Dad, 86, living alone since mom died a year ago...congestive heart failure, afib. He refuses to cooperate.
Dad is refusing to wear compression wraps, take his meds, (he is on Eliqus blood thinner) eat his food properly. Likes salty junk food tho. He has also fallen twice and refuses to tell me tho I live right down the street. Tells the medical help system he it's fine when he falls. Called home health and told them send no more help. My sister and I do not know what to do!!!! We want to see him stay in his home but we try everything to help him help himself and he is non compliant and stubborn. Oh, also because he will not take meds properly his heart failure is causing his lungs to fill with water and this will be 4th time we have to go to hospital to have it removed. And we'r are trying to keto him away from hospital because we are a hotspot for Corona virus... please help my sister and I are lost. And he refuses to live with me. 😖
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My father also had CHF and tended to be uncooperative. I discussed with Dad the impact salt would have causing fluid in the lungs and lower legs and how I didn't want him to suffer with the skin splitting or the drowning sensation of fluid in his lungs. I convinced him the low salt diet was for his _comfort_. I tried to be his enabler by giving him as much of what he wanted as possible. When he wanted something high salt, I would comment on the high salt and encourage him to eat a small amount, but I didn't try to tell him he shouldn't eat it at all. He didn't like compression socks because they cut into his legs and hurt, so we switched to wrapping his legs and later a lower compression sock. I cooked meals for him so I could reduce the salt content but he could still have the foods he wanted, even after he entered MC. And I didn't worry about "balanced" meals much either. When he couldn't eat peanut butter anymore, peanut butter milkshakes became a substitute.
Whatever I found, I tried to _never_ start the visit with a criticism. Take time for some normal small talk with each visit. I tried to make sure I included things he enjoyed in my visits, like singing his favorite hymns or a game of checkers. For me, the final years were more about maintaining comfort and embracing what enjoyments remained than trying to extend life with ideal life choices. Dad had always used a layer of mayo on any sandwich and that wasn't going to change just because his health was failing. Make sure the battles you choose to fight will really have an impact. Then fight your battles with cooperative persuasion instead of conflict and realize/accept some battles cannot be won. Do your best and try to let go of the things you cannot change. My experience has been arguments usually make stubborn seniors dig their heels in even more.
If her pills weren’t sorted correctly by a new nurse she would tell us. The ends of her fingers were numb so she couldn’t make it right. (But she could work her puzzles. The pills were too small).
If she said the pills were wrong. They were wrong.
I would call HH. They would go sort them correctly and call and let me know that once again she was right. She fell a couple of times. Once lay on her floor for quiet awhile. Didn’t want to use her Medialert. She believed they would take her to the local hospital where she knew she didn’t need to go. Didn’t think they would take her word for it. When I asked why she didn’t just have the dispatcher call one of her children, she said. I was okay. I wasn’t hurting. Why bother everyone.
I always told her we would do whatever she wanted. Which meant live at home or go to a NH. She would have liked me to live with her. That wasn’t an option.
It was a miserable existence the last couple of years. I don’t blame your dad for not caring to prolong it. My mom had aspiration pneumonia when she died. She was in rehab in the hospital after having fluid removed.
No matter what you do, your dad will die. I’m sorry. The human body is fabulous but in the end it is not meant to last. I care for my DH aunt, 93, with dementia. Quiet the contrast. Sometimes I think a little dementia makes life a lot easier for the patient. It’s obvious you love your dad and Im sure he loves but you don’t know what you are asking of him. I second reading the book “Being Mortal”. It will help.
That said, I know your frustration & certainly sympathise.
Lay the options in front of him with the facts & the consequences. Let him choose. It is hard.
I need to repeat CM's paragraph over & over too! (Not even asking what my Dad has been up to over the weekend - instead of isolating at home).
It’s okay to let go. My relationship with my dad has become much better since I stopped bothering him to do what he won’t.
It’s okay to let go. My relationship with my dad has become much better since I stopped bothering him to do what he won’t.
I've cut and pasted three times because... EXACTLY! God bless you, Dof1930.
Tiredandsad, we really do understand how desperately worried you and your sister must be. But this is all about choices - some still your father's to make, some yours and your sister's. Some of it's complicated but some of it really isn't, and not wasting your time and temper on anything that won't *help* should be Rule #1.
Read "Being Mortal, Medicine and What Matters In the End."
Practical tip - the usual reason for refusing diuretics is that they make you pee HUGELY and in a hurry. It's uncomfortable, as well as panic-striking, and when you're overloaded with fluids you can't get anywhere in a hurry. So people who aren't expecting that and prepared for it avoid the diuretics, either not realising or not caring that the consequences are worse.
The answer is: 1. explain that this is indeed what's supposed to happen. 2. Get him several urine bottles. 3. Make sure he's taking his diuretic at a convenient time and in a convenient location where he can pee comfortably for as long as he needs to.
I hope you have POAs in place to be able to make decisions for him when he can't.
If he doesn't like homecare, he probably will not like Hospice. In home Hospice means someone has to be there with him 24/7.
You can't force a person to care about himself.
I remember after mom's second thoracic procedure, her pulmonologist said to me "stop poking holes in your mom. Let the NH manage this and let her die peacefully". She did, 2 years later, with palliative care and finally hospice.
Make a bargain with dad. If he allows home health to check on him, no more trips to the hospital.