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Wishididntneedtobehe

Dcfffffffffghhjjji

M1

Wow. That's a lot, and it doesn't sound safe for either one of them.

I will start with one comment: Seroquel should be given consistently and is NOT really as "as needed" medication. He should be dosed daily, perhaps at bedtime to start, as that will help him sleep and perhaps prevent some of the nighttime havoc. Additional doses can be added if he continues to be agitated during the day, but definitely start with a consistent nighttime dose.

harshedbuzz

@Wishididntneedtobehe

Hi and welcome. I wish you didn't need to be here, too, but I am glad you found this place.

I agree, that is a lot. Even without your responsibilities to your young children, your dad's presentation along with your mom's poor decision making and coping skills are a lot with which to deal. It's a lot a lot.

I agree with @M1 that you dad, and mom, would likely benefit from a steady level of Seroquel in his system rather than attempting to play whack-a-mole with an "as needed" approach. If he tends towards violence, a short stay in a geripsych setting might be needed to get his medication managed and a manageable care plan made.

FWIW, my mom was a bit as you describe yours. She was loathe to bring in help for a lot of reasons. She felt she'd be judged for having caregivers or placing dad in a facility-- the whole "in sickness and in health" thing of her generation. She didn't want to pay the eye-watering costs for HHAs. Dad had made some financial missteps early in the disease which cost them $360K of their nest egg, so money was tighter than she'd planned on. And given mom's own complicated health history, we didn't want to spend down on his care if it meant she'd be limited to facilities that accept Medicaid from the outset. If she was home, dad wouldn't accept care from others and what she really wanted was time alone in her own home, so she didn't see the value in it.

That said, because dad could be aggressive (Team Seroquel b.i.d.) and mostly refused to submit to care around hygiene, medication and toileting, dad was getting substandard care in the home while mom was in a bad state emotionally where she let her own care needs slide. She made some disastrous choices that robbed her of the independent Stage 8-- and me-- to which we looked forward. And she was too close to the situation to clearly see the reality of how it was impacting both of them-- kind of like the frog in the pot of warm water set to boil who doesn't realize the trouble they're in. Your mom might be the same.

One concern I have is about how your mom is containing dad's messes. In many jurisdictions, locking a person in a room alone without access to a toilet overnight could be considered false imprisonment. Can you imagine this being allowed in a child's IEP as a consequence? In your shoes, I would be worried about APS getting wind of this as it could result in charges of abuse and also the loss of your family's role in decision making were he to be given a court appointed professional guardian.

Can I lock wandering dementia dad in room at night? - AgingCare.com

If he's prone to wandering/soiling overnight, then motion detecting mats that alert her so she can redirect him would be the appropriate choice over locking him in a room. If medication can't make overnights easier, then an aide should be hired to attend him.

My mom fought me on placing dad. I finally had to have a CTJ with her. His care was killing her and I told her that if she wanted to pick his MCF, she needed to act now, because if she left it to me, it would be the first place that would take him. It worked for me. What she didn't know was that I had already toured a dozen facilities as part of my Plan B should I need to step in because she could not provide care. I took her to visit my top 3 options and talked her into a trial respite which became permanent.

Dad saw the staff at the MCF as professionals and mostly cooperated with them on care. As a result, he got better care and even looked better. And my mom was able to stand down as caregiver and just be a wife. Because she wasn't making him do stuff, their relationship improved.

HB

M1

Do you think your mom could also have some cognitive impairment? I think harshedbuzz' point about locking him in as potentially abusive is well taken, i would check with an attorney and the fire marshal about that. You may need to pursue power of attorney for both of them.

A quick Google search says this is highly illegal and considered elder abuse. I think you better consul an attorney. Certified elder law attorneys can be found listed by location at nelf.org.

psg712

Can you ask your dad's primary care doctor for a home health referral, for a home safety evaluation? Then be there at the home visit so you can fill in the blanks. Just an idea to get the ball rolling. Any home health nurse worth her or his salt will have social services on the case in a hot minute, if you provide the information you laid out here. They may even be able to help with a geropsych admission. Just brace yourself for your mom's ire for ratting them out, so to speak.

I wish that your mom would allow the respite visit to the memory care. You might have to take her out of town so she doesn't go check up on him. Then perhaps she'd get enough of a break to recognize that she can't keep doing what she's doing. Hard to predict. But you are right, what she's doing isn't safe or sustainable. You are in a tough spot.

M1

Id still be very careful about bringing anyone in like that without legal advice. A social worker might be obligated to notify adult protective services and you might well lose control of the situation to an outside guardian. I understand your justification but that doesn't make it legal or acceptable.....

harshedbuzz

@Wishididntneedtobehe

Locked in a room could be a problem still.

What if your mom suffered a bad fall or heart attack? Your dad would be locked-in alone without food or water until she was discovered. APS would take a dim view of that. And likely of you given you were aware of the situation.

What would you do if you walked in on that scenario? Do you have a Plan B? It's said that 1/3 of all caregivers die before their PWD.

FWIW, it would be OK if someone were in there with him which is why is OK to bolt exterior doors or lock doors of rooms you want to keep off limits. Your mom could easily reverse the doorknobs on the ensuite bathroom to keep him out.

It doesn't sound like your mom is up to the task of caregiving. You say her cognition is not impaired, but the choices she's making are risky. You mention losing her home 18 months ago; BTDT I lost mine in Floyd. It was difficult. Even with insurance and some FEMA aid, we took a financial hit. Could your mom be avoiding MC because she can't afford it? Could she be suffering from PTSD, depression or anxiety that is limiting her ability to appreciate the potential consequences of her decisions?

For fecal smearing, one-piece garments can be helpful if she can get him to cooperate with wearing them.

Back-Zip Jumpsuits - Jumpsuits - Men's Clothing Adaptive Clothing for Seniors, Disabled & Elderly Care (buckandbuck.com)

HB

psg712

https://alzconnected.org/discussion/comment/197278#Comment_197278

True, M1. Thanks, I didn't think about that consequence. In no way do I want this family to lose their rights to make choices for their LO. I just want them all to have a safe situation as they care for him.