96-year old dad refusing care home or at-home overnight care

[BlueRaspberry7]

Hi, hope it's ok to post on behalf of my DM (69) who isn't on Mumsnet.

Their DF (my grandpa) is 96 and living independently in a flat. He has no major health issues and no dementia. He is very slow and bent over, increasingly less mobile and he has some digestion problems which prevent him leaving the house much. He can't really cook for himself any more, or clean. He has a cleaner every so often, and a physio who comes every fortnight, and a carer comes by a couple of times a week to make his lunch.

My mum and her sister share the bulk of his care - though my mum lives slightly closer and takes on most of the daily stuff, along with her husband who is great with the DF.

The DF made my mum and auntie sign something saying he would never be put into a care home, and finamcial provision is there for him to have care at home if and when needed.

My DM would like a carer to stay overnights with her DF for 1 week while my auntie is away this summer - as she feels anxious at the idea of him having a fall or an emergency in the night.

He is putting up a fuss about this, saying he doesn't want a stranger in the house.

DM has told her DF he won't have to interact with the carer, he's just there for emergencies.

Can anyone relate to this scenario of an elderly parent who lives independently not accepting the idea of having occasional overnight help at home - to give their adult children a bit of a mental break?

Having watched how much strain my dh suffered looking after his df (I did help too but was mainly my dh) I know how difficult this is.
In a similar situation I told my FiL that there was no choice but to go into respite care for a week. I assured him he would come home and we were not leaving him there forever.
FiL not happy but accepted it because it came from me not dh.
Could your dh say the choice is overnight carer or respite and there is no negotiation. It is not going against the (ill-advised) agreement about not going into care.
I predicted my FiL would feel safer with 24 hour care and he did. He only came home for 2 nights and then chose to go back into the care home where he remained until he passed away. So much better for everyone.

Thanks for your thoughts @caramac04 , i think presenting the option of at-home care or a week in respite would probably help his decision along.

My gran is long gone but my mum and aunts a few adult gc shared the care and it is such a stressful thing, she had daily carers at lunchtime for meds.and a sandwich and respite twice a year for a week at a time she hated people staying in her house, I do think giving him the either or choice for the week will give him control but it is a definite either or, your Aunty deserves a worry free holiday. Id also see if he will up his daily care.

Very familiar with all of this

So my question is... does your mum realise that if there's some kind of emergency, the default will be for the carer to ring her probably? I don't think the carer would take him to hospital or whatever. So if it's something she'd like in the interest of being able to sleep at night, sadly it may not work.

By the way, whatever they signed, it's not likely to be valid is it? You can't sign something to cover any and all circumstances. Was this legally organised agreement?

Does your aunty usually stay overnight? Not quite sure he is actually living independently if so. Or is it that your mum is worried about having to deal with any falls / emergencies alone while your aunt is away - and if trying to circument this by having a carer in overnight?

I'm not sure tbh. If my parent was compos mentis and generally okay at home and understood that no one would be able to come immediately if they fell, I would probably let them crack on tbh. Presumably your mum or someone else is visiting every day?

What @EmeraldRoulette has said.
I think save your energy and emotion and let your GF have his way and redirect it towards reassuring your auntie.
I've seen people suggest Alexa as a way of keeping in touch and speaking to a vulnerable person on their own.
But Im not technically savvy enough to understand how or if this would work.
Even if accepted by the person at home on their own.

If he is capable of making his own decisions then he is allowed the consequences of those. Those around him need to be very clear they are exhausted and anxious and worry about his falling/becoming ill and suffering and dying alone at home. He is likely to be fully aware of that possibility and choses it over any other option quite rationally. He is close to the end of his life, does he need to do what anyone says? If your mum isn't able or willing to give what he needs minimum or asks for (which is likely to be different to what she thinks is needed) she needs to spell that out to him and hear his decision.

When this was my gran it took its toll out of my mum OP. And me too.
We didn't want her in a home but domiciliary care was a fair compromise. And one we had to insist on in the end for everyone's safety.

If he has the capacity to make this decision and understands the risks then there’s nothing you can do other than respect his decision.
Does he have assistive technology like Telecare, falls sensor etc. That can help. Alexa’s are also useful.

I second a falls alarm or telecare -why should he have strangers in his home at 96 'he sounds amazing 👏

A falls alarm would be the first step, you can’t force him to have a carer. If he has capacity there’s not a lot you can do, have you arranged poa?

i agree about suggesting a pendant alarm. But ultimately as long as he understands that if he falls then nobody will be coming, it’s up to your dm to manage her fears about that. It sounds as if he’d rather die alone on the floor than have strangers in. I don’t think I’d make the same choice but it’s not unusual.

We got my nan a fall guard that alerts as automatically if she goes down sje wares on wrist if she fals people talking to her via intercoms and if no response auto 999 and us plus meals on wheel (pretty gross so I've taken back over meals)

I don’t understand why your mum thinks having someone stay with him overnight when he lives alone all the time is needed when your aunt is away on holiday. Does your aunt usually go in every morning or something like that?

if she is anxious about him having a fall at night then that could happen at any time and the best thing may be to get him some sort of fall alarm.

Several options

Respite for a week. Clear drop off and pick up arrangements might reassure him
Carer in the house. My dad was very resistant but showed more interest when he saw some profiles as he loved to chat and some had very interests career paths into care.
DIY it. Why can’t your mum, you or a grandchild spend the week there and give your aunt a break? A friend lived with his very aged GPs during a year of uni specifically to be there overnight in an emergency. They had other folk coming and going during the day.
Tech. Alexa (needs broadband), wearable stuff (but they need to wear it), Siri, other.
Remote cameras. You can use Alexa to “drop in” ok someone. So if you get an automated alert you can drop in and see what’s going on. Tricky unless you put one everywhere or install cctv and most falls will take place out of bed or in the bathroom I think

Why don’t you get a link line for him to wear?

When my DM came to live with me we had an agreement that DH and I would be able to have a fortnight’s holiday a year when someone else would look after her. She was all on board in theory but of course when it came to making the arrangements she wasn’t so happy. We bent over backwards to get family members to help out but no-one would do it more than once. So with no option but to put her in respite care, and despite her protests, that’s what we did.

Once there she loved it and it subsequently became her home.

Do your homework and find a good home and your DGF will be fine. FWIW I doubt very much that any written promise not to put him in a home will carry any legal weight.

I find it very unlikely that anything was signed to say he will never go into a home. No family member can be obligated to care for him, much as they might want to and feel they should. Ultimately if no one has power of attorney to make that welfare decision for him in the event he isnt mentally capable, and professionals were sufficiently worried, they would seek to take guardianship I think.
It doesn’t sound like he is at that stage if he has all is mental faculties, so right now he can totally refuse to go into care. But equally, family can refuse to care for him or provide as much care as they currently are. Obviously his family don’t want to refuse as they love him, but there is only so much they can do. Your mother is entitled to a break away.
He can refuse to have the carer in overnight as that is his right. But that doesn’t mean family can be forced to pick up the slack.
Has anyone asked him what he thinks should happen while your mum is away? Sometimes these things go over more easily if the person feels involved in the decision. If he refuses, then the people helping him need to say ‘ok, fine, but we are only prepared/able to offer this (state what) as support and that’s all’. He can’t have it all ways. He wants autonomy to make his own decisions, fine. Others have autonomy to refuse to pick up the slack and while he still has his faculties, he has to take some responsibility for the risk he might be be putting himself at. Maybe that sounds harsh but in short….
He can make his own decisions.
So too can the people helping him.

As others have said, I don’t think you can do anything against his will as long as he has capacity.
Some interventions we used in a similar situation with MIL (who had Alzheimer’s) included the emergency call necklace (completely objected to), a doorbell camera, a camera in the living room & garden & a key lockbox at the front door so emergency services could be given the code if needed (a trusted neighbour also had the code). Also had a cleaner/carer come for 2 hours a few times a week. All combined we feel this allowed for an additional 18 months of “independent” living, before MIL sadly passing away.

Does your Auntie usually sleep there every night?
If he is deemed to have capacity then you can’t force him to accept any help.
I would make sure he has a call bracelet/necklace that he can press if he falls if he’ll wear one.
My mum is prone to falls and absolutely won’t wear one because ‘they are for old people’…. We’ve sent up a smart speaker in each of the main rooms so that she can ask it to call me if she needs me and can’t reach her mobile (last time she fell her mobile was on the work top and she was on the floor for 4 hours until she was found).
I wouldn’t stress him out by insisting he do something he doesn’t want to, but would up the care visits to each morning and evening.

Incredibly selfish of him to expect two family members to give up their own life to look after him and to refuse to consider alternatives.

Frankly your aunt and mother should make it clear they cannot cope any longer and that he needs to accept external help.

God I hope I don’t do this to my family. Dreadful.

Is he not on his own at night at the minute? It’s a bit unclear to me if the auntie lives there or not.
I would get him an alarm he can press for falls, but really if he hasn’t got dementia and isn’t regularly falling, then if he doesn’t want someone in overnight then I can see his point. Maybe upping the frequency of the carer when Daunt is away could be an option.

Your Mum and aunt need to decide together how much they are willing and able to do for their DF while still protecting their own health and sanity. And then they make it clear to DF that it is NOT POSSIBLE for them to do more as they are both getting older themselves.

Then they tell him they would feel happier if he would accept more care and help, but they recognise that that choice is his - he can either accept extra help to be safer while not harming his DDs, or he can go his own way - but they are already giving everything they can and can't do more.

Unless your Mum and aunt are prepared to stand up to this bully, nothing will change. They need to give him a week's notice that they can't come anymore. Up to him if he pays for a carer or copes alone.