My father is currently in rehab, following a hospital stay for a MRSA infection. He does not like going to physical therapy, but he goes. The therapist reports that dad can do everything he is ask to do: walk, climb a few stairs, put on his shoes, button his shirt, etc. But, when he is in his room, he lays in bed completely helpless. He makes my mother do everything for him. Dress him, cut his food, change his Depends, everything! He will not even walk to the bathroom. He asks her to hand him a urinal, which she does, even though we have stressed to her he needs to get up and walk to the bathroom. Let me add, he was making these demands of my mother even before the hospital stay. They live at home and she tends to his every need. She is 90 years old and not in perfect health. She refuses to leave his side, even when family offers to sit with dad so she can take a shower or a nap.
He probably will be released from rehab later this week. Since he demonstrates to the therapists that is able to do things for himself, they will probably say he can go home. Going home is what mom and dad both want, but family does not think they are capable. We have looked at assisted living, but it will be a battle to get them to move.
My question is - why won’t he do the things for himself that we know he can do? We know mother will continue to wear herself out doing everything for him once they get home. No reasoning with her about it. They are not mentally incompetent, but are definitely showing cognitive decline.
Any insight is appreciated.
Mom has always done these things for Dad.
He likes the company of Mom.
Mom loves to do or is used to doing these things for Dad
Hard to break a pattern.
Etc.
Just let them alone. If something happens that forces one of them back into rehab, they may make a determination that they can no longer live independently. At that time, the choice will be taken away from them and they'll have to be placed in Assisted Living.
Unfortunately, so many seniors refuse to make the correct decision on their own and wait until the choice is taken away from them, then wind up complaining about it for ages. Sigh.
Best of luck!
"We've tented a LOT of houses."
In other words, a white lie of needing to get the house tented for termites (a common issue here in California) or a "major plumbing repair" will require the parents to move out for a week or so in order to facilitate the repairs. After that time, they often feel at home in their new surroundings.
I will say that my parents really did need their house repaired and we moved them to an independent living place nearby for a couple of months. They hated it, especially my dad, who was completely capable of still living at home, but was put off by how unfriendly the other residents were. (Ironically, it's a home for retired ministers and missionaries!) They weren't moved there to get them out of their house permanently, but I was kind of hoping they'd like living where they didn't have to do absolutely everything to keep up the property themselves.
Nevertheless, your dad sounds like he needs skilled nursing and your mom needs assisted living. Perhaps their house will need some "work," and you can get them in someplace where they're in the same location and he can work toward moving to assisted living with her rather than getting home again. That might be more of an incentive to get him doing for himself again, because he wouldn't qualify for assisted living in his current state. You mom will kill herself taking care of him (as my dad did with my mom), and then he'll be in a nursing home alone.
However, its become a little unbalanced.
Although, from how you explain the situation neither complain..and both seem content with the dynamics.
Your concern for their health is understandable
I agree with other comments about home physical therapy and your Father getting the body moving.
With apathy he will die sooner than if he was mobile.
You might speak to him quietly by yourself and kindly explain that by getting the body mobile daily, it will give him more time here with your loving Mother
This is a fact. If he loves her as I think he does, once he understands the probable consequences of his laziness, he will improve himself.
They are lucky to have such a caring daughter.
If AL placement is not likely to be tolerated, would they accept some part-time help at home?. Hired help for bigger chores might make some pressure off your mother. She could still be in charge of meal planning and personal care.
It may be that he thinks, right or wrong, that she gets joy from helping him.
Your mother feels needed and your father feels taken care of. At their age, habits are already deeply ingrained and you will not change them.
RE: the Urinal: This is actually very common for his age. My DH used one starting around age 93, after his heart valve replacement and it was preferable to me as he never used Depends until his last 3 days on earth, and he was almost 97. Until he became bedridden during the last 3 days, he still went to the bathroom to eliminate, but I had to assist him.
As long as they can meet all their needs and nobody is at risk, they can go home. If they need help, there are lots of options: assisted living facility, home health care aides, family and friends...
Nothing is going to change, your acceptance is the key. My step father does the same thing, I have learned to let it go and continue to work on me.
Good Luck!
They always do well in therapy. Its a good way to be sent come. Like said, Mom waiting on Dad is a pattern that ur not going to break. Early stages of Dementia they lose the ability to reason. So u can't reason with them either.
1. The sky will not fall in if she doesn't monitor his every waking moment.
2. Even more important: her doing things for him DISABLES him. It is actively the WRONG thing to do for the person you want to remain healthy and functioning.
Every time she hands him that urine bottle, she is stopping his heart getting the mini workout involved in his going to the bathroom. And cutting up his food? - is her manly husband a spoiled infant at heart?
It feels good to pamper and be pampered, but she can do this in better ways that won't render him helpless and immobile. As for why does he let her? - ooh, lots of reasons. Because he's tired, it's easier, it's nice to be cared about and waited on, it's what they're both used to... If you want him to start *liking* being more independent, never criticise him, only ever praise and flatter good efforts and good habits that are more in keeping with an autonomous adult.
Short of breaking her leg, can you get her away on some pretext for his first few days at home? If not that, can someone go and stay in the house with them at the beginning?
We currently have a lovely client with a lovely wife, in her eighties and tiny and she has been forced to accept our service because she physically can't manage his needs. There was a farcical moment a couple of weeks ago when she tried to wrest his overnight catheter bag from me as I went to the bathroom to dispose of it. I hitched the bucket out of her way and kept going with thanks and a smile; but she has a hard time letting anyone take over what she can manage. Doing absolutely everything can be a point of pride, I think.
As others have suggested, there is no reasoning with either of them. Hopefully, when they get home tomorrow, she will at least be able to get a little more sleep.
Family will keep a close eye on things. We will be calling several times a day, dropping in unexpected, bringing groceries, doing laundry, etc. We can concentrate on helping her, so there is a chance she will stay healthy enough to take care of him.
Thanks again for your suggestions.
I remember when my Dad had a heart attack, he was very weak and it was recommended he go live in Rehab until he got stronger. Well, that didn't sit well with my Mom, she insisted she could take care of Dad, that was her "job". Little did she realize she no longer had the strength to pick Dad up when he fell, which he did on a regular basis until he regained his strength. And Mom wasn't able to help Dad climb the stairs to the bedroom, so she would sleep in the livingroom on the sofa and Dad slept in his recliner.
And Mom even insisted that Dad didn't have a heart attack.... what would be the neighbors think? Say what? Apparently that generation the health of the husband was a reflection on the wife. My Dad being sick would have been a poor reflection on my Mom. Good grief.
My take on this, let Dad be home with Mom, and let her cater to him which she is doing out of love [I know, we may not see it that way]. You can't break with tradition.
Thank you you for your thoughtful response.
I've known people who say, him going home with mom to provide care, in her condition is not a good idea and we don't support it. You might not be able to prevent it, but, I would still be clear to them and the staff at rehab. One reason is that it is a recipe for disaster. Things won't go well......and, then the adult kids will get the calls.......so, the adult kids will become the caregivers while parents live in their own home. I suppose that works for some people.
I'll add this, since you said you thought there was some cognitive decline....I know that prior to my LO having dementia, she exhibited odd behavior of not wanting to do things for herself, even though she could. Her refusal to do use toilet, bathe, change clothes, etc. were the first signs of dementia. She could talk, remember, pay bills, etc., but, it was an odd sort of apathy and lack of initiative. I wouldn't hold faith in you being able to convince a 94 year old person to do more things for themself. He's likely very tired and not motivated to do more, if he doesn't have to. I fully understand how he might feel.
It is a sad situation and you may have to wait for a major event to get them to move in to assisted living.
Do your parents have all their paperwork in order? Updated Wills, POA, Healthcare Representative etc up to date? I think you may be better to push to make sure this is all in order, that way when Mum collapses from the stress, a family member can step in.
Your assessment of the situation is probably correct. Thank you for your answer.