Please help! Elderly FIL a danger to himself and about to travel solo internationally

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I will try to keep this brief, but I need some help.

My FIL is 77 y/o, with numerous physical ailments, including rheumatoid arthritis as a result of lyme disease which he has suffered from for decades. His skin is like tissue paper, and is jet black in large swaths from blood underneath, I guess? A minor brush against a car door will peel his skin off. He walks with a cane, after nearly having his foot amputated last year due to an infection he acquired on his last solo international cruise.

He is also starting to show signs of failing mentally: He's been in the hospital with TIA's. He has, on isolated occasions, exhibited the symptoms of dementia. He is inordinately stubborn, insisting on gardening and climbing ladders himself. He fell off a ladder last fall and was released from the hospital too soon after (this was the hospital's error in my opinion). He started to lose track of time and talk incoherently and they kept him for a week after several days of that.

My MIL, his wife, is a retired registered nurse of 30+ years. She and he aren't getting along because he continues to do these things with no regard to himself or his family.

When under pressure, he "snaps to", alert and puts on whatever show is necessary to convince the healthcare provider in front of him that he is fine. His physician has said if he "falls again" he wouldn't recommend taking this trip he has planned (see below) but he's telling us he plans on disregarding his physician's advice.

Sometimes, when sick of listening to his wife (who I will admit, she does nag), he pretends he doesn't hear her and acts like he's out of it again. He did this yesterday, being unresponsive to everything she did, including trying to see if his abdomen was still tender (unfocused eyes, general moaning, no responding). She picked up the phone and called 911, and started walking down the hall, and when he heard that in a flash, he was in the hallway, upright, telling her she didn't need to call anyone he was fine.

So now we don't know when he's 'faking it' and when he's legitimately checked out.

He had extreme abdominal pain on Friday and took a ton of medicines. He woke up in the middle of the night to go to the bathroom, tripped, shat himself, and took 20 minutes to get up. My MIL found him and helped clean up. The next morning his BP was incredibly low (60 over 40 I think), which she attributed to dehydration. She got him to drink and his BP came back up to normal.

Here's the thing: In 2 weeks he has a 3 week international cruise booked, **solo**. He will be leaving the east coast, flying to Sydney, then to Hong Kong, then boarding a boat for 3 weeks, and then flying back from the far east back home. The last time he did a trip like this he fell and got the severe infection that almost caused him to lose his leg. He is in worse health now.

Nothing any of his family has said will deter him. My husband asked if there was anything, any of us, could tell him that would make him change his mind and he said, "No" he's going. My MIL has threatened to leave him during his trip if he goes, and yet he still insists on going.

If my MIL doesn't live with him, I am convinced he will die within a few months. She has called 911 six times over the last 5 months. This is the second time she has found him unresponsive with dangerously low vitals, and the second time she's forced him to hydrate to bring them back up. 18 months ago, he took his medicines (Vicodin, and other narcotics) twice, forgetting he'd had the first dose, and he was heading to grab his third dose when she caught him wandering about aimlessly in his underwear, not knowing who she was. She locked up his meds after that.

What can we do? He won't listen to anyone. I have not spoken directly with him, as I am not his family. I have heard of getting a court-appointed guardianship, but my husband and his sister are convinced their dad will magically "perk up" and put a good show on for any hearing. He tends to do this.

Our greatest fear is that he will go on this cruise and injure himself severely, causing someone to have to fly and get him, and likely impairing his quality of live *greatly*. After all, he nearly lost his foot after his last cruise. At one point they were talking about amputating up to his knee, but after thousands of dollars (they have good medical insurance, and pricey!) they managed to save it.

He's made the argument that if he goes there and dies he will "die happy" and morbidly my husband isn't concerned about that. "I'm fine if he wants to go die on a cruise ship somewhere, but what if he hurts himself severely and he *doesn't die* and instead he's more infirm than ever, and we have to go get him and he has to be miserable and unable to function even as he does now?"

We just don't know what to do. Any help or advice would be appreciated.

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Did FIL take the cruise? Did he return with cool pictures and stories?
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The medical staff on the cruise ship could be alerted to check on FIL that is once he gets as far as the boat. Before that he will probably be in public places like a plane so someone will notice if there is a problem. not much you can do about a night in a hotel in an exotic location but at 77 unless he is physically restrained he is going to do what he wants. He has already spent years abusing his health so I don't see him listening to reason now. as the DIL you have no power so the best thing you can do is prepare to support the family when the inevitable happens. He's a loose canon no doubt about it.
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I can't see why if he can go on a cruise by himself, no one else can go on the same cruise too. They don't have to have the same cabin. In fact you could hire a caregiver he doesn't know, pay that persons way and have them watch him like a hawk and intervene as necessary to get him medical care as soon as possible. Many caregivers here might volunteer as respite from their usual routines.
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if hes going to europe or the mideast id like some hash. bon voyage. ( salute )
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Travel insurance, once the company sees what is going on, they may refuse to cover him. Thid might be a wake up call for him.
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I agree with Jessiebelle about alerting the travel company. Also, maybe you could pay the steward to check on him more often. If I ran a cruise ship, I wouldn't want a pre-dead passenger on my ship.

Sorry you have to deal with this.
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Get him travel health insurance. His American insurance will likely nit cover him.
I know someone whose dad fell ill, thanks to the travel health insurance, he even had a nurse accompany him home.
Sounds like dad wants to put the pedal to the metal with what time he has left.
Hurtful to his wife,but maybe that has been a poor relationship.....who knows.
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I have to add that if the travel companies are willing to work with your FIL to make his final wish come true, I would say Go For IT, FIL! And I would think the travel company was about the kindest ever.
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I also have concern about the people who will be taking him on his trip. I put myself in their place. Would I be willing to take someone on a trip knowing that he might die on my watch? Chances are that they would be willing to deal with it, but I think that they should be informed of the possibility so they can make an informed decision. If they were informed, chances are that you wouldn't have to worry about a decision -- they would make it for you.
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