My father lives with us in a guest house. He has dementia onset, is obese and is unhealthy. He has a life long habit of sleeping in a recliner with the tv on. He has severe swelling in legs from dormancy (mobility issues).
In my care, should I be waking him prior to going to bed to get him into his bed? Or do I let him live his life?
Alcoholism was dealt with while in assisted living. We took him out due to cancer when they locked down facility mar ‘’20. He was in a facility with many deaths.
As a rule of thumb: encourage and praise steps in the right direction, and say nothing about poor choices.
Is he able to manage his personal care at the moment? - i.e. washing, dressing, toileting and continence care. Skin integrity will become an issue but that's a whole 'nother kettle of fish.
I’m sorry if this isn’t ‘validation’ for what you are doing, but it could be time to think again.
I had a bit of an issue with my DH aunt not leaving her chair. It was more wherever she was, she didn’t want to move. It was getting too hard for her to walk. I was encouraging her to walk and didn’t even consider the wheelchair as I thought she “needed” to walk.
When she went on hospice and got a hospital bed, she was much happier. She really likes the bed. I was so surprised. I really hated to take her from her bed but it was too hard to change her or bath her in a low bed or the recliner.
Have you asked if your dad would qualify for hospice? You would get more CNA help and he could get all the equipment he needs.
Also he might get up more with a lift chair. He needs to move.
To me it is not that you are wanting to run his life or prolong an unhappy life, it is more about quality of life. He may have about run this phase out and will need a different routine to preserve the integrity of his skin.
Perhaps there are massage air mattresses for recliners, I’m not sure.
Is your dad on antidepressants? if so, is he on the right dosage? We increased DH aunts dosage after her having been on it for several years and it has helped. It might be worth a trial.
As far as validation, I understand that feeling. I used the ADL list and NH ratings and reasons they received warnings, etc. I judged and checked myself to make sure my mom was getting the best care possible in line with what she wanted to do. I know that may sound like a low bar to some but when I needed to know that I was doing everything I could, it helped for me to go over all the things that might go wrong and know I was doing as well as could be done for a 97 yr old at home.
With DH aunt, I have lived in fear of bedsores. She had a month of rehab therapy earlier in the year that really helped her with transitioning. She gets up almost every day and she could not/would not do that prior to the therapy. It is hard to get hospice to provide it once they have made that transition, but if he isn’t on hospice now, ask his doctor to order home therapy to see if it will help. The therapist can also advise you to keep from hurting your back. We took aunt off hospice while she had the rehab. She is back on it in a NH now. She will be 96 in Oct.
She really likes where she is and that makes it so much easier. I do understand you wanting to keep dad with you but sometimes what we want isn’t what we can do.
You have to also validate that you are doing what is best for you.
If he wants to sleep in a recliner and he is getting good sleep and not complaining of aches and pains that might be related to the recliner then let him be.
There are going to be other things more important that you have to put your foot down on the recliner is the least of the problems.
If the TV remote can be set with a timer so the TV goes off after a set number of hours at least the sleep will be less disturbed by light and noise. (I used to have a remote that you could set a timer for 1 to 4 hours and the TV would shut off it is one feature I miss)
If the chair is a fabric one I suggest that you get a washable, water resistant cover for it. Maybe more than 1 so when 1 is in the wash the other can be put on.
I would think getting him up walking during the day would be a goal that you want to try to achieve.
Thinking about this...if your dad is eligible for Hospice they would provide a hospital bed that can be placed where the recliner is. The head can be raised and the foot of the bed adjusted so it is comfortable for him. The hospital beds that Hospice can provide have an air flow so that it will help prevent pressure sores. If he is spending a lot of time in the recliner pressure sores will be of concern.
My mother refused to sleep in a bed when I first moved her to a nursing home and insisted on sleeping in her big leather chair that wasn't a recliner. She, too, had CHF, and eventually her legs were literally dripping water from them because they were never elevated. The staff at the nursing home tried to get her to sleep in a bed, but she claimed to be afraid she'd fall out of bed and refused, so they gave up.
Eventually I decided to move her to memory care, and we didn't bring the chair to her new place. She happily went straight to her new bed and her edema improved markedly.
I would discuss pros and cons with the doctor and possibly OT.
Lately though she's risking a fall by the way she gets out of the chair. She doesn't always put the chair back in the upright position and basically climbs off of it. Used to happen occasionally, now at least once per day. I can't reason with her about it anymore:( I'll have to have a talk with my brother about it soon and we may have to take the chair away! It's a tricky issue with some people.