So I have an amazing, 95-year old-grandfather who lives on his own, still drives, still grocery shops and tries to do everything on his own. Also, his brain is still fairly sharp. The issue is none of the family is able to convince him that he would be better off at an assisted living community or at least he needs someone to come a minimum of 3 times a week to help him with groceries, laundry and light housekeeping. He gets around on a scooter and is on oxygen most of the time. His living conditions are not the best, lots of trash, spoiled food, goes out in dirty clothing and we do not believe he bathes regularly. He recently fell multiple times in a week at his home and finally had to call family for help. Turns out this was not his first time to call 911, but he didn't let any of us know. What would be ideal is for him to loose his driver's license, but there are no accidents reported (though he obviously hits things by looking at his vehicle) and he continues to pass the vision test. We all have tried in so many ways to convince him to let us bring someone in to help. My next step is surprising him with a meeting with a visiting angle consultant because when i told him I was going to do it he got very mad. Issue is no one lives close enough to visit every day usually just once week. He is the most stubborn man I have ever met and so proud to do everything on his own. My question is at what point do we need to call someone to force him? Is there an organization to force him? Does he have to have a bad fall and go to the hospital? Has anyone just ever hired someone without them knowing and have them show up? I respect that he wants to die at home and we have the resources to allow that to happen but unfortunately i don't see that happening for a few more years and he gets worse every day. Any ideas of what others have done would be great. Thank you in advance for reading.
I also found that talking to neighbors can be helpful. Sometimes they see things that are troubling, but, they don't know who to share it with. On the other hand, they could offer positive information that this man is doing quite well. To me, doing due diligence to find out what he can do safely, would be the goal.
Our family interfered after my 89 y. o. father(with similar living conditions) fell and was hospitalized, was placed in a facility for his safety and could not go home. He colluded with my youngest brother to help him escape to another state, where he ended up committing suicide. We will forever have regrets for doing , what we thought was best for him.
You do have an amazing grandfather! I wish I knew him because I know I would like him. He is very independent and strong willed. That seems to have served him well in his lifetime. He is not going to give up his independence until he absolutely has to - that is on his terms - not yours.
so, in that case I would suggest you being very subtle instead of directive in aiding him. That includes never telling him what to do. However, there are other methods of achieving your peace of mind and his safety. i would suggest when you visit you choose someone you think would get along with him - and take that person with you (as your friend) when you visit. If they click, in time, and there is a trust between them - then that person would perhaps be welcome and familiar with him. Now when you do this do not tell him that person can help him - tell him she or he is a friend of yours and is coming to help you. It would be helpful if the person has some similiar interests to your grandfather.
I accomplished this with my friend that I take care of with this method. I found a gal that is knowleable with the elderly - and medical terms- and big and strong so she can handle a large older man that needs help. I told him she was to help me because the medical part confuses me. So he thought she was helping me not him. Then they became friends (because she knows what she is doing and how to do it). In my case he cannot drive and I also have problems because of eyesight issues. So she drives us to doctor appts. and that involves her in his medications etc. They have become friends, due to her skills - she is a young very knowleable gal - and she has gained his trust. This did not happen overnight. In my case it was a female - that is not a necessary requirement.
What interests does your grandfather have - sports - fishing - reading - etc. Find someone knoledable (sp?) areas. That would help establish a friendship and then it would be natural for your grandfather to accept their assistance if he views them as a friend
I wish you the best of luck. To be succesfull in this project you need to find someone who your grandfather can relate to and trust - certainly not anyone that will tell him how to live what life he has left and how to do it. I am pretty sure he already has a plan in mind - your responsibility (or help) would to find a caretaker that fits in (without him knowing it is his caretaker - but your friend - and also he could be a friend of.
I am sorry if this sounds crazy but I truly think it will work for you as it has worked for me.
Good Luck,
Rose Petal
My husband and I were wondering if he was safe to continue driving? We followed him one day and witnessed him making a right hand turn on a "no turn when red" red light; saw him weave in and out of traffic without using turn signals. Our daughter gave me the wake-up call I needed: "Mom? What if he causes an accident where a little family in a minivan is seriously hurt???" Am ashamed to admit that I hadn't thought of that, as I was only thinking about my father's safety.
So, I called his doctor and asked if he could assess his cognitive capacity at his next appointment. The doctor gave him a mini-mental-status-evaluation. After the appointment he called me to tell me that my father had FAILED it. He then told me that he would need to report this change in his medical chart to he Department of Transportation. Physicians are liable for any driving accident that may occur if they have not reported a change to his medical status and it is determined that the change had been documented prior to the accident.
The DOA then recalled his license, pending a doctor's confirmation of an improvement to his medical status.
My father was referred to an occupational therapist specializing in driver rehabilitation. She gave him the full mental status evaluation. He failed it. She then told him that she could not approve a reinstatement of his driver's license.
In your grandfather's case, with family not living nearby, a similar scenario would put him in a position to HAVE A NEED. He would now need a driver. Hopefully this would be the beginning of introducing a caregiver into his life.
I have a 91-yr old friend who is still in her home doing well, with a live-in retired widowed sister-in-law; a part-time cleaning person; and neighbors that keep an eye on them. One thing that has really made the whole thing possible is a middle-aged man, the son of a deceased friend, who is not able to hold a job but is capable of driving, some maintenance, and general assistance. He lives in a motor home that is parked at my friends' house most of the time but he takes it out occasionally for a day or two of camping out. The sister-in-law helps with the bills and sees to the helper's paperwork and medical care. The result is three people who are coping well with taking care of each other, none of whom could realistically live alone.
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1. His car has many signs of accidents. Red flag that things aren't going so well in the car. I'd have to explore that, check on accidents. Most cities have collision reports on line, so you can see what's happened. If there are none......you know that he's hitting things and just leaving. Not good either. I'd have to explore this, because it's the safety of others, him being stubborn doesn't get a pass on that.
2. Multiple falls in a short time. This can indicate strokes and/or poor balance. Poor balance can be an indication of more serious problems. Stokes can lead to cognitive problems. Has anyone actually observed him in the home, doing all the things that he says he does? I'd confirm that it's true.
3. Multiple calls to 911. I'd check to see how many and what for. People who are in distress may call 911 a lot for all kinds of reasons. It could indicate that he does need assistance, no matter what he may say otherwise.
If it turns out that he's still competent, then, I'd step aside, as it's his decision as to how he lives, even if we think it could be better, but, I would pursue that driving issue pronto.
Why should the POA be commenced, it sounds like he has his marbles and physical health
Why is he sucking on the oxygen, what do his levels fall to? that alone is a reason NOT to be allowed one's drivers lic.
What would your attitude and approach be to him if he was 75 !!!
HOw dirty were his clothes when going to town. Heck as 15 yr old Id race in in my dirty farm clothes and gumboots cos I was in a hurry, and 55yrs later still do it.
BUT if more than grubby, and with say some incontinence. THEN he needs guidance/assistance.
IF you feel the house is a mess and needs cleaning what about suggesting a once only clear out. either the family do a four hour wonder extreme clean up. Telling him you are all coming to do something for him to get ready for winter, and for him to sit in the middle of the room and bark orders.
Dont write him off, unless he really does need to be. There isnt much left at 95 so a bit of dignity, and his memories are all he has.
A nice gesture may be *asking* your grandfather if you can give him the gift of a weekly housekeeper. Keep the conversation light and, if he declines, ask again next month.
MOVING: the family may think he will do better in assisted living, but he does not. Take it from his perspective--my philosophy is that it's about their quality of life, not necessarily their quantity or complete safety. Having said that, safety IS important, but do you want your grandfather to be completely safe but unhappy or even miserable? I believe it's very different from our perspective and theirs. At 97, a move will be very emotionally difficult and upsetting. I suggest doing what you can to keep your grandfather fed by bringing meals/snacks in, getting someone to do shopping for him, and get along the best you can in the current situation. Regardless of how you proceed, it will not be easy, but it will only be for a time. Of course, there may be a time when you have no choice but to transition to institutional care, and don't beat yourself up for that. Be strong, and good luck! You're a good, conscientious grandchild.
My own father fell and broke his hip at age 92. The hospital course got complicated by other reasons, and both nurses and social workers would come in daily and tell me that he had to go to rehab. I kept saying: "No, he'd be mad". Finally, when he was able to communicate, his MD said: "Mr X, they want to send you to rehab." Dad's immediate response was: "No, I'm going home. I'd be mad." Dad went home and died three months later from a UTI. He wanted no further treatment and refused to go back to the doctor or hospital. We placed his bed in the dinette where he could be in the center of things. Yes, we were fortunate that Mom was still alive and could shoulder the brunt of the caring, but the rest of us took turns in the evening and we had a good plan in place as a family to support Mom & Dad.
The other thing we put in place was hospice. Dad had severe lung disease from smoking and was oxygen dependent. His doctor felt that the COPD alone was sufficient to place him on hospice. He accepted this and we had a bath aid come in two times per week to give him a bed bath, plus the weekly visit from the hospice nurse. He morphine alone that hospice provides eased his breathing and made life more bearable for him.
Mom and Dad's house was terribly cluttered and not very clean from never throwing anything away. We didn't worry too much about that because what could we do anyway? It was comfortable to them and they wanted it that way. We cooked them meals and took them over, and checked the refrigerator and tried to discretely throw out spoiled food. I cleaned the bathroom. Other than that, we let it be.
We had an interim help service coming twice a week at first to help with the wife's self cleaning neglect and chores, then for 24 hours a day when she became incontinent and started to wander out of their town home. At that point, it became clear she needed much more help and a controlled environment and the husband agreed to the move. We made their one bedroom memory care apartment look just like their town home bedroom and den with the same furniture arranged the same way, same pictures on the wall, etc, so their transition went very smoothly. I understand the pride he must feel, along with the fear of losing those abilities so he can't admit to an issue. There is a condition called ansognosia (or something like that) where it is impossible for a person to see/understand their failings, but I don't know what the answer to that is. A physician's diagnosis and recommendation would give some ammunition for getting the change to happen. Paying for AL-MC is another issue. Those places are not cheap and that must be considered as well.
Be creative An example: As siblings one occupied him with an all day outing, and we had his house cleaned and one washed his clothes. We took photos to put everything back EXACTLY as he left it
More immediate supports can be more attractive, and lower key, even if you want a major decision made. Visit with him, and use a caregiver agency that uses older caregivers. More familiar with the hollowness of words that come from plans on paper - that's the older generation - they want to play "Host", not care receiver.
Transition plan is what makyes the difference. Hire people on different initial basis, when their real job is to allow your father to get used to them. Like hire a caregiver, but don't make a WHOLE plan for his care - just have her start as a "cleaning lady", for an hour and the rest of the time, visit with him, have tea. Or have someone help with an outdoor job, then sit and have tea.
It doesn't take as long as one would think. I did that, was caregiver who sat with 96 year old, independent fellow, similar attitude. I listened to his stories and showed my delight in his resourcefulness and ability to innovate. And I left. Downplayed the whole care perspective, said, I don't know if he'll want help or not. And came back, visited, helped gently with a small task he started to do. AND I agreed with his mistrust of the healthcare system - I agree anyway, for I find their expectations are designed by researchers, so instead of working in praise of a very capable old man, they are worried about answering to their supervisors who barely know the fellow.
When the fellow began to accept that I was there as a helper to HIM, not to the goals seen by family or services - and I laughed at his wonderful jokes and stories - but also kept alert to doing small things - when it was simple - he began to rely on me. One day he found his electric garage door was open when he woke in the AM. He was paranoid about neighbor vengeance, and sure this was a prank from a particular neighbor opponent. I told him I thought that unlikely, but that I agree, it needs to be fixed right away, and I stayed late that day, standing on a ladder in his garage fiddling with the control device as he read me the codes that he had stored in his wallet for decades..... We got the door closed, and I just said, "good" - for I knew that if I had left that job undone when i left him, his paranoia would have been triggered into crisis.
He came to see me as his "right hand man", even if I was a 60 year old woman, but I had owned my own home alone, and knew the challenges of upkeep, so I helped with many tasks. After he had accepted me, my Care Manager made the arrangement more formal, and a couple of weeks later, another stable caregiver was added, and for 3 years, we lived there overnight and handled care tasks through his decline.
Many care agencies know of these issues, and plan to work with them. And sometimes that resistance has meant that a caregiver just sat outside for their shift, while the client never let them in! Trying different approaches, and writing down what worked, because SOME caregivers could persuade him, others were shut outside. I was a fill in for a woman - and sat outside, until one day as the woman refused me entry again, I said, sure, I understand, but can I use your phone to call my company? My cell is not working. Allowed her to be "host" not care recipient. Once inside, I used the phone, chatted a bit, noted her nice home and chatted some more - turns out her internet had stopped working, so I said I'd try to fix it.
By the end of that day, she had accepted me, and I cleaned the kitchen and bathroom before I left. The next time I came, she might not remember - and it's just a repetition, accept, be glad to see them, follow their lead, and gradually add a bit of help. It's all a transition process, not planned in advance on paper, without the initial period of a month or two, of trial to add bits of help.
Fact is, once a place has been gradually organized for them - the brain injury people write labels on the outside of drawers - if you remove clutter, don't throw it out, but put it in a "later consider box", and they agree, then hide it from sight so they forget about it - but keep it, in case they get worried or suspicious, so they can review it again, always going along with them to support their ways of self organizing, laugh with them at the difficulties, and help by making some small change, which you are willing to undo, if they don't like it. That approach lets them experience small changes, and get used to them, not be asked to say yes or no ahead of time.