FIL won't accept outside help

[StubbornFIL]

I don't even know what I want to get out of this post, other than just to let off steam, but maybe people have suggestions for how to deal with this that we've not thought of!

FIL is not in the greatest of health. Has become increasingly unsteady on his feet.
There have been a couple of incidents recently of him injuring himself, on one occasion quite badly, whilst trying to navigate around his house/do housework.
He is also terrible for not wanting to go to the doctor/hospital. He'll leave things because 'I'm at the doctor's next week, I'll just mention it then' (which includes a head injury that was bleeding profusely!).

He absolutely refuses to have anybody come in and clean or care for him. Is incredibly resistant to anything like a stairlift being installed (bathroom upstairs so he has to go up the stairs). He can easily afford these things, it isn't the money.
He does have a nurse that comes in a few times a week at the moment to redress a wound he has, but that is it. He is also adamant that he wants to stay in his house, and I think sees any discussion around his ability to cope as an attack, and will almost go out of his way to 'prove' that he CAN cope (resulting in him, one one occasion, falling down the stairs because he cannot, in fact, cope...).

DH is not his only child, but is the only local one. His siblings do help when they can, but obviously they're not nearby most of the time. So it is all falling on DH and I'm really worried that he is going to burn out. He is working full time and then having to go round to his Dad's most nights at the moment to check on him, fix something, make sure he's eaten something etc. His Dad also has a frustrating tendency to not ask for help, but rather just hint at it "My curtain rail has broke. I expect I'll have to see if I can try and fix it later.... I'm going to try and get outside later and do the weeding" knowing that DH will then say he'll come and do it straight away to avoid his Dad trying and hurting himself.

He has an alarm thing that he wears that is supposed to alert if he falls. He doesn't always wear it, or it has failed to go off a couple of times.

I really feel for him, as clearly he is struggling with the loss of independence, but my DH cannot keep on like this either. His Dad often talks about how he used to care for his Mum when she was older - clearly suggesting that he expects the same back. But his Dad forgets that he was retired then, and his children all grown up (whereas we have a young child).

I help where I can as well - I do his shopping for him, send meals round to him, and am picking up some of the jobs DH would usually do at home so he's not got them on top of helping his Dad. But we both work full time, have a young child, its taking its toll on all of us!!

As I said, I don't know what I hope to get from this post other than just to get it off my chest, as I don't believe there is anything we can actually do, beyond setting some boundaries with him about what help we can provide.

Setting boundaries is right. You need him to understand he can’t cope, and he won’t understand that as long as your DH is enabling him.

Keep a record of falls. It’s usually falls that trigger the move into a care home.

You could get an Occupational Therapist to suggest aids - a well placed grab handle or two, a perching stool for bathroom and kitchen, a bed rail to help getting out of bed, and so on. These are all provided free on the NHS.

Try and find a local handyman who can do things like curtain rails. Having paid for “acceptable” help can be the gateway to getting further help eg with cooking and shopping. And never talk about “carers”

Might be useful if "someone else" he or you knows had x support etc, with older people I know it seems more acceptable if someone else is getting that help. With the button you could tell him about someone my mum knows who was stuck for a few days as she didn't have a safety button. (Which triggered the neighbours to all get one).

Yeah, we do try the 'someone he/we know has x' - and he has been occasionally open to the idea of certain things (like the stairlift) immediately after something happens (like falling down the stairs) but once he's recovered and/or seen the cost he turns against it again. He's also convinced he's going to die any day (has been saying this for as long as I've known him!) so sees it all as a waste of money.
And to be clear, money is not an issue - he can very well afford it. But he also hates spending money!

What I'm unclear about is whether at any point the decision moves out of his hands - is there any point at which he HAS to go into a home? I wonder if every time he ends up in hospital having fallen or injured himself whether it gets 'logged' by someone (no idea who!) or is it purely for us to keep trying to persuade him.

I can see that we can refer him to the occupational therapist at our local council - what happens if we do that without his knowledge I wonder? He wouldn't allow us to do it willingly I don't think, but I see that I can tick a box to say they're not aware... (I imagine he'd find out or have his suspicions and be furious!)

Do you have LPOA for finance?

I have this for my DM and if she even vaguely hints at having something, I've bought it for her before she has a chance to change her mind or find out how much it costs.

I got treated to how much her podiatrist had cost the other day, a whole £32.

I pointed out this was a degree educated professional, who provided all their own equipment and had visited her in her own home.

I think there is a tendency to revert to 1970s pricing.

Is there power of attorney in place. If he has capacity then you cannot force him to get help or equipment in. The nurse might be able to help persuade him with having a therapist to look for equipment, they are free up to £1k. Every ambulance and hospital visit will note he fell and that they suggested care and that he declined. You can report your concerns to the nurse, his gp and social services so he in on their radar but often it takes a crisis or a serious injury until anything changes. I would try and get a keysafe installed, the fire brigade can do a safety check. Your dh needs to say he cannot carry on like this, it's affecting his health. Does he claim attendance allowance and your dh carers allowance, your dh can ask for a carers assessment

It is also worth one of you going with him to medical appointments, or being present when the nurse visits.

It's more than likely he will only mention 1% of what is really happening. The nurse may be just going in, doing her task, and leaving, with not a lot of insight into the other problems.

I had some success with my DM when she started up about not taking her blood thinners so she could die of a stroke - I pointed out she might not die and be stuck alive unable to speak with someone wiping her bum. She packed it in and got on with taking the blood thinners. Turned out she had been assuming she'd just keel over and die, not linger on heavily disabled.

It's incredibly difficult. I tried a few things for my mum with varying degrees of success: going to docs with her and doing a lot of eyebrow raising and gesticulating every time she said she was fine! Phoning docs myself and crying/begging etc for a home visit that I could explain away to mum as 'the doc visits everyone over 80 once a year'. Getting a rota going of people to visit. She had a cleaning lady which made things a bit easier but I also asked her neighbour to pop in occasionally and a handyman I'm friends with, to get her used to the idea of people who weren't proper friends (all dead!) being there. It sort of worked for a bit but inevitably, she only 'accepted' carers when she ended up in hospital and they wouldn't discharge her without a care plan. As soon as she was recovered enough of course she sacked them and got rid of all the disability stuff. So the whole thing had to be done again the next time she was in hospital....

There can be a point at which he HAS to go into a home.

Usually this is for one of two reasons -

1 he doesn't have capacity anymore. Ie he is deemed not able to decide in his own best interests. In practice this is usually people with dementia, often quite severe.

2 he injures himself so badly that when he winds up in hospital the hospital refuse to let him go home and insist on a care home.

2 is rare.

I had a conversation with mum about how I would support her to stay at home as long as viable, but that meant she had to cooperate. So a mutual plan to meet her wishes to be home.

Getting any help in is key to then adding to it as he becomes more comfortable with assistance. We started with district nurse for one thing, then cleaner, then carer to help shower twice a week.

I was also direct in what I could not support and would need outside help.

My mum had a fall at home three weeks ago (she has had many, many falls previously) and is in hospital. She has cancer and it’s likely this will be the last place as we move to palliative care.

Option 2 as explained by Octavia is usually more:

He goes into hospital and at the end of the admission physically cannot get himself out of bed/into a chair/has had several falls even while in hospital. It is impossible to manage his needs even with a care package.

There is then a family meeting showdown where he gets told he can't manage at home.

This is fairly common. However if he has capacity he can still insist on going home - the concept of 'going home to fail' does happen where a rapid readmission as it isn't working is basically expected.

Thanks all. His last fall was backwards down a flight of stairs that resulted in stitches in his head in double digits. He didn't tell anyone, other than to ring the people who manage his fall alarm thing the next day to complain it hadn't gone off. Thankfully they sent someone round to check on the device who managed to (after some time) to persuade him the massive gash in his head that was bleeding profusely needed looking at...I'm hoping that got logged somewhere... The hospital weren't actually keen on sending home after that but he insisted.

DH does have power if attorney set up, but only for when fil isn't of sound mind anymore.

DH is going to try and sit him down and convince him to have the occupational therapist visit, and is getting quotes for a stair lift, so hopefully that goes somewhere. And a neighbour's relative who has done some things for him in the past has offered to clean for him, and he seems to be coming round to that as it's someone he knows...

God it's exhausting though. I hope I'm not this stubborn when I'm his age!!

Starlings are not always safe especially if people have poor balance and coordinations they can still falk down the stairs falll off the stairlift,,.

speaking as one who has been in your position .... time for some tough talking by your DH to his DF.
"Dad, I'm getting quotes for a stairlift. If you learn to use it you'll be able to stay at home, like you want to."
"Dad, work is really busy and tiring, and the kids are having a tough time at school just now, so I'm getting someone in to [insert jobs here - housework? gardening?] so that you don't have to do it all yourself. You know how tired it makes you."

Alongside that, do get the local council social services to do a proper assessment on him. Ours were very good, and they supplied some items free of charge, such as a Zimmer frame, grab handles for the toilet, and height-adjusted stool for the kitchen. We'd no idea this was even possible. Turned out that the local council was keen to see people stay in their own homes as long as possible. So your DH may need to focus on reassuring his DF about this. Ours had a script along the lines of "you've paid in all your days, now it's time you got something back" - avoids it looking like 'charity'.
It's a tough time, OP. Hope you get something sorted for him.

Has he got LPOA for finance set up? This gives the option of being used before the person lacks capacity - my DM finds this v useful for getting me to do her shopping for her.

Honestly finance is by far the most useful LPOA.

If not, or the box wasn't ticked, it can always be done again.

Lots of good advice here. The key point to hammer home is that these adaptations and changes are what will enable him to stay at home for as long as he can, and that’s what everyone involved wants to happen!

your DH will have to push this forward.

@AnnaMagnani , sorry, it’s a bit OT, but re 1970s pricing, I once visited my mother’s (dementia) care home when some of the ladies (not Dm, she was long past being bothered) were having their nails done.

I stopped to admire, and said to one what a pretty colour her nail polish was.

’Yes!’ she beamed, ‘and do you know, it was only one and six!’ (7.5p!)
(so more like 60s pricing)
Another resident thought she was running a guest house and complained more than once that another resident owed her nine quid for last week’s rent.

@GETTINGLIKEMYMOTHER a long time ago I was working as a care assistant for a lady with dementia and we needed to pay the plumber. It took me all day to convince her that the bill of 100s of pounds was right and no, she couldn't just give him 1 and 6.

DH's parents were always like this as they are just tight, but my DM doing it who wasn't like this and definitely doesn't have dementia was a shock.

Having said that DH who WFH was moaning about the price of a bagel when we went out so maybe we all do it if we aren't regularly spending and so keeping up to date.

Having said that DH who WFH was moaning about the price of a bagel when we went out so maybe we all do it if we aren't regularly spending and so keeping up to date. I think that’s right. A lot of my feelings about prices date back to my retirement. I’m ok about the prices of holidays and grocery shops, not so OK about smart skirts and boots. And mascara. Saw an expensive one in Boots today so scoured the shelves for a cheaper one, and they were all the same price!

Have you claimed attendance allowance.
It is relatively easy to get and not income related at all.

I then said- the government are paying you £60 (later higher rate at £100) a week to pay for help- what help do you want to use it for? And that seemed to work.