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My father is a type 1 diabetic with mild dementia on an insulin pump and lives home alone. He was hospitalized a year ago for unknown reasons and then we had caregivers set up 7 nights a week for the past year and daytime care, but now he’s revolting and wants nights off- first it was one night off then two nights off a week.
He suffers from depression, anxiety, OCD and probably a personality disorder. He’s seeing psychiatry and a therapist.
My brother is ready to give up and let all the caregivers go and if my dad ends up in the hospital again then refuse to take him home and have him placed in a facility.
I don’t agree with letting all the caregivers go, but I’m also not willing to continue to backfill caregiver positions.
Help. I need to figure out my boundaries and how much I can support my brother. We’re having a family meeting tomorrow.

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It’s understandable not wanting to backfill . Don’t do anymore backfill , so he can be placed . You are propping up this house of cards . A wise social worker told me “ Stop helping “.

Has anyone told Dad he has to keep the caregivers or he will go to a care home ?

If Dad is wanting to let go of the caregivers and no one has POA that has been invoked , then let them go and call APS . You can also try Dad’s local County Area Agency of Aging to help get him placed. Or like your brother said refuse to take him home from the hospital if he lands there .

You do not have to backfill these care holes.
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Reply to waytomisery
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Lakegirl2 Sep 9, 2024
We’ve tried to tell him if he doesn’t keep the caregivers he will need to go to a home, but legally he can still make decisions at this point and would never go to a home.

He just wants to be left alone and says his house feels like “a prison” with the caregivers.

my brother manages the insulin pump and meds.
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Do not keep backfilling! By doing that you've already set the stage for him to continue wanting you, not caregivers, there. I'm with our brother on this. If he ends up in the hospital, then move him to a facility from the hospital.
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Reply to Jacquelinezr
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Has dad appointed a POA for financial and healthcare decisions for when he’s not competent to decide for himself? How do you see his safety now when he’s on his own? In other words, is it time now for a new plan, one that doesn’t involve you scheduling or filling in for hired caregivers? If dad’s already not competent, I hope one of you is POA and can decide the next living arrangement. Something for sure, don’t move him in with you and don’t use your finances for his care
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Lakegirl2 Sep 9, 2024
My brother and I both have POA but my father wouldn’t be deemed incompetent at this point so our POA doesn’t superseded his bad decisions.

He’s not safe as a type 1 diabetic on his own.
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Your brother has the right idea
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Reply to ZippyZee
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What a great start!

✔️ Both you & your Brother being able to decide your own limits.
✔️ Communicating these limits honestly to each other.
✔️ Understanding that limits & tolerence between siblings can differ (+ that's OK).

👏👏
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Reply to Beatty
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Now as to your Dad.. The strong boundaries you & your Brother use should help against Dad's strong will.

Is Dad open to discussing his situation?

He doesn’t like the the feel of care staff marching through his space & invading his privacy. OK, sure. I get that.

He doesn’t WANT that.
But he may NEED the help.

Does he understand?

Are there cognition issues? Lack of insight? Denial? Or plain old stubborness?

Now stubborn people still DO go to nursing homes. Oh yes!
When a crisis brings them to ER... depending on the event, disharge plans don't always point home. Especially for care refusers.

One example;
"I've told you & told you & told you... Choose your Nursing Home or your family will".

I overheard this yelled at a patient once by the man's obviously very frustrated Doctor 😶

That man was indeed transferred to the first free nursing home bed.
Do not pass home.
Do not collect your belongings.

The man had had many opportunities to change his trajectory & stay in his own home longer. He had agreed to services before, only to cancel once home. This time his injury was worse & his needs were higher, so he needed a rehab stay. He refused, so long-term care it was.

Happens all too often.
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Reply to Beatty
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I am not a diabetes expert so I may be getting this wrong, but I thought that most types of diabetes can be managed by the sufferer, so long as they are competent adults. F isn’t keen on having ‘carers’ in his home all the time. Does he really need them? Can he test himself, work out when and if he needs special care, and then either arrange it himself or call for the help he needs? I have an older friend in a class I attend who does just that, so is much more independent than your F is being allowed to be.

If there is a self management option, you try it, and it fails, it may be easier to convince F that he needs the care that he currently thinks is excessive. Worth thinking about?
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Lakegirl2 Sep 10, 2024
He’s had type 1 diabetes for 35 years. He has an insulin pump that he’s incorrectly entered insulin numerous times.

He also has a continuous glucose monitor which alerts him when he’s low but he forgets to bring the phone with him to bed that alerts him.

In the past month, his insulin pump fell off during the middle of the night and his blood sugar was so high it couldn’t be measured. There was no caregiver and I saw the high numbers on my phone and called my brother to put the pump back on in the middle of the night.
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I agree with your brother that it is time for placement in care now, as the caregiver situation for this complex patient who needs good medical followup daily is no longer possible in the home.
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Reply to AlvaDeer
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It's time for dad to go to a facility for all the reasons that others have mentioned.

If he doesn't, and you or dad manage to salvage him so he can somehow continue to live at home, that is not a permanent solution. You'll be faced with what you are facing now over and over until he is placed. Dementia is a progressive disease. It becomes more difficult to manage day by day, week by week.

Make it easy on yourselves. Get the inevitable placement done now and ignore Wrath of Dad. You and your brother could stay on good terms, and dad will be safe where professionals can take care of him. Don't step in to do more than your share. Don't offer the moon and back to soothe dad. Do realize that by placing him, you'd be doing the best thing for your father and also your relationship with brother.
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Reply to Fawnby
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So father is not self-medicating well, is refusing carers, has mild dementia, and is risking death. Could you - would you - should you – ‘force’ him into a facility against his wishes? Or ‘allow’ him to take the risk of an earlier death?

Why don’t you ask him?
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Reply to MargaretMcKen
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My situation is the opposite. She is ok with caregiver coming 3 days a week. My 95 year old Mom wants to go to Assisted Living. If only, she could get along with others and not have her narcissistic attacks on others. My fear is, she will get evicted from Assisted Living Facility, and I will get a call to move her out. I refuse to bring her to my home because she will destroy my marriage. Husband will move out, and I will loose my mind with her constant complaints and lack of empathy for anyone but her needs not being met fast enough or to her liking. She can’t get evicted from her own home. I have a nurse coming weekly to check her vitals. Your Dad has control over his decisions until he becomes a danger to himself.
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MargaretMcKen Sep 19, 2024
TxP, I suspect that you got a snotty reply which has now been deleted. Please don't be put off, or 'keep your opinions to yourself'.
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I agree with your brother. He needs to be eventually placed in Memory care LTF.
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Reply to Onlychild2024
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To assist brother: Know that he is at his wits end!
Brother needs the caregivers so he has a break!
Father needs to be told too bad the care givers are required and you cannot have a day off - the caregivers must be there or he goes to a facility.
If he has dementia he does not know what is required and what is not. I told white lies to my daddy about the facility being a new kind of hospital! Examples: The doctor has not signed you out yet, he says you need to be here before you go home. Dr. has required that this person come in and shower you. If you do not do this then we lose the insurance and YOU will have to give this person cash $1000.00. It worked - why- because money and that amount was in is long term memory and he knew that he did not want to give that kind of money away and he knew that he needed insurance.
Caregivers, facility, assistance is what brother needs - he cannot do this by himself! Bless him!
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Reply to Ohwow323
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MissesJ Sep 17, 2024
I LIKE your style❣️
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You don't say how old your dad is nor who has POA nor who is paying for the caregivers. The best person to talk with is his primary care doctor. I saw no reason to pay caregivers when my mom was asleep. She is doing well in my house with no caregivers. Each person is different. Talk with his doctors.
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Reply to CareforMominTN
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Lakegirl2: Prayers sent.
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Reply to Llamalover47
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I saw your recent reply and thought I would mention about what happened to my aunt who had type 2 diabetes. She was living with my cousin for a short time because of this diagnosis and my cousin decided to put her in a home. I believe it was a Medicaid facility and did have good reviews. My cousin had already put her assets in her name and several years had passed. My aunt had a roommate and the room looked like college furnishings. She was in a wheelchair by then but her mind was good. She had had one reaction and been resuscitated. My cousin put DNR on her profile and the next reaction after given insulin she died. I still feel bad about it. But my cousin's life has been much better with her travels and friends. We all have to die and all we can do is respect our parent's wishes as long as we can.
My other aunt also died after being placed in a LTC facility after she gave everything to the same cousin. She was moved from her apartment to the LTC facility because my cousin was tired of driving to her apt. She fell shortly after, couldn't get up by herself, lay there all night. Taken to hospital, then one night in nursing home, back to hospital who determined she had the disease with diarrhea that the elderly get somewhere in facilities, and they let her die. It was not a pleasant two weeks for her to know she was going to die.
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Reply to CareforMominTN
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I'm going to agree with your brother here. Sometimes the hardest thing to do is show some tough love so that someone you love gets the help they need.
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Reply to BlueEyedGirl94
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I am on Team Brother.
Placing your dad in a Memory Care facility might be the safest option.
(or because of the insulin pump he may have to be placed in Skilled Nursing, most MC will not want a resident with dementia that has "tubes or pumps" because they tend to try to pull them out)
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Reply to Grandma1954
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It sounds like you're in an incredibly difficult situation, balancing your father's needs with your own limits and your brother's perspective. The key here might be finding a middle ground where your father's well-being is prioritized, while also recognizing your and your brother's boundaries. It's clear that your father still needs support, especially with his medical conditions and dementia, so reducing care might not be the best option. During the family meeting, I suggest focusing on a care plan that meets his needs without overwhelming you or your brother. Maybe compromise on a reduced but consistent care schedule or look into alternative care solutions that don't rely entirely on either of you. It's also important to be honest with yourself and your brother about what you're each realistically able to handle.
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