New to Forum - Dad has ALZ

Welcome to the forum. Several thoughts:

He is not in denial of his demenita, he has anosognosia. This is a feature of the disease that actually prevents him from perceiving his deficits. He truly thinks he's fine. Most here would tell you not to remind him of his dementia as it will just make him defensive.

He is sundowning. It is probably no accident that the calls and confusion are happening late in the day and in the evening. This is very very common. Medication can help, specifically atypical antipsychotics such as Seroquel or Risperdal. If he is to this level, this brings the third point:

He almost certainly should not be living alone. You don't mention a spouse/your mother: is he on his own? You need to think long and hard about that. He is susceptible to scammers and safety hazards. Is he driving? Also a huge red flag, he should not be.

If you plan to be responsible for his care going forward, you need to hold power of attorney for health care and finances. If you don't already have this, you need to talk to a certified elder law attorney ASAP (look at nelf.org for lists by location). They can also help you plan for how to finance long-term care, he may well already need to be in. assisted living if not memory care.

If you look to the right under Quick Links, there is a Group for new members that lists a lot of freqeuently cited information and materials. You have come to a good place for support, but sorry you need it. He is fortunate that you are still willing to have a relationship with him and oversee what is going on.

Hi Erin,

*I would say that if he's been feeling unwell and you've noticed a recent escalation that you do get a UTI ruled out by his provider.

Basically, his memory is now such that he won't have the ability to 'pin' a memory. So that means that he exisits in the here and now, and won't remember even very recent conversations or actions—without memory he won't have much sense of the passage of time, and his ability to use cues from the environment will be affected (for instance, he won't recall eating, can't tell if he's hungry, and won't be able to interpret the time on the clock or look out the window to know it's lunchtime). He won't be able to juggle information or stay on task, or recall conversations once he's hung up, but he'll pick up the phone every time he sees the trigger that reminds him he wants to call you. Additionally, the disease will start to affect his stored memories as well, on a 'last in, first out' basis, so he may not recall much of the last years, or that he had a dementia diagnosis. At this point in the disease it's a bit easier to try to meet the person in their reality rather than trying to orient them to events they can't recall. While we raise children to expand their world through new experiences and stimuli, it's the opposite for the person with dementia—routine and sameness help them get through the day, and new tasks and juggling new information or making decisions becomes difficult for them.

Like M1 said, he'll need more support. If an emergency occurred he might not be able to rescue himself. What his care looks like will depend on his resources. Plans should realistically take into account what can work well for caregivers too, knowing that his needs will increase and that people with dementia need a lot of oversight. A lot of times a parent is moved to an AL or MC near a primary caregiver who keeps an eye on things. I found it a real challenge to work and have my mom with me for a bit, and there's no way that it would be a feasible long-term solution for her or myself given that we always would butt heads.

I found it helpful to learn as much as I could about the disease—it didn't make my mom's behaviors less frustrating, but understanding the source helped me be more patient and be able to find ways to try to set up protections for her. The forums are a great start.

I like these as well:

Tam Cummings assessment tools/AD checklist

https://tala.org/wp-content/uploads/2019/04/Tam-Cummings-LLC-Handouts.pdf

Understanding the Dementia Experience:  

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

Moderate stage changes: https://www.youtube.com/watch?v=6cZTgG6kDjs

5 losses: 

Teepa-multiple videos: https://www.youtube.com/playlist?list=PL2E2lPBsUeBjA1Utglo8q6yANAijEf8cX

Careblazers-How To Convince Someone With Dementia They Need Help:

Careblazers-5 mistakes to avoid:

The Alzheimers diagnosis by itself should be sufficient for the state to refuse to renew his license. The doctor could help you out by being the bad guy and telling your dad that he can't drive anymore.

100% agree that he should not move in with little sister. It isn't unusual for the family who live at a distance to have an unrealistic view of the loved one's capacity. She has no idea how this would affect her life, new marriage, adjustment to parenthood.

You sound as if you have a more realistic perspective of what is ahead than your sister does. Stand firm with your boundaries, both for yourself and family AND your dad's best interests.

M1 is right ... most of us still think our loved ones are more capable than they really are. I know that was true for me with my mom. Even though I was the one in the family who recognized she wasn't safe at home and took action to move her, reality still stunned me after the move. People asked if I felt bad about moving her to assisted living; after the fact, I only felt bad that I hadn't done it sooner. She needed it that badly.