Carers UK Forum

Hi! I would be very grateful for advice please. I think my 89 year old father is depressed. My mother is in a nursing home with dementia and my sister has washed her hands at being able to deal with the situation and has abandoned my Father. He lives very near to me in sheltered accommodation with a good care package and I visit him several times a week. My father is very sad about Mum and how my sister treats him and has started to be withdrawn and won't join in any social activities at his sheltered accommodation, refuses to go to his Day Centre and says he doesn't want to socialise and just be in his own company. Yet if I ring him for a chat on a day that I don't visit him, he complains of not having seen anyone and is thoroughly fed up! I sadly can't change my Mum's situation but we do visit her several times a week. I can't get my sister to do more with my Father and as he now won't socialise at all I am at my wits end worrying about him!
I wonder if I could talk to his GP without my Father knowing as I doubt if I could get him to go to the GP! I'm just wondering what I can do?
I'd be grateful for any advice you can offer.

Hi Catherine

My thoughts would be to arrange a meeting with manager of supported accommodation and see what they are saying to it. I'd have thought they have a duty of care to get more involved with your father or alternatively to assist in moving him on to somewhere more suitable. I am going by the booklet I got when I took my mum to visit supported accommodation.

Speaking GP about your dad's declining mood sounds like a good plan, then maybe GP might do home visit facilitated by you?

Dear G Fraser
Thank you for your advice. It was very helpful.
Best wishes
Catherine

This might sound a bit extreme, but I wonder if your father would benefit from some sensitive bereavement counselling? One of the dreadful things about dementia is that it does 'take the person from us' - it is, in its own way, a kind of 'pre-bereavement'. The person is physically alive, yet their fading mind is taking them away from us - the person we once knew and loved is 'going' and will eventually be 'gone'.

This is very, very hard to accept, as you already know.

I'm a widow, and bereavement counselling was very helpful to me in the initial stages to help me 'come to terms' with what had happened. So I'm wondering whether similar might help your father. He is in a kind of 'slow widowing' state - neither a husband, nor a widower any more, but somewhere 'in between'.

Does HE see his wife any more, or just you? If not, would it help him if he did, or just bring home to him that his wife is 'fading'?

We have a member here whose husband has dementia, and I would think of all the folk here, she would be the one who most understands what your dad is going through.

I would, speaking only personally, put your sister 'to one side'. If she 'can't cope' (or 'won't cope'??! It happens on this forum an awful lot, siblings who 'bow out' of any involvement with their ageing and ailing parents), then I would 'let her be'. It's her choice, and in a way what can be done anyway? You can't force her to care about her parents. To be charitable, let's assume she finds it too distressing, but it could also be that it's personally inconvenient to her to have parents with needs.......

Thanks Jenny!
I am also a widow and I can fully empathise with my Father's situation because when my husband was terminally ill it was a kind of bereavement knowing that he was slipping away and not coming back. My Dad does visit my Mum. Sometimes he takes himself off in a taxi or I take him. The visits aren't always easy as Mum can be agitated and verbally aggressive and yet other times is very pleasant. Dementia is difficult all round.
I have decided not to focus on my sister any more. I can't force her to care more but it does upset my Dad.
I am visiting him tomorrow so will broach the subject of some form of counselling. I'm not writing it off but he's a man who internalises his thoughts so he may not want to go for counselling. I can only try!
I suppose at the end of the day, if Dad doesn't want to see the GP or have counselling then we will just have to carry on as best as possible.
Thank you for your help.
Best wishes
Catherine

Ah, well then you know exactly what partner-bereavement is all about sadly....

You mention his GP - although the GP can't discuss him with you, there is nothing to stop you writing to his GP to tell him your worries, so that that can be 'input' for future reference. I don't think the GP has to say to him that you've written.

It could be, though, that there is nothing you can do now to 'cheer your father up'. He's gone into mourning, so to speak, for his wife, for the life that he used to have that is no more (we widows know all about that alas...), and is, in a way, mentally shutting down towards the end of his own life maybe??

Yes, he probably is depressed, and who would not be - but it could be simply 'sadness', and nothing therefore could 'cheer him up' other than his wife getting better, which she can't do now.

Any 'cure' has to come from within - again, as we widows know. He has to find in himself a reason to enjoy his life even in the limited way that is now possible. If he has neither the wish to do so, nor the ability to do so, then awful though this is, that is 'his choice'. We cannot force others to be happy (alas, this forum is full of members who have had to come to that conclusion).

Maybe all you can do is to speak robustly to him and say that just as YOU had to find a reason to get up each morning after being widowed, so must he - IF he wants to have any enjoyment of his life at all any more.

That said, counselling may help him reach that final stage of grief - 'acceptance' (which does not mean 'agreement'), which we know we have to reach in order to keep going.

How long has your mum been in residential care for her dementia (which does sound of a distressing kind, if it can be verbally aggressive)? That may give a clue as to 'how long' his 'mourning' can be expected to last.

One final point for now - please do do do be very very very wary of being 'sucked in' to his situation. When you said he complains of not seeing anyone, when you haven't been to visit, there is a red flag running up the flag pole, because I fear that what he is meaning 'I haven't seen YOU'......

DO be firm on this. He can't turn you into a substitute 'wife' for him - ie, someone to give him the constant companionship that a wife does. I've known this in my own case - my son is now a young adult and on NO NO NO NO account must I try and make his company 'companionable' in the way my husband's was! I think there can be a very real danger that a bereaved person flails about emotionally to try and find a 'substitute' in a way (I have to be careful of that in respect of my brother as well.)

So, you cannot become the person he becomes totally emotionally fixated on, dependent on - especially with your sister refusing to get involved (maybe she has a sense of self-preservation???????).

Like it or not, your father has now to get used to a great deal of his own company, and that, sadly, is that. It's up to him whether he choses to socially interact with others. But he can't 'collapse' on to you. Sad but true.

Thanks Jenny. Very sound advice and yes as widows we know how we have to try so hard at getting a life back and at the moment that's what my Dad is battling with. I know I can't be his substitute wife or make up for my distant sister and I am still coping with my own grief.
Tonight I am sitting in A & E with my Dad because he fell and couldn't get up and now they have found that he has an infection so he will be kept in hospital.
I was going through all his physical ailments with the doctor and along with his low mood I really felt that I need advice about an assessment for his care. I wonder if a care home would be better for him or an increase in his Carers visits.
I have my own physical problems - arthritic back, knees and a permanently damaged shoulder so couldn't help my Dad at all tonight to get off the floor. There is no money in the family to pay for care so I wonder how that would work out?
Maybe I could ask to speak to a social worker? But I will try and talk to my Dad again about his low mood and how he's coping physically and socially etc.
Sitting here in the hospital tonight for hours is giving me time to have a good think about the situation.
I would appreciate any further thoughts, opinions and advice please.
Thank you very much
Cathy

This loneliness is weakening him from inside, as mention by jenny bereavement counselling is essential for him. Other than that try to converse of cherishable moments you were together Good Luck!!

In brief for now - definitely explore other care options. Yes, talk to SW, and Occupational Therapist etc.

Something we always read on this site when it comes to the hospitalisation of the very elderly is this.

The hospital MUST do a 'care plan' for his discharge! They cannot LEGALLY (ie, it's illegal!) discharge him back to an 'unsafe situation' (eg, one where he can fall 'unsupervised'). Or that becomes an 'unsafe discharge' and they are breaking the law (I read this here.)

Hospitals, usually because they are desperate for the bed back (sigh, elderly bed blockers....) very often either skimp this, or just 'assume' that YOU will 'be the carer'.

So you have to make it crystal clear from the outset (I would put it in writing, and email them and print it out and hand it to the ward sister for the attention of his consultant)(I think all hospital patients are 'overseen' by 'a consultant' at some point in the heirachy - even if they never see them) that you DO NOT LIVE with your father and ARE NOT HIS CARER.

On speaking to the SW stress this too.

Falls are serious, and can lead to death eventually, so it is taken seriously.

Again, from what I've read here, if your father falls, he should only be lifted by a trained professional, so if the warden is not that, then phone the ambulance sevices. Don't try and lift him yourself - a 'dead weight' is VERY hard to lift. You could injure him more, and yourself as well.

As for affording other care options, the general rule is that whilst medical care is 'free' via the NHS, 'social care' (including dementia by the way) is only paid for by the local authority if the person has less than £23,500 in savings and property (remember, if your mum is in a dementia care home, then HALF of the 'marital estate' is hers!) (I take it she is not self-funding???) (so you will doubltless know that already).

Speaking of your mum, would your dad benefit from moving into the same care home as her? If it is a 'mixed ability' care home with both cognitively impaired residents and 'full capacity' residents?? Would that help him, do you think, if it were possible? Or just make him sadder as his wife 'fades away' before his eyes??

But one thing that forum members here often fine - it can take hospitalisation to 'rearrange' the care situation and 'force the issue', often for the better (or less worse) in the long term.

Wishing you all as well as possible, kind regards, Jenny

PS - I think Raun raises a very good point. How about if (when your dad is out of hospital), sit down with him and ask him to prepare a 'family history'. This will be good for you in the long term, and might encourage him to remember all the nice things in his life. It could give him a project??!