How to get parent to accept the need for a carer?

[PacificState]

My lovely dad (86, early Alzheimer’s) lives at home but is increasingly dependent on his friend/sort-of partner (80, lives down the road) for most things: shopping, sorting prescriptions, attending appointments, fixing stuff around the house, keeping to arrangements etc. I live a few miles away and am happy to help out more as well. But am beginning to think we need to get him to accept some level of home care now before things deteriorate (he’s gone noticeably downhill over the past year). His poor friend/sort-of partner is being run ragged, and (as she tells me, quite reasonably) ‘this isn’t what I signed up for’ (my dad had all his marbles when they met a few years ago). He’s mostly safe, I think, but has started doing things like leaving the gas hob lit for hours. I’m not convinced he can do any cooking other than making sandwiches and heating up soup, so he relies on his friend for a lot of that.

the problem is that my dad is a HUGE personality, incredibly stubborn and almost impossible to argue with. Independence is his reason for living, pretty much. I have a very good relationship with him, but I cannot fathom how we will get him to accept a carer - he just thinks it’s a ridiculous idea and that he doesn’t need one.

added to that (as others with experience of Alzheimer’s will know) even if you construct the perfect argument, he’ll have forgotten the entire conversation within an hour.

does anyone have any experience of this? I’m worried that if I just override him and insist (I have POA) I’ll cause a major fracture in my relationship with him, which would make us both totally miserable.

This would be private care - he won’t qualify for any council help.

thanks

The only way is for you and his friend to be less available. Even then it might not work because each crisis is quickly forgotten. Speaking from experience.

Could you frame it as being to take the load off his friend? Would that help?
I think you should also look at getting an assessment done by GP or social services there's a significant safety issue he's doing thinks like leaving had hob on

Yeah, I will suggest that to her. She’s more on the spot so she gets most of it, and she finds it hard to say ‘no’. If he has to ring me up and wait for me to drive over every time he needs something, it might help the penny to drop

I have gently tried that, but will carry on. She’s been quite unwell (probably stress related!) for about six weeks but of course he can’t remember that… will think about the assessment, thank you

It's not fair on the friend, she's obviously struggling and it's not surprising.

If he is able to accept help from his friend or you, he can accept help from a carer.

Put it to him that it's a temporary measure whilst his friend is recovering. Introduce the carer/s as friends.

Yeah, I think getting her to take a big step back will be a part of it (brilliant as she is).

’Presenting them as a friend’ is one of the things that has occurred to me before. Does anyone have experience of this working - a bit of subterfuge? My dad was a journalist for 50 years and it’s always been difficult to get stuff past him - I don’t usually even try! But am beginning to think something like this might be my best option. (And then hope he comes to enjoy the carer’s company, if we find the right people)

My DM has dementia, is wheelchair bound and lives in a carehome. Problem is that she forgets she can't walk. She gets very angry/upset if I use her buzzer to get staff members along to help her to go to the toilet.

The way I present it to her is that these are 'the rules' and I will be in trouble if I don't call for help.

Saying that I have to follow rules makes her accept the care staff help.

If 'friend' is too tricky as cover, there are more neutral options - 'hone help', 'cleaner', 'someone to run errands while X is unwell' - that may trigger less of an argument than 'carer'.

Ooh, actually he has a RUBBISH cleaner who does bugger all once a week… I wonder if I could slip someone in under the cover of being ‘someone who cleans but will also walk the dog/go to the shop/heat up your lunch’. That might work!

Can you put a note by his phone saying "remember friend/partner is ill so you can't call her for help" as a reminder each time he calls?

Good thought, thank you

Sorry I didn't explain it very well, I didn't mean gaslighting him into believing the carer is a friend, more like "this is Claire, she's a new friend/ nice person who's going to help you whilst Dorothy is out of action. "

But cleaner, housekeeper etc might work the same. Anything but "carer" if you think that would be a problem for him.

It must be very difficult and sad for you to see him becoming more vulnerable, it suddenly creeps up doesn't it 💐

It sounds like he does accept help & carers in the form of you and his friend, so it could be a framing issue, as others have said introducing a person as a friend who does cleaning or housekeeping might work better.
My MIL had a job like this looking after an old lady where she'd clean and make lunch but part of the job was also to just sit and chat with a cup of tea. Does your dad have a load of old papers and photos etc from his career? Maybe you could have someone who would sort through them with him & do odd jobs/ make lunch so it doesn't seem quite so much like it's a carer situation.

two general point things

1 - the penny won't drop, I mean about your Dad not automatically contacting Dorothy. That's the issue with dementia

2 - get ready to watch a slow motion car crash, that you know is going to happen, know just how to stop / ameliorate the impact, and yet are powerless to prevent the crash. That's the one part of the heart break of dementia for family & friends watching their loved one deteriorate.

Yes - introduce a cleaner / errand runner to take some pressure off Dorothy & yourself. This time of year you can sell it as a spring clean

Contact local Aged UK / Alzheimer's Society groups. They will have lots of local information to share, activity groups to attend and general support. Maybe Dorothy could go with your Dad. My Dad was reluctant to take my Mum, as he said she wouldn't enjoy it, she did and they are not just for the dementia sufferer, the group also supports carers.

Contact local social services for an assessment of your Dad and also a carer's assessment for Dorothy & yourself.

Thank you. Yeah, it’s horrible. It’s not even the vulnerability - it’s that he was always such a lively, fascinating guy, the kind of person who could hold anyone’s attention. And now I can see him registering that people think he’s foolish/boring/rambling (which of course to them he is), and it’s making him sort of fold in on himself. That’s what makes me want to cry!

Thank you. With the assessments - is there any point for dad, given that he is reasonably wealthy? I applied for carers’ allowance for him months ago and nothing happened, I need to chase that up. But I was assuming that we wouldn’t qualify for anything else.

Dorothy isn’t cash-rich but does own an expensive house (just the part of london they’re in) - might she be entitled to something?

Sometimes the assessment helps get them to accept carers. The old "coming from a professional" thing.
Notes may not work. My mum removes them as soon as you've left because it's "treating me like a child". I've gone back in and caught her doing it and also arrived shortly after a visit from a sibling knowing they've left a note that has vanished within 30 minutes since they left. Then she forgets the note ever existed let alone what was on it.

Getting an assessment is important because professionals (GP, occupational therapist, social work etc etc) can tell what he needs, what will help, what to expect. Look on your local authority website for this sort of thing. Just because he may not qualify for free care, doesn't mean you can't get support and advice
https://www.northlanarkshire.gov.uk/social-care-and-health/older-people/support-and-services-for-older-people

You could also try Age UK for advice

Yes - the assessments are worth the effort.

They set a baseline - it's not uncommon for families not to realise how bad things have got as the changes have happened gradually. They can suggest services which can help, although your Dad may need to pay for them. And yes - the authority figure has more power then family and long term friends.

I'm rusty on the allowances side of things - Aged UK website is very good for this.

When you arrange for a carer, the manager of the agency will visit to do a needs assessment, so I wouldn't bother with social services. I did get SS to assess, and all they said was yes the care agency is doing a great job. We used the Home Instead agency who were brilliant.

I agree though that your dad is at risk re the gas cooker. My mother had a habit of leaving toast under the grill and setting off the smoke alarms, so the care agency arranged for the gas cooker to only be usable when the carer was there. If that isn't possible it would need to be disabled.

Don't attempt to argue with your dad, dementia means he will be impervious to logic and unaware of his real needs. I would definitely go the route of 'someone helping out/friend/cleaner', do not use the word carer. I didn't even discuss it with my mother, I went ahead and arranged it and told her on the day. When the carer arrived they got on brilliantly.

Your dad will be entitled to Attendance Allowance, it is not means tested and is well worth having. You don't need to tell your dad about it, it's a lengthy form but you can fill it out on his behalf. I would get Dorothy's input so you get the full picture of his daily needs. I'll post the link below.

https://www.gov.uk/attendance-allowance

With Dad, we had to get the (male) GP involved. Dad would listen to a male Doctor. The Doctor told him he needed X Y Z (including care at home) and ....it was agreed. Same with driving. Dad wouldn't listen to us or any woman regarding things he felt strongly about

We had this with my parents.

The trick was to make it look 'only temporary', while Dorothy is out of action. They will soon become dependent on, and used to, the under-the-radar carer, and talk very warmly of how they don't know how they managed without them.

Either that or you have to wait for a crisis...

Your dad does sound a lot like my mum. She has had a basic care package following a social services assessment for a while now. She is still quite uncooperative with the carers, preferring me and my sister to run round after her. I'm not sure there is an easy answer. Your dad's friend needs to take a clear step back although it sounds like things might come to a head soon. You then need to keep reinforcing what you [and the friend] can and cannot do. Get an assessment and put care into place soon and hope that he will get used to it.

With regards to food. My father and FIL both have Wiltshire farm foods which are easily heated up in the microwave. They are kept in the freezer so won't go off and are cooked from frozen.