To let my dad go home at the cost of my mum's well being?

[JustAllRoundShit]

A couple of months ago my dad (mid 80s) had a stroke. He requires full time care as he is very weak, can't get up or walk or do anything else himself. He's fully there cognitively but very apathetic in the day. Just wants to sleep all the time. When he is not sleeping he is very agitated, aggressive and very quick to anger with lots of shouting.

He is currently in a rehab home kind of thing. He seems to be slightly improving there but he absolutely hates it and wants to go home. I totally understand why. He's always been very independent and also very dominating. It must be terrible for him to be so out of control and helpless, completely at the mercy of the carers. I would hate it as well.

I think we could organise staff to look after him at home. It would take a lot of planning, lots of staff, money, etc but it's doable (we are not in the UK). The problem is it will be a massive burden on my mum. Massive responsibility, massive mental strain because he keeps yelling for her (and not very nicely) and I'm worried that she'll spend the last few years of her life (she's early 80s) being stuck by his bed, caring for him and basically just getting yelled at all the time.

I don't want that for her. She's done her bit for him her entire life (he hasn't been the best husband. Good father but very dominating, borderline abusive husband). For my mum it would be much better if he was in a home. Then she would be free. But he'd absolutely hate it. He keeps crying, begging me to let him go home. I just don't know what to do.

What would you do?

Yanbu: bring him home, while trying to set up the house so that he will trouble my mum as little as possible

Yabu: let him stay in a home and give your mum peace. She's done her bit and we can't expect her to take on this burden.

No, it's his wife's decision to make. Without being guilt tripped by him or their daughter.

She deserves for her last remaining years to be free of her abusive husband.

(And, as OP has explained, her father does not have a social worker, and any public assistance seems to be minimal wherever it is they live... )

I'm afraid I agree with this.

This is a classic 'you reap what you sow' situation. His poor behaviour towards the person he's supposed to love most - over their whole lives together and even more so now - means that it is not feasible for him to get what he wants now, when the decision is finally no longer up to him.

Have some proper compassion for your poor mother, please.

A lady visited her DH every afternoon in the Care Home my relative was in. I really felt for her, what a commitment, but better than having the angry and unhappy man at home.

You said you wanted to take him home for a 'trial' run - to see if your mother can cope? But so far, despite improvements in the rehab home, he hasn't managed to improve his behaviour towards her? If he has full cognitive ability, and badly wants to go home, then he could make the choice to treat his long-suffering life partner with more respect and kindness. But he hasn't. Why aren't you telling him that he needs to step up and change his attitude/ treatment of your mum, that he's on trial and he needs to prove that he can do this, in order to have any chance of getting out of his current situation? Otherwise yes, he will stay stuck there (or a similar setting) until he dies.

He may have the capacity (and legal right) to make a decision, but so does your mother. I'm proud of my gran, for deciding to separate from her dominating/'borderline abusive' husband (of over 60 years) when they were both in their 90s. I hope you make it clear to your mum that she doesn't have to accommodate him in her living space. If he decides to go 'home', that home doesn't need to be the same place as her home. (If they were to divorce their marital home might conceivably be sold, and the money used to buy two small places - he can't force her to stay with him).

If you were in the UK, you could get social services to do a full assessment of both of their care needs. I suspect their advice would be that she lacks the capacity to look after him without it detrimentally affecting her health and wellbeing. She probably won't have the wherewithall to do all the admin involved in coordinating a full rota of paid carers for very long either (it can be quite exhausting).

If you insist on bringing him 'home' it's unlikely to be sustainable in the medium to long term. He'll still be a 'prisoner', just in a different-looking cell (with less support/ care/ professional help/ human interaction rehab than he can access in a home). And your mum would be a prisoner too.

Please don't do this to her.

The only circumstance which I think he should go home in is if your mum leaves. Could you afford to buy/rent another property for her to stay in? And even then it's a sub-optimal option as presumably she'd be distressed to leave her home. But if she stays, she's going to get sucked into caring for him.

What is it that your dad really wants? To go home to familiar surroundings? That's a valid wish. Or to go home to familiar surroundings and having your mum there to bully and order around? That's much less valid.

What if your mum turned round tomorrow and said 'If he comes home, I'm out of here!' Would home still be an option without her there to facilitate his care?

My experience of this is that one or both of your parents fire the carers. Or they leave without notice because your dad is being his vile self.

Your mum kill's herself in a fairly short time looking after him literally 24h a day with no sleep. He still ends up in the home.

Honestly I can't believe you can't see this and can ignore all the posters saying the same thing.

You look after him by yourself for'24 hours and then come back and tell us that your plan is a good one.

You know your father is safe and improving in the facility.

You know your father bullies your mother, and has forever.

You know your mother struggles to deal with his verbal abuse.

Why is his feelings about going home more important than your mother’s, AND the reality that he’s proven to be better off at the rehab? What he wants shouldn’t be the sole deciding factor. His dr has said this won’t work, that it’s not a healthy or sustainable option, having him move home.

I’ve worked in homecare. I can tell you that you can schedule 24 hour care, but that doesn’t mean workers will show up. Staffing problems are in pretty much all areas of healthcare, in many countries. Covid has absolutely taken a massive toll. Plus people get sick, take time off, etc. I can’t begin to tell you how many panicked calls I got asking me to fit another client in, to pick up a shift or even just an hour or two on a day off, or come back to a client after being off ill to hear that they hadn’t had anyone covering my shifts. And, the company I worked for, we were allowed to opt out and refuse clients whose behaviour we didn’t feel we could manage. With homecare, you don’t have other staff to switch off with, to get a break with a challenging patient. If your father yells at staff, or bullies your mother in their presence, you may find it quite difficult to keep staff coming. What happens if there’s an 8-12 hour shift that can’t be covered? Or can only have two hours managed? How will your mother cope? How will your father’s needs be met?

What would happen in the U.K. is that he would come home, fall, lie on the floor for 8 hours waiting for an ambulance, eventually get taken to hospital and then catch Covid and die.

He's better off in a care home. Why can't he go outside with a carer in one? Are there no good care homes? Is it a choice of going home or being locked in your room 24/7 in a care home?

I'm sorry OP, it is a difficult situation for you.

For context, my MIL had a hard time when her dominating, dictatorial father died, a large part of which was down to the fact that her mother (his wife) was overtly pleased and relieved that he was finally dead. Her mother had been obliged to take on a lot of the caring responsibilities. I completely understood MIL's mother's feelings but it was very rough for MIL for a bit, as she knew her father's character but also loved him.

Why destroy two lives instead of one?
Unfortunately your dad's needs now out trump his wants. Today is the best he will ever be. Think long term.
I would encourage a care home, and if your dad insists on going home then for your DM to move out.
Any decent husband wouldn't put this on his wife anyway. The fact he is willing to says a lot about him.

It’s an emotive thing to do and a hard decision OP and I think you’re not considering it with a fully clear mind. I’ve been in your shoes and my dad is also difficult and into the home he went! Initially I was trying to keep him at home but it’s not the right place for him.

your mum deserves to have some peace in her final years.

You don’t seem to care at all about the impact on your poor mum.

So long as the Big Man gets what he wants eh?

Your dads GP clearly understands the situation best. You should do what he advises.

I’m this country if they have capacity to make an informed decision about their discharge they would be allowed to make an “unwise” decision. Nobody would provide 24 hour care, it would have to be privately funded. If he qualified for social care he would get max 4 double handed care calls a day so part of the capacity assessment would be making sure he understands what the reality of that would look like. If it was felt that his needs could be met at home and he was expressing a strong desire to go home, even if he lacked capacity part of the mental capacity act in this country would be to act in his best interest in the least restrictive way possible, which would be facilitating d/c home if it would be a safe and sustainable option. It’s almost irrelevant to tell you the law and discharge process of the uk though because you’re not in the uk, and you would need professionals to assess his needs and his capacity to follow this process. It sounds like there are professionals involved in his care where he is now so you’d be better to ask for their advice (although the GP who’s related to your mum sounds inappropriately close to the situation to be impartial) because they will know the relevant law and process more than we do on this forum not even knowing which country you’re talking about.

I’m going against the grain here but as you can afford 24hr carers then you should bring him home. If I were you I’d then move in with mum for a couple of weeks, even if you have to bring your DC with you, and help her to set up a routine involving the carers doing the caring and her visiting him little and often. Help her to have the trust in them to go out shopping or in the garden out of earshot knowing he’s being cared for. It would give you peace of mind too. I understand what people are saying here but as you are in the privileged position of being able to pay for 24care it seems that this is the best and kindest solution for all but your mum will need that initial support to adjust and accept that she is not his carer nor his servant.

Op clearly cares about both her parents. That’s why she’s posted.

I hadn’t considered this. Good point if the same in op’s DP’s country.
weekend visits home? My friend had her DM and her MiL in care homes and she had them both to stay with her, with paid help, every weekend. Knickers up, knickers down all weekend but both she and DH loved their DM’s and it worked well.

As your parents aren't in the UK, it's almost impossible to make alternative suggestions as we don't know the setup in their country.
It could be vastly different to the UK.

I personally think it would be very unfair on your mum but as other posters have mentioned, you haven't said what her opinions are re him coming home. I still don't think it would be fair on her to be honest.

Also, a PP pointed out that sometimes 24/7 care breaks down for a variety of reasons. What then?

The trial run sounds like a very bad idea. So what if he comes home for a couple of weeks but it simply doesn't work out? Can you imagine how much worse that would be for your dad? He'd have a taste of home and then carted back off again. Not good.

Is it possible to find a more suitable care home? One where he can see the garden (if he can't already but you mentioned a garden).

I do think it's time to put your mum first now though. Best of luck.

I'm so sorry you are facing this situation. It sounds difficult all round.

I absolutely don't think it is right for your mum to have to be caring/putting up with shouting etc. Caring for someone is extremely difficult and after stroke, people can change/become even more demanding- not all obviously, but some do.

I know you said you don't expect mum to do the caring/would get 24 hr care in, but it is worth investigating (as I am sure you would) whether this is actually possible. I know they are not in the UK so it may be different, but my experience is that 24 hour care in the home doesn't necessarily translate into someone being their 24 hours a day. It may be a certain number of visits throughout the day which wouldn't be enough.

I can see why your dad wouldn't want to go into a home but realistically, him going home may well not be feasible. It's as much about him being safe and having appropriate care as it is about your mum not being landed with the responsibility.

Again, no idea if this is possible but would another option be, mum stays at home and dad moves into some sort of supported living on his own? So not a full care home but a sort of in between set up like warden controlled flat with carers?

I hope you manage to find a solution.

If they were in the U.K. and your dad was deemed to have capacity and has a right to be in the house eg. Name on deeds or tenancy agreement, he would be going home no matter what you or your mum said. That’s just how it works unless you dad was deemed to be a real danger to your mum.

as you are not in the U.K. I cannot comment on how things work where you are and whether the same rules would apply. It can be very hard on a relative to have someone home who is difficult to care for. The only compromise would possibly be to set him up with enough support that your mum can be discounted from his care and support needs. Eg having a 24 hour live in carer. Would this be a possibility?

it’s a bit of a no win situation all round really.

I know they are not in the UK so it may be different, but my experience is that 24 hour care in the home doesn't necessarily translate into someone being their 24 hours a day. It may be a certain number of visits throughout the day which wouldn't be enough.

24 hour live in care is exactly that. You’re thinking of a care package which will have visits at different times throughout the day. Which would mean that the mum would be having to support in between visits. But having a 24 hour career could work so long as her dad was onboard with not expecting her mum to do any care at all.

It wouldn't work. For exactly the reasons that the OP has hinted at. Her dad wouldn't leave her mum alone. He would still shout at her and expect her to do things, complain to her if the carers weren't doing things properly etc etc.

And as a pp has said, who is going to want to provide 24 hour care for a man who is aggressive and abusive? No one. It's going to be a struggle to retain people.

The best solution for everyone is that he is in full time care. And the OP's mother finally gets a bit of respite from years of marriage to an abusive bully.

Here's how it works in the UK. Its quite complex but keeping someone in a hospital against their will and sedating them in order to do so would be something that would need very careful consideration and assessment. A relative couldn't just request it and have it happen. Its intended to be fair to all parties so your mother could refuse to be part of his care but if he owns the house or they own it jointly then she couldn't refuse to let him have access to the home assuming he has the capacity to make that choice. https://www.nhs.uk/conditions/social-care-and-support-guide/making-decisions-for-someone-else/mental-capacity-act/

24 hour care is hard hard work. The people who do it can usually pick and choose where they work.

Unless you have a large supply of desperate people available, spending 24 hours a day being shouted at is not appealing and you will struggle to keep staff.

24 hour live-in care is not a magic wand - I had huge problems with it. First of all you get little choice of carer - the agencies say you do, but you don't. The carer quite rightly has a chunk of 2/3 hours off during the day - and you can bet your life my OH would need transferring to toilet (which I could not do alone) as soon as they walked out of the door. The fit spouse has to adapt to a stranger (usually from a different culture) in their home with dietary and other special needs and the loss of privacy involved. They change over every 4 weeks (length of time depends on agency) and you have to scrabble around trying to get a replacement in time, which leaves you little or no choice. Some of the carers are very strange indeed! Some are bad at their job and need constant supervision. There were tasks which my OH did not want the carers to do so I finished up doing them. Some tasks they refused to do out of concern for their backs - and who can blame them? - but getting the right safe equipment was a non-stop battle - try getting convene condoms in the right size and at the right time - blood out of a stone! Sometimes there were personality clashes. If the patient needs attention during the night, some agencies insist on a waking night carer being employed as well - when we got to that point my OH went to a nursing home.

I could go on ...... well and on and on. It requires constant supervision and a lot of patience. You will not be able to do this for your Mum from a distance, and your Mum will get worn down by it - I know I did.

This is a classic 'you reap what you sow' situation. His poor behaviour towards the person he's supposed to love most - over their whole lives together and even more so now - means that it is not feasible for him to get what he wants now, when the decision is finally no longer up to him

Exactly - except that even now, it seems everyone's expected to kowtow to "what he wants" and to hell with the mum's needs