NEW PERSON: need help/advice/don't know what to do

TechGurl

My mom and I do not know what to do about my dad. He has been acting irrational and loses his temper a lot. I have heard him tell my mom he wants a divorce and that she is no longer his wife and I am no longer his daughter. He has repeatedly say to my mom that he wants a divorce then a few hours later he claims he never said it. He often changes his behavior. He can be nice in morning and by the evening he can be at his meanest. He never was like that when I was a child. He seems to be a very different person. He has disconnected from us and watches tv all day long. He has started to blame my mom for mundane things around the house. In June, my dad wanted to get on the roof to clear the branches and we told him not to because he might loose his balance. We stayed outside with him and when he got half way on the ladder he froze and stayed that way for ten minutes. He could not get down and said he was scared. It took both of us to help him come down safely. On Father's Day this year, he wanted to work on the table saw for a project and my mom said for him to come inside because it is too hot for him to be in the garage, he got mad and said I will do what I want. Then an hour later, he comes rushing in the house with blood on his hand saying he cut his finger. He refused the ambulance so we took him to the ER. Thankfully he kept his finger but he was really cut up. He treats the hospital staff nice and speaks to them with humor but once he is around me or my mom he talks to us in an ugly tone, yells, threatens us, bullys us and says the meanest things. On July 11, 2023, my dad was at work and he tripped on the carpet and broke his hip. He was taken to the ER again and had to have emergency surgery. When he came out of surgery, he was talking to the nurses and even ordered a huge sandwich to eat. But he did not acknowledge me or my mom. He did not look at us once! A week later we asked him if he remembers us being there in the hospital and he said no. Since he has been home recovering from hip replacement surgery, my dad does not shower for three-four days. He tells us he has but really hasn't and gets mad that we are "nagging" him.

My dad is 77 years old and he has had an EEG and it came back that he has mild cognitive impairment. We are not having any luck getting him an appointment with a neurologist. We are in desperate need of help and we do not know what to do. He has not been diagnosed officially by a doctor. My mom has been sick over the verbal abuse and threats my dad has said. Can someone provide some advice?

thank you for reading my long story.

M1

Welcome to the forum. Im so sorry you are facing this. Seek help from his primary care doc and see if they can speed things along. Your mother needs to have financial and health care power of attorney, if she has not already done that you need to speak to a certified elder law attorney as soon as possible. As hard as it is, try not to take his insults personally, that's the disease talking. There are medications that can help make life easier for all of you.

Iris L.

He should have no more access to power tools. What is his work situation now?

Iris

SDianeL

Agree you should talk to his primary care doctor and get a referral. I wouldn't tell your Dad it's a Neurologist, just an appointment. MY DH was diagnosed 2 years ago and your Dad's behavior is very similar to his. Anger, agitation, memory lapses, not showering. Get the attorney involved asap. Get the book "The 36 Hour Day" it will give you tips on getting him to shower. After I read the book, I realized that there are 3 reasons someone with memory loss won't shower. 1. They don't remember when they last took a shower. 2. Taking a shower involved several steps and it's overwhelming for them. 3. They may be afraid they will fall. So I told my DH that he needed to shower 2x a week. We go get him a newspaper on Wed & Sun so those were the days he agreed to. Then I got get his shower ready. Wash cloths, towel, body wash, even turned on the water at first to get it warm and not too hot. I put a seat in the tub and got a hand held wand so he can sit when he showers. Now when it's time for his shower, I get it ready and say to him. Your shower is ready when you are. At first he balks but he eventually will go take it. If he's not feeling well that day, he says he will take it the next morning and that's OK. He always does. My husband is now in Stage 5 going into Late Stage 5. You need help now. Also call the ALZ helpline and they may be able to offer more help. 800.272.3900

harshedbuzz

@TechGurl

Hello and welcome. I am sorry for your reason to be here but pleased you found us. You clearly belong here.

Much of what you write sounds very familiar to my experience with my dad. I noticed mood changes (2005) ahead of obvious lapses in empathy, executive function and memory (2008). TBH, my dad and I never got along well, so I was pretty used to this side of his personality. But when my mom, his brother and my late sister's kids were on the receiving end of his ire, I took notice.

You and your mom have steps to take to plan the progression of the disease in terms of making financial and medical decisions on his behalf. You and mom should see a certified elder attorney to create a durable POA for both of them (you need to be mom's agent, although dad doesn't need to know that) for medical and financial reasons. You should also discuss Medicaid planning in the event that they don't have a comprehensive LTC policy and/or unlimited funds. I would make this happen asap.

He needs to be diagnosed and likely medicated. He needs bloodwork to rule out something treatable that mimics dementia. He needs imaging and some sort of cognitive testing. Did a family doc order the EEG on which they are basing his MCI? Sometimes a PCP who has a long-term relationship with a PWD is hesitant to diagnose dementia as 1) it's not their area or expertise and 2) it's a terrible diagnosis to give someone with whom you have a long-standing relationship. He should be seen by a neurologist or memory clinic team. You may need to create some sort of ruse-- a therapeutic lie or fiblet-- to make this happen. You can report what you're seeing at home in terms of behaviors discretely by creating a written list to share on checking in, so you don't have to throw dad under the bus. I always sat behind dad at appointments, so I could communicate nonverbally with the doctor when dad is answering questions.

Based on what you've shared, I would not be surprised if your dad is further in the disease process than mere MCI. Two things in your post suggest this. The first is the broken hip. This is a not uncommon occurrence in PWD and generally results in a significant progression of the disease from the trauma of the break, the anesthesia and the hospitalization that follows. My aunt broke her hip in stage 5-ish and it fast-forwarded her into stage 7. The other thought is the shower refusal-- this behavior is right out of the stage 5/6 playbook.

This handout includes the 7 stages. It's not unusual for a PWD to straddle stages, but they're generally considered to be in the latest stage for which they have a symptom. Note that the stages have developmental age equivalents-- these can be useful for deciding matters of safety. I agree with the others that you dad's days as a handyman with access to power tools and ladders should end today. He should also not be driving at all and his access to credit cards and the internet may need to be shut down as well.

Tam-Cummings-LLC-Handouts.pdf (tala.org)

You didn't flesh out what dad is saying but it's not unusual for PWD to say ghastly things to their LOs. I was routinely accused of theft, selling his house for $360K less than it was worth (he lost that amount in the market) and leaving my son in a bar to go have sex with some rando. Mom, on the other hand, was a liar and having sex with dudes in the Rite Aid parking lot. This article helped her get to a place where she could deal with this graphic nonsense as a symptom of the disease--

https://www.smashwords.com/books/view/210580

If your dad's behavior is truly a risk to you or your mom, one option is to call 911 and have him transported to the nearest hospital with a geriatric psych unit for medication management to take the edge off his agitation and violent ideation. Medication can help a lot. Dad was on a cocktail of 3 meds to dial back his anxiety and aggression which allowed mom to keep him home until a few weeks before he died.

Good luck to you and your mom. This is hard stuff.

HB