Father won’t accept they need help

[NetZeroZealot]

Dad is a frail 89. Mum is 85 much stronger but bad memory loss, getting worse. She looks after him, he can’t really be left alone for long.
They have a lovely cleaner but I have been trying to persuade them to get extra help at home.
Dad gets very angry at the suggestion.
Yesterday Mum had a fall in the garden & couldn’t get up.
Luckily cleaner was there and saw out the window.
Mum taken by ambulance to A&E. Luckily she was Ok. DH stayed with Dad.
Could have been so much worse.
she now accepts they need help. But because the outcome was ok Dad still gets very angry at the suggestion of help.
Money is not an issue.
im at my wits end.
The need for help is becoming increasingly frequent and I live an hour away & have a busy job & life.
I don’t know what to do.

My DF was the same. I ended up arranging a carer to come in once a week despite his reservations, and he very quickly got used to them being there at which point I could up the hours the carer was coming and have them come more and more often.

What extra help do they need?

I chucked away about £30 worth of food that had gone well past its use by date.
They only buy expensive ready meals, soup etc.
My Dad does not always take his meds & Mum forgets to remind him.
They are both always losing things. Often bank cards which they then cancel then they find the old one. And can’t reactive the new one without my help. This has happened about 5 times in the last year.
The house is messy and covered in papers.
Need help with any paperwork.
Mum needs help organising private physio.
Dad shouldn’t drive but thinks he can.
But most importantly I want a sensible person around in case one of them has a fall again.

I have got PoA but don’t want to do anything they don’t agree to.
Mum now accepts that extra help is a good idea, Dad just gets very angry when I bring it up.

Do they have bracelets or pendants with something to press in an emergency when they can't get to the phone? My Mum's council provides these and a base unit connected to the landline, for a small monthly fee. It was useful when my Dad fell in the house a couple of times towards the end of his life and Mum couldn't lift him.

It sounds as if a carer PA might be required - someone who can help with life admin and organising stuff. It's a gradual process getting them to accept help, I worked on my parents for 2-3 years before they really needed it. It's hard to get the parent / child relationship to shift onto an adult : adult basis. You have to re-frame the help so that it doesn't feel like a loss of independence / power. If you know your father, you'll know which angle to use. Can you try that your mother needs a bit more help after the fall and introduce someone new as helping the cleaner and ease them in that way?

We persuaded my mum to get one of these, she regularly "forgot" to wear it.

Same here. Dad has a pendant. He only wears it if Mum goes out & then it needs to be physically placed around his neck & Mum usually forgets.
He complained yesterday that the cost had gone up.
i said, well it’s a lot of money for something you don’t use!

I have tried framing it this way.
He just says they don’t need the help yet and doesn’t want to pay for it unless he had to.
They have plenty of money.

If they have capacity you are a bit stuffed.

MIL has a daily carer who goes in to cook her lunch and just check in. DH organised it and has let her think it's state provided but he pays for it. Is that an option?

He hasn't lied. There was an episode when she put a silver container in the microwave, it blew and she went to report it at the police station and they reported her to social services. DH simply told her that SS felt a carer was appropriate and we have never disabused her of the fact SS doesn't provide the carer. She would never spend a penny.

She's almost 89 and has Parkinsons.

If he won't accept help theres not a lot you can do.

The trick is not to bail them out in an emergency. It's only when you actually allow an emergency to befall them and for them to have to deal with it all by themselves that they finally sit up and listen. You have to actively let them fail. Going running and sorting everything out for them for free is them living the dream really isn't it? For you, not so much.

You could put in a safeguarding referral to your local authority detailing your mum’s memory issues and her fall risks. Nothing may come of it as she may not have enough issues to be consuu it served a vulnerable adult - but it’s worth a shot.

After that unfortunately if they both have mental capacity there’s not much can be done without consent

id be calling DVLA about your dad - there was a man like that in my local area - he ended up killing a young woman when he ploughed into a shop. You have a duty to report anyone who you do not think should be driving

My own experience and on MN, about 20% of elderly people are planning for the future, make changes are a willing to get appropraite help and then rest are actively refusing help.

Things you can try

• get GP to talk to them
• referals to memory clinic
• referals to falls clinic for Mum and Dad if he is at risk. The falls clinic is really good.
• Now is the time to get things in place ‘just while Mum is recovering’

I would suggest memory assessments for both Mum and Dad.

It will help you in the future if Mum has a formal diagnosis of dementia so proper capacity assessments get done, instead of minimizing as 'memory loss'.

And while she may be worse than Dad, if he isn't remembering his meds and hasn't got insight into his problems, he may well have a memory problem too.

I think I am starting to realise this. I’m too available for them.
They had a crisis when I was away on holiday at New Year.
I didn’t cut the trip short but went straight to them as soon as we got back.

Can you knobble your DF’s car so that he can’t drive it or take it away “to the garage” and just keep it at yours?

If your DF is driving when he shouldn’t and getting angry at the suggestion of extra care, could his cognition be declining too?

And a tip I’ve seen on here is to introduce the carer as a friend and go with them the first couple of times and all have a cup of tea together, then the carer jeeps going but finds a few things to help out with.

You need to think of a way to get him to champion the idea so leverging mums A&E / memory issues

You go with mum needs help and you Dad need to solve her problem.

Look at all that mum is doing
and she is just out of hospital
and do you not love her
and I do so am very worried about her
and do you not want what is best for her
and i do think she needs every day help
and do you not think A&E shook her
and she may say that she is fine now
but she ended up in A&E that worried her
so man up
and make sure that you get someone in who will make her like easier
that is what a man who loves his woman would do

And guilt trip him into believing it was his idea to begin with and push what a hero will be for organisning it

Tricky. There are a lot of different issues in your list, which probably require different ways of tackling them. And tbh not many of them fall directly under the ‘care’ label - some are ‘life admin’, some are not urgent (many people live in messy houses with ood did in the fridge, others are probably more urgent.

so for me, I would try and deal with the issues seperately and in order of urgency.

top priority has to be safety: how safely can they live in their house and how can it be made safer? Have they ever had a care assessment? Has your mum been assessed for her memory loss? Or your dad for his frailty ? Does he struggle in the house? That’s not imposing help on them - it’s making an objective assessment of whether they need help and what kind. your dad taking his medication correctly is part of this, it’s personal care and living safely.

second for me would be your dads driving. how serious are you when you say he should not be? This is one that would keep me awake at night. Does he have any medical conditions that should be disclosed to the DVLA? How much do they rely on driving for transport? Is he having small accidents?

for the house stuff, like I say a lot of people do live like this. How do they feel about you tidying / filing / rearranging / declutterring / taking on admin for them? Do they recognise that it’s an issue? The way DH and SIL tackled this was for DH to basically get into everything - bank account reviews to work out what he was spending on (there were lots of old subscriptions and direct debits still going out, he was paying for two phone subscriptions etc), filing years of paperwork and setting up a new filing system for FIL. Also decluttering the house, removing rugs / stools etc, and getting handrails etc put in. Also set up a taxi account, as we had to take his keys / car off him.

But tbh the whole thing depends on SIL popping in 2-3 times a week to check the mail, deal with admin, remind him about any medical rdv and take him to them, check the fridge for ood food, stick a wash on and just generally keep an eye on things. He also has carers going in three times a day, but they don’t do any of the above. Do you have any other siblings or anyone able to pop in?

@DenholmElliot11great post-ageee 100%. Really it's the only solution here.

If someone does have progressing dementia, in some cases there are medications (Memantine, Donepezil) which can improve the symptoms and do a lot for quality of life. Would this be an incentive to get the memory assessment?

Tricky. My parents did wear theirs. To begin with, they took them off at night in the same way they'd take off wristwatches, but when it was pointed out to them that nighttime was exactly when they were likely to need them they did start keeping them on. I think I've been very fortunate with my parents compared to many here and many other people my age I meet.

Re the car, I was absolutely amazed that my Dad's GP and optician seemed extremely relaxed about giving him the go ahead to go on driving after he had a series of TIAs, was becoming very frail and was in the early stages of macular degeneration. The DVLA suspended his licence for six months because of the TIAs, but then gave it back! I was very worried, but he died shortly after that so we didn't have to intervene.

The loss of independence when he couldn't drive hit him really hard psychologically and seemed to completely outweigh all other considerations. I was taken aback, as he had always been a very sensible, law-abiding, altruistic person. I think I underestimated how much of his sense of self came from being a driver. Turning into someone who depended on others being able to give lifts, or having to get a taxi, was a real blow to his self-esteem, even though decades earlier he'd told me when they moved to the island that they'd thought carefully about where to live and chose somewhere where everything was in walking distance in case the time ever came when he couldn't drive. Easy to say when it's a distant possibility. (Also, they'd not considered that if he wasn't able to drive he probably wouldn't be able to walk very far either.)

Thanks all. Some great advice here.

I’d start with the help they have accepted- their cleaner. They would be able to do fridge sorting, assistance with use by dates and what needs to go on the shopping list, general tidying and maybe a little cooking/ meal prep (like a plate of sandwiches for later). It would mean someone there more often and who could be asked to help to look for things.
it sounds like what your parents need at the moment is companionship care, not a traditional carer, and I know many independent (rather than agency) cleaners are happy to do more housekeeping and companionship

I feel for you - having looked after my elderly father I remember it well. We got the ball rolling by requesting a visit from adult social care. Her recommendations for my father de-personalised the issue and made him more readily accept help.

Like you, fortunately my mother had employed a cleaner before she died, so that was a massive help. I would definitely start with contacting Adult Social Care at your Local Authority, stress to them that you feel they are at risk because your father will not comply with having any reasonable help and take it from there.

As their cleaner is lovely, does she have any friends?

My DM built half her support network from her cleaner. Cleaner slowly did more, cleaner's husband did any handyman jobs, cleaner has a friend who works as a carer...