discussion about progressing dementia with dad

borodawkajlb

My father was diagnosed with Early Onset Alzheimers at the age of 56 and is now 64 and we are seeing progressing paranoia/agitation/aggression with neighbors/strangers to the point that I'm afraid he is going to end up getting hurt or hurting someone else. I wouldn't be surprised at all at this point if the police get called by someone feeling threatened and know my father would probably be combative with the police and end up arrested. I've had one of his neighbors reach out to me who has known him for years, to let me know how he is harassing people and scaring children. He will come right out of his unit to yell at someone walking by accusing them of talking about him. I've tried talking to him about my concerns but he isn't able to see these behaviors or believe anything negative will come of it. He was always a very happy helpful friendly person and still see's himself like this. How do I have the conversation with him? I can't expect him to understand or agree with my concerns. We feel he is at the point where he can no longer really live on his own due to his paranoia/aggression but he doesn't want to live with anyone else. Help? I am working on getting his medications adjusted but of course that all takes time and I feel the need to make some changes now.

harshedbuzz

Hi and welcome. I am sorry for your reason to be here, but glad you reached out.

This sounds like a very difficult situation all around. I does sound as if you have to be proactive at this point to keep him and the people around him safe. Do you have the legal paperwork in place to act on his behalf in the form of a DPOA? If not, you will likely need to obtain guardianship to make a move happen. 

My concern is that the neighbors have stepped up to inform you of his behavior. This is your warning shot over the bow. If any one of these folks feel you are not acting with the appropriate sense of urgency, this situation could escalate in ways that make things worse. If he mouths off to the wrong person, police will be called. If he's not cooperative with police, he will be arrested or even shot. Alternately, a well-meaning neighbor may report the situation to APS in which case you risk losing any control of the situation. 

It's great that his meds are being adjusted, but how are you certain he's taking them? 

EO ALZ can progress more rapidly than in those who develop it later in life. It sounds as if it is time to put a Plan B in place to keep him, and others, safe. If his disease has progressed to paranoia and delusions, he will no longer have the executive function skills or the memory to participate in any conversation regarding care. It is the responsibility of his POA or guardian to decide what comes next and make it happen. 

Often people use a therapeutic lie (aka fiblet) to force a move. This might be telling dad he has to stay with you because the sewer line to the condo has failed and the water will be turned off, or perhaps his doctor ordered a stay at this fancy rehab (MCF) to work on an injured joint or strength or maybe he needs to stay in a senior community (MCF) because his unit has termites and will be tented. Whatever might work for him. It's hard, but doable. One woman here told her dad a story about going out for breakfast and drove him 1600 miles to a MCF near her home to get him away from a gold-digging "girlfriend". 

HB


ETA: I would start touring places if you won't be moving him in with you. It may take some time to find a place willing to offer a placement given his age and behavior. Many MCF are wary of younger men as they have a reputation for physical strength and the potential of sexual activity from which they will need to protect staff and other residents.

borodawkajlb

Wow! Thank you so much for all that great information! Yes, I do have POA so that is at least in my favor. I call him every night to remind him to take his meds and I can hear it over the phone but I guess without actually seeing it I can't say for sure. He is always striving to live to 100 though and knows his meds are to keep his brain healthy just like his body so I truly do feel that he is taking them. As far as elder services go, they have already been involved b/c he must have accidentally turned on his gas stove. I've removed the knobs so that he can't do it again. They were just out this past week to assess and make sure he was safe. They plan on coming out again in a few weeks to reassess the situation. 

Maybe I will try and think of a white lie for getting him to stay with me till his meds are fully adjusted and he is back on a more stable track (not so paranoid/agitated/aggressive). I just don't know how to keep him from going back to his house. He still drives and is only 20 minutes away from me. 

borodawkajlb

oh and what does MCF mean?

M1

Borod, sounds like you need to take the car keys away yesterday, before he kills someone.  Maybe that could somehow work into your excuse to keep him with you.  But no way he should still be driving, from what you describe.  Even if you have to go over there and sabotage the car/take the battery out, you should do it.  I realize what I'm saying, I had to pull similar stunts here too.

And Harshedbuzz is right, you may not be able to find placement for him until the behaviors are under control.  He may need admission to a geriatric psych unit if you can't get medicine adjusted at home.  I had to do that too.  The upside is that you can arrange placement direct from the hospital so that he never goes back home.

I'm sorry it's so hard.

harshedbuzz

borodawkajlb wrote:

They plan on coming out again in a few weeks to reassess the situation. 

Will you be there for that? I would try to make sure there's a second set of ears at that visit. 

Maybe I will try and think of a white lie for getting him to stay with me till his meds are fully adjusted and he is back on a more stable track (not so paranoid/agitated/aggressive). I just don't know how to keep him from going back to his house. He still drives and is only 20 minutes away from me. 

This is very concerning. I can appreciate that it's hard for you to step in and take control of this situation given your dad's personality and inability to understand or appreciate that he has a terminal illness that has caused significant cognitive and personality changes, but it still has to happen. My dad was like you describe yours in many respects and the moderate stages were the most difficult as a caregiver. LOL, he also believed he was going to live to be 100 and talked about it constantly.

I would also have serious concerns about him driving. Dementia with a behavioral disturbance (his paranoia and agitation) is a recipe for disaster generally. Have you driven with him recently? Would he be OK in a traffic stop? Have you discussed his diagnosis with his insurance carrier to make sure they'd cover in an accident? (Dad's insurance would not cover in the event of an accident with an Alzheimer's diagnosis/against medical advice)

Another concern is that, in the event of an accident, he could be sued. I went through this recently with my own mom. She doesn't have dementia but had some vision issues that caused her to have 2 accidents in less than 60 days. One of the folks she hit in the second accident was injured and sued her. This lawsuit hung over us for almost 2 years and we both felt terrible about it. Had there been dementia in play, the person who was deposed and called to testify would have been a lot more impaired than they were when they had the accident. 

You'd want to talk to the lawyer who drafted the POA to understand what your liability is should he have an accident? A POA gives you not only the right to make decisions around safety, but it also obligates you legally. 

A MCF is a memory care facility. These are almost always "secure" in that they are locked. These places allow a PWD to age-in-place which is a nice way of saying "die there". As a result, when you tour, there will likely be a lot of residents who are much older and even further along in their dementia. That will be hard for you emotionally to picture your dad moving to such a place. But care needs dictate placement with safety trumping happiness, I'm afraid. 

HB

 

N00dles

Welcome to the site you wish you weren't on.

I can relate; my father w/Alzheimer's has at times been agitated.

You might enlist the assistance of his doctor, to approach the conversation about driving, along with medication management. 

Here are some helpful links:

https://www.alz.org/help-support/caregiving/safety/dementia-driving

https://www.nia.nih.gov/health/driving-safety-and-alzheimers-disease

See the link on the right-side of screen 'Help Info' for abbreviations.

Take care.

easy23

borodawkajlb wrote:

 As far as elder services go, they have already been involved b/c he must have accidentally turned on his gas stove. I've removed the knobs so that he can't do it again. They were just out this past week to assess and make sure he was safe. They plan on coming out again in a few weeks to reassess the situation. 

I'm sorry for your problems.  Just an FYI - I removed the knobs from my stove and my husband was able to turn on the gas using the stem. He just pushed it in and turned it.

 I don't know if your stove is the same as mine.

  

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