What can I do?

mikeandbarbJanuary 11, 2009

My dad's getting worse. His depression has him spinning downward. I got a call this week for the nurse to get permession to place him on more pills to help him out. I have been to see him for two weeks and I'm scare to go see him. Last few times I've gone to see him he wants me to take him out of there. He complains about everything, it's to hot it's to cold, their cleaning the toilets wrong, he won't take a bath, then he says they won't let him take a bath. He complains about the food, he's had them chance his food so many times they don't know what to do.

What am I to do? I want to see him and see how he's doing but he does just want a visit he wants out. He wants to go home and I know he wants me to let him go home for good. This is the last place he wanted to end up at in the end.

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You have a choice. 1. You can go see him and go through the same thing everytime until his condition gets too bad for him to even talk to you. Or...

2. You can check on him less frequently, and try to quit worrying about him. Can you call and check on his condition with to the head nurse? Trust me on this, they want him to do as well as possible. Some patients can be a real problem to the entire unit.

More or different medication may be just what he needs. I think that you need to stop looking at this as depression. It's more of a senile dementia. If you can accept dementia instead of depression, you may be more able to think more clearly about the proper course of action.

To many older patients, Home is more of a feeling than an actual place. They want to go back to that time when they felt safe and secure. Where everything went as they wanted it. Later in life, they don't feel safe, they feel uncomfortable and unsure. And they react by saying...HOME. It's more than just a place, it's a way of life. Even if he were to go back to where he lived, he wouldn't feel at HOME. That place doesn't exist anymore and he is unable to understand why.

What I don't understand is why they are asking you about his medications. Families are seldom able to make decisions about proper medications. It should be up to the staff.

    Bookmark   January 11, 2009 at 10:31AM
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Barb, I'm sorry you have to deal with this. I think Agnespuffin may have hit the nail on the head. Your dad is more than likely suffering from dementia not just depression. That explains the way he self-medicated before he went into a nursing home. He really isn't able to make any kind of rational decisions because that ability is gone. You need to keep remembering that when you visit him.

And she's also right about the "going home" concept. My mom has lived in two different AL's for the last four years, yet she keeps bringing up going home too. For a while she was convinced that her parents lived across the street from her AL. She also thought her present AL used to be one of her brother's hamburger restaurants. This Christmas someone at the memory care unit gave all the ladies Victorian dolls. My mom explained at length to me how she wanted to wrap up the doll so she could take it home. I've discovered if we go down a different hallway to get to her room, she's convinced she's going into her "other" room.

It's all very confusing and unsettling for our elderly loved ones. Their overall health is deteriorating. Their vision and hearing might be failing too. That creates a lot of confusion. Add to that their diminished cognitive capacities. It's no wonder they get disoriented and long for simpler, easier days.

Regarding medication changes, isn't that authorized by a doctor? Does the facility have an on-call or in-house physician? Or would you have to arrange for your dad to be taken to an appointment?

    Bookmark   January 11, 2009 at 5:59PM
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I'm not sure why the nursing home ask for my ok. Could it be cause I have MPA, Medical Power of Attorney.
They have a dementia unit and I felt they would be able to handle dads condition but my dad is not easy to get along with. At first is all smiles and easy going but now that he's got use to the place he's very demanding and gets upset. I hate not seeing him but it just upsets both of us. I do call and check on him and they call letting me know if he needs something. Sadly I can't talk to him and let him know how this has effected me and let him know that I understand. On one visit I tried to talk to him letting him know that I understand but that he needs the help, well that doesn't stay in his mind.
He thought that his roommate moved out when it was just that he'd gone on a visit. I think it is upsetting to dad that his room mate gets to go for over night visits with his daughter and he doesn't. I know without a dought I'd have my hands full, he'd beg to go see the houses to check up on them and then his medicine I have no idea how he'd do there. I don't even know what, when and how many he is taking now. With the pacemaker put in it's had to be changed a few times.
When he found out he was coming back he started complaining that he'd have to help him out and clean up after him.
No he doesn't have to he does it cause he thinks he has to.

    Bookmark   January 12, 2009 at 11:42AM
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I think the first thing on the agenda is to have him re-evaluated. Let his doctor examine him, review his meds and make his recommendations. Guessing as to the problem will not solve it. You need facts. Does he have dimentia or is he having problems from the medicine he's on interacting or what is causing this drastic personality change?
After the evaluation, sit down with the center's administrator to discuss a plan. His medicine is to be given on time, discuss any foods he's not to have or if food needs special preparation. Is it disturbing him too much for you to see him as often as you do? Work out a schedule. What do they consider disruptive about him?
Stuffing him with more medicine to calm him down is not necessarily what he needs but what they want in order not to deal with it.
It's a take 10 steps back, re-evaluate, make decisions based on all info, and proceed.
Sometimes it seems very appealing to maybe walk backwards. Then we don't have to see what all is coming at us. Just take a few deep breaths to think clearly and do what you have to do.
Take care

    Bookmark   January 13, 2009 at 1:31AM
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Previous poster has some good ideas. (phllh). You are not a Dr. and the home should be corresponding with the Dr. regarding changing or giving meds. Then in turn talking to you. Meds and attitude make a big difference. Because he has made up his mind to "go" home, where he is does not seem to be working with you. Maybe if you set up a schedule if possible, like every other Wed. to visit, then he has something to look forward. Be honest and tell him he cannot come back as you cannot take care of him. Do they do what ever he demands? Food? personal hygiene? Does he have one nurse that waits on him most of the time? Do you always have to talk to the director? Does she/he really knows what goes on or does she just depend on what her staff tells her/him. If you are near a library, look for Dr. Dobsin's book--Tough Love. It really has some excellent help for many types of questions.
You may have to see him once a month. Can you call him? Be firm, kind and short . Good luck

    Bookmark   January 14, 2009 at 3:27PM
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I guess I stated it wrong, the home did correspond with the Dr. regarding changing or giving meds. Then in turn talked to me.
Mariend, I have tried sitting up a time to go see dad but it only gives him time to think of what all he wants to complain about, that is if he's doing well that day. If his mind isn't working good then he's forgotten what he wants to say but still has his complaints for the day. He'll tell me I know there was something I wanted or needed to tell you but can't remember.
I called the home Friday and talked to the nurse and she said that dad was doing them same and has some confusion.
It is very hard for me to give him tough love. I just turn to yell-o when he's being demanding.
He is sad and it makes me sad, I don't know how some can put on a happy face when their so sad and don't want to be cheered up. It doesn't help that he's obsessive, he'll chase down the nurse for his medication if he thinks it's time to take it. Even they can't get his mind off what he's wanting.
Anyway, I talked to the Social worked at the home and she's sending me a list of counselors to help find me someone to talk to.
Right now I'm throwing myself into doing thing's that need to get done, which is a long list but one day at a time and it will get done. Mind you I'm having to go over to check on the two homes and I'm trying to get them cleaned up. There's 75 years worth of paper's and stuff. I had the electric turned off at dads house and forgot all about him still having some frozen yogurt in the freezer. We went over this weekend to clean out the fridge and I was lucky to have had the container still holding up and the yogurt only leaked a few drops.

    Bookmark   January 19, 2009 at 1:19AM
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Mike and Barb,
My MIL has lived with us for almost 2 years now and she still talks about getting better and going home. Some days, she will pack a suitcase and tell me that she loves me but she has deceided that she has to go now. It's not gonna happen. I have to sit her down and take her down memory lane to a time when the social worker from the hospital (when my FIL was sick and then passed away) told her point blank that she couldn't go home and live alone. I tell her that I'm thrilled she is with me, I enjoy her company, and I really depend on her around here. First she gets a hurt look in her eyes because she has forgotten all that, and then she sort of "accepts" it. I hate to go through this over and over with her but I don't know what else to do. She has to reach that "accept" place in her mind or she is trying to run around all day with a suit case or trying to call her neighbors from home (most of which are dead) to come get her. I thought it was depression from the loss of her husband with a lot of her "dipseyness" mixed in at first. It's not, she has dementia.
One day at a time and I dread the day when she's lost the capability to reach that "accept" place.

    Bookmark   January 19, 2009 at 10:45AM
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Barb, no great words of advise here. Just some sympathy & understanding. I had a mini episode with my mom last week, similar to what you're describing. Her memory care unit just started taking its residents out to lunch once a week to local restaurants. I've gone along on the first few trips.

Last week we went to Round Table for pizza. My mom enjoyed the outing. But when we got back, she wouldn't let me leave on my own. She kept telling me that she wanted to walk out with me so she could figure out how to leave and go home. No matter what I said, she kept repeating that she wanted to follow me to the door so she could figure out how to get out and go home. I was scared and didn't know what to do.

Finally, I just walked her back to her room where we spent a few minutes chit chatting. Then I walked with her back to the big living room, but we walked back using a different route than she was used to. That confused her enough that she willingly sat on a sofa. I told her I had to talk to someone and kissed her goodbye. Then I left via another door. She didn't see me & I breathed a sigh of relief.

I thought of you and your dad. This is so hard because your brain is telling you one thing, but your heart is just aching over the situation. No easy answers, that's for sure. Take care of yourself.

    Bookmark   January 19, 2009 at 2:33PM
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The home is required to tell you about any changes in meds, treatment or accidents. The care home my husband was in had to have permission from me to put him on new meds or take him off any. I was very strict about that. He had a comfort care document and I was his POA.

    Bookmark   January 19, 2009 at 3:44PM
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Shambo, You are where I have been with my dad ever since I had to place him into a home. He goes as far as faking being hurt and grabs a hold of me forcing me to hold him up. He'll do this trying to get me to take him to the hospital. He's cried wolf so much I didn't know what was real and what wasn't and it pulled hard at my heart stings.
He did this when he was at home too. I'd get a call to take him to the hospital or doctor's office at 4 or 5 in the evening. They wouldn't find anything wrong but then the next time his heart beat would be below normal. So I couldn't play doctor and tell him he was ok and not take him but at the same time he was running me down. Not to mention fighting him over going to the doctor or hospital when he really needed to go, like when his legs swelled up from congestive heart failure. I didn't know what was going on but felt it wasn't right. Thankfully he finally went but it could have very well been to late. God was not ready for him. When he was admitted into the hospital they took his blood pressure the nurse ran for a wheel chair and they put him on the heart monitor, his heart was only beating 20 beating a minute and it wasn't beat in rhyme.
The doctor told me dad's heart is worn out and it's just a matter of time. I pray he goes in his sleep nice and easy.
Dad didn't even realize he was near death when he had the pacemaker put in. He wasn't in any pain, didn't feel anything was wrong.

When he went to the new place he's asked to go to the hospital twice and I let them take him. First time they kept him over night just to be sure he was ok cause of the new pacemaker, second time he asked I again let them take him and he had to wait a long time for them to pick him up. He hasn't asked to go again. I didn't go see him, cause he's just feeding off the attention he was getting from it. I got to the point it was him or me. Either I care for him till I'm in the hospital or 6 foot under.

My best to everyone, and Thank you for listening to me Barb

    Bookmark   January 19, 2009 at 11:33PM
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