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My husband and I sold our home in another state and moved into my father-in-law's home. Our goal was to help care for him as he is 103 years old. He is in great physical health and can take care of all of his personal needs. He does have dementia. He still knows all of us, but doesn't really remember people outside of our immediate family. His short term memory is inconsistent. He does a lot of things out of habit and muscle memory... like making breakfast, mowing the lawn, etc. If he stops doing an activity, he will completely forget how to do it and can't relearn the skill. He is mostly pleasant to be around, but can get moody, angry and depressed. He can be alone for short periods of time, but he doesn't feel safe being alone. Therefore, he wants us to be around ALL of the time. We love him and enjoy spending time with him, but we need to get some balance. We bought a house a short distance from him that we use for respite for ourselves.



We would like to move into the house we bought and bring care for him into his home in the evenings and possibly throughout the day. We don't want to hurt him, but we can't be 24/7 any longer. He will not move into an assisted living facility.



Any advice on how to have this conversation with him?

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At 103, how many more years could he have. I'm thinking you moved into his house to help him out and then found it more than you want to do (or can do). If you can afford to hire caregivers if you moved away, why not hire the caregivers now while you are there to relieve the load?

Once you get others involved in the care on a regular basis, then you could evaluate moving to the other house. Considering his age, I just don't think I would up and move without a better transition plan - or - just continue to live there to spend what time is left with him and use hired help to handle the chores. I don't think I'd be able to move on at this point leaving him in the hands of others without my own watchful eye. Dementia stability (if there is to be any) lasts longer when there aren't drastic changes.
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Go on 23 and Me and find out if he has any UNacknowledged children that you might bring into the family fold, who knows they might want to help. I know a guy who found 7 brothers and sisters he’d fathered with different women. This way you’d meep dad’s demands that his help be his kids and everybody can bond over bed changing. Not joking, the illegitimates might be the work force you need. Thankgiving dinners a real hoot.
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MargaretMcKen Sep 2022
Way to go! I knew a guy who went through the same thing. He was named after his father, and got a phone call out of the blue when he was about 40, from someone saying "I think you might be my father'. They quickly sorted out that they were half-brothers, father had a second family. They then followed it through and found out that there was a third family as well. No divorces, just disappearances followed by bigamous marriages.

Now we have tax file numbers to get a job, so it probably would be more difficult to get reborn!
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Can you bring a Caregiver in & say that person is a family member ;-) Maybe sneaky...but seriously time for this 103 yr old to work with you. You can't be 24-7.
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MargaretMcKen Sep 2022
Why not suggest that the person is actually a son or daughter? read the other posts.
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You and your husband have already made a huge personal sacrifice to do what you have been doing up to the present. You are on the right track as far as making an alternative plan so that you too can have a life. There are already a lot of great, helpful suggestions here so I won’t try to add any more. Just follow your instincts and heart - they seem to be spot on.
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If I'm reading correctly, you don't want him to move out of his house. You only want to cut back on the amount of care that you and your husband directly give. I'm assuming that when you are not directly giving the care, you will be managing his care. In other words, you would be choosing the people to take care of him and also, if they don't show up, you will be the one who finds someone to replace them (and this person could be you).

I think there are 2 "tricks" to this situation.

1. Everyone who can possibly be giving care to your father-in-law, needs to be in agreement with the plan and decisions. In order to be in agreement, not only must you agree to the plan, you must also come up with solutions for the "what if" scenarios. Everyone needs to agree to the actions that need to be taken in order for the plan to succeed.

2. Then choose a time to gather everyone and tell your father-in-law of the plan. When you tell him of the plan, make sure that you put the reason why things must change, on you, not your father-in-law. The reasons for this are because in addition to being the owner of the change, it also sets up the discussion so that HE does NOT have to change. In other words, no matter how he promises to change, the plan will still go on because the plan is not dependent upon him.

Even though my Mom was moderate dementia, she immediately become more rational and coherent and conniving when it had to do with anything about her care. She tried the divide and conquer, the guilt trip, misinterpretation of what was said, and of course the bully. Because we were all in complete agreement with the plan, she got consistent straight answers, which is key to communicating with people with memory loss. She didn't like the answers, but no one wavered, hence the plan went through. Even 3 months later, she was re-asking the same question (and getting the same answer.)

You can do it too!
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My mom resists having caregivers but I'm burnt out, busy with watching grandkids (which I LOVE and will not give up for any reason!) and want to have my life back. So I did not ask her, I just did it. And, yes, she pays for every penny of it. She gets pissy about it sometimes and I tell her it's this or she'll have to live elsewhere because I can't/won't do it all. It's an on going battle but it's imperative that I have my grandkid, kid, hubby, me time (not in that order but still).
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danginar: Since he has dementia, perhaps he shouldn't be mowing the lawn. You'll have to let him know that he must hire help since you can no longer be there 24/7. Considering the fact that your FIL is 103 years of age, you both have to be elders yourselves. It is imperative that you take care of yourselves, else you will be good to no one.
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Get hired help! If you burn out, he will lose your help. It's going to be either in-home help or a facility, so talk with his doctor and a social worker. If he is trying to save money for his inheritance, it may not work out. His money pays for his care.
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If my MIl lives to 103, so will be 84. I will be 85. You two are probably at least in your 70s, and in any case, we age out too.

Tell dad that the home care is what will keep him at home.
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You are not a victim, you are a volunteer. If you want change, then "be the change." Get Dad evaluated for Memory Care, near your new home, and be a frequent visitor. Adult Protective Services can assist with placement.

There is no cure for dementia...........make plans that address his issues today and tomorrow, no matter how many tomorrows he has left. Oh, and start making your own end-of-life plans so that no one else needs to make decisions for you.
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Tell him you love him. Tell him that you love each other and need more "couple time." Explain that you understand that he feels safer with others with him and that you will help with the process of finding "helpers" that can be there when you can not. Then, follow through on getting him help.
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My suggestion would be to take a different approach to the conversation. Instead of asking him to agree to outside help, why not go ahead and arrange for the help you need and then tell him you have engaged part time help... not for him, but for you?

In truth, the help *is* for you, and I do not say that in a critical way.

Another suggestion is to actually be there with the new caregiver as your FIL is getting to know them. Hopefully, even with his limited ability to learn new skills, he will become familiar enough with them that he isn't frightened the first time you leave him alone with them.

Good luck to you. You sound like a wonderful, loving family.
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againx100 Sep 2022
Yes, don't ask for permission. And yes the help really is for the OP so that's what you tell FIL. This nice person is coming here to help ME because I'm tired, etc.
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Can you present it as something that you need to do for you and your husband, so that you can have breaks? Some men prefer male aides, especially for bathing and dressing. What about a transitional period when you bring in aide(s) and also are there at the same time while your father in law adjusts to the aide(s). You'll also have a chance to see how the aid works with your FIL. If you will have "strangers" in his house, lock up his valuables and personal papers, especially financial papers, or better still, remove them from his house and keep them at your house. Maybe it's time for your FIL to go paperless. Are you handling his finances? If so, this will be easier. In time, as he gets used to the aide(s) he may be OK with having an aide. Does he need 24/7 care? If so, he'll need to have aides in shifts for the times when you cannot be his caregivers. Is his financial situation such that he can hire in-home aides? Connect with a local social worker to discuss his options. Medicare/Medicaid cover in-home caregiving in some situations. At 104, and with dementia, he should be entitled to some benefits. His doctor may have to prescribe in-home caregiving if it's for Medicare. Hopefully all of his paperwork is in order with setting up powers of attorney for medical and financial matters, having a living will with his medical directives, and a will (he has a house, so he has assets). If he doesn't, and his dementia is still not far advanced, he may still be able to sign legal papers. All the best to you all.
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Clairesmum Sep 2022
good points...though Medicare does not pay for in home caregiving. Medicaid sometimes does, but that requires financial eligibility (spending down liquid assets in paying for his own care and daily living needs) before he could be eligible.
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He mows the lawn at 103? Maybe that's not a good idea if he has dementia.
He will need a live-in caregiver to take over for you and your husband. Move into your new home and tell him that he's getting a live-in 'housekeeper'. Make sure to tell him Medicare is paying for it because so many of our beloved elders don't want to pay for anything.
There will be an adjustment period, but he will get used to her. I've worked for many elders with dementia who would not remember why I was there. It just takes time. The new 'housekeeper' will become familar to him in time and he will accept her.
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PeggySue2020 Sep 2022
Hiring an aide on his money won’t happen unless the kids have poa. Plus even at a reasonable 23 an hour, the cost is theoretically over 200k a year for 247.
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Allowing him the dignity of being a part of the choice process will be admirable. Even though, as you say, he may not recall the conversation. Perhaps also you could share with him that because of your love for him, you both want to be certain that help in in place should either or both of you, God forbid, become ill or worse. Sharing with him that it is a safety necessity for him that you both are responsible for, to assure his well being and safety should either or both of you ( God forbid) become unable to care for him, perhaps help him to consider it that he is doing this also for you ( your peace of mind). Perhaps you could also consider having the conversation with him in the presence of his physician and/ or a faith leader if you have one; that way you have a neutral caring and responsible witness and, support for the difficult conversation. Once you do decide on in home vs facility placement, then move forward in positive ways . You can expect him to resist along the way, so be prepared to view this through what I call the " lens of grief"; he is grieving that changes need to made and along the way he may become angry or simply sad. Viewing this as part of the normal grief process associated with aging, loss of control of one's independence, and needed changes may help everyone cope . There may also be the " guilt trip" factor that comes into play if it has not already. This is also a part of 'grief' and, can be used by aging parents to try and control their adult children or the situation. Acknowledging his feelings and thoughts are admirable for his self esteem; but do not dwell on negative; sometimes a simple redirection of the conversation is helpful. Prayers for you all as you make this journey as many others have. It is a blessing to hear that you , unlike many others, do have some options and choices. Peace . jnm
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Plan move into the house you bought and in the meantime install safety features and security cameras, motion detection lights, etc. Plan a system of scheduled visits during the day. It will just be a matter of time.
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Grandma1954 has it about right, whether it is "Gail" or "John.". Begin to introduce outside help, perhaps introducing them as there to help YOU. You may go through a few care workers before you find a real " fit" especially with current shortages in the home health field, but the goal is to find someone your FIL accepts as a helper.
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Once of the many challenges with caring for LOs is we cannot wait until all our questions and concerns are answered. You have to decide--start--figure it out along the way. There will be many wonderful people to help you. You just have to start and answers and options start showing up. Good luck!
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You’ve tried the conversation, it appears: it didn’t work. Get moving! Because you can’t do it all, nor should you have to! Do what you need to do, and say - gently but firmly - this is how it’s going to be.
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Introduce a caregiver SLOWLY.
Have one come over, introduce your friend "Gail"
Gail can help you change bedding and do laundry on Monday.
Gail can help you do some cleaning on Wednesday.
Gail can help prep some dinners for the weekend on Friday and all of a sudden you need to run out to get potatoes for the stew you are making. Gail can stay with FIL for 30 minutes to an hour while you run to the store.
The following week Monday is the same but Wednesday you have a "dentist appointment" and will be gone for 2 hours.
Friday you are going to meet a friend for lunch and will also be gone 2 hours.
He will get used to "Gail" and be more accepting of her.
The other option is to find an Adult Day Program that he can go to. They typically pick up in the morning, the participants get a snack and a lunch. Maybe an afternoon snack as well then the bus/van returns them home at the end of the day.
A program like that is good as it is consistent and it sounds like he likes routine.
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Cover999 Sep 2022
Why couldn't it be John?
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Does your H have siblings? How/why was it decided that H and you would be the ones to uproot your lives to move in with fil?

What are fil's finances? Could he afford a facility, if (probably WHEN) increasing needs require that? Could he become Medicaid-eligible?

Are YOU willing to take on more and more of his care? Often this is (wrongly!) expected of the DIL.

Are you being compensated in any way by him?
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Some posters have had success with introducing a carer gradually. She comes in as ‘your friend’, and talks with you and him together. ‘Her mother recently passed, and she is at a loose end’. Third time, you ‘have to slip out for a while’, and she is prepped to do something he might enjoy. Then you extend gradually. It might be worth a go? It’s probably not as quick as you hoped, and it is too expensive for some people to manage, but you’ve done so much that you may be willing to take it a bit slowly. Good luck, Margaret
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againx100 Sep 2022
This is a great plan! I thought of also having the first person be a cleaning lady for example. But maybe they're actually a caregiver that can slide easily from one role to the other. If the aide can do laundry, cooking, etc. and say it's for the OP, not for the elder, that could work in most situations.
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Arrange the care he needs.

He can't drive anymore - time to take the wheel.
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With short-term memory impairment I personally think it is unproductive to have any discussion with him that he won't remember, but if it gives you a clear conscience, then do it but have no expectations of him recalling it. And certainly don't bother telling him a second time.

Do what you think works best for both parties (him and his caregivers). If he is still active and mowing the lawn, etc. it may be best to have aids come to the house and maybe someone over night. Maybe consider an adult day care. Him wanting you to be around 24/7 is called Shadowing and is a characteristic behavior of dementia. You won't ever be able to get him "reassured" that he is "safe" so do what you need to so you don't burn out. Have the aid(s) keep him physically and mentally busy during the day so that he sleeps through the night. Having in-home aids 24/7 will eventually cost more than a facility.

In any other situation I would recommend AL for all its healthy social exposure but at 103 and him having great mobility and activity level... I'd say it's ok to preserve that by keeping him home, if possible.

If you decide to transition him to AL then you can use a therapeutic fib to get and keep him there: The house has a dangerous gas leak / infestation / broken a/c or furnace, etc. You have to go to a temporary apartment until it is fixed. Most facilities are familiar with going along with this type of strategy.

Your profile says he has depression so I would recommend this be discussed with his doctor to see if meds would be an option, and it *may* "help" the shadowing.
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In different circumstances we told my dad, living in his own home, that there was no choice, either he have a helper in home part time or he move to assisted living. We stated this very firmly, though we really had no power to make it so. For whatever reason, I guess our firmness, he believed us. We hired a part time helper despite his insistence of “I don’t want anyone in my house” Thankfully, she was experienced and very good at her job and she quickly turned him into a believer in her skills. She became very valued by him and we were grateful. Don’t make it a choice and back away when necessary
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Beatty Sep 2022
Choice A or B: Accept help (from others at home) or Be without help*

* If without help option is safe, it may work for a time... but if not, this forces moving into care - which IS choice A anyway: Accepting help from others, in a different location!

My LO, same. Help got accepted & staff quickly became 'trusted people'.

Staff shortages has brought challenges, cancellations & unknown replacements + fear of strangers again but the choice is same.. Choice A or B: Accept help or Be without help.
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You say he has limited short term memory so no matter what conversation you have with him he'll forget and deny it happened. So, as @funkeygrandma59 said, give him a choice of in-home caregivers or assisted living and then once the decision is made no negotiation with him. JUST DO IT. He will forget that he agreed (if he did) and you'll have to repeat this discussion over and over but you have to be kind but firm. You can no longer provide all the care. You have found a way that he can have the necessary care. He has not been abandoned. You will continue to visit frequently. end of discussion.
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Cover999 Sep 2022
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Just be honest and upfront with him, and then give him the choice of hiring outside help in(with his money of course)or tell him that you will have no choice but to have him placed in the appropriate facility, as you guys can no longer continue the 24/7 care that he requires, as it's just too much.
I would venture to guess that with those being his only 2 options that he will welcome with open arms outside help coming in to assist him.
Good luck!
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danginar Sep 2022
Thank you! I appreciate your advise. It is really tough!
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