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Carol Bradley Bursack, Published August 31 2008

Dad’s behavior could be a sign of depression

Dear Carol: My dad is living in his own home, which he claims is what he wants, but he’s living in squalor. He refuses to have anyone clean for him, and he can’t do much of it himself. What he could do, he won’t bother with. His bathroom is on the second floor, and he often doesn’t make it on time, so the carpet smells. He doesn’t bathe. I’ve tried to convince him that he needs to hire help, or better yet, move to assisted living. How can I get through to him? – Sam

Dear Sam: This isn’t as uncommon as you would think. Elders often have less acute sense of smell and sight, so many don’t notice the smells and dirt around them. They think they are fine, even though you know they never would have put up with that years back.

However, a more serious situation could be depression.

Think of a nonthreatening excuse to get your dad to a doctor so you can see if he is clinically depressed. Sometimes depression is enough to keep even young people from caring about their surroundings or hygiene. A depressed elder, who may find it physically hard to do the work of self-care, would be even more vulnerable to this unhealthy situation.

If actual clinical depression doesn’t seem to be an issue, the fear of change, combined with resentment about being told what he needs to do, could explain a lot of his resistance.

Elders are so often afraid of any type of change that they will put up with misery rather than budge. There’s also the feeling of lack of control over their lives. When people (particularly their adult children) start telling them what they must do, many will dig in their heels, even if they are unhappy with their life as it is.

If there is any way for you to let your dad know that you aren’t trying to tell him what to do but that you are trying to help him decide what he wants and needs, he may be less resistant.

You could offer him choices. Home remodeling could make it easier for him to get around and use the bathroom. Sometimes the price of that alone will get an elder to consider another option. But at least he’d feel he was part of the process. And sometimes minor remodeling makes sense.

If he is absolutely resistant to any changes, and his health and safety are in danger, you may need to call your county adult social services and ask for a welfare check. Once these professionals get inside the home, they will evaluate the situation, and you will have some authority behind you when you seek to improve his living conditions. That could mean upgrading his home and getting him in-home help or moving him to another living arrangement.

Again, your county social services can help direct you. Also, the eldercare locator at www.eldercare.gov gives care options around the country. These are not rated, so you will want to investigate any options you uncover, but it’s a good place to check to see what is available in your area.

Bursack is the author of a support book on family elder care. To submit questions to “Minding Our Elders” and view past columns, go to www.inforum.com and click on columnists. Readers can reach Bursack at cbursack@forumcomm.com or write her at The Forum, Box 2020, Fargo, ND 5810