Help! Overwhelmed and Dad won't address things

moe777

My mom (79) has dementia. I don't think she'll ever have any diagnosis. She won't even take her temperature. My dad (78) still has POA but won't do what's necessary for taking care of himself let alone her (i.e. meds, driving, home safety, home help, future planning, etc.) He/they don't know what state to live in when they go to senior living (or memory care -shhh!): near me in another state (I'll have POA at some point), or in their home state where I will be 10 hours away. They're miles away from having any specifics figured out here, let alone be on any wait lists. Dad won't hire home help because Mom will get angry, etc. We decided together on my last visit (lately been visiting about 2 weeks on, 2 weeks off) that she should not drive, but while I was enforcing it, he wasn't by the time I left and I doubt he's doing so now. I'm not sure he's tracking her meds appropriately. He's not even cleaning out the refrigerator. His physical and mental health decline as he refuses any significant help. He gets furious when I try to suggest or tell him anything. I told him on my last visit that if he won't take care of Mom's health needs then someone else is going to have to do it. This threw him into a rage. He still insists that this is her job. He needs to be way further along in dealing with all of this. It seems no one knows/accepts this but me (and that includes him). This is eating him alive, which is horrible to witness on its own. It's increasing risks for my mom (or, in the case of driving, for others). I'm afraid something will happen to either or both of them. If to him, she'd be in charge of herself, and she shouldn't be. We seem to have a good likelihood of some eventual crisis. I don't want that for either of them, obviously, and I don't want that for me either. I have one sibling who is completely uninvolved despite repeated pleas for assistance and won't be involved legally either. Her best friend is the closest thing to acknowledging all of this and has been supportive to the degree she's able. Before anyone asks; yes, my dad and I have communicated about all of this. He'd be surprised by nothing I've written above. HEEEELP!

ARIL

Oh, I am sorry. It is very hard, I know.

It sounds as though both of them are having significant decline. Are they seeing doctors regularly? Could doctors be enlisted to help? Sometimes a doctor will order home health for a little while, and a nurse or social worker can help move the care forward.

Driving is a huge problem—and dangerous for them and everyone else on the road. There are lots of posts on this site about driving; you may want to search for some of them.

If you can possibly move up the day when you have DPOA, that would be a good step.

I do understand about the feeling of waiting for a crisis. It’s awful.

towhee

Hello and welcome to this site🙂. Long distance caregiving is indeed a challenge. There is a saying here "Caregiving for dementia is a marathon, not a sprint". I know it does not seem like it to you but you are only at the beginning of this journey. It might help to take stock of what you know and what you have to work with and prioritize the most important next steps. From just one post I can't totally grasp the situation and might get things wrong but it does seem clear that your approach to your father is not working. It could be that he just does not want to take advice from someone he still sees as a child, or he could be having judgement problems from beginning dementia himself. There is a youtube channel called dementia careblazers that has several videos on getting people to accept help. Telling him he is not doing things right is probably counterproductive. To have care happen, we often resort to workarounds or even plain manipulation, while validating feelings. So for the driving, you might say something like "I know this is hard for mom, and I know that makes it really hard on you. But I am so worried. People sue at the drop of a hat these days and could you imagine mom in a courtroom? You could lose everything." And repeat the conversation, without blame or anger as many times as it takes. If your mom has her own car, then sometimes out of sight is out of mind. It can be in the garage, not working, "waiting on a part". Living 24/7 with a person with dementia who is angry is really hard. I have been there, walking on eggshells. You cannot reason with or easily console someone with dementia who gets angry. Also, PWD react differently to different people.

Your father might react better to another person, family, friend, pastor, doctor, or even support group.

Doing everything that needs to be done is overwhelming. He might simply not be able to do it. You might have to do a lot of the legwork and present him with some solutions, while letting him keep his pride. It might be best to drop the subject of moving to senior living, at least until things are calmer. Go ahead and research the various options and visit facilities yourself, just do not talk about it. You are probably going to be the one to make that decision anyway.

Like I said, take stock of what you know. Your mom is taking meds so she has a relationship with a doctor. If she is taking any of the dementia specific meds, she has at least some form of diagnosis. Many PCPs are capable of diagnosing dementia in an elderly person, a visit to a neurologist is not absolutely necessary. She might not be diagnosed with a specific type, but that is not absolutely necessary either. You do need to know what the doctor has said and have some way to communicate with the doctor, as it can be very helpful for the doctor to tell her she needs "x" or should not do "y". Authority figures can say things you cannot.

From what you said about POA it seems that you are successor POA for your mom if your dad cannot serve. Does your dad have the same arrangement with your mom? Are you now his POA? You do need to know how this works and how long ago these were drawn up. Sometimes state law changes and POAs need to be updated. For elder practice lawyers we recommend nelf.org or naela.org.

There are various things that can be done to make medication giving safer. Blister or bubble packs, automatic medication dispensers, etc.

When you say clean out the fridge, do you mean it is messy and the shelves are not clean or that you have found moldy and spoiled food?

If you are ever in need of a quick response call the Alzheimers Association Helpline listed at the bottom of the page.

Again, welcome, come back often.

,

harshedbuzz

@moe777

Hi and welcome. I am sorry for your reason to be here but pleased you found this place.

You have already gotten some excellent advice from the previous posters.

Your situation sounds very familiar to the one I had when dad developed dementia except that genders were reversed. In most respects, my parent without dementia was the more challenging one to deal with; mom fought me for a decade on having dad screened or evaluated for dementia. I don't know if she was too close to the situation, didn't want to deal with the restrictions a diagnosis would put on her lifestyle, feared dad's wrath at forcing the issue or what but getting to a point where she took control of the situation took almost dying with him as her advocate.

There is another option. What finally worked for me was letting the other shoe drop. That wasn't easy. I am a planner by nature, so I made my Plan B finding doctors to diagnose dad near me and even places where they could live and started exploring AL/MCFs. When the sky fell in, I was somewhat prepared to take advantage of the situation. I got dad evaluated via a hospital admission, them in an apartment, replaced all their doctors with new ones and got their beach house listed for sale within a month while dad was in rehab.

My parents lived at a distance, and I did visit once over the winter and for a weekend monthly when they were only 3 1/2 hours away by car. I figured out that "supporting" their dysfunctional lifestyle only prolonged the inevitable. Mom wasn't ever going to hire the help she needed with dad so long as I was free and dad was willing to tolerate me around for a few days. So, I made myself too busy to participate and kept my visits quick and purely social. At a certain point, there was a crisis, and I was able to force the changes that needed making. Doing nothing to help wasn't easy, but it was effective.

The other piece I would look at is dad. He is not making the kind of prudent decisions a capable person with good judgment would. Could he be depressed or be experiencing his own cognitive shift? Having 2 parents with dementia is not unusual. Often they present differently which means the one who is less progressed flies below the radar.

HB