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So thanks to all who recommended that wonderful Boundaries book! It's been a huge help. In particular, I've been able to set up a schedule with Dad in terms of when we see him, when I take phone calls etc. Part of the frustration was no matter what I said about being busy, not being available until X time, he would ignore it. So I had to take matters into my own hands (including sending his calls directly to voicemail when I'm working)


But he has had several health crises since he came down to live in AL near us at the end of July, including two hospitalizations and a bout of COVID (limited symptoms; he's vaccinated). Obviously, when I get the call that he's in the hospital I drop everything and go to deal with it and all my "rules" and "boundaries" go out the window. It's an emergency, after all.


But I'm finding that after the emergency is over, he's having a really hard time going back to the boundaries I've set before, and getting upset and lashing out. And it's causing me (and my husband) to wonder if maybe I'm not doing him any favors by suddenly dropping everything and rushing to his side because he's in the ER, because then he doesn't seem to understand why I'm also not doing that when he can't find his cell phone in his AL room and he's angry. I'm a disappointment all over again!


I'm wondering if I need to be less available when he's ill so that he is less unhappy when he's not? Which is a weird way to phrase it. But I think the lack of consistency is upsetting to him. In his mind, I saw him every day the other week, why aren't I coming every day this week? When the other week he was in the hospital. But he sees it as a change in attention and doesn't see the context. Does that make sense?

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Don't forget - boundaries are not for him to remember, they are for you to establish and enforce.
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Myownlife Jan 2022
This is a really good point.
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Good for you and your boundary-setting! Your profile says your father has dementia. If so, he really won't be able to remember a whole lot with each break in the routine. Dementia takes away his ability to do so. But, you still need to keep your boundaries so you can keep your sanity. Nothing you do will "teach" him to remember the boundaries, so it's up to you to uphold them. Tempered and realistic expectations is what you also need in addition to boundaries.

When he insists on grinding on unpleasant conversations (why haven't you visited me, why haven't you done this or that) you do not owe him an explanation because he can't internalize it. Redirect the conversation, distract him, do whatever you can. If all fails, leave.

If it's at all possible can you visit him while there's some event or activity in his facility? Take him to this, and then leave right when it ends, and allow an aid to help him back to his room. Leave on a high note or when he's distracted. To some problems there are just no really good solutions, so do what helps YOU.
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If the course he’s on is anything like my dad’s there will be increasing hospital trips. Please don’t feel you much drop everything and run each time. Call the hospital, ask for his nurse, and get your info and updates that way. It may even be required as Covid is crazy again. Anything urgent they’ll let you know. He needs to depend on others and not just you. Caregiving can be done from a distance
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If the ALF sends a member of staff to escort him when he's taken to hospital, you don't need to be there - arguably, you *shouldn't* be there, it's a needless exposure and you're an unnecessary vector.

At the risk of having things thrown at me, I'll share that the way I put it to myself is "be more man." No man would drop everything and rush to the bedside unless there was actually something to be done (or other clear necessity). So why do we ladies feel the urge to?

You're right about the consistency too. Confusing for him, and incompatible with establishing boundaries, but you can create a flexible bit of boundary for use with hospital admissions, you know, and bend it round events. E.g. ER, no. Ward, yes, day of admission and follow up calls. Surgery, call before pre-op, attend on return to recovery. ICU - whatever you think best. That kind of thing.
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It took me a long time to learn that I did not need to go to the hospital every time my dad went. I was told that they can manage it but do make yourself available by phone. That's been a few years back. It finally sunk in. Dad is in memory care now and his dementia has advanced in the last year so things are calm now. They do a very good job of keeping him safe and his medical conditions are managed so hospital visits are pretty much a thing of the past. Through my 7 year journey with him, boundaries have been the hardest thing to learn.
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Seems like you may need to create a "medical book" for your dad to help EMS providers, Get a bright colored notebook - put it on top of a shelf that he can not reach easily. Inside list his medical and surgical history with dates. Also list his current medications and time schedule for these medications. Put a copy of his health insurance info and his doctor(s) contact info. Put a big sign in his place that says "EMS information in _________ (color) notebook found ________. This info helps EMS and hospital personnel fill in the details when there isn't family available, (I am an RN working in a hospital.)
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When your Dad is in the hospital, why is it an "emergency" requiring that you drop everything to "take care of it.?". You are not the doctor or the medical staff. They are the ones dealing with the medical emergency. You may need to be involved in choices made for his care and his subsequent discharge. You may need to arrange some temporary extra hired help for him. It might cost some extra money, but your sanity is worth it.
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I might suggest explaining your question to the nurse or doctor when he is at the hospital. Ask them when it is helpful for you to visit, when it is an interference, what else you might do. They have clear ideas about what is helpful or not. In fact, call the hospital director's office or their social work office. This in formation all families should have, and they might consider making it available to them on the wards, ER waiting room etc.
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DoingMyBest73: Your father's brain does not have the capacity to discern emergencies from something that is troubling to him at the time (think finding his cellular phone). Dementia has zero ability to make sense.
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Boundaries are necessary when you're being abused. When you're dealing with a person in the hospital with limited mobility and cognitive deficits, it is a vulnerable and scary situation for them. They need an advocate there. Please deal with each event as a separate event - and continue to support your Dad as needed. Returning home from a hospital visit is extremely disorienting to the elderly. Perhaps you can hire some local care to help your Dad transition back to his normal routine. Each hospital stay is most likely causing him to feel more and more vulnerable and someone there - coupled with your check-ins- will help alleviate his stress and anxiety (and yours too!).
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