My Dad is stuck in an Assisted Living Facility

[AndrewW132698]

Please let me know if there is a better place to post this. My dad is 77 and a combination of strokes and diabetes has left him incontinent and in a wheelchair with one hand mostly cripple. Due to finances and family moves, this is his fourth ALF in 4 years. He is ABSOLUTELY MISERABLE and depressed and understandably so. He is stuck in his room and watches CNN all day (which would depress anyone). I visit twice a week and offer to take him to dinner. He often refuses because he doesn't like to be seen in a wheelchair and is afraid of the burden it puts on me (chair to car transitions can be difficult). He says the staff is mean but I have never witnessed it. I have however seen him get offended when someone opened a door for him or did something nice. He is no ray of sunshine himself. I speak to the director regularly and think there may be an ounce of truth to a pound of perception. Recently, he has become even more aware and depressed about the finality of his situation. I could go on about his conditions, but what really troubles me are the lack of options. 1) stay where he is and be miserable 2) move to another facility ($1000 move in fee) with new routines and new staff (with their own issues I am sure) 3) move in with us requiring us to turn a carport into a room which none of us have money for and would require us to hire a home care person while my wife and I work 4) sell the house and buy a new one that we could all fit into which still requires a home care person and a down payment (and probably better credit than we have). It is literally breaking me to see him so miserable and leave a visit with him crying. I am desperate for any alternatives or even suggestions for some sort of counseling to help him cope. Thanks.

[JaneCares · Accepted solution]

Hi Andrew,

I for one think this is a fine place to post this issue. 

Let's see if i can generate some ideas and options. 

So much for your father to adjust to. He is depressed, I'm guessing. Is there any (more) rehabilitation that can help him? PT, OT? Will he be able to gain any more of his previous independence? Probably not a whole lot. But if he experiences some improvement, any really, he'll feel a bit better. 

Meanwhile, would he agree to take an antidepressant? My dad had a whopper of a stroke, a right brain one so he could still talk but not do much else, and zoloft actually really helped. He still wanted to go home every darn minute but he stopped crying and was a lot less cranky. So that's an idea. 

Keep visiting him. Visits help enormously, even though it is so so hard. And he's cranky. But he is safe to express his sadness, frustration, etc. with YOU and knows there will be no ramifications: he can be himself. He might actually be enjoying wee bits of the place but needs to show you his displeasure. Maybe he feels you put him there? So there's a chance that he's not quite as miserable as he seems.

He'll have to get over his pride about the wheelchair business. Same reason folks resist using walkers. I get it. But heck, go ahead and BE isolated rather than be seen with a wheelchair or a walker. Beats being dead. Argh.

Excuse me for being blunt.

Another options: hire a geriatric care manager, who is a whole lot cheaper than an eldercare attorney, to look at everything: medicaid long term care eligibility, home care at someone's home, nursing home care, etc. Compare all the options. Make a decision as a family. Then whatever you all decide, make the best of that. Make the BEST of it. Overtime, everyone will get used to it. Even your Dad. 

Or he'll just be a cranky old coot. At some point he needs to decide to make lemonade out of aging. 

Anything here give you hope? Www.caremanager.org is how to find a care manager. I used to be one. Really helpful, if i do say so myself. Gives you peace of mind at the least.

[AndrewW132698]

Jane,

Thanks for your quick and detailed reply.  I like the idea of a caremanager.  I will definitalty look into that.  Dad is on Wellbutrin already, but I am not sure that is working.  Maybe Zoloft will do the trick.  For the outside, it seems like he choses to wallow in his misery than to look for any bright lights.  I am sure that this is what depression does to you. Its just so hard to see him sooo sad and not be able to do anything to help him.  Thanks again.  I will look into the caremanager thing.

- Andrew.

[LaurieK433572]

Hi Andrew,

Jane made some important points. My father had multiple life-threatening conditions and would not let me call an ambulance because he was worried about what neighbors would think! He absolutely refused to go to a rehab center after partial amputation due to diabetes. He wanted to live alone at home, AMA. His anger from anxiety and depression included irrational thinking.

Eventually, he had hospice care at home for COPD, congestive heart failure, etc. I never forgot how much he cried when he realized he could never leave the house again. I couldn’t stand to see my father cry.

It helped whenever the nurse, physical therapist, social worker or chaplain visited. He was never religious, but the chaplain was nondenominational and had counseling skills.

It’s important to meet him where he is in his reality without a lot of correcting and too many positive reassurances that he might find annoying.  Listen to what he says, reflect back to him on how he must feel, and just connect with him before offering solutions. Someone once told me that unsolicited advice feels like criticism.

Your father is probably feeling dependent and infantalised, so he needs to still be treated like an adult and with respect— even when his thinking doesn’t make sense. 

These things might not apply to you, but they’re approaches I eventually learned.

Laurie

[AndrewW132698]

Laurie,

Thanks for the feed back.  I am learning that while I would like to come with solutions to make him healthier and happier, it is also comforting to me to hear from other care givers that are going through the same thing.  I also like the thought of some sort of counselor or chaplain although I am not sure how to employ one.  Thanks again.

Andrew.

[LisaM701626]

 Hi Andrew, 

It is so challenging as our parents age and we want the best for them. It sounds like you are doing all the right things. As a social worker in a hospital, one service that refer families to  is A Place For Mom (717) 265-1001. You can connect with a senior living advisor and they will help you go through a variety of care options for your father. . Not only would they be able to help you find and tour other assisted livings in your chosen price range and area that your father may prefer, but they can also refer out to homecare services too that could possible supplement the care that his is receiving. Some assisted livings may have supplemental counseling or other similar services offered  onsite or as mentioned in this article, some homecare can companies can provide homecare within the assisted living facility too. https://www.aplaceformom.com/blog/tips-for-implementing-home-care-services-in-assisted-living/. Be sure to bring this up when there are careplan meetings with the Assisted Living facility staff to make sure you know all of the resources their facility can offer. Best wishes 

[AndrewW132698]

Lisa,

Thanks for your reply.  I will look into  A Place For Mom.  I also plan to look more into counseling.  Thanks again.