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Janey
Reply with quote  #1 
Like many of you on this forum, I have an extremely N parent who makes my life miserable.  So seeking some advice here!

My dad's ~90, mentally sharp (recently declining), physically quite frail (has Parkinson's), financially very well off, in NH.  He has no friends, my sister-in-law and I are the only family members who can stand to be there for him, this despite him walking out on my family when I was still in grade school.  He is neurotic, controlling, selfish, stubborn...everything that we all complain about here.  He also possesses extreme self entitlement and does not like to spend a dime.

Since having a series of falls in his senior's home a few years ago, they declined to have him and so he was admitted to a NH.  I was told initially by the social worker there that most seniors experience some anxiety upon admittance, but that it usually goes away and they get accustomed to NH living.  This has not been the case.  Despite physically deteriorating, he still insists he needs to move out of the NH, that he can go out on his own, take public transit etc.  Ideally he'd like to live with either my brother or I, but we both cannot, and don't want, to live with him (I have a serious illness myself).  His previous senior's home refuse to admit him again. 

For most seniors, we might brush these off, knowing they cannot do these things on their own, and knowing that if we didn't help them, they wouldn't be able to enact these changes anyways and let them live in the NH with others to care for them.  However, in my father's case, he still controls his own purse strings as he doesn't trust anyone else to do it.  He has previously attempted to sue his bankers, regularly accuses people of trying to steal from him (even me, and no this is not due to old age, this has been like this even decades ago), regularly cites mistreatment and trickery from anyone including e.g. his phone company, the NH, etc.  As a result of him trying to sue me a few years ago, I am unwilling to take over his finances until the point where his doctors tell me he is incapable.  This means that should he stop paying for his NH, I have no choice but to move him out.  Should he refuse to pay for escorts to take him to his weekly doc's apt, I can either cancel the apt or let him go by himself.  I try to take him when I can, which is about once a month, but the frequency of the apts prohibits anyone from taking him every time, so we hire escorts.

The problem is of course, that everyone but him can see that he cannot do these things for himself.  Yet he insists.  I ask the NH to do mental examinations of him every year, but every year they tell me he scores very well and is still very capable mentally.  We can't restrain him.  We can't be there for him 24/7.  He moved his money out of his long term and is ready to buy an apt.  He has also fallen about 4 times in the past 3 months, once fracturing his collarbone. 

I don't know what to do.
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Equality
Reply with quote  #2 
Janey I am so sorry to read about your quandary. Perhaps you could hire a concierge doctor to visit your dad, the big yearly fee may be less than the costs of escorts and if you could hire one it could save you emotionally.

One of the reasons I am considering care abroad for my mother who has Parkinson's is because the doctors come to the infirm like they used to do it in this country.

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Janey
Reply with quote  #3 
Thanks for the reply, it helps just to know someone else is there with the same issue.

He is unlikely to hire a doctor to come, but at any rate, his doctor appointments are all for different doctors - e.g. this week is for a cardiologist, next week is for the fracture clinic, last time it was for a kidney specialist, the week after it's for yet another specialist.  (I'm in Canada so health care is free, I'm not actually sure whether there are doctors for hire who come to the NH). 
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'daughter'(beth)
Reply with quote  #4 
Hi Janey,
I guess if your father is mentally competent (barring the N disorder) then he can do whatever he likes.
I would presume to say that you are not responsible for him. Here in the U.S. if a mentally competent (andphyscially incompetent) person wants to withdraw all their money, live in an apartment or under a bridge, they can do so. The most one can do is call our version of "social services" and I doubt that would go very far. They cannot do anything unless the person is really deemed incompetent. Cannot get guardianship unless the person is deemed incompetent. Can get POA (only if eldelry parent agrees which yours won't) but evne POA does not stop the elderly parent doing from whatever they want to do (ethically).

You are asking for advice, and about the only advice I can give that keeps you sane is to stay out of it.  He can leave the NH whenever he wants to (I'm assuming). They can't stop him either.

It will take the trainwreck or multiple trainwrecks over and over again for him to realize (if he ever realizes) and I just don't think you want to live that scenario over and over.
If he insists on moving out of the NH then I would tell him that you are not available to help him. I know all about the guilt and worry. But at least in my case, my mom gave me POA, she trusted my judgement, and she let me handle things she could not handle (not exactly fun but oh well).
Your case is very different.
I would never take on an elderly person who wants to call all the shots but makes a lot of bad decisions. Not your fault!

hang in there
beth

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Equality-janey
Reply with quote  #5 
Janey,

I thought you were in the US and were dealing with our nightmare system. I had no idea that the Canadians dragged the infirm out of NHs for office visits. Things must have changed since my Canadian friend's mother was in a NH, but maybe her mother got special service, because her mother was a retired doctor.

The concierge thing is becoming more commonplace here. My friend's former cardiologist offered her a discount to stay on as a concierge patient. He pitched home visits as part of the benefit. Lol she can barely pay her bills, nevermind pay him a hefty key fee.

What PD medications is your father taking?

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Equality
Reply with quote  #6 
I found a few articles about concierge medicine in Canada, here is one of them.
http://www.ctv.ca/CTVNews/Health/20110802/concierge-medicine-private-clinic-110802/
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Janey
Reply with quote  #7 
Thank you so much for the advice. 

-Equality: wow I didn't even know we had this in Canada.  The video was informative. 

-Daughter Beth: you're right.  I think my only option is to remind the NH to routinely check his mental capacity, and I can move in when he is declared incapable...but until then, as a mentally capable adult, there's no way to restrain his behaviour.  I guess I knew that too, but I wanted some reassurance since I was uncomfortable letting him behave in a way I felt was detrimental for him...
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wendy
Reply with quote  #8 

Has his home been sold. If he can afford it, you might be able to find him home-care services. This is what my dad is doing for as long as he can afford to, or for as long as we can provide him with caregivers than can care for him reasonably well.

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Janey
Reply with quote  #9 
Oh, and I wanted to clarify: the nursing home does have a regular physician and physiotherapist that comes weekly, but no specialists. 

Wendy: yes, that's a good suggestion.  He use to live in a senior's home that was a rental until they refused to rent to him.  He wants to buy a place, but I am discouraging it and not helping him do it.  But should he really buy a place, I'll arrange for home care service. 
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Insanity
Reply with quote  #10 
Janey, good for you for declining to take your father into your home. That sounds like a disaster all around. 

If your Dad is mentally capable of making his own decisions, then I doubt there is much you can do to keep him from making poor ones. 

I suspect that most N's detest being in NH/AL situations because it is impossible to be the center of attention there. What with the ratio of staff to residents, N's just have to wait their turn, something they detest with a passion. They are the center of the universe you know.  

Perhaps living in his own apt. with home health care aides coming in would allow him to live out his life in a manner befitting his importance in the world.

That said, I would see no reason why you would have to assist him with making these arrangements. He is, after all, mental capable of making his own decisions and has the financial wherewithall to do so. There's really little you can legally do to stop him. 

Plus, he likely loves the drama where he insists he can live on his own but you and the SIL are preventing him from doing so.

Wish him well on his adventures. But make it clear that you will not be fetching and carrying. You will visit once a month (or whatever) to celebrate his successes, sympathize with his setbacks, and then go on about your life while he goes on about his. 

If he can get it organized to move out and hire home health aides, then I see no reason why he can't hire escorts to take him to doctors appts. and arrange for ambulances to transport him when he falls and breaks collarbones, hips, etc.

I know it sounds hard hearted, but you have made the best arrangements you can for him and he is still not satisfied. He is lucky his family has not walked out on him like he walked out you those many years ago. 

What does your brother say about all this?




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Insanity
Reply with quote  #11 
I meant to add that though legally you cannot stop him from moving out into his own apartment, neither are you obligated to assist him in this endeavor.

An added thought, his moving out to live on his own might be just the information a judge would view unfavorably in determining your father's mental competence. 
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Janey
Reply with quote  #12 
Insanity: you may be right re: centre of attention because he LOVED living at the hospital last month when he had chest pains.  He told me he spent his time pulling his bathroom cord to see how long it would take his attendants to come. 

My brother does not really care what happens to him.
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Annette
Reply with quote  #13 

Janey, at some memory care centers or senior homes, certain doctors office will send a physicians asst to do blood tests or general checks there if you are there patient.

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added
Reply with quote  #14 

their not there/typo

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Equality
Reply with quote  #15 
"Insanity: you may be right re: centre of attention because he LOVED living at the hospital last month when he had chest pains.  He told me he spent his time pulling his bathroom cord to see how long it would take his attendants to come. 

My brother does not really care what happens to him." janey


no wonder.
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