dad, but his care level is now too much for you to manage yourself. If you leave your job to spend more time helping your dad with fruitless dietary efforts and complete care, both of you may become homless.

It's possible that he understands the concept of the new diet, but has no real understanding of what that actually looks like. Potassium, sodium and sugar are things most of us need to consider more seriously. Learn together about it through the internet, his nutrition/dietitian, and reading labels of his current food choices. This is time consuming and can be frustrating, but something you can both benefit from.
Be willing to eat the same foods he needs to eat, normalize it. Make it a routine and make menus and grocery lists together if that is something he will be doing on his own.
It sounds to me like he is reluctant to be on his own, and he is depending on your instruction in this and possibly other matters of care. By educating yourself, you can give him the confidence to be more sufficient.

If your dad’s food preferences have changed, it might be physiological. Our taste buds can change in conjunction with our health and some problems permanently alter our sense of taste and cravings.

if your dad is having difficulty remembering, post his new dietary limitations somewhere he can easily find. Shop for and stock foods to meet his needs and keep restricted items that you crave out of the general area (even if you need to buy a mini fridge for your room). If he cheats when he is dining out, eat mostly at home. Over time he will grow accustomed to this new normal.

If, however, your dad is straying from this direction to get attention or rebel from you or his doctors, do your best to not pay any extra attention when his behavior is out of line. It’s possible that his own body might give him punishment for his bad choices (such as gastrointestinal distress) and that may be enough to help him with better future choices.

I agree with you that since your dad is an adult, he should be able to make some of his own choices (and mistakes) especially if he is acting with full capacity. If he is not straying too far off the directive, don’t nag him or make a huge issue. If he loves food and for him, quality of life is reduced by these restrictions, don’t punish him emotionally for living the life he chooses.

As a retired nutrition counselor {worked 27 yrs in geriatric long term care}…you can not control his diet…short of buying and cooking appropriate foods. It is his choice what he will eat. Even in a facility you offer appropriate foods but they CAN choose what to eat. No point in worrying.

Try going online and at chefsforseniors.com in his area. These chefs consult the client on dietary needs and prepares several days of individual heat up meals. I live in a large senior community and my friends say the costs are reasonable. Afterwards, if dad wants to supplement with unhealthy snacks, then he draws the line in the sand to mess up his health as he chooses

I can’t see the long term plan here. You ‘hope’ that you are taking just a semester off work, and you both ‘hope’ that Dad will go home. Dad ‘hopes’ that his ‘numbers will go down’, and that you will ‘keep him in line’, but without him following any rules (even basic politeness).

What looks more likely is that Dad will never go home, you will be off work as long as he stays with you, and that life will be a permanent battle between you both. Is this really your long term plan? If it isn’t, forget the ‘hopes’.

There may be two realistic choices:
1) You find a suitable placement for Dad, and let them have the battles.
Or 2) You let Dad stay and choose his food and way of life, with both of you accepting that it will lead to a quick death. The quicker the better for both of you.

Dad is probably of an age to remember the mantra of “Live fast, Die young, and have a Good Looking Corpse”.

I've been living with rage and disappointment for at least a year but have finally (with the help of a good therapist) made peace with the idea that he has the right to live and die as he chooses. I've tried everything I know to help him and he resists it all. I now provide food, help with drs appointments and medication.

It's horrid to watch him do nothing to help himself but I've given up the guilt. I've created a peaceful environment for him and fulfilling life for myself. We're at the early to mid stages so he doesn't require much physical help. When he does I will place him.

It is understandable that you want to do the best you can for your dad('s health and well being) and not sure how to go about it. You love him and want the best for him. The question is . . . How to proceed.

This IS your ticket in: "he keeps talking about how I'm helping him stay on track and he is worried about all his numbers getting worse (blood sugar, potassium and sodium levels, etc)"

* He wants to get his numbers better. Remind him. Make that connection, i.e., better numbers = different diet)
* Try more / different seasoning spices. What did / does he like?
* Find out specifically if / what he does / doesn't like with your cooking. He may be throwing out the baby with the bathwater (due to frustration). Ask him ... do you like (this spice?) ... the texture ... the item (meat? vegetable?)

The carrot on the stick is also "If you want to be able to go home and function / be on your own (be healthy), it will require a change of your diet. (show compassion: "I know this is hard ... this is a challenging adjustment although it will pay off in the long run") - phrase this as you can which will encourage him. Too much and he won't hear any of it.

(I haven't read the other responses although I am sure you'll get some good advice / suggestions).

* I would limit the 'options' and 'asking' and give him xxx.
* If you feel strongly that its his 'right,' then you do what he wants and that may not be in his best interest (it won't). Try to ... give a little. Okay, how about you eat xxx (something he likes) with xxx something new added to his diet (or taken away, i.e., salt or something)?

It does seem to me that when you give him options, you are saying "I feel vulnerable thinking I am unable to help you and so leaving it up to you" although this procedure doesn't work (in his best interest). He will continue to resist so do not open that door anymore than it is.

He may or may not like your food. He may be re-acting out of frustration.
Try not to take it personally although that is likely very hard.
Ask him "What would make (my food) taste better to YOU ? (This is giving him / showing him independence and him making decisions on his own.). Then talk about it.
- If you feel it would help you, look up recipes on line or ask a dietitian. Perhaps after eating xxx, he could have a treat (very small).

I lost 70-75 lbs - for the third time over 40 years ago. I did this by integrating more healthy choices more of the time although I never eliminated any foods totally. The key is to move in the right / healthy direction a step at a step. "Cold turkey-ing it' doesn't work well, if at all. People who do this go back to unhealthy behaviors/habits.

Try the food you prepare yourself. Do you like it? How could it taste better to you? Then ... if it is salt, find substitutes (kelp perhaps) ? Cheese (Oh, how I love grated cheese) - instead of sprinkling it on top of vegetables, measure out a 1/2 teaspoon for the 'taste' -

Don't get discouraged. You will find ways to support him and his new eating behaviors to support his optimal health / lifestyle. The GOOD NEWS is that he wants to be healthy and return home, etc. This IS your carrot on his stick. Its called delayed gratification.

I looked up delayed gratification. There is a lot of information. Read it and see what may support your dad.

How do you rewire instant gratification?

Meditation can have the opposite effect, helping you to manage your emotions and impulses, stay mindful in your daily life, and ground yourself in your truest values and long-term goals. Meditating for even a few minutes a day can help to rewire your brain and undo the damage of indulging in instant gratification.

I'm not implying that you dad could meditate, although just having soothing music on is a kind of meditation. Anything to shift him towards relaxation and interrupting his old, unhealthy behaviors (how he eats) will help.

Gena/Touch Matters

It's time to plan a tour of 3-4 Assisted Living facilities near you. Let those professionals take care of him and visit a dietician to plan meals that are good for him and that he likes.

While he's living there, you can start living your own life and be the best visitor you can be.

Get him on some anti-depressants - Depression is VERY common after heart surgery. If he is happier, he might be easier to deal with. But remember, most men have NO clue about nutrition so educate him as you serve him his meals. Then thank him for doing his best to improve his health. Tell him you love him and that making these changes in his diet will allow him to be with you longer. Tell him you need him to be around longer.
He's also dealing with anger at his own body for betraying him, angry that he's older and no longer "a hunk". (He's a man, remember). He's upset that he's not strong like he used to be and that he can't eat what he wants. Now he feels impotent & old and he's not happy about it. So keep telling him how happy you are that you still have him & want to keep him around for many years and you appreciate his efforts to change his ways. However if he has dementia, then none of this will mean much to him. But you can try at least. Anti-depressants might be the key to helping him help himself.

I agree another plan might be best, assisted living, etc. In the meantime, realize his frustration is with his situation, not you. Decide what you can tolerate, and explain it to him. You are part of the equation. After that, stick to it. And do make it clear to him, that there are limits beyond which "If I can't be comfortable that I am helpful, I won't continue the situation".

I have pre-diabetes glucose level at around 5.5 - 5.9 A1c and at a ten-year risk to go to diabetes II level at 6.5 A1c. My doctor told me to largely avoid refined products and sugar, concentrating on produce, lean meats and low-fats with low salt, yet the American diet feeds us junk. I do eat out often, making very hard to stick to my advised diet. What I try to do is takes portions of the "wrong" food home and eat it in small daily portions with my correct dietary requirements. What makes it challenging is that I am thin all over, except at the waist where the danger zone is. But following this special diet made me lose about 5 pounds. I am 5'7" and only 115 pounds. This pear-shaped figure with a tall and thin body comes from my mother's side of my family.

Start conversations with "the hospital wants you to follow these dietary guidelines" and "let's talk about foods that are OK to eat on this diet". Then, help him to develop menus and snack options that are within the dietary guidelines. Ask him if he wants to stay out of the hospital by following these guidelines or if he would rather not... and let nature take its course when his numbers get out of bounds.

Use his answers to guide your next steps. If he really doesn't want to follow this diet and is OK with the consequences, talk to his doctor. He can get a prescription for palliative care - assistance to help him enjoy the days he has on earth rather than "cure" the problems.

Have you asked him what he would like you to do? I found myself in the same struggle until someone suggested I simply ask. Granted, the answer I got was a bit of this and a bit of that, but it did point me in the direction of some options. You might consider one of the popular food prep/cooked meal delivery solutions like Hello Fresh or something similar that can accommodate a special diet.

employedsnail: His unhealthy eating habits have been acquired over a lifetime and may take a specialist such as a nutritionist to break, which I see further down your thread you did mention.

It sounds like you are getting mixed signals as to what your role should be. Make sure your dad understands what the dietary plan is that he needs to follow but you will not be the food police. He is an adult and responsible for making his proper food choices, not you. Don't baby him if you want him to remain independent.

Oh dear!

I can relate to your Dad. It takes time to get used to a new diet. I was never one of those people who could change their diet cold-turkey. Then I crave that "forbidden" food and that is worse.

Is it possible to slowly move to the desired diet. For instance, you cook without adding salt, and you make sure the salt shaker has very little salt in it and allow him to add his own salt....then slowly put less and less salt in the shaker. Check the sodium and sugar levels on food prior to preparation. For sugar, no more pasta (try zucchini curls) or white rice. If he has to have rice, then it would be brown rice, white rice mixture, with it slowly, moving to all brown rice, Less red meat dinners and more chicken/fish/seafood and vegetarian meals. Or less meat and more vegetables in the actual meal. Does he drink coke/pepsi products with his meal? You can get rid of a lot of sugar by changing over to water. Does he drink the coke/pepsi with substitute sugar? That is even tougher. Best is to reduce use until it is not used. If he does it for the carbonation, look into a soda stream to provide carbonation without calories.

In awhile, his palate will change. However, hopefully you will have shown him some new options so that his old eating will no longer taste as good to him.

I think that he is correct about what happens when he lives independently. He is very likely to go back to his old eating patterns. Therefore, you need to find out what he ate before and why he ate it, and try and see if you can find alternatives within his new diet that he can prepare to meet those reasons. You probably will have to show him how to prepare those meals (and keep him from eating out since restaurants put a lot of salt and sugar in their food.)

It is hard. I didn't realize that over the years, I've used less and less salt until I returned "home" to take care of my Mom. At first, the additional salt tasted horrible, however, now, I find that I want that additional salt. So now, I'm trying to slowly limit the salty foods to one night a week and have different new foods the rest of the time, prepared with no additional salt.

...and yes, I would ask him directly what he wants you to do, if anything, just to call his attention to the fact that he is giving you conflicting information on what your role is, regarding his nutrition's impact on his health.

Good luck! Changing one's diet permanently is one of the hardest things that anyone has to do in their lifetime.

I have had the same issue and arguments with my mother. She has been with me and my husband for over seven years, she was told awhile ago to cut back on her salt and sugar intake. My husband and I try to monitor our diet intake, and we tried to monitor her intake as well. It has never and continues to not be well received by her. I have stopped advising her, salt and pepper shakers are put in front of her at dinner, when I go to the store she asks for candy, ice cream etc. I buy it. She will do what she wants. I am tired of trying to care more about her health, than she does. Less anxiety for me.

I would just let him eat anything he wants. It’ll make him happy, it will take a load off you & at this point in the last phase of his life it’s time they can do what they want