My dad, a stroke patient, refuses food, medicines and physiotherapy. He gets stubborn if we insist and heads off to sleep. What do we do?
My dad has a history of health problems (diabetes, heart disorder, hypertension). He suffered a brain stroke in April this year that left him with right hemiparesis with loss of speech. From total flaccidity of his right limbs to gradual movement of muscles - he has witnessed improvement (though there is negligible improvement in his speech). He recently started refusing food and any treatment and gets stubborn and angry when we insist. We have tried cajoling, pleading and shouting but in vain. What makes it hard is he can't even tell us why he won't listen. We even took him to a psychiatrist to alleviate any depression he may have (after guidance from his doctor) but that has hardly made any difference. A friend suggested keeping him under the strict supervision of an old age home for 15-20 days that would build in some discipline. It is heart wrenching for us, seeing him like this, but all options have seem to have run out.. Does anyone feel for or against this?
As an example, there were many men that killed themselves because they were prevented from joining other men going to battle in WWII.
I also feel these things very strongly.
I've already told one of my daughters I do not want them (I have 2 daughters) to provide any personal care for me at any time. I was sexually abused and I cannot experience that without it being sexual. I can't let men even touch me without strong emotion, my son cannot help me here. If I need that kind of care it would be easier to die. A woman that would provide that care would sexually arouse me but would do nothing about it, I would quietly go insane with desire (depression, angst wanting something I can never have), pure torture - I'd rather be dead than suffer. That sounds like I'd rather die than live without sex. Not so, if I'm that bad off, yeah I would because there's no way for me to live without suffering significantly. I live without sex now. I am disabled with PTSD and I'm not fit to be a romantic partner. I'm not gonna force anyone and I'll stop it unless I'm convinced a woman wants to help. We all have to die sometime, why can't it be with some dignity?
Dad has started walking using a tripod walking stick but he keeps losing his balance every now and then. He uses the bathroom on his own, however, he needs our help when he takes a shower. He has expressive aphasia and some amount of cognitive difficulties. Therefore, he can't speak, write, form words/ sentences or identify objects though he does read/ skim through the newspaper. He also feels lost when we write sentences to ask him something.
At present, I stay with dad all day, then the family is together in the evenings when mom and sister get home.
I live in Mumbai (India) but couldn't find the appropriate postcode whilst registering.
I really appreciate your inputs and all of it makes so much sense. I am glad I could talk about this with someone who has experienced the situation my family is in.
We took dad today to an old age home and surprisingly he didn't resist. I felt so overwhelmed and emotional that I was struggling to not cry. However, we are doing this with the hope that he will get some discipline back into his life and eat and exercise on time. Like his doc mentioned, physiotherapy is what will improve his condition and we can't take a chance to delay it. We will be constantly monitoring his progress.
We also have been trying speech therapy but have hardly noticed any improvement.
After I move to the UK, my family would think about two options - moving him to an old age home where we can get him home on weekends OR keeping a 12-hour maid along with a family member (right now, we are not sure who this person could be. We are thinking one of my 2 grandmoms.)
The past few months have been really difficult but its all worth it if we can get dad to somehow lead a better life.
Thank you so much for your suggestions... I will keep you posted :)
Is your dad able to walk safely on his own? Can he use the bathroom on his own, shower on his own? With his speech issues, I'm assuming he is not able to communicate with you easily. Can he write notes or get his point across?
I take it that your mom lives with your dad, so she is home with him at night. Is that correct? With your dad being diabetic, having heart issues and now the stroke, he's definitely setting himself up for another heath disaster by refusing to take his meds.
Your question is does it make sense to have him in a facility where he can get 24 hour care, medications, meals and more rehabilitation. I can see why that would make sense, especially if he knew if he improved and got on board with being more cooperative he could then come home. That might give him some motivation.
I'm assuming that you are in the US, but I can't check your profile right now or I will lose this post. You and your mom need to talk to your dad's primary care physician and getting your dad in a facility. My questions would be, what if your dad refuses to go? I'm not sure he can be forced. It's possible that Medicare will not cover his facility care if certain things don't happen prior to placement. Most situations require a 3 day hospital stay before your dad can go into a skilled nursing facility and be covered by Medicare.
You need some answers from his doctor to better understand what obstacles you may encounter in placing your dad. If you have a facility in mind, you could also go in and talk to the social worker and get a better understanding of what is required for placement under Medicare coverage.
You are in a difficult situation Reann. I appreciate your concern about have an in home care giver who will be unsupervised and observed due to family work hours. If it comes to that, I would suggest you check into video cameras that allow you to observe the situation from a computer. There should be some experts in that field who can offer suggestions.
I don't know if this is helpful. Stay in touch and keep us posted.
Hugs, Cattails
Before he had a stroke, my dad was an active person. He was also, however, stubborn and a pessimist, which we know could be the reason for low motivation and therefore consulted a psychiatrist.
We take him for regular check ups and had sorted his urinary tract infection. I am right now in a hospital as I type this, since he felt dizzy yesterday and collapsed. Doc said its nothing major and the trigger could have been cuz he refuses his food and meds and regular exercise.
Pl let me know what would you suggest. Thanks :)
I can tell you that my dad suffered a serious stroke in July of 2011. His speech and ability to swallow was badly impaired as a result. His speech is still a problem and his swallowing has improved, but he still has limitations of what he can eat and the types of fluids he can drink.
My dad will be 90 years old next month. After he left rehab, we brought him home to live with us as he needed 24/7 care. He really could do little other than feed himself. We kept him with us for 9 months, but then put him is nursing home care. We had been taking care of my parents for 7 years. My mom had passed. My husband and I felt badly placing him, but we just needed to have some time for our lives.
My dad is not doing as well as we hoped in the NH. It's a good place and only 10 minutes from us and I see him often, but he seems to have suffered a loss of spirit and doesn't really want to eat much or engage with the staff.
I can so appreciate your comment that it is heart wrenching to see a parent decline. It breaks my heart to see my dad so uninterested in the world he occupies. Also, I so understand your frustration about the loss of speech. I would love to have my dad tell me what he is feeling and thinking, but he is not able to do that and so I am always trying to read every possible indication of what he may be feeling. It's very hard on both sides.
My dad really missed my mom after she passed 3 years ago. He did love to take his walks on our street and visit with the neighbors. The stroke took what little he had left to enjoy away from him. My guess about your dad is that he may just not want to carry on anymore. If his quality of life has been drastically reduced and he is lonely on top of it all, he may just be losing interest in keeping up the fight.
I'm sure you have had your dad tested for a Urinary Tract Infection. They can really change an elderly persons personality and willingness to cooperate.
If you could answer the questions I asked at the beginning, I might be able to offer more suggestions.
Wishing you the best. Cattails