Starting diagnosis process

sreim606

Hello, my 91 year old dad has been showing signs of confusion and memory loss for about a year now. A few months ago he fell and had to be in the hospital and rehab. The fall has caused issues with his kidneys and heart. We elected to move him to an assisted living facility. He is completely wheelchair bound and a major fall risk. He has declined cognitively and memory wise a lot since his fall. He gets confused on the time of day. He doesn't remember daily tasks as dining times. We try to write everything down for him. But he forgets to look at what we write down. He has PT and OT with home health care to try to rehab him as best as possible from his fall. He was referred to SLP by both the ASL facility and the therapists. He had two sessions and then started accusing her of trying to steal his land he has. I went to see him last week and he started accusing me of stealing from him. When he was in rehab a couple months ago, he signed paperwork so I could be his financial and health care POA. He also asked that his mail come to my house because he had such a time the last time he moved getting his mail forwarded. I added myself to one checking account so I could write his rent check while he was moving from rehab to the AL facility. Now he is accusing me of stealing his land, with the SLP. My sister lives in Colorado and he's started calling her and telling her I'm stealing. I actually pick up the bill for anything extra he has. We furnished his apartment, buy his groceries, bought him clothes for rehab. The doctor and SLP tell me he shouldn't have access to his checkbook or drive. I give him his statements so that he feels he can still see and maintain his money. He got mad when I wanted to keep his checkbook. He's been writing checks to Publisher's Clearing House and other different scam type places. I didn't want to argue with him, so he has his checkbook. He was confused on how to write his rent check this last month. He is supposed to have a full neuro workup to hopefully get a diagnosis, but is refusing at this point. I am not sure what to do. My sister doesn't know how to handle him calling and accusing me of things. He has the AL facility to aid him, but they can't take him to his appts and is getting to the point he can't go out with them and be on his own. I am not sure how to handle the finances at this point. He thinks the "rent" is too much. I try to tell him it is for his care, but he is determined that the VA would pay for any nursing home care and wants to either move there or go back down south where he is from and buy a house and live on his own. He doesn't qualify for VA benefits because he has too many assets, as well as his deficiencies are not "service related." I'm at a loss on how to help him since I am the only family he has anywhere near him. And I hate my sister has to try to wade through the delusions he is having about me. I try to send her screen shots of his account and his bank statements. I have never taken a dime from him. I also took care of my mom the last year of her life. I just want to keep him safe at this point.

M1

Welcome to the forum. It is very hard to have to take charge of a parent to whom you are used to deferring. But you need to.

First, he probably needs to be in memory care and not assisted living, it sounds like he needs a higher level of supervision than he is receiving.

I am not sure i see the point of pursuing an elaborate diagnostic workup at his age-to what end? If he has had head imaging and bloodwork, then treatable problems have been ruled out.

Take the checkbook away. I had to do this with my partner, who wrote thousands and thousands of dollars of checks to animal charities in the year or so before she went to memory care. i tore them up and took them out of the mail, and she never knew the difference. She also insisted on getting her bank statements, but couldn't read them. He could write away his life savings to an unscrupulous person who sees his checkbook. As you are the poa, you are obligated to act to preserve his assets.

Medications may help some with the delusions and anxiety. A geriatric psychiatrist may be of more help than a neurologist, but a good internist can also handle this.

Im sure others will chime in, this is a good place for advice and support.

jfkoc

Please make certain that a diagnosis following protocol is made. You can Google this.

Then make certain all legal and financial matter are in order.

Then as far as communcating and gettign things done please keep in ming that approach is everything and that you have to be withing the 4 corners of your father's world now.

-Judith

JDancer

If he has assets, I see no reason for you to pay for furniture, groceries, etc. Sometimes it seems easier than possible arguments about how the money is being handled, but in the long run, PWD, usually don't know the difference.

I hope that doesn't sound too harsh. My comments are based on my own experiences, other may disagree.

housefinch

I think the chances of him doing any PT or OT exercises are slim. Forgive my bluntness here. I would put him in memory care and get a hospice consult and be sure geriatric psychiatry or someone who can prescribe medication can see him ASAP so he doesn’t get evicted from memory care. I would not pursue an aggressive medical evaluation as @M1 said. He’s 91 and has dementia and agitation with delusions. He has 1 trajectory at this point. I’m sorry. A physician needs to speak very honestly with your family in a care conference.

Iris L.

Tell him that all banking is done online now.

Then, stop talking about money. Out of sight, out of mind. He will eventually forget. If the topic comes up, distract.

Iris

MN Chickadee

I'd tell him you are working on getting him out. Find the right therapeutic fibs. You will look into a place down south. You will arrange a move when the weather is better or when you have a break from work or after the grandkids birthday. Validate his concerns and requests, fib, re-direct to something else. Repeat. I know it's exhausting. Arguing that you didn't steal land won't help. His ability to process the logic of why that's incorrect is gone. You may just have to apologize or say you won't do it again. Whatever you can to kick that can down the road until he loses more memory and stops asking about his land or finances. Also consult his physician, it could be a medication would tamp down his anxiety. Most PWD are on something for mood/behavior. I probably wouldn't bother with diagnosing at his age unless there are red flags for something out of the ordinary like Lewy Body dementia or similar, but it doesn't sound like it. You would put him through a lot (and make him resent you) and there wouldn't be much doctors could do any differently for him once he is diagnosed. At his age he is likely to decline quickly from dementia. I'd focus on getting through this delusional phase in one piece without him blowing his money and see what the next phase brings. It's so hard, I know. You and your sister have to let it roll off, hard as it is.