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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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Can you give us an update?
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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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Two things. Does he currently have a license to practice veterinary medicine? If he has let it lapse he is possibly acquiring these drugs illegally and charges could be brought. That would stop him leaving. The overuse of steroids is what has led to his thin skin. You either have to let him go and hope for the best or all get together and physically stop him whatever it takes and wait for the consequences which doubtless will be many
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Hi JessieBelle - His body temperature also drops in these times. I think honestly that he feels like this is totally his "last hurrah" and while he has all the right in the world to go out how he wants, we have no guarantees of course. We DO love this man, and if we could "send him out" in a fashion he would want, and be guaranteed that he wouldn't be MORE miserable in his existence, in pursuit of that, I can honestly tell you we would.

I will ask my husband if his mom has spoken with the travel company. I am a little frustrated because I suggested the earlier, most simple, suggestion of contacting the airline and confiscating his passport, and my husband is right now taking a, "Well I only want to do that as a last resort." stance. If it were my Dad, I would have been over at their house tonight picking up that passport.

I'm frustrated in part because I'm the "Pragmatic One". The irony is that my FIL used to be the "Pragmatic One". My husband, his sister, and their mother, are all seriously emotionally driven. I used to be the most popular "in law" in the family because I could "speak" to my FIL. We were both the pragmatists. He and I were logical. The rest were emotional. Now, I don't want to use that "power" as it were, to interfere. It's not up to me. It's up to his family.

I will give a few days to see what the emotional components of the family do. I have made it very clear that I will go to his house and confiscate his passport if all of the "emotional" folks refuse.

I don't begrudge him going to a foreign land and dying at what he feels his "his peak". In fact, if I could hire a company to do that, I would give it to him today. The money exists to do that. What I DO begrudge is his disregarding his family wishes in favor of becoming a total invalid - which is highly likely if he is left for 3 weeks without constant supervision.

I just wish the guy would acknowledge what "dignity" means, which includes respecting his family and doing things within his means. I'm so disappointed.
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helpplease, what troubles me most about what is going on with your FIL is the drop to such low bp's. How is his body temperature? I wonder if he is thinking that this might be a last fling for him, since his time left on earth seems to be drawing short. You do have some serious weighing to do on the benefits and the inconveniences of the trip. Perhaps his wife can discuss it with the travel companies. It may be that they are not willing to risk losing a passenger when he will be their responsibility. My thoughts are with you. It is a difficult decision.
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Make sure he has good travel insurance including transport back home with any necessary attendants and tell him to have a good time. He obviously likes going away and travelling alone. It sounds as though he will get in as much trouble at home as at sea and MIL will get a break. Bon Voyage FIL
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Thanks jeannegibbs, for your questions. Yes, he does fall at home. The difference is that his wife, a registered nurse, finds him immediately (or very soon thereafter) and performs triage (for minor falls) or gets him to the hospital (for major falls). One of our biggest concerns is that he will fall during the night on the cruise ship (there is usually a "lip" between the outside cabin and the bathroom floor and he shuffles) and he won't be found until a steward finds him possibly up to 12+ hours from the fall.

He is indeed not yet 80, but physically his body is way, WAY more frail than most 77 y/o people. In fact, my husband comments frequently on how my father, a mere two years younger than him, is practically "youthful". My FIL caught lyme disease because he was a veterinarian. He retired about 10 years ago, very frail. The issue is that he has a prescription pad, so he has self-treated for two decades. He has taken steroids far longer, and far more potent, than any doctor would ever prescribe. He also has taken narcotics for an extended period of time to self-medicate his pain. I don't know 100% that he has written prescriptions for himself, but I do know that he has used his medical knowledge (he studied medicine beyond being a veterinarian but has no degree) to get doctors to write him prescriptions for medicines that have taken a toll on his body.

In short, I have seen 90 y/o's (For goodness' sake, Betty White at 92 could run circles around him) who eclipse him in health. In my entirely non-medical opinion, I'd think he was 90+ looking at his skin, his mobility, and his engagement in every day conversation.

The solo trip is not just because my MIL won't travel with him. He WILL NOT travel with others. She investigated going on the trip with him, but it is apparently too late to do so, no matter what the fees. (They have plenty of $$... She's not shy to spend it. A companion cannot go, is what she has told us. She swears she's looked into it.)

We also feel sad to deprive him of what he wants, but my eyes are opened a bit from reading these responses. Especially the comment about how his decision will affect fellow passengers, crew, etc.

What bothers me is this: I have known this man for nearly 15 years. He always prided himself on his intelligence, his thoughtfulness and his DIGNITY above all else. As I told my husband today, his dad is trashing his own dignity by not admitting he is not physically fit to travel. I am disappointed that someone who likes to believe he is so smart, will not admit that he at least needs/requires a companion. My husband offered to join him on a cruise in the fall, as his companion, but apparently that won't work. He must go on THIS CRUISE and WITHOUT anyone else.

I sincerely feel that 15 year-previous FIL would see that what he is doing is destructive to himself and his family. I do not believe he is in any way capable of deciding for himself what he does at this point. We would take him on "a cruise" internationally in a heartbeat, if that's what he wanted. The issue is that it must be THIS special charter cruise with the financial folks (he fancies himself a financial guru) he likes, and WITHOUT any of us attending. It's just not safe, at all.
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What I'm trying to settle in my own mind is whether there is something inherently risky about taking a cruise. Last time on a cruise he fell, got an infection, and nearly lost his leg. He falls at home, too, right? Could something similar have happened at home? I'm sincere in asking this. I'm really trying to weigh the risks of travel.

Here is a man not yet 80, with lots of indications of failing health, who wants to live until he dies; who wants to die with his boots on, or with his passport in a pouch around his neck. I can certainly understand the concern that he might be injured in a way that wouldn't kill him but would significantly decrease the quality of the rest of his life. Is it more likely he would have such an accident on a trip than at home?

Why must the trip be solo? I take it that his wife does not like travelling or does not want the responsibility of traveling with a man with impairments. What about a child or an adult grandchild? What about hiring a travel companion? If he weren't traveling alone, would that bring his risk level down to match his risk of staying at home?

There are many things I prevented my husband from doing during his journey with dementia, to prevent injury. (Skiing was one!) He definitely had dementia, however, and not occasional dementia symptoms that might have been faked. I can't imagine him traveling alone (because of the dementia) but together we cruised internationally and domestically, and did lots of land travel, too.

It just seems sad to me to deprive someone near the end of his life from doing what he wants to do and apparently can afford to do, if there is any way to make it happen.
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Yes. Hide the passport, convince MIL to cancel his travel plans now and say his health doesn't permit it to the travel Agency. The other option is to tell him, he must have a doctors clearance and hire a nurse full time to accompany him if he insists on going.

Crazy, how these elders insist on having their own way with little consideration for others including fellow passengers, crew, family, etc.
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Hide his passport. That is so simple. I will run that by my husband. I think we have been feeling so out of control (his dad is good at making us feel this way) that we haven't even thought of the simplest thing. Thank you for this. I will suggest it.
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Hide his passport. Alert the airline and the cruise line. And tell him there is no way in Hell you are going to go get him, what goes down under, stays down under.
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