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.

Two carers four times a day in my area was costed at about £57000 a year. That was two half hour visits and two 15 min visits. Just to give an idea

^^ This

It’s an impossible dilemma. You’re not being unreasonable to want to help your Dad go home when that’s what he wants. But you are sacrificing your Mum’s wellbeing for his needs. If that was what she wanted too (as my own Mum did), if she was saying “it’s worth it to have him home”, then I would encourage you to support her, even knowing the toll it would take (my Mum would never have forgiven herself for not having my Dad at home). But it’s a huge burden. Even with carers she will be dealing with them, directing them, running the house, plus all the emotional burden. It’s time to put her first and enable at least one of them to have a good, full life

Yes. He's had them before after his stroke but we put him into the rehab facility as he wasn't improving in any way. However now he's much better mentally and maybe physically as well.

because he keeps yelling for her (and not very nicely)

Well, there, right there, is your answer. He doesn't get to go home and be cared for if he can't even treat his wife decently, with dignity.

It really is that simple.

Why should his desire for autonomy not be extended to your mother? Please think about that very, very carefully

when he's so desperate to go home

And yet, and yet, not even prepared to act like a decent human being for one moment. Why are men so often treated so differently to women? Why does the idea persist that women are gone how there to facilitate men.

Ugh.

So much better for him to be properly cared for in a home and allow her to visit him, and leave if he is not kind. Let's face he, he is probably going to be miserable wherever he is, might as well let it just be one person. Surely you can see that your mother had done enough and deserves a break.

If he does go home, it will only last until your mother is broken and the a crisis will see him in a home anyway.

So, Your dad needs full time medical care, that's not under dispute from any medical professional.

Being independent and objective, and without taking either your mum or your dads views into account, or any family history, where is he best placed to get that care?

I don't think it's back in the family home.

I'm in the US so its home care situation is different than the UK, etc. Here he would be evaluated and your mom would also as to her ability (physical, mental, psychological, etc to provide care). Unless they were wealthy or had long term care insurance, most likely they could not afford 24 hour care. To get Medicaid, for home care or a nursing facility, all of their assets would be attached. Mom could wind up destitute even to pay for a care home. Healthcare and or eldercare is shit in the US.

So when he was at home he wasn’t improving but he has in the rehab centre. That supports those professionals saying he needs to be in the centre.

What does your mother say? I don’t think you’ve said ?

Then leave it a few months and see where you are.

but seeing people who used to be strong not longer being so is brutal. Bring back at home isn’t going to change that he needs 24 hour care and that level of care just isn’t possible at home. It just isn’t

UK often facilitates at home care for up to 4 times a day at 30 mins a time. The level of care he needs is way beyond that.

it’s hard because you are leaving him so where he isn’t happy but sadly it is fairly normal at that stage of life.

he isn’t ready to go home and rushing him back isn’t the best thing for him either. He needs to be where he is and see what happens from there

Also, you say he’s much better mentally since being in the facility. DH responds much better whenever he is in a hospital or care environment and relapsed mentally and emotionally when at home. The staff and other patients around stimulates him whereas at home he got bitter and angry despite our best efforts to help him. It sounds like your father has similar traits and injury

When I said my dad can only come home if she can ignore his yelling I meant if she can ignore him calling for her and learn to say no and just not go to him

Sorry, OP, but after a lifetime of being dominated by him I think you're kidding yourself to imagine this would happen

As for "carers doing it all", what's to stop him simply refusing to see them, thus making sure your mum's the only one available?

Is he in the UK as if he is assessed and deemed to have mental capacity and his name is on the land registry for the property, he can choose to go home with a package of care. No one can stop him without a court order.

Even with support from outside carers (usually 4 visits per day at most) your mum would still be on her own for 22 hours a day looking after your dad. No paid job is advertised for over 80's with 22 hour days and no annual leave. When my (lovely) dad was a similar age and situation to yours my mum knew it was too much for her and only after receiving gentle reassurance from staff and family did she feel able to say she couldn't look after him any longer. She had been worried about admitting that, felt guilty about it and feared that neighbours etc would judge her. Your mum may say she wants him home because of some of the reasons my mum almost did and it would have made her life miserable, lonely and exhausting. I know you are not in the UK but if at all possible it might be a good idea to come or at least to attend meetings remotely (If your dad hasn't got a Social Worker request one asap) If someone can go with your mum to look at care homes now that would help and do it with support from a friend/other family to help decide. If she can find a suitable one near their home your mum can visit as often as she likes without the relentless grind of being elderly and a carer. I have volunteered in a care home and if you can find a good one where there is some activities and you can make the bedroom homely people he will probably settle very quickly (people do even when they have been adamant they would hate it). In fact many people preferred it because they had company any time they wanted it and liked being visited, enjoying entertainment, regular parties etc which your mum could be present for if she wished. Bringing your dad home for a week would not be a realistic way to assess how returning home would be, it is too short a time and if you did bring him home it would be more difficult or need a crisis to get a care home place in future and that might end up being for your mum and dad as carer burnout is a risk

'Sedation' is quite an emotive word. I suppose from one perspective my mother is on sedating medication in her nursing home since her stroke. Her distress at being there was enormous but there was absolutely no way she could be outside 24 hour care in a secure environment. So she is on medication to manage her mental state. That isn't a terrible outcome in the circumstances imo.

I mean the thing is he can't even stand without being held by someone (or ideally 2 people) obviously no matter how much he wants to go home he can't go home without someone facilitating that. It's not like he can just get up and go home.

I mean this kindly OP - but I do not think you understand exactly what him going home will mean for your Mother. Unless you have Round the clock 24 hour care for him she WILL have to do things for him - and eventually it will break her too - at which point he will have to go into a home anyway.

I think you have a lovely picture in your head that you can keep your Dad happy by letting him go home and at the same time your Mother will be ok because she won't need to do any of the caring. That way it will make you much happier - but, if he's as difficult as you say, I would expect him to insist your Mum has to do things for him and not the carers. She is in her 80's as you point out. I get that it would make you feel better to get him home and have people going in /living in - but it really doesn't sound like that would be at all good for your Mother.

You say, to all purposes, it will be your decision, and I think you need to accept that sometimes you have to make these difficult decisions, and not feel guilty.

I have just reread all your posts. You have not said what your mother wants. It’s all about what your father wants and what you want for him but nothing about what your mother has said she wants or can manage. Have you actually discussed it with her?

I'm going to step away because I’m finding this too upsetting as “your mother” in this situation and being totally ignored by hospital, social workers etc to the point I had to say I was leaving to get action to help me.

Talk to your mother . No scrap that LISTEN to your mother.

No, you can’t do this to your mum becasue he was a good dad to you. You can’t use your mum to alleviate your guilt that you are out of the country. You would set him up at home again and your mum would have to put up with it and you would leave. He’s not a good husband so you need to choose putting him in a home or living with you since he was a good dad, not sacrifice your mum so you don’t feel bad. Even his gp says this. Have you always just thought everyone is better off if your mum jsut keeps putting up with him as that suits you? Do you see how selfish that is? Do you value your mum half as much as you do your dad?
can you afford carers who could take him outside to come into the home for him?

Have you considered the he is "much better mentally and maybe physically" due to being in the rehab facility? And that if you remove him from there, there will be a return to "he wasn't improving in any way"?

Why do you owe it to him? Do you not owe your mother too? You'll be as bad as him if you facilitate this, ruining her last year's. You'll also not be here so you'll essentially be dumping her on her own with it all.
This might all seem harsh but you can't sacrifice one for the other

Absolutely your father should go to a nursing home.

I think it is actually morally wrong for you to sacrifice your mother's last few years at the alter of your dominating, borderline abusive fathers, self pitying tears.

May god forgive you if you do that to your mother.

You have a chance to ignore his tears for himself and do right by your mother.

Its not like you are around to protect her.

How any daughter could condemn her elderly mother to that is completely unfathomable.

He was a borderline abusive husband?

Have you any idea how absolutely miserable that is for a woman?

What their long marriage must have been like for her?

Unbelievable that you actually have to ask.

You don't think she deserves some peace?

Unbelievable. Unbelievable that you don't know what the morally correct thing to do is.

So bloody sad.

Do the right thing.

He’s making progress at this facility? Well maybe he should stay for a bit longer. How about a further 2-3 months before making the big decision?
Your father has bullied your mother for many years - is there a possibility that he is trying tondo the same to you now? He is just not used to people saying NO to him?

It is your father’s decision to make, not yours or your mother’s. Social Services will assist.

What a difficult decision for you and your dm. I don’t have any suggestions, except to say that there is no right or wrong & in these circumstances you sometimes have to muddle through.

OP I just wanted to say you sound so compassionate and thoughtful and I'm sorry you have such a difficult dilemma. I don't 100% know what the legal position in a theoretically similar situation in the U.K. would be; sadly I think it's likely as far any decision / guidance from the doctors / hospital / social services would be, I think costs and a shortage of beds / care would be a huge factor in any guidance given by professionals rather than that guidance being focused on balancing the welfare of your DF versus the practicality of him being cared for at home and the welfare of your DM. I think you're right to consider the welfare of your DM here as to how much can really be done by having outside careers come in to care for him at home and how much (even if just from an emotional perspective rather than physical) would fall to your DM. Ultimately I think if it seems unlikely you'll be able to bring about the ideal situation you describe (ie with carers doing all the practical aspects and your DM visiting for a bit in the morning and afternoon in his room as she currently does in the home), then realistically, it may be the best for him to stay there.

I think it's an increasing issue for us to grapple with in developed nations (ie with low birth rates and aging populations) how we properly care for the elderly. Im sorry I don't have practical real advice but didn't want to read and run when it sounds like you're weighing up these conflicting needs with such thoughtfulness and compassion for the needs of both your parents, and I hope a solution can be find that isn't taxing on your DM and that your DF, if possible, can come to terms with.

Would add I don't think there's a right or wrong, you're clearly all just doing your best in a difficult situation.

He needs to go in a home. It sounds like there’s no way your mum will cope.