How can I help my dad to live at home independently

[Muminabun]

My dad is 78 and very independent but he is showing signs of dementia. He is on his own in a huge house and generally refuses all offers of help. He will drive to the newsagents each week and buy things and has a small old dog. My thoughts are to order his shopping online very week and be there for the delivery, find a daily dog walker and walk and feed the dog at weekends myself. Find him a local neighbour who will pop in every day to check on him. I respect he wants to be independent and is very stubborn but he does sort of listen to me sometimes. I will also go once a week to clean up the house and do any admin bits that need to be done. Is there anything else you recommend if you are craving for aN older relative.

Sorry I mean caring for an older relative. If you are craving an older relative then please pm me as I have the perfect solution 😂😂

Would he have a cleaner? As in someone who cleans not a carer. If you are very clear on the difference they will often agree.
Any ready meals from the places that supply elderly people or the ones that are aimed at everyone such as cook or donald russell.
One of those buttons you press if you need assistance but he needs to wear it all the time. A relative of mine only put it on when they were dressed, they fell over in their nightwear.

Probably interfering with his routine will not help.

If you get this all taken over, what will he do? Sit in the house and get worse, no stimulation, no interaction except with those coming to the house.
Does he not walk his dog himself or do you think he is too unsteady/unstable to do this?
Are you worried about his safety and that of others while he drives?

You local social services can assess him, but you may need to exaggerate his lack of coping and your inability to help, in order to get the assessment first. Play down what you are able / willing to do (or you'll be left doing it all). However, an independent assessment will either allay your concerns or will identify what he needs support with. It also provides a benchmark, for a future assessment.

Some excellent advice here thank you. Yes I have thought of a pendent but I don’t think I will get him to wear it. I will definitely get some nice ready meals and he does like the cook ones. I am not sure about the cleaner. I just am not sure I trust someone going in. Great advice about social services but he would not be up for that at all.
Crosser he really isn’t that far gone yet. If he was I really wouldn’t just be thinking of light family and neighbour support.

Try Age UK. They're not running their usual day services at the moment (not in my area anyway) but they tend to have lots of local knowledge about services who they know like plumbers, gardeners, shoppers and cleaners etc. They don't verify them but they tend to hear by word of mouth about people.

Our local Council has been running a support service for older adults who are vulnerable and anyone, actually, who has been made more isolated by the pandemic. Maybe yours does too. My Dad actually did accept a Lifeline bracelet much to my surprise and he wears it all the time - he is like your Dad OP but 87 and much more advanced in his dementia and we just cannot get him to accept any help at all.

Would your Dad let you consider Lasting Power of Attorney?

After my mother died I tried to help my father, who was frail but mentally sound. He liked his routine and didn't want his activities taken away from him. He still wanted to do his own shopping at the supermarket for example because he enjoyed the interaction. The only practical help I could give was driving him there and carrying purchases. He did have a cleaner and a gardener though. It is very difficult to force people to accept help and you will get no thanks if you try and take over. You might be better finding, and paying for, a private carer to pop in on a daily basis. It would be a terrific imposition to expect a neighbour to do this all the time for nothing. Your father may also be entitled to attendance allowance which would help to pay for this. My fil, who has alzheimers, started getting attendance allowance when he had just my dh and a carer once a day.
If you think he is really getting dementia, and not just a bit forgetful, he should be assessed by his gp. It takes months to get a proper diagnosis (and probably even longer now), but my fil has had so much support (and my dh so much advice)since he was diagnosed - you get 'on the radar' so to speak.
There are companies that do delivered frozen meals, like Wiltshire Farm Foods, but my father thought they were disgusting! He preferred his ready meals from Waitrose.
Btw, it doesn't sound like he needs a dog walker for an elderly small dog that has his company all day, and it would be expensive. Encouraging him to take it out would be much better.

Contact the Red Cross and see if they can help in any way. I know they have a service called Care and Support at Home as part of their Independent Living team, but I don't know exactly what that service offers. Volunteers going to visit your dad once a week perhaps? Worth a phone call maybe.

Also look at what Age UK can suggest and any dementia charities/support.

I wouldn’t look for someone to replace him doing what he currently does. Eg no dog walker.
What I would look for (age concern do this as a paid for service in some areas) is a companion. So your Dad still walks the dog etc but has someone who does those things with him as a companion/carer. With dementia routine is everything, so you need to help dad with his routine as opposed to taking over his routine iyswim.
When things open up again - things like senior lunch clubs at a social center or church hall would way of ensuring a hot meal and socialisation.
If you decide to advertise for a companion - look for someone with a common interest and a current enhanced dbs.

No advice op but you gave me a proper laugh with your second post😂 - good luck.

Those pendants are not usually much use for anyone with dementia since they will a) forget to wear it, or b) hide it, or c) forget what it’s for and what to do with it, even if they do wear it.

As pps have said, routine is very important with dementia, so best to stick as far as possible with the familiar.

One ploy I’ve heard of, with people who are very reluctant to have a cleaner in, is to say, ‘X really needs a little job, so you’d be doing her a favour.’

Or, if the cost is what they object to (and your own funds permit) say, Oh, it’s free from the government now, once you’re over x age.

When filling in the form for claiming Attendance Allowance, it’s important to state how things are on the worst day/night, don’t gloss over anything. Or get someone from Age U.K. to help you fill it in - they are very helpful.

Please do get Powers of Attorney for both Finances and Health and Welfare sorted out ASAP, if they’re not done already. Can save monumental headaches later. People with dementia can become very suspicious of your motives, and think you’re just after their money, so vital to do it before this stage.

One more thing, do make plenty of copies of keys! Once a person has dementia they are very apt to be lost, thrown away, or hidden so successfully that they never see the light of day again. (Can you tell I’m speaking from experience here?)

@GETTINGLIKEMYMOTHER thank you for such good advice. He is not to bad at the moment but your post has made me realise perhaps what realistically lies ahead and perhaps I need to give that more thought. In 3/5 years he could really deteriorate.

You’re welcome, @Muminabun.

One thing I forgot to say, the Alzheimer’s Society Talking Point forum for carers of people with dementia, has been a lifeline for many, including me.
Whatever you’re going through, someone will have been there. There aren’t often any easy answers, but at least you can offload or let off steam to others who know exactly what it’s like. People who haven’t lived with dementia or been very close to it, hardly ever have a clue about what it means in practice, although they often think they do, and may well try to tell you what you ought, or ought not, to be doing - bloody infuriating!!

I agree with getting lasting power of attorney is place, if you haven't already done so.

The point about keys is a good one. My Mom spends 50% of her waking hours looking for keys, even though I put them on a huge chain to make it harder for her to lose them. There's a key safe on the house so selected others and her carers can get in.

I wouldn't get anyone to do things for him until he's struggling. My Mom has carers in and I only arranged it when I realised she was struggling with her medication. I live 125 miles away so I needed someone to supervise her. For 2 years she's had one visit per day. I've just had to increase it to 2 visits as she's now struggling to use the microwave properly (she kept burning her meals). The longer they can stay independent the better.

As others have mentioned, routine is key. It's changes to the routine which can cause the symptoms to worsen.

Change any gas appliances to electric. Get him a microwave if he doesn't already have one. Put up a calendar. Cross it off when you visit. Would he wear a bracelet with your number on it? In case he gets lost or has an accident? Does he have a simple mobile phone with numbers programmed in? Long battery life. Tape a phone charger to one convenient socket so that it doesn't get lost.
Make sure he is taking b vitamins if he isn't already. Magnesium and vitamin D too. Helpful for memory, sleeping and mood.

Getting power of attorney just now is vital while he still has a capacity as it will potentially save a lot of headache down the line.
A trip to the GP would also be in order to get a diagnosis as there is drugs which can slow the progression of certain dementias.

I would caution again taking away his routines unless unsafe. Exercise has been shown to be beneficial for memory problems so gentle dog walking would be ideal. Cognitive stimulation has also been shown to slow symptoms.
Encouraging use of memory aids such as a calendar or diary to get him into the habit now is a good idea. A notebook by the phone, an ID card in wallet or labels inside clothes, a simple turn dial microwave and electric cooker as mentioned above are all good ideas.

Get wifi if he doesn't have it & an echo dot. You can set up reminders for him to take meds, check job is off etc, use smart plugs so he can use his voice to turn stuff off & on & ring people hands free-useful if he has any mobility issues.

I think it's a great technology for older people

Another person advising getting a power of attorney sorted as soon as possible

The biggest thing for me is getting him to accept some outside care now. Get local recommendations for a companion type person (a mature, self employed cleaner maybe would expand to this, but ask around - the vicar is a great source of local knowledge) who will enable him to keep doing as much as possible, but prompt him to take the dog for a walk, help him change the bed, make sure he has a meal sorted and so on. If you know there is someone going in every weekday and the major things are done it lets you be there at the weekend to just do any odd bits. Once you have acceptance of a cleaner, its a lot easier to accept a carer or whatever later.
My dad resisted having people in, but starting with a cleaner, then a carer, then a gardener, handyman, companion for mum to take her out when he couldn't anymore meant that they stayed at home together till the day he died, just as he wanted. And it kept him active and occupied rather than passive which would have happened if I was close enough (and willing) to do all those things for him.

Has he been diagnosed?
If not then get him to the GP. Don’t just accept it as inevitable part of ageing. They can refer to memory clinic and maybe for a scan, and there is some medication that can sometimes help with symptoms early on eg. memantine.

If you can get him to agree to a cleaner check with your local care companies as they often offer domestic calls. You know the staff will be dbs checked and will be able to monitor how he is whilst not providing care.

I’m a carer and we do this for a number of people. We also have one lady whose son pays for us to go and have lunch with his mum who is in the early stages of dementia whilst he is at work. The call is literally to make sure she is ok, is having lunch (Which she makes for herself) and to provide companionship.

There are a few ‘light touch’ options which really help to reassure. But definitely try and get him to agree to a community alarm

Whilst it is a good idea to know what is available and what you could offer him, have you actually spoken to him about what he wants? If he has capacity, then he is perfectly at liberty to refuse any of your "help".

Is he diagnosed as having early dementia, or have you just noticed changes yourself? If you can, persuade him to go to the doctor to eliminate other causes (even something simple like a urine infection can mimic dementia) and see if anything can be done to slow the symptoms. Different forms of dementia present in different ways and may not affect every area cognitively so you need to build in the help he actually needs when he needs it. This may also open up the door to other help, like managing his medication, equipment for the home etc.

Seek advice from the Citizen's Advice Centre in his area. Different services may be called different things or accessed in different ways, depending on local commissioning. Our Social Services said they hadn't got anything they could offer when we described my relative's needs to them. When we said we need xyz, suddenly those services existed.

You may have to get to crisis point before anyone will act. If he gets admitted to hospital at any point, make sure to have a conversation with their Discharge Social Worker (job title may vary) - they will want to safely discharge him as quickly as possible and can get what is needed put in place to do so.

Ideally, you need him to arrange Power of Attorney (medical and financial) whilst he is still able to. You also need to have some idea of his financial situation (which may not be what he has led you to believe) and his own wishes e.g. does he want to stay in his own home, so you need to think about adaptations, or would he consider moving whilst he is able to an easier to manage property?

If you have siblings, ideally you need to be working together on this. That may be the first conversation to have.

@GETTINGLIKEMYMOTHER

Those pendants are not usually much use for anyone with dementia since they will a) forget to wear it, or b) hide it, or c) forget what it’s for and what to do with it, even if they do wear it.

As pps have said, routine is very important with dementia, so best to stick as far as possible with the familiar.

One ploy I’ve heard of, with people who are very reluctant to have a cleaner in, is to say, ‘X really needs a little job, so you’d be doing her a favour.’

Or, if the cost is what they object to (and your own funds permit) say, Oh, it’s free from the government now, once you’re over x age.

When filling in the form for claiming Attendance Allowance, it’s important to state how things are on the worst day/night, don’t gloss over anything. Or get someone from Age U.K. to help you fill it in - they are very helpful.

Please do get Powers of Attorney for both Finances and Health and Welfare sorted out ASAP, if they’re not done already. Can save monumental headaches later. People with dementia can become very suspicious of your motives, and think you’re just after their money, so vital to do it before this stage.

One more thing, do make plenty of copies of keys! Once a person has dementia they are very apt to be lost, thrown away, or hidden so successfully that they never see the light of day again. (Can you tell I’m speaking from experience here?)

Absolutely all of this! I know it sounds harsh but he really shouldn’t still be driving. We had to stop my dad from driving and it was heartbreaking to do, but we were able to mitigate it a bit initially by arranging an account with a local taxi company so he was still able to get out without having to rely on us. Please don’t try to enlist a neighbour to look after him, his needs are going to increase, and possibly quite quickly. I know it’s difficult to get people on board with accepting help, my mum had early onset dementia in her 50s and my dad had mixed dementia in his 80s. What worked for us was very much emphasising it was for his safety, and that it would massively help me and my sister if he could get on board with it.(he adored us and always wanted to see us ok) I can’t emphasise enough about the Power of Attorney, that should probably be your highest priority as it has to be set up, even if not enacted, whilst he is of sound enough mind to sign up to it