My 79 year old dad has been showing signs of dementia for a little more than a year. My mom passed away a couple of months ago and it seems it has gotten much worse.
We are dealing with a few different issues but not sure where to look or how to go about it.
1) Because my mom's social security is not coming in anymore, he will be losing his house. He probably has around 6 more months. We have tried to talk to him about selling it. He won't budge. He said he is never selling it. He is going to lose it to foreclosure and then there will be nothing for him. Living with family is not really an option.
2) He insists on driving. He should not. He recently was yelled at by a woman saying he almost hit her cart that had her baby in it. I learned tonight that he hit his mailbox. He did not pull out to the road and instead, he cut his wheel prematurely and backed up onto his grass, and hit the mailbox with the passenger side backend.
3) He does not want to go to the doctor.
4) He has been mistaking my sister (who lives with him) as my mom. Several times he called her "June" and "dear" or would mention me as their child. Earlier today he was doing something with the tv remote control and 10 minutes later, still doing it. My sister asked him what he was doing and he said he was trying to call me. She told him that he was holding the remote control. He laughed and then reached for the clock that was on his table. He laughed again and said "no, that's a clock".
5) He knows and admits his mind is not the best but he doesn't think he is "that" bad. He is argumentive and not nice at times.
We just don't know what to do. He has Medicare now but we are trying to get him on Medicaid. I don't know if this is what we should be doing though.
Can anyone please offer me some advice or ideas?
Thank you
Grief stands out to me.
Often a couple is doing OK, but the sudden passing of one is a catastrophic change. Such a huge loss causing much stress.
Stress on the older brain may be like anaesthesia, cause delirium. This is only my non-medical opinion! But friends & workmates have had this happen many times. Their folks functioned OK as a couple (covered for each other etc) but grief uncovered a gaping hole & the one left was unable to go on alone. (Had more cognitive decline than they knew).
Also/or there can also be real medical issues going on. Eg UTI, lowered kidney function, COPD & reduced O2, heart etc etc. So many things can cause confusion.
I would keep up pestering he see his Doctor. Tell him not because he is broken, but because YOU are concerned.
Then the very first time he falls, is dehydrated or confused - call his Doctor. Or use EMS. Then he gets a full medical check up. Then you can make realistic plans for the future.
If this can get done, then he should first get checked for a UTI or any other medical reason for his recent confusion and behavior changes, then have a cognitive/memory exam. He cannot live on his own no matter what he wants so you'll need to get creative to work around his resistance. My advice is to first meet with an elder law/estate planning attorney and/or a Medicaid Planner so you can know what to expect and do (and it can get screwed up if you don't know).
He may needs meds to address his agitation/anxiety/depression. The PoA needs to somehow get him to his doctor. Using a "therapeutic fib" may work (Medicare/Social Security now requires an annual physical in order to continue benefits uninterrupted"). At the doc appointment make sure to request the HIPAA Medical Representative form. Fill in your name and have him sign it. This allows the medical staff to discuss your dad's private info with you without him having to be present or agree to it. If he has guns in his house these should be removed discretely due to his agitation.
If no one is his PoA then you will need to report him to APS as a vulnerable adult. When things get bad enough they will pursue guardianship and then take care of all his affairs. Or, family pursues guardianship but this is very costly ($10K +).
Discretely remove his car and tell him it needs a very expensive engine repair. Do not tell him any names of shops or he will probably call there. Park the car where he won't find it. Tell his neighbors, friends and other family to NOT lend him their car under any circumstances. In the meantime go online to anonymously report him as a dangerous/impaired driver. The DMV will send him a letter stating he has to come in for a test (not sure what kind, maybe eye or behind-the-wheel -- it differs by state). If no one takes him to the DMV then his license will expire and that's the end of that. Be sure to set up rides for him to replace this loss of transportation or he will drive YOU crazy with hounding. Good luck!
Does someone have POA? Hopefully he has all his paperwork in order. Will, living will, POA, etc.
Sounds like it's time for him to move into a facility. I'd ask around about your local nursing homes that take medicaid. Living with family is often way too difficult for everyone.
Are you and your sister on the same page as to how your dad is doing? If you agree that his driving is bad, it's time to pull the plug on driving. I'm a wimp and probably would take the passive route of hiding the keys or having it go to the shop and never come back or having someone disable it.
Can he understand that he's going to lose his house? Seems like it would be better to get it on the market, especially since some housing markets are having crazy high prices now.
Since your mom recently died, he is grieving and depression could explain why his symptoms seems worse. Has he been to the doctor recently? Is he on an anti-depressant?
Best of luck!