Return of the "fugitive"....an update

mrahope

After DH's PCP told him he was fine and that his "family were trying to put you in MC" and that the PCP refused to sign the form because he was "perfectly fine", the following day (yesterday) my DH called and Uber and left the house. After about 3 hours I got a text from him saying that he was at the airport in the next large town about 25 miles from home. He said it was a nice airport and that he was now on the bus back to our town. He then called for a ride from the campus where the bus had dropped him and DS went and got him. We don't think he actually made it to the airport as his phone tracked to the train station throughout.

I don't know how to express how angry I was. But knowing all, I just gave DH the cold shoulder upon his return. And in fact, I'd gone to DS's home while DS went to retrieve DH.

Meanwhile, we got word that both the neuro and the geriatric doc had signed the cognitive impairment form. This should trigger our DPOA. This leaves the medical form alone, and we are unsure whether the geriatric doc can or already has completed that. If so, that leaves merely the preparations for the move to MC.

In some way, it's good not to have to "fib" about it anymore, in others it's like being on a powder keg about to blow. Thanks for all your wise counsel everyone. To say this situation feels surreal is an understatement.

midge333

I am glad you found your DH and he was ok. I am glad the pieces are finally falling into place for getting him admitted to MC.

Joe C.

I glad he got home safely. I hope the placement goes well.

M1

I too am glad he's home. It still feels like an explosive situation though. Do you have a contingency plan? What if he gets violent or aggressive at the time of placement? Do you have a hospital in mind where he could be taken? Does the MC have a hospital or a psychiatrist they normally work with? This just feels to me like it could still go very south and I am concerned for all of you. To me it would at least make sense to have the appropriate places identified just in case.

wose

Dio mio!!! You need some hugs. I hope the placement goes smoothly and so glad DH got home safely. I feel so sad for you and hope you can find some moments of peace💜

housefinch

Agree with @M1 – I would hate to see him escalate as he realizes he’s staying at MC and have you lose Plan A.

ButterflyWings

I agree with @M1 and @housefinch and I also think it absolutely is still time for fibs / fiblets. Even moreso right through here, despite the signed paperwork (congrats on that BTW). Your DH cannot process the truth. And it seems to make him volatile, so it is time for you to do some award winning acting, while also keeping yourself safe and at arms length. Anosognosia is real.

I think I saw you were sleeping behind a locked door, is that right? Good, if so. And make sure your ID, wallet, and phone with charger are with you at all times. I don't know if the house has been cleared of all weapons or anything that can be weaponized, but that is an urgent must.

I don't recall if your DH has already been prescribed meds that might help take the edge off? Many can be crushed and stirred into puddings, applesauce, soup, juice, coffee, water, whatever. I have spiked DH's food or drink in earlier stages without him ever knowing, because he wasn't so much med resistant as offended that I would be managing his meds. Either way, he was unmanageable and at one point unsafe without Seroquel, so I learned to do what needed being done - don't ask, don't tell.

mrahope

Thanks so much everyone for your support. @M1 , I, too, am still concerned about what happens next. My DDIL called the non-emergency police number some time ago and gave them the information about DH's condition at that time, so if I call them, they have some knowledge of what the situation is. There is an inpatient psychiatric unit at a hospital within the health system we use which is about a half hour away, and I was told that if police could not stabilize the situation, that is where DH would be taken. FWIW, this is a small town and we don't have much choice re: where he ends up. There is also a geri-psych associated with the geriatric doctor we are now working with, so that might be who we work with. The MC and that doctor's office are in the same town. Hospital is within sight of the MC. I am wondering if we need a plan B memory care facility that deals with difficult individuals. Do those exist???

@ButterflyWings Yes, I am sleeping behind a locked door (sigh). And I keep keys and phone on my person at all times. My keys stay under my pillow at night. We've never had guns in the house, thank goodness. Beyond kitchen knives, there really isn't that much left. Good point about my wallet, though. And yes, re: medicines…DH was just prescribed Lexapro about 2 weeks ago, so we're still waiting to see if any effect is noted. When the geriatric doc was told about the outburst, he considered adding Abilify, but decided not to do it yet since DH has a history of heart attacks and bypass surgery. I'm not sure what the next step is there.

For now, I was fortunate to be visited by my sister and brother-in-law from out of town this weekend, and since DH especially likes brother-in-law that seems to have calmed him somewhat. One day at a time.

fmb

I'm glad you're getting a bit of a respite from his behaviors this weekend.

To add to other's suggestions, make sure your smoke/CO detectors are in good working order and remove all matches/lighters in the event he decides to burn you out when you're locked in your bedroom. Be sure you can get out of your bedroom through a window if necessary. If you're on the second floor, keep an emergency fire escape ladder in the bedroom. Keep a go-bag ready at all times and be sure to include your meds (if any), copies of all important documents, spare phone charger, and any other critically important items you may need if you have to escape.

harshedbuzz

@mrahope said : I am wondering if we need a plan B memory care facility that deals with difficult individuals. Do those exist???

They do to a degree. Generally speaking, the social worker who helps with discharge planning if he's sent to a geripsych unit will generally know which facilities are likely to accept a resident with a history of challenging behavior. Another terrific resource will be a local Alz support group; the facilitator and other participants are likely to know which places are willing to accept a person with difficult behavior.

I anticipated this with my dad and asked around. Many folks cited the state VA home which was not dementia-specific but had nurses and aides were nonplussed by behaviors. This wasn't doable because of the waiting list said to be 4-6 months at the time.

Even more folks mentioned the place where he landed as having the training and affiliate geripsych to manage behaviors. It was my second choice after the state home. A few places I toured clearly cherry picked for the most pleasantly befuddled; dad wouldn't have done well there. Mom leaned into a few of these because they put a lot of resources into decor which would have appealed to pre-diagnosed dad. Mom's first choice (nice decor and walking distance to her in a pinch) didn't accept him based on his diagnosis which they said was associated with certain behaviors they weren't willing to manage. He never exhibited these, but they weren't willing to risk it.

Ideally, you'd want to get his outbursts under control as an outpatient as it would give more options for MCFs which can impact things like distance for you, overall quality and cost. On the other hand, having him transported from a geripsych unit directly to a MCF under the fiblet of "rehab" would be considerably easier for you and your family.
HB