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I am of the opinion that both of my parents are approaching not being able to care for themselves. My mother is in rehab and is not walking. She is getting belligerent because she wants to come home and thinks she is walking. My father is barely able to walk around the house. I could go on but the bottom line is they are declining, refuse to recognize it and are just talking about getting her home. They are not compliant with me, only want my assistance. I know I am going to be asked to do things that are unsafe for them, and I won't. So, I am curious if anyone has any suggestions to prepare for this. I do not have power of attorney (narcissistic father) and don't want it. I just want to be there for them but let them do their thing. They will not let anyone in the house, will not go to assisted living, have to be forced to call 911 and I doubt will get any modifications to the home. I try to drop hints by talking about what I am going to do but I don't hold out hope. It will get ugly, that is their track record.

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You can’t “ be there for them but let them do their own thing “ since they are unreasonable . Tell the social worker at rehab the situation and that it is an unsafe discharge to let your mother home . You tell the rehab you can not care for her . People like this will never let hired help come to the house either, or they will keep firing them .

Call the local County Area of Aging for a needs assessment. Tell them your concerns . They will send a social worker to your Dad’s house . If that doesn’t work call APS . And you stop helping them , propping them up delays placement . A wise social worker told me “ Let them fail , so they realize they need help .”

Unfortunately it may take until your Dad ends up in the ER to get him placed.

I don’t blame you for not wanting POA .
We are in a similar situation , no POA and waiting for mother in law to land in the ER , for eventual placement . It can take more than one try . Sometimes they ride the ER, rehab carousel a couple times before permanent placement. Step back and let the chips fall . That’s all you can do with stubborn people . Let the state/ county take over and place your parents .

Beware that your parents may lie and say you take care of them and live with them in order to get discharged home . My parents did that. Make sure everyone knows they live alone and refuse hired help and that you can’t help them because they are non compliant and unsafe .
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SusanM56 Feb 29, 2024
Excellent advice. Parents do lie to get what they want, even if what they want is hazardous.
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"I just want to be there for them but let them do their thing."

This statement contradicts itself. Which is it? You want to help when they ask (but only if they ask you the "right" things) or are you willing to step back and let the chips fall where they will?

You can't have it both ways. You will be ricocheting between those 2 things and burn to a crisp in a brief time.

You cannot force an adult to do something against their will very easily -- even whe you *do* have legal authority. Please don't help your Mom get home. Don't cook or shop or clean for your Dad. Don't prolong the delusion that they are "independent" in their home. They're not. Stop being willing to be their solution.

Instead, tell rehab your Mom is an unsafe discharge. Ask to speak to a social worker. It may be an opportunity to transition her directly into LTC. Whoever goes to bring her home gets to be suckered into the black hole of their needs. Then you can report your Dad to APS to get him on their radar. Everyone needs a legal representative to manage their medical and legal affairs. The county can acquire guardianship for both of them and will deal with them. This is the care your parents planned for, so let them live out their plan 100%.

No one can be assumed into caregiving. The caregiving arrangement needs to work for the caregiver, or it doesn't work at all. Please read other posts on this forum on adult children who are struggling to get out from under the burden and guilt of demanding and uncooperative (and unsympathetic) parents.
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"Just be there for them but let them do their thing", like you said. Don't hint at what you'll do for them, be up front about it. Without POA, there's not much you CAN do anyway. If the rehab facility feels mom is not capable of going home to live independently, they will refuse to release her and insist dad make arrangements to place her in Assisted Living or Skilled Nursing care.

If not, they'll release mom and you'll have to wait for a crisis to happen to one or both of them which will force placement against their wishes. That's how it works for stubborn elders who refuse everything and everybody's help. The upside is they get to live and die on THEIR terms, which is nice.

Wishing you the best of luck with a difficult situation.
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My ‘suggestion’ is that you tell your parents you will visit them at a care facility but not at home. Beef it up a bit: They will not be safe together at home, and if you know they are not safe but stay involved you risk being legally liable. You simply cannot and will not risk it, because you are not willing to end up on the wrong end of the law. You will not have any involvement in them doing something that you know is unsafe. You 'are there for them' in a facility with proper care for both. Start with this for Dad, straight away.

If they want to ‘go home’ they do all the organisation of it themselves. To get M home, for both to live there, and to cope with any paperwork and medical arrangements that need to be made. The lot!
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CaregiverL Feb 20, 2024
There’s a ton of paperwork to be done if both of them placed in facility. It has to be done properly & accurately. The new job will be as an advocate.
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My friend, think about this situation. Your mother thinks she is walking when she is not. That's pretty serious dementia right there.

Your father has serious mobility issues too. So really at this point it's not about what they will "allow". It's going to be about what is safe and what isn't.

You say they only want your assistance but refuse to be compliant with you. Well, too bad because there is no one without the other.

Ask to speak to a social worker at the rehab your mother is in. Tell them the truth about their unsafe situation at home. Then let APS take it from there.

Do not help your mother get out of rehab. Don't even go and pick her up.
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You may also need to prepare yourself that there is nothing you can do about this, and that the court is unlikely to remove your parents powers to manage their own lives and make their own choices unless the MDs diagnose them as a danger to selves and others.

To be honest there is nothing you can do with uncooperative parents who are not in dementia enough to the level of being unsafe in their own care.
And you aren't POA, and I AGREE WITH YOU COMPLETELY that you never SHOULD BE. As someone who was Trustee and POA for a lovely, organized, quite with it and cooperative brother, it is hard enough to do in the best of circumstances, and in your current circumstances it is impossible.

I would not intervene. I would call APS when you decide that is needed and they should be put into the care of the state. Tell APS you cannot intervene. Meanwhile attempt to see they have food to eat, and if they will allow it, some household assist to do straightening and cleaning for them.

I am so sorry. This falls under there is not always a "fix" and not always an "answer".
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Southernwaver Feb 19, 2024
Yes, Alva. My mil won’t assign anyone POA and I have realized that is a gift she is giving me.
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Why Mom is in Rehab have her evaulated for 24/7. If found she needs it tell them it would be an unsafe discharge if she was sent home because your Dad is not capable of caring for her. You have no POA and do not want it and cannot care for both of them since they won't do what they need to do. Then Dad needs to see an elder lawyer to split their assets. Moms split going to her care in a NH and when gone, apply for Medicaid.
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Your mother is an unsafe discharge. She lives with a spouse who is barely able to care for himself. Alert the social worker of that fact. You will have to tell your mother if she wants to come home, she needs to coordinate how she will get there and who will be helping because you will not enabling this situation anymore.

Contact an eldercare lawyer to recommend how to get her on Medicaid.

I guess you will need to wait until your father falls or needs medical attention that will put him in the hospital. Then you do the same thing for him. Hopefully you won't have long to wait for that to happen.

It does get ugly because they were in denial as to how bad their situation is. Mine are 95 and I finally got them both into a nursing home after years of watching this train wreck.
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Repeat this phrase all day every day to the rehab: unsafe discharge.
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Start practicing your versions of "No"
"I don't agree"
"As I don't agree, I won't help with that"

In short:

Offer them choices
Let them decide
The Consequences are theirs

If this means 'failing' at home, this is how they will learn. Then you may have an opening for them to consider change. Maybe.

Alternatively, if they still refuse, let real world consequences force them to change. Medicos* make the call on home vs ?? (*Rehab or Hospital discharge planner, Social Worker etc) while you stay neutral.
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AAAH! I did have this problem with my brother. I would not bring him home. I told him he was too sick that a rehab center is where he needed to be. He refused and I refused. So I left him at the hospital and I told them that I would not take him that he needed to go to a rehab place. Of course he was of sound mind so he called a friend and the friend brought him home (he lived in my guest house). Anyway, 5 hours later the ambulance showed up (he called them) and took him back to the hospital. I went out to see what was happening, he would not even look at me. I just prayed he would be okay and that he would make a better decision. After he was checked out he did not come back. I found out later (two weeks) that he did go to a rehab center and he was finally released and his so called friend did bring him back to the house. I know a long story just to say... please stand your ground make sure the hospital knows that it is an unsafe place for her to go and get a social worker involved.
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You have to speak the truth to them. They will know what you are saying is correct, even if they don’t want to hear it. My parents were the same until my dad got sick. Then my mom realized they can not safely live at home.
Live with no regrets is the rule of the day. Don’t be left thinking “why didn’t I say something?”
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Kayleen,
I wonder if you have any update for us on your problem here.
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I always like to think about how I would be in the part of the parent. I would want to be in control over my life, even if I learn later that I made the wrong decision. Respect your parents and their decisions whether you agree or not. Yes, they may realize later that they need help but allow them to find that out on their own.
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If they fall, call 911. If your parents cannot get up off the floor on their own, EMS or the Firemen will force them to go the hospital. From the hospital, the doctors and social worker will be involved with getting an Elder Care Attorney petitioning guardianship. I am the only child and never obtained POA.

If your parents fall and there is a fire, they will not be able to escape in time. Remember that. Your goal is to keep them safe.
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Beatty Feb 29, 2024
5 yrs of calling EMS for falls here.

Transported to ER only when head strike reported or other injury evident - otherwise lifting device used, placed in chair, obs taken & back to 'business as usual".
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The mother is easier as you can ask the doctor to be the bad guy and tell her that she medically cannot go home. The father will be more difficult as he is already home. He may go into AL if his wife is there, otherwise, you may have to wait until a medical event happens that causes him to go to the hospital.
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Thank you. You have a 'good' handle on things and that is the first step.

* Know your limits.
* (Continue to) set your boundaries of what you will and won't do.
* Realize that they are in control of how they proceed 'even' though they do not have the mental / psychological clarity to actually be in control to do what is in their best interests.
* What likely will happen is that they / individually will end up w a physical injury and be UNABLE to return home. They will be forced to move into a care facility that offers what they need / cannot get at home.

Of course, they will go 'kicking and screaming.' That you know this already will help you prepare mentally (as it seems you are already doing).

There is NO HINTING. They will not listen to you now or later on.
You need to resolve yourself to 'what is to be will be,' knowing that you have done the absolute best you can / could.

At times, a third party can 'get through,' talk to a person that you are close to... they will hear / listen in a new way. The family / familiar history or baggage isn't there and often others respect the professional of a stranger, i.e., a psychotherapist for instance. While this may not be the situation here, enlist your 'helpers' as you can - and for YOU.

You need to keep yourself together.
You deserve to have a full life and not drained due to their resistance.

Bottom line: If they are not compliant (as you say), then they DO NOT get your support / assistance. They will not be happy campers. This is the reality of the situation and isn't that unusual although painfully sad and unfortunate.

Do some thing(s) nice for yourself. This may feel very much like a mixed bag of history, attachment / detachment. Let us know how things move along.

Gena / Touch Matters
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JColl7 Feb 29, 2024
I’m in this exact situation with my 98 yr old aunt. She refuses any help, will not allow anyone in her house, except me & my sister, and of course does not want to move anywhere. Her doctor even told me there’s nothing I can do. She doesn’t have dementia but she is going blind (because she refused to use eye drops prescribed by her doctor when that could have prevented her lost of sight). Hate to think it but only a crisis will get her out of the house.
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The hardest answer is that you do as little as possible. The more you do - the more you enable them to believe they are independent and don't have any need for help - all the while you are facilitating all of the gaps. Before you know it - the little things become big things.

Don't take mom home - if Dad can't walk and mom can't walk who will be taking care of them? If they can't take care of themselves - if Dad can't take of mom - then mom is an unsafe discharge. And that's what you tell the rehab. If dad wants to take her home- he can get an Uber and take her home himself. (sarcasm and my point - we know he can't do it) The more you step in and make things work for them - the harder they will fight you on doing what needs to be done because they don't believe they need it.

They will not let anyone in the house, will not go to assisted living (frankly it sounds like they are both beyond ALF at this point) have to be forced to call 911 and don't want to modify the home.

Do you know what I read there. They don't want to help themselves. Sometimes we get in our own way by trying to do what we think is the "right" thing - when its really what society tells us is right and not necessarily what is right for our family member or for us.

When we come to this fork in the road - a lot of emphasis is put on our loved one's wants. They don't WANT to go to a SNF. They don't WANT to leave their home. They don't want to let anyone in, they don't want to call 911. While it would be great if people got some of the things they wanted, priority has to be given to their needs - and top priority - at least one of them - is safety.

Yes, while they are competent they are allowed to make any stupid decision they want. No matter what we think. But that doesn't mean we have to like it. And it CERTAINLY doesn't mean we have to help them do it. If they are not compliant with you and only want your help - don't help.

They believe they can do things on their own because you are the solution. I don't mean to be cruel. We want to help, society teaches us we should help. But the only way we can help sometimes is by not helping. It is when we step back that they have to find another solution.
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waytomisery Feb 29, 2024
I agree,
That word “ WANT”. The root of the problem .
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I would write a real paper letter, address, date, signature and all, to Rehab saying that you cannot and will not care for your parents. Reasons if appropriate – live too far away, must keep job, personal illness etc. Keep a copy.

When things are done verbally, or even in emails, it’s too easy for the comments to ‘get lost’ from the facility file. Hearing one thing from you, lies from them, listening to them is more like what the facility staff want to hear and is what gets onto the file. Paper letters don’t normally get lost.
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mich5210: Call APS and then step aside. It should be noted that it would be an unsafe discharge to home from the rehab for your mother.
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Who did your father leave POA to? Maybe that person can intervene and help out. You seem like a caring and responsible person. Sometimes we have to accept when our hands are tied and hope for the best. Don’t forget to Consider yourself too and all of your wishes. You matter too.
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Talk to the care manager or social worker where your mom is getting her rehab. Explain the situation. Ask her doctor about the level of functioning she need in order to live independently since your dad is not doing well either. Let them be the ones "to tell" your parents that the time has come for assisted living or skilled nursing.
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