How do I help Dad with his feelings of letting his wife down by putting her in a home for 24/7 care?

09/14/09

Linda

Topics:Advice

My father has lost the sight in one eye and is going blind in the other, glacoma. He is hard of hearing. He had a stroke a year and a half ago, but has mostly recovered. We have seen evidence that makes us wonder about his decision making capabilities. 17 days ago he suffered a heart-attack and is now home and doing fairly well with a stent having been put in. But he is still recovering. We just took our step mother to see the doctor for an evaluation and the doctor said that her condition is severe. She didn't notice that Dad was gone, never asked about him. She doesn't know her daughter's name. While she is not totally incontinent, she has hygene issues. My father has been her main care-giver. With his health problems, we, his children, and hired help took over until he insisted that he could care for her again. Now I fear that he may have problems with congestive heart failure resulting from the damage done during the heart attack. Her daughter has found a home for her near where she lives. But now Dad is having seconds thoughts. He feels that he is letting his wife down by putting her in a home. We have repeatedly tried reasoning with him that she really needs more care than what he is able to give her. He can't afford to hire in 24/7 care. The nursing home will be a big drain on the finances as is and HIS health is deteriorating. How can I help him to cope with his feelings and make the right decision?

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Answers (2)

Tuesday, September 15, 2009

Carol Bradley Bursack

More than 30% (the numbers are rising) of caregivers die before those they are caring for. Your father's illnesses may or may not have been brought on or made worse by the strain of caring for his wife, but the facts are evident. He is sick and can no longer do it, no matter how much he wants to.

The unfortunate, but understandable, part is that it seems his wife is not in a home where he can visit her regularly. There is no doubt she needs the type of care she is getting and I can see why her daughter wants her close. But this does leave your dad out.

Your best approach is to just keep telling him, gently but consistently, that she needs more help that she can get at home, even with hired care, and she would want him to take care of his own health issues. She doesn't want him to kill himself caring for her.

You'll have to be patient and expect him to grieve. This is natural. If there is any way he can visit her, that may help, but it also may make it harder. His health is fragile. I don't know how far away she is.

Let him grieve and let him know you are there for him. Assure him that she wants him to take care of himself, and at least for the time being, this is the best way.

Good luck with this. It's hard for all of you, I know.

Carol

Thank you for your input
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re: How do I help Dad with his feelings of letting his wife down by putting her in a home for 24/7 care?
Linda
Tuesday, September 15, 2009 at 09:46 PM

Carol,

Thank you so much for your input. My father's health poblems are due to 50 years of smoking, but nonetheless, these health problems are a necessary consideration in making the decision.

After submitting my question I went back to different articles and others questions and their replies and printed off some of the information and gave it to Dad so that he could make a more informed decision, meaning making the decision based on more than just his feelings as normal as they are. I included the information on caregiver skills needed for severe stages and also what the stages are so that he can see what is coming very shortly. Rosie has deteriorated quite a bit in the past four months. I also included an article about caregivers listening to their bodies.

The response from the ARA below was very helpful, too. Getting an unbiased opinion is a very good idea. I hope the information from this site will help in that respect. When we took her to the doctor, the doctor mostly left it up to us to make the decision. But she did say that 24/7 care was in the near future and that caring for Rosie is more than he can handle in light of his health problems.

The nursing home by Rosie's daughter is 14 hours away. Rosie would have a brother and two sisters visiting her, also. I asked Dad if he would feel better if we had Rosie here in a home in town. He said he didn't think so. Putting her in a home seems to be the issue, not the location of it. I have been trying to reason with him that as a husband he is responsible for her health care and that includes gettting her the help that she needs.

I wish that we could keep her at home longer. We live in a small rural town where adult day care is not available, neither is there much in the way of reliable, trustworthy individuals that could be hired. We do have one woman that is wonderful, but she works several hours a day for someone else. And she can't spend more time with the folks than what she is.

I am very thankful for this site. It has helped me a great deal in coping with this situation. The advice given from both you and the AFA is both caring and helpful.

Again, thank you very much!! Linda

re: re: How do I help Dad with his feelings of letting his wife down by putting her in a home for 24/7 care?
Carol Bradley Bursack
Wednesday, September 16, 2009 at 07:20 AM

You are handling this well, Rosie. It's hard for your dad and he will grieve and feel guilty no matter how much information he has. That's human. But giving him the information you have gathered will help. And, yes a third party giving input is always a helpful idea.

I'm glad the location of the home isn't an issue, as this does seem best for Rosie, and for all of you. You will have your hands full with your dad, and Rosie has her kids to help her. It's sad they need to part this way, but since her AD is so advanced, she'll be less aware of the separation than he is. It's your dad who is suffering for it. You are a wonderful caregiver and your help will get him through.

Take care of yourself, too.

Carol

Tuesday, September 15, 2009

AFA Social Services

Trying to convince someone to place his or her loved one to a facility is an often challenging task, but it sounds like you are doing a great job so far. Even though you have not been able to convince your father yet, you did something very valuable – you planted a seed. In other words, you opened up a difficult topic by addressing the importance of long-term care, and laid a foundation for future conversations to come. You have also demonstrated that you are a positive, supportive force in the family, and hopefully your father will be able to see your position and come to the same conclusion eventually. The truth is, these decisions often come with time, because guilt, grief, and denial are very complex emotions. Your father may be having second thoughts because he feels responsible for his wife's well being, and doesn’t want to disappoint her. He may feel that admitting her into a facility is synonymous with giving up on her, or abdicating his responsibility. Although admitting her seems to be the most responsible choice, he may not be seeing it this way because the idea came from a family member. A professional opinion – such as from a doctor, nurse, case manager, or social worker – can go a long way. This may register differently for him if the advice comes from a neutral, or even anonymous, source. Another way of getting this form of unbiased feedback is by joining a support group. Support groups are an excellent way of connecting with others in the same shoes, and unloading some of the intense emotions brought on by the caregiving role. What helps is hearing from others what has been successful or not so successful in the past. If you father can identify with anything that the support group participants are saying, he may hear the message quicker and be more inclined to change his position. This may help him come to the realization that a nursing facility might just be the best place for her. For support group listings in your father’s area, please contact (866) 232-8484. As an alternative, your father may be interested in “Care Connection”, AFA’s national toll-free telephone support service. Your father can call into this wonderful service every Thursday night at 9pm EASTERN TIME, to gain valuable education on a vast array of topics, and connect with family caregivers from across the country. Simply dial (877) 232-2992 and enter Guest ID 271004#.

Another option your father should consider is respite care. Although he is unable to afford 24 hour care, he may be able hire a caregiver for a few hours a day or afford the expenses of an adult day center. These centers can provide his wife with several hours of care, supervision, activities, and meals, while giving your father a much needed break. If your father allows himself that break daily, or several times a week, he may come to the realization that she might be better off in the hands of professionals. Another idea is to try out respite care at a nursing facility. He can admit his wife into a facility on a respite (short term) basis, just to take a break for himself while giving facility living a chance. After a trial period, he can decide whether she can receive better care at home, and if so, have her discharged back to the community. If on the other hand she can be better served in a facility, he can speak with the admissions department about transferring her status to long-term.