How do you motivate and encourage to be pro active

[jessup]

I know that being positive and encouraging is the way to go but "you can take a horse to water but you can't make it drink".  Anyone got suggestions on how to motivate Dad.  I believe I should respect his decisions but WTF - it's hard to sit back and not "tell him" a few home truths.  I don't want to rattle him 

[flip]

Set some goals for him. Talk about things you want to do and places you want to go. Find some chores that he needs to do. Sometimes too much caregiving causes complacency.

[monrein]

Do you think your Dad is clinically depressed Jessup?  I mean more than "down" or "blue", I mean depressed.  Has he ever seen a doctor about this?  It's a fairly common feature of dialysis patients.

[jessup]

Yes I think he is but I'm not a medico
 his response is
"I'm not going to a psych "or" you don't take tablets .. you just have to get your head around it.."
"who wouldn't be depressed "

[willieandwinnie]

jessup  many dialysis patients go through depression or anxiety. My husband was put on Ativan for a few months and that seemed to help him. The doctor at the clinic can prescribe it or something similar. Good luck.

[monrein]

OK.  He's right.  Who wouldn't be depressed is right on the money.  You can reassure him that he wouldn't need to see a shrink, just his family doctor.  You could also tell him that several of us on here take them because we tried ,just like him, to get our heads around it and had a tough time doing it so we're trying to take a tablet to make it easier to find our former selves again.  I'd also tell him that these meds don't have to be a long time commitment, if they don't help he can stop.   Without getting mad at him you can also tell him a few "home truths", like how much you care for him and how painful it is to see him not himself and how you'd do anything to get him back even just for short periods of time.

Here's a link to an Australian site that addresses the symptoms of anxiety and depression.   Hugs to you Jessup for your caring self which shines through so strongly, even in the face of your understandable frustration.  


http://www.anxietyaustralia.com.au/depression.shtml

[jessup]

jessup  many dialysis patients go through depression or anxiety. My husband was put on Ativan for a few months and that seemed to help him. The doctor at the clinic can prescribe it or something similar. Good luck.

You  are not going to believe this but IT IS TRUE ............ There is not Doc or Neph at the renal clinic.  He comes to the clinic once a month and checks the patients charts etc. But in four months of Dad receiving dialysis at this clinic he has never seen the Doc/Neph.  I finally was able to speak to the "man"(doc/Neph) and he told me on the phone that patients can't make appointments to see him - the "team" will make appointments to see the patient if "they" deem it necessary.
So to put it more clearly
whether you are a private or public patient you (the patient) can't make appointment
BLOODY UNBELIEVABLE - there is only one neph in the capital city where we live - YES A CAPITAL CITY IN AUSSIE
WTF !!!!

[monrein]

Does your Dad have a family doc?

[jessup]

Does your Dad have a family doc?

Yes but he has said last two visits "I'll refer you to neph because I'm not up to speed on this dialysis stuff and medication" 
It is also worth noting that this doc is on the board of the AMA
But anyway Dad likes him and doesn't see a need to find a new doc
I think he (the doc) passes the buck and treats us like we are pathetic impiciles (?)

[monrein]

Jess, don't give up on this family doc.  Let him know of your frustrations with the clinic/neph situation and tell him you need his help to advocate for your Dad.  He will most likely not be able to give you info about your Dad because of patient confidentiality but you can give him your ideas and concerns about your Dad and also about the system.  Another possibility is to talk to the team, tell them your worries and ask them to schedule an appointment.  I know that it's you who deems it necessary but I'm hopeful you can convince them.  Talk to the charge nurse, head muckety muck or whatever you call her/him there.

BTW, all this stuff drives all of us nuts and you don't have to take any action at all until you feel really ready to.  I keep suggesting things and I know it feels hopeless to you right now but I'm stubborn and persistent and you can be too.  I just really wish you weren't having all this on you.

[jessup]

Thanks everyone
NB - Monrein - I appreciate your honesty and forthrightness (is that even a word)
I will contine to be a pain in the bum to these so called "professionals"
I think they hope I will get sick of hum bugging them with questions and advocating
But I will continue to persist even if Dad is not proactive
Surely he can't stay in denial for ever!!!!!
 

[G-Ma]

jessup...you keep being a great family to dad and keep on persisting...I know sometimes you see things that dad doesn't see and it may feel like a long time of what he is feeling but please hang in there with him.  I know he appreciates it.
Ann

[RichardMEL]

What the.... One Neph in a capital city?? Are you sure?? Where are you guys? Perth? or come to think of it did you say Canberra?

That seems very odd.. but I can't believe the response you got that the neph doesn't let patients make appointments with him but the team does.. what the...?? I'd definitely kick up a stink there with the unit manager that your dad has been put on dialysis and the neph hasn't seen him AT ALL in that time? Who is managing his medication and checking his labs to make sure everything is stabalising and all that kind of thing? Sounds like a mess.

Although maybe what the neph is saying is that if there IS only one(?!!) then you'd think he'd be pretty busy so perhaps the idea is that the dialysis staff should be vetting things a little as in they should be handling more day to day things as opposed to bigger things.. still the mind does boggle somewhat. I can't imagine a situation like that at all.

At least I know in my unit there's 3-4 nephs on the staff so if mine is away (usually the case! LOL) or something I can see one of the others.. most of whom I know in one capacity or another - and they definitely know me!! LOL

Of course I'm attached to a hospital unit so I guess things are different since they're right there.

Anyway onto the motivation issue... 4 months is still pretty early in to dialysis to get settled into the life changes this brings about and it can be very depressing to find suddenly you're resitrcted in diet, drinks and of course the thrice weekly grind to get on the machine. Perhaps you should listen to where your dad is at and try and be there for him. I bet the last thing he wants is his daughter telling him "you HAVE to do this. You HAVE to do that" - I bet he gets enough of that from the dialysis people. Maybe an idea is to sit with him and ask him where he's at and what he'd like. If he's like "oh nothing it's all too much. I feel like crap" and that sort of thing or in denial and not wanting to know about what is going on get the unit manager to refer you to the social worker and/or a psychologist to try and work something out. It is a huge transition but it's also NOT the end of his life...

It's important to remember that dialysis is not the end of his life or anything and he can live quite well with it - even with the restrictions and stuff. It may not seem like it at first, but it is possible (we are all proof!! )... Does he talk at all with the other dialysis patients? Maybe there might be someone chatty at his unit that he can talk to who has done it for awhile and sort of show him through action they get out and do stuff and live still..

Not sure what else to suggest at this point...

[jessup]

Thanks for the post RichardMEL
I have sent you a private message to let you know where we are
I am worried if I identify myself and Dad too much there might be consequences from the neph
He might or maybe a nurse read this website

He is an egotistical, self righteous f$%@k wit who has a reputation of being rude, arrogant etc with patients, staff and fellow docs

I can assure you my info is spot on
It's un bloody believable

Cheers
Jessup