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...SIL would get upset when others would bring food or clean their home. She thought she could neglect them into moving."
I empathize with SIL. I send email reports of my time spent with my mother, making sure to detail how many hours it is. (That's because she has told me I don't do much for her at all.)
Your in-laws needed help, but it certainly wasn't fair for SIL to have to do it all. My mother won't let other people (other than the man next door) to anything for her. Plenty of people think I should be doing more for my mother ("It's your mama!"), and I refuse.
When people refuse to move or get help, it's usually a child who ends up being the slave. I think the adult children who refuse this role (your SIL) should be applauded.
So cover your behinds, too. Request a wellness check or a needs assessment from your father's local social services, telling them what you've told us about your concerns and your father's preferences.
Do you have any immediate worries about his actual safety? Is he driving or cooking with gas, for example?
My in laws had dementia and refused to leave their home. Their eldest daughter lived near by and wore out her welcome by trying to “reason” with them that they needed more care. DH would listen to his sister complain about their parents. He would talk to his dad. Again trying to reason when that ability was gone.
Finally DH turned his father into elder abuse and they were investigated.
In laws reported that they enjoyed the visits from the agency!
When DH followed up they told him unless there was a severe problem such as rodents and or feces etc the agency could not do anything.
MIL had always been an excellent housekeeper so even though it was apparent to those who knew her that things weren’t up to her standards, their living conditions were acceptable to the state.
It is very difficult to legally force an elder to do something they don’t want to do.
SIL would get upset when others would bring food or clean their home. She thought she could neglect them into moving. It’s a catch 22.
Many employ what they call therapeutic lies to get their parents out of their homes and into LTC.
Read the book “Being Mortal:Medicine and what matters in the end” by Atul Gawande. Do what you can to care for your father. Educate yourself on Alzheimer’s.
To me there is no one perfect answer but life happens.
Usually an event occurs, a broken bone or severe illness that necessitates hospitalization and rehab and then a placement in longer term care.
In my in laws case they had to be evacuated due to a hurricane. They wound up in an assisted living. The storm hit the end of August. FIL died in Oct. MIL in Nov. They never got to go back home.
It will be ten years this August since that happened. When I look back on how they chose to live out their last years any regret I feel is that I wasn’t able to do more to help them do what they wanted to do.
I have one last vulnerable elder to care for these days. She has dementia and lives alone in her home with lots of help. Each event has the potential to upset the fine balance that gives her independence. Without a crystal ball, I’m not sure if she’ll live at home until she dies. But her desire to do so will be the guiding factor in all my decisions made on her behalf.
If Dad is able to get himself up in the morning, take a shower, get dress, and do whatever he does during the day, plus get meals for himself. He should be ok.
If you visit him on a regular basis and notice that the house isn't being kept up, Dad looks unkempt, and there is expired food in the refrigerator, then the family will need to decide what to do next.
Here's a good article by Aging Care: https://www.agingcare.com/articles/warning-signs-that-elderly-parent-needs-help-138989.htm