My parents are sleeping in chairs in the living room

[Pigeonangel]

And I don't know what I'm supposed to do.

I live very close and visit often. Always have done, am happy to. They're good company and have been fantastic parents and grandparents. When DH was terminally ill, and subsequently died, I honestly don't know how I'd have got through it without them.

That was only 5 years ago, they were there constantly for all of us, helping with house and car repairs, running errands etc. Until they hit 80 they were amazing sprightly older people who could do anything - furious at the suggestion they might be "vulnerable" during lockdown 🤣

How things change. In a matter of months they've both had health issues that mean their mobility is badly affected. Until recently it always seemed to be worse for one at a time and they're a great team so got by supporting each other, without asking or wanting much from me.

Now Mum can shuffle a bit with a frame and Dad is unable to walk at all. Last night they both slept in chairs downstairs. Mum suffles about to get food, do some cleaning and bring him a bed bottle etc. She managed to do a roast dinner for them both at the weekend, although I can't believe for a minute that would have been safe.

Mentally they are both totally with it, the house is perfectly livable (ie not dirty, if not practical), they seem OK from a personal hygiene pov, and are insisting they don't need anything from me or social services, they slept well last night and can manage.

Am I supposed to just leave it at that? I'm feeling very overwhelmed. It's just me with DH gone, my DC live away and DSis is also several 100 miles away but has lots of opinions on how Mum and Dad should behave.

I don't know what to do.

They are both under the doctor. TBH last time he was hospitalised I was amazed they discharged him without Social Services assessment. I guess he probably told them Mum was more capable than she is, and that his willing daughter lives round the corner.

I agree with asking them if they'll allow a referral to an OT via social services, there are lots of gadgets that could help and preserve independence. And can be returned if health issues resolve. A lot of older people sleep in chairs but depending on chair it can lead to further issues I think, I remember an OT I worked with saying people can 'end up chair shaped ' i.e affects posture. Some areas have 'showroom' type places with gadgets on display

Definitely worth getting an OT in to see what adjustments can be made and they might also qualify for Attendance Allowance which could pay for a cleaner to come in or someone to do any of the things they struggle with. Can you sell it to them as trying to keep them in their own home and as independent as possible for as long as possible?

They'd be furious. If they want new chairs they're perfectly capable of organising and paying for them etc etc.

I’m a carer to my paralyzed spouse so I have a lot of experience of taking care of a loved one who can’t make it to the toilet on their own.

If your Dad can’t walk at all he’s going to need some serious intervention in terms of help and equipment.

There are lots of options. But you need to have the tough love conversations sooner rather than later.

At minimum they need a commode for the living room as the bed bottle won’t be enough for bowel movements.

Sleeping in a chair is going to hurt more than help over the long term.

If Dad is going to need help with bowel movements from bed then you need a raisable hospital bed for him in the dining room so that your Mum or visiting nurses don’t hurt their backs cleaning him.

Your Mum could then have a regular single bed in there.

This is all you can do

From experience I know how difficult it is, but there’s nothing else you can do at this stage

Could they get a stair lift, so they can get upstairs? That could be phrased as it will make life easier even when they are more mobile again.

I would respect their decision but I would I’m afraid make it very, bossily clear that I thought they were taking a very silly approach that was going to land them repeatedly in hospital with even less independence, more pain etc. And I would do water drop on rock effect, ie keep making it clear - and I might do things like take the kettle to make tea myself because ‘I’m not going to sit here and watch you burn yourself in front of me Mum. You can do that on your own time.’ . When one of them dies the other is going to have to go straight into care. Have they decided which home they want? Oh they don’t want that? Well get an OT in, regular physio, maybe Pilates at home.

i work for a stroke team so alongside OTs and physios so i see exactly what an amazing difference their work can make. How ludicrous that they won’t let you take action.

I would apply for attendance allowance for both of them, they seem from your description that they would qualify.

Then use that money (I believe about £80 p/w each) to pay for a cleaner

Try and get them to move into a downstairs bedroom - failing that into lounge chairs.

An OP assessment would really help - but you need them to let you.

My grandparents were living like this....luckily in a bungalow but unsafe to cook and wash.

Once I set up attendance allowance they would allow a cleaner and used the money for "nice" ready meals which meant my grandad (who was pretty much blind) wasnt being a danger in the kitchen.

Eventually they agreed to an OT assessment and were impressed with the aids provided to help them...very much why didn't we do this earlier

How is your dad going to have a poo?

Yes they are grown adults but they are also not ok and if it was me I would be interfering whether they like it or not.

Do they have a downstairs toilet?

I would be telling them that you’re going to ask the doctor to do a home visit.
It may be something as simple as needing antibiotics.
It may be that he needs to go into hospital and if that’s the case then so be it.

I will then be telling them that I’ll be getting them electric recliner chairs.

I wouldn’t care if they were offended or upset.
Your dad literally cannot walk!

They're not short of money. It's true they don't like spending it but there's nothing they want that money is preventing them from having.

They're not children or animals. Theure human adukts with capacity. I can't make them have a cleaner and chairs they don't want, and neither should I.

They definitely need beds at the very least, if they can be convinced to let you arrange that.
Sleeping in chairs can increase the risk of painful oedema, DVT, pressure sores, breathing issues, joint pain etc.

I realise it is manipulative but can you divide and conquer? Persuade mum that dad needs help and persuade dad that mum looking after him is too much for her. There might be waiting lists for OT, physio etc so getting referrals in place would be a good idea. If their circumstances improve they can return aids or not implement proposed changes.

Then, bluntly, there's nothing you can do.

If it were me, I would have one last go at letting them know about services that they can access now, not waiting for GP diagnosis etc, and really make them listen, don't let them interrupt with 'we don't want to go to any trouble'. Make it clear that you would be available and willing to help them set things up to make life easier and safer in their own home, but you're not going to facilitate them living how they are currently, and then step back.

Let them get on with it. If a crisis happens, so be it. But also, contact their GP and Social Services to let them know that you are not providing care of any kind, and make sure that goes on your DPs records.

Maybe frame it like the attendance allowance is specifically for getting them help and then they might entertain spending it rather than their own money? It might break a psychological barrier.

Hopefully they will get better but at their age they may also go downhill rapidly again. Tell them although you're hopeful they recover you would feel more comfortable if they got aids put in place for the future so they can live independently in their house for as long as possible. Do they also have a disability badge?

The issue is if you and they have no experience of how quickly things can go down hill when dealing with mobility problems they might leave it too late to get help in and things will be worse.

As a pp said - skin breakdowns leading to pressure sores are very hard to treat once they start so it’s important to be checking the skin regularly.

I think you do need to approach with a bit of a tough love perspective. And as a previous poster said divide and conquer.

Stress to you Dad that he needs help to protect your Mum’s health.

At this point could your Mum help your Dad get up from the chair and onto a commode. Is she physically strong enough?

If he was in a hospital bed could she roll him onto his side to clean up bowel movements etc?

OT, PT, district nurses should all be available to them now - and could be the difference between going back into hospital or a care home.

NHRTT but deconditioning may becme an issue even if there's nothing acute immediately. Does your area have an Home Visiting Service for the local GPs, specialist elderly primary care or falls prevention services or such like? Usually GPs would be the avenue though social services or DNs might be an avenue?

This must be very difficult for you. However, I don't think anything you have said here would cause any agency to be alarmed. They're clean, fed, the house is clean, they aren't falling. My MIL used a frame and cooked for herself for years. I am hoping that the chairs are reclining because an upright would be uncomfortable, I would imagine. May they just didn't want to climb the stairs? I am nowhere near 80 but I do have a bum knee and I dread the walk up the stairs at the end of the day.

Contact adult social services. They can provide support, and help, as well as mobility aids etc.

My mum was the same. Very mobile until she had a bakers cyst on her knee and a few other health issues and then couldn't drive etc. That couple with her hearing loss and now she has vascular dementia. It all started in her 80's.
She is now 91. My mum was very reluctant to have any help. She felt there was nothing wrong with her. I just swung it as being someone to help. My first port of call was the doctor. Through the doctor I managed to arrange carers who come in 3 times a day. They are provided by the LA. It is quite honestly a godsend. I think with your parents you need to just have a discussion with them about getting help, even if it is a short term thing. Also agree get power of attorney. I was fortunate when my mum was changing her will in her 70's that she included this. Hope you sort thing out.

There will be a crisis and help or adaptations will be inevitable. You can't forces them to accept assistance, just talk to them and make suggestions.

Would they be up for at the very least an OT assessment for aids, or even looking on Amazon for equipment? I broke both my shoulders within a couple of years of each other recently and got a grab rail and mat for the shower, something to help me clean my bum after the loo (sorry!) etc.

is it their house or social housing? If it’s council or HA they might be able to offer something. Sell it to them as a one off to make it easier to stay independent.

If they're mentally competent there isn't really anything you can do without their agreement. You need to find what will work for them.

What does sway them? And what would you be happy to do for them? Would they (and you!) like it if you went round and cooked a roast for you all each weekend? Can you pop round in the evening and make them dinner? Or in the morning to get their cup of tea? If you talk to your mum about your dad getting bed sores from staying in the same position all day might she be more amenable to some intervention? And if you talk to your dad about the risks to your mum of using the kettle they have, might he be more open to some changes?

They may much prefer the risk that comes with doing things for themselves because they'd rather have a shorter, freer (in their terms) life than a longer restricted one. That's a valid choice and one you can support them in. But also, I think it takes time for things to sink in. You say their frailty is fairly recent, so I would just keep on making suggestions in a friendly way while also talking to them about all the other subjects you always have, so when they are ready, you have an open door they can easily access.

I'm so sorry ~ I've been through a similar scenario and it's very hard

The one thing that helped enormously was our GP requested an O.T. visit. The O.T. was absolutely brilliant with my DP's and they accepted all the suggestions she made even though they had refused when my DB and I had suggested the same

The OT was able to get some minor adaptations made, equipment delivered and we were able to go ahead with moving furniture around to make a better living space for them

Hope you are able to get the help and support you need @Pigeonangel 💐