How do we deal with the care my obese father needs?

A fellow caregiver asked...

Help! I don't know what to do. My father is 61 years old and weighs about 500 pounds. He refuses to tell us exactly how much he weighs, but that is my best estimate. He's about 5 feet 4 inches tall and his waist is 70 inches.

He can't stand, nor can he barely move. In the last 3 weeks, he has fallen FIVE times and couldn't get up any of those times. He has had to call 911 each time to have them send the fire department to come lift him up. It's taken five people each time to lift him up.

My mom has to bring all of his meals to him. My mother can't take it anymore - I fear she is close to having a mental breakdown. She flies off the handle and starts snapping/yelling at me and my sister for the littlest and most minor of things because she is frustrated with taking care of my father.

He kind of rolls off the bed into a wheelchair and she has to push him to the bathroom where he walks the one step from the wheelchair to the toilet to use it. I have tried talking to his doctor numerous times and his doctor just tells him to take more pain medication for his problems. Hello? Pain medication is not going to help him lose weight, or move better. My father refuses to believe that his weight is a problem. He won't listen to my mother, myself, or my brother.

I really think it's time for him to move to some sort of assisted living facility, but he refuses to listen when I bring up this idea.

What can I do?

Expert Answer

Kay Paggi, GCM, LPC, CGC, MA, is in private practice as a geriatric care manager and is on the advisory board for the Emeritus Program at Richland College. She has worked with seniors for nearly 20 years as a licensed professional counselor, certified gerontological counselor, and certified geriatric care manager.

Caring for an obese parent is challenging because there are two questions. One is how to deal with the extra weight and the other is why food is such an issue for this person.

To begin with the second part, I suggest that you look for a physician in your community that addresses weight and diet issues. Your father cannot see his weight as a problem because he cannot consider the possibility of living without whatever need the food is meeting. He shold be checked medically for metabolic conditions, such as diabetes and body chemistry imbalances. You can hire an ambulance service that transports wheelchair patients to take him to the doctor.

The goal of seeing a physician is to establish that he does or does not have a metabolic disorder that can be treated, and to help you and your father understand the long term consequences to his health of his curent weight. Almost certainly his heart is affected.

The point is not to try to scare him into losing weight but just to understand the consequences. If he could lose weight, he already would have; he has probably tried numerous times and failed. Understanding that he has a problem he he has not been able to fix will help you be more supportive.

Next the question of how to deal with the additional weight. I tend to take a tough love position. While he may be helpless with regard to losing weight, you and your mother are also helpless to help him reduce the pounds. Help your mother set limits on what she will do for him. She can refuse to cook foods that are fatty. She can refuse to bring him his meals, and insist that he find a way to get to the table on his own. She can place a urinal near his wheelchair and insist that he manage that need without her assistance.

Your mother is enabling him to maintain his current weight. She probably doesn't recognize her part in the problem but suggesting that she manage her responses may help her recognize that she is part of the problem.

Once the family is working together to solve a mutual problem, the results are morelikely to be postive. As it is now, you and your mother are on one side against your father. This really isn't helpful. The family as a unit can decide whether he needs to live in a different setting. A facility will use a hoyer lift to transfer him. You might look into buying or renting this device or other assistive devices as part of the family effort to deal successfully with this very complex issue.