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Dad has type 2 diabetes, has been in the hospital twice within 2 weeks, had a stroke which he fully recovered from but mom is refusing to give him care. She hasn't picked up his meds in 6 months, won't get a test kit to test his blood sugar, gives him candy and high sugar foods, refused the ambulance to take him to the hospital after he had a stroke when his sugar was at 600. Their Dr. is furious. At their last appointment he told her she is incapable of caring for herself or him. His sugar was back to 600 and he was very lethargic barely awake. Dr. suggested assisted living. She refused. He then strongly suggested a home health care nurse to provide their meds every day and test his sugar. She reluctantly agreed. After the nurse came for the interview she told mom she can refuse the care if she doesn't want it! She did. The nurse called the Dr. and he is 1000% behind helping dad. How can she refuse? Isn't that an abusive caregiver? What options are out there?

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Why doesn't the doctor order assisted living for dad? Let mom alone.

This is so tragic. I take it that this was not a functional marriage before Dad got so ill?
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What standing does mom have for refusing care for dad? Find an Assisted Living Facility and move dad in. I'm assuming dad is able to access his funds to pay?

Is mom mentally ill, or does she have dementia?
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Your mom can refuse the nurse's care for help with her own care.  I don't think she has any basis, or legal right, to refuse care for your father.

Have you considered a call to Adult Protective Services?
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jjFlorida, sometimes a spouse will be in total denial that their love one has serious illnesses. And if they do realize it, they become scared, resentful, and angry. This is not how they had planned their retirement.

When it comes to diabetes, it is a complex illness, so your Mom may find it too confusing to understand, so she sweeps it under the rug. Thus if she ignores this, maybe it will go away.

My own Mom I believe was still under the impression that my Dad was still in his 40's instead of being in his 90's. She would still do a "honey-do" list for him which would include climbing ladders and doing electrical work. Dad use to be able to do those things quickly but no longer at his age.

One time my Dad fell on his driveway and got a huge bump on his head. Mom thought an ice pack and a good lunch would do the trick. Once I found out about the fall, noticed that Dad was too wobbly to take him to urgent care, I called 911.
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My mother took no care of my father. Looking back, I really can't think why I supposed she would. She'd never in her life taken effective care of anything else, human, animal or vegetable - why would she suddenly start in her old age?

I once, when very angry, pointed out to her that if she'd taken even the slightest notice my father might have received life-saving treatment before he dropped dead on a squash court at 71. I apologised immediately, because what I'd said to her was cruel and pointless. But the reason it was so cruel is that it was also true.

Stop wishing that your mother would turn into a capable, willing nurse. Are you geographically close enough to supervise their care? What did their doctor mean when he told your mother that she was not able to look after herself, either? - what are her medical/care needs?
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Freqflyer, the part about resentment makes real sense to me. My mother was AWFUL to my father when he got out of the hospital after his stroke. He had heart and blood pressure issues, and she would start arguments and keep arguing with him even when he turned blue. I told her that a spice pack she wanted to use was too salty for the diet the doctor had given him, so she used two of them and poured ladles of it over his meat. Later, when he nearly died from the heart issue, she wept that she never believed he would ever die on her. She was better with him after that.
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JJ, is there any update on your father's care situation?
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He may die from neglect, so I hope you find someplace or someone to care for him whether she wants it or not. Good luck.
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Oh my gosh, l cannot believe some of the answers here, this woman has no right to dictate that her husband does not need care, she is incapable of caring, that has been verified by the doctor and the daughter, so therefore this man needs to be protected, to put him in a safer setting. Is this what happens in America, l know Australia is not that much better but this is 2018.
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Unless Mom has a POA for your Dad I don't understand. HIPAA has been around since early 90s so someone has to have written consent to speak for another. Spouses are no longer exempt. Due to second marriages, etc there was a big stink with adult children having "step" parent being able to speak and have power over parent's health and wealth
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Dad needs skilled care and if Mom won't let it happen at home then the State needs to step up and put him into Assisted Living. The problem with that is the money separation.
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Calling Adult Protective Services May be the only option at this point. If your father is taken to the hospital, you can enlist the help of the doctor and social worker, and he may be taken to a facility for care. I was in the same position after my father had surgery for lung cancer (another story) at age 87. My mother (bipolar) was manic at the time and in her delusional state refused to believe that he was in need of a lot of help. He eventually called hospice and was admitted. He died two weeks later. I live 1200 miles away but if I had lived closer I would have been able to help. I still have guilt feelings.
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My mom treated my dad in much the same manner. I think there were marital problems that I was blind to (mostly after I moved out as a young adult). Also, I think my mom has mental health problems that maybe my dad kept under wraps for years. I had to move my dad into an assisted living facility 10 months ago so he could get proper care. He was underweight and frankly malnourished. The hard part is now dealing with my mom who lives on her own and feels sorry for herself that she's now alone. I told her for years she would have a lonely, guilt-filled future for her treatment of him...now that future is here :(

I guess the point of my post is that marital issues and/or mental health issues may be at work here and there may be no way of overcoming them. I tried for most of the last decade to get my parents to be kinder to each other but all I got was heartache. You may just need to step in and help your dad get into a better situation. Just be prepared for the "mom fallout" once she is left alone and the guilt sets in. I now get the privilege of an angry, tearful phone conversation almost daily from her. And when she visits him in the facility, she continues the verbal abuse, it didn't stop...
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Oh, and by the way, for several years I waiting for someone, someone, in the medical community to call out my mom's treatment of my dad for what it was...abuse. She would berate him in public all of the time including doctor's offices, when he was in skilled nursing, etc.  People would turn around and stare at us at restaurants and other public places.  She, too, ran off the prescribed home health care for my father.  The home health nurse told me my mom told her they were "intruders" into her home. I always believed if a man were treating his wife that way, someone would have stepped in. Nobody ever did and I'm never aware of anyone even calling my mother out and saying, stop treating him that way!! It's totally screwed up. I wouldn't expect anyone in the medical community to care, I guess they just chalk it off to a "cranky old married couple".  I really thought someone would step in, but in the end I was the only one who could be an advocate for my dad!
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If your mother hasn't always been so uncaring maybe she's
depressed and feels fed up and unable to cope. Not everyone should be a caregiver. Can she give any reasons for the disinterest in your father's well being?
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And maybe she is like my mother. Mine is mentally sound, but wants nothing to do with my father now that he is weak with many conditions - can’t walk, heart condition, diabetes, wears diapers etc. She was so eager to dispatch him to the nursing home it made my brother and I cry. She has POA. Shame. Wait until it’s her turn and see what happens is what I say.
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As a caregiver for my husband for 29+ years (cancer), I know how difficult and consuming caregiving can be. As an adult child, you must recognize the fact that even though your mother's married to your father - what dictates that she be the 100% full time caregiver? Why can't she be the spouse? If she is refusing care, look at the financial picture - it's easy to suggest "assisted living" but what happens to their finances? Get an elder attorney to help them (AND YOU) wade through the finances - this will be the only way that you will understand current law and how it will impact them in the future. Insist on hiring a home-health agency to help out at home, or put your father in a facility that will help take care of his needs. But you should be the adult and stop thinking that your Mom should be the one to do the caring.
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Yikes, Maallis10! She said her mother refused the home health care. It seems that her mother is dictating to be the sole caregiver. What is an adult child to do? You are supposed to do what you can to take care of your spouse. That's what that whole vows thing is for...
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My family is living the aging/illness/care nightmare currently. I am like an only child. I have a brother who has mental problems. My dad broke his pelvis around Thanksgiving 2017 after recuperating from a quadruple bypass in Dec 2016. He is very badly diabetic. Non compliant unless taken care of and argues all the way. He broke his pelvis because he fell down when drunk -so the medics found out. He snuck vodka in the kitchen when my mother didn’t know it and she was inside - supposedly. They have had major marital problems that I have just come to find out. He is extremely abusive. My mother has Lupus which flares under stress. He’s nearing the end of his Rehab allotted time and he is still not ok to bear weight. He argues with the rehab people. He is incontinent. He has the beginnings of dementia, I think. My mother is terrified of the prospect of him coming home. She doesn’t believe that an aide will show up daily. I can’t blame her. I feel like he’s sinking and going to take her down with him. She’s a complete wreck. My father won’t do a thing she tells him to do. The whole situation is a mess. They are 78 (mom), and 80 (dad). I have 2 kids, the youngest is 9 and I still run all around with my daughter. She deserves a childhood. I have an eldercare attorney working on everything. My parents still have 1.5 years to go on their trust fully being in place. However, I told my mother that she has to make the decision about what to do. I do not judge her. It’s her life, her money. She can live with us if she wants. My husband is on board. Even with all the abuse, she is racked with guilt over not being able to take care of him. It’s a horrible situation. Very depressing. I try to stay upbeat and calm. Praying for a good outcome … somehow. Thoughts and prayers appreciated.  And the same to all of you who are living through this complicated/sad time in our parents' and our lives.  It's very difficult.  - Lisa
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I’m dealing with this in another country and have a similar situation. Dad has some memory loss and needs my mom to do all the logistics for him. But mother has a Personality Disorder. The key in this country is calling the equivalent of Adult Protective Services. Given what you are describing, the GP can probably alert them too.

Key issue is if your dad is ‘of sound mind’ your mom cannot decide for him that he cannot go into assisted living. If he can say himself ‘I want to go to assisted living’ and you can make the arrngements (if mom won’t) , the deed is done. Is he unable to express himself or is the problem that he can’t make arrangements and you have to do it?

I am literally dealing with this now. You have to protect your dad- he needs that help if he can’t himself.

I would also document everything - verbatim- with dates and what your mom and GP say.

Also talk to an elder care lawyer - they should give you general advice pro bono.

Also talk to your GP about scheduling a mental health assessment of your mom. (MRI for signs of Alzheimers etc)

And.. if she has POA and you don’t, get your dad to give you POA.

Note that with POA you are required to act in the best interest of the person for whom you are an attorney.

If your mom has POA and is behaving as you describe, she’s clearly not acting in his best interest and the GP can back you up.

My parents have had a bad marriage forever and this is sadly one of the consequences.

Good luck- I feel your pain. PM me if you want. (I’m dealing with this in another country so my advice is general)
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Blood sugar levels hovering around 600 is no joke! There’s really something wrong with that situation. If you’re concerned, get proactive and intervene quickly before it is too late.
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This is a tough situation which does come up in some families.

In terms of decision-making and refusing care:
- Patients have a right to refuse particular medical services (although if they do so when it seems obviously a bad idea, clinicians and others should start to wonder whether the patient is impaired and lacking the needed decision-making mental capacity to legitimately refuse).

- When a patient is ill or unable to make medical decisions, a healthcare proxy/surrogate is generally allowed to do so on their behalf.

- A healthcare proxy can be appointed via a durable power of attorney for healthcare document. However, in the absence of such documentation, virtually all states allow for the next of kin to make medical decisions. In practical terms, most providers will accept the decision of a spouse who lives with the patient, unless the situation is extremely high-stakes and there is obvious family conflict (e.g. ending life-support).

- State law governs healthcare proxies and also defines elder abuse. Generally, the proxy is expected to act to serve the best interests of the patient or to make decisions in accordance with what the patient had previously specified. If they aren't doing so, in most states there is presumably a mechanism for removing the proxy from the decision-making role and finding a way to protect the patient. But getting there can be messy.

In terms your situation, @jjFlorida, one thing that is very good is that your dad's doctor is involved, concerned, and upset by your mother's actions. Things to consider and that you might do:
- Is your dad incapacitated and unable to make decisions? Or can the doctor specify to home health and the others that he should be making decisions, and not your mom?

- How does your dad feel about the decisions your mother is making? Is he able to voice preferences? To sign legal documents?

- Is your mom making decisions because she's named in a durable POA for health, or is she doing it "by default"? If she is DPOAH for health, does your dad have the mental capacity to name someone else?

In terms of next steps, you can try calling Adult Protective Services and you can try getting help from your dad's doctor in exploring options. I am pretty sure your mother doesn't have the right to refuse care that is in line with your dad's medical needs, unless he has previously been quite explicit about why this would be in line with his goals and preferences for his medical care.

You can also consider talking with an experienced elder law attorney in your state. Sometimes legal representation is needed to get what is "right" to happen.

In short, it's a tough messy situation. Your dad's doctor may certainly be able to help but it might take a while for the two of you to figure out how to do so. Good luck!

ps: I have not even gone into whether your mother has the capacity to be managing her own affairs and healthcare, but that's a whole other kettle of fish that you may have to deal with eventually...
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jjFlorida--I'm going to ask a question that hasn't been asked yet but probably needs to be (and I'm not trying to be unkind or cruel): Is it possible your mother is deliberately trying to cause your father to die? Deliberately doing things that have a direct detrimental effect on your father's health (such as candy to a diabetic) and refusing attempts to provide appropriate medical care suggests, assuming your mother doesn't have dementia, that there may be nefarious motives involved.
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Most Senior Centers / Council for the Aging or Elder Services have a social work department. Contact the one that services your parents and explain to the social worker what is going on. The social worker will probably know how to proceed. The social worker might make an appointment to see your parents and talk to your mother about what's going on. This person just might be able to convince your mother that your dad really does need care.

You might need to contact your state's Adult Protective Services and file a report. I would do this after talking to the social worker... It's entirely possible that, after visiting your parents, that the social worker is willing to contact Adult Protective Services, in order to compel your mother to allow care for your father.

You might want to have a regular health and welfare check done on your parents. The social worker from the Council for the Aging can arrange for this. Do keep an eye on them, especially your father. If he doesn't sound right, you can call the police department non-emergency line and ask for a health and welfare check be done.

If you don't know where to turn, call your state level legislators. Most have a constituent services representative, who will help you determine who you need to talk to. A lot of people in your situation don't think about contacting a politician's office--they are there to help. If you don't know where to turn, calling them is well worth it.
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Perhaps social services can offer some alternatives. Why can't Dad manage his own diabetes if "he is fully recovered from stroke" ? why would you expect a woman who is "incapable of caring for herself" to care for another ?
either help them find solutions to their care issues or let them accept life endings
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jJFlorida - any update?
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I'm not sure what's going through you mom's head (denial? onset of dementia herself?) but I would stop short of calling what she's doing "abusive."

What would be abusive, however, would be if none of their able-bodied children stepped in to help.
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Get a letter from your doctor and the next time Dad becomes even mildly ill, have him 911-ed to the ER. Explain that he can’t go home because he has medical issues and there is no one at his home to provide him with decent medical care. Show them the letter from the doctor. How Mom feels and what she’s doing or not doing is irrelevant. Dad and his health and well- being are top priority now, not her. You can call APS on her if you want to, but get Dad out ASAP. Figure out the why’s and where fors of her behavior when Dad is safe.
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Apply to the court to be appointed your father's guardian and conservator. If you are the guardian, you make the decisions about where your father lives and what treatment he receives.
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Whatever your parents' relationship history, your mother clearly is INCAPABLE of caring for your father, either physically or emotionally. You need to GET HIM OUT of there and into a safe environment. Her neglect of his health will kill him.
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