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My FIL is a 92-year-old retired colonel and lives by himself (my MIL died 3 years ago) in a nice condo 10 minutes away from us.

He has 3 sitters who work from 7:30 am until 7:00 pm. He's alone then until the morning.

He has become almost immobile and is in a great deal of pain almost continually. In addition, his hands and feet are very swollen. He sees a local doctor who is truly a quack and who has lost his affiliation with one of the hospitals he worked with. He does things like give my FIL testosterone shots and lots of tests and doesn't (as the dr. himself says) know what's wrong with him. "Maybe it's his heart."

The Colonel (as everyone calls him) is a very angry man with a strong will -- he's always been like this. He won't let anyone tell him anything and will listen to no one nor accept any advice.

For example, he lived in a wonderful independent facility where he could have gone to assisted living when the time came and then into the healthcare facility. But they couldn't give him a parking spot where he wanted, so he said "I don't have to stay here," and a few days later bought the condo and moved. The place is huge and expensive. But that's the way he is.

We're very worried about him, especially his being alone for 12 hours a day -- but he can be very cheap and refuses to pay for a sitter while he sleeps -- though he's sleeping most of the day anyway. Sometimes when talking to him -- either my wife and/or I visit him every day -- he'll fall asleep during the conversation. He's also talking less and less.

Given all that and the fact that he's clearly declining quickly, has no adequate medical providers, and is in constant pain, we just don't know what to do.

We were wondering whether any of you might have any suggestions as to paths we might pursue in order to alleviate this terrible situation?

Thanks in advance for any help or suggestions you might be able to offer.

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My father is also ex military. When I see something that would improve his condition, I don't tell; I ask. Such as; do you think physical therapy would improve your balance, and stop some of your falls? I always phrase it as a question, and I honor his authority and intelligence. If he says no, i let it go.

When I believe in his abilities to find a solution, he listens. I even reply yes sir, honoring his position. Have you looked at his diet? A change in diet to eliminate white flour and sugar may decrease his pain, and give him some energy. Again i would just leave cut up fresh fruit on the table, not lecture him on his eating habits. What does your FIL have left.but his dignity? Honor him, flatter him, and maybe he will start listening.
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It sounds like calling hospice might be an option at this point. He may not need hospice yet, but they might have some good suggestions (like a different doctor!) about pain relief and mitigating his sleepiness. Falling asleep in the middle of conversations is something that my father in law did many years ago; it turned out that his kidneys were failing. I'd try to get him som medical evaluation that's worthwhile sooner rather than later.
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I think it's often much harder for career military men to accept age related decline, especially officers who've been in charge of their men/women for so many years and now find themselves weakening and having to rely on others.

From your description, I don't think the strong willed attitude will change, so perhaps all you can do is provide ancillary support in the event something does happen.

Do you have a life alert device for him? It won't necessarily protect him from falls but will provide an immediate alert to a service which can call first responders and you.

I researched the various units and decided on one monitored by a local alarm service. The salesman was more honest with me about the limitations of GPS features than any other service I questioned. I wanted frank assessments of the devices, not sugar-coated descriptions of how great they could be.

If you don't have a lock box, it's an excellent idea. We looked at two versions: one had a u-shaped top and could hook over and be locked onto a door knob, and the other would be screwed in directly to the exterior of a home.

My father, who's done woodworking all his life, experimented with the door lock and discovered that it could be removed by a would-be burglar, so we opted for the lock that screws into the home. There's no way it can be removed without knowing the access code so a burglar can't steal it.

It's already been used twice by first responders; I give them the access code when I call 911 as I'm 45 min - 1 hour away.

Since your FIL likely won't go into any facility unless it meets his specific criteria, about the best you can do is make his own condo as safe as possible.

Are there grab bars outside the doors, in the hallways, in the bathroom? Does he use a walker? If so, it can be padded. We purchased a type of foam insulation at Lowe's and my father padded his walker himself. If he falls with it, at least he won't fall on the bare support bars.

I've wanted to get front padding as well so that protection would be available from any direction if my father falls; I'm still working on that concept.

I rather doubt he'd express his concerns or anxieties, but if he does, perhaps you could ask him what he would improvise for the situation. Let him feel as though he still has some control over his life.

I did tell my father I'd make a carrying pouch for his walker and iron on a patch of Fifi or one of the WWII bombers; that's an attention getter and provokes other vets or mlitary aircraft enthusiasts to begin discussions, enhancing the social aspect of using a walker. I wanted to turn using a walker into a positive rather than negative necessity.

If mobility from the bed is an issue, there are side bars that can be installed to help him get up. Some communities have loan closets; perhaps a hospital bed might be available on loan, if your FIL would use it.

I assume he has a phone right next to his bed; if not, get one installed - a corded phone so there's no issue of having to check batteries.

Shower chairs that extend out beyond the tub would help with bathing as he could sit down, slide over and lift his legs to get into the tub.

As to the edema, is it from lack of activity combined with cardiac insufficiency? If he's not taking a diuretic and is not on any blood thinning medicine, there are some foods that have diuretic properties that work for me, although I don't have a constant edema problem.

My father uses a partial stationary bicycle to exercise his legs; it becomes a competition with himself to see how many he can do. It can be used sitting down; it's not an exercise bike that requires getting on and off. And it does produce blood movement within the lower legs to keep edema at bay. He got it from a medical supplier, I believe. It's a cheaper version of the ones used in rehab facilities that can be used to exercise arms or legs.

Wish I could offer more suggestions but I also know what it's like to work with a military man of your father's age and try to make them realize how vulnerable they are - something's that anethema to any military man.
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There are many things that could be done, starting with a change of doctors and continuing through GardenArtist's suggestions. The problem is not so much what can be done to help him, but how to get him to let you help him, right?

Is there any part of his current situation that he would like changed? I would think the pain might be a candidate for that. Could you start there? Would he be open to a new doctor in order to treat the pain?

Mostly your hands are tied. Make peace with your limitations and continue to love the stubborn ol' geezer.
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Thanks so much for your answers and suggestions. There are lots of good ideas here that we hadn't thought of or considered. We appreciate the time you've taken to help us.
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Kathy, excellent advice. You are so right about honoring and flattering the OP's FIL - advice which I can take to heart for my own father. You obviously have good insights into your relationship with your father. I'm copying your post for reference for my own caregiving issues.
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Unfortunately if he's going to refuse help you'll just have to let him be, until something tragic happens..

Does your wife have POA for his medical or financial?
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assandache7, no my wife doesn't have a POA for his medical or financial. That would be the last thing he'd consider.
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