He is active and thinks he is fine mentally, but he has become very forgetful and increasingly aggressive and cruel towards her. She is and has been the only care giver for him since his wife died. Other siblings refuse to take him because of his behavior. What can i do for her? She is at wits end and making her miserable.

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sragsmom, I have been in your sister's shoes.....Here is my small tidbit of advice from my own experience with a mean stubborn father. Tell your sister thanks and support her and BELIEVE the things she tells you. Try to get the other siblings on board with helping her. If at all possible, plan to take a week off, and come and trade places with your caregiving sister. Even if she does not have the $$ to take a vacation, to be free from your father for a week is a gift worth more than anything. Bless you for caring about your sis.
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I have come to terms with the fact that meds sometimes have to be used to make it possible for other people to take care of an elderly person. Sometimes the brain impaired have to be drugged up enough that they can be decent to the people who take care of them, or can accept direction, or can be calm enough to go along with certain things. I always aim for the fewest possible meds for Mom, because meds always have side effects. But without her Seroquel and her Paxil Mom is so anxious and angry that its really hard for people to take care of her and be with her. There is some adverse sedation (afternoon naps) and some constipation (requiring antidotes) but mean old people are too hard to direct into any kind of normal day. Without meds, Mom can be impossible. With meds she can go out to dinner and be pleasant, go to church, cooperate at the doctor, call her friends. The side effects are worth it. I remember the screaming mean old men tied to wheelchairs at night at the VA cursing at everyone and hitting where they could. Drugs are needed for some people. What I am saying is I see it as a legitimate moral choice to use meds to make someone easier to live with or take care of. Cruel and does happen.
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I found that if you have the POA document, that will get you far.
Becoming guardian/conservator for someone will run you at least $4,000 in attorney fees, bonding, and court fees. (ask me how I know.....)

Parents will refuse our help when they need it most, so make a plan to get around it that isn't as obvious as a nuclear bomb.

It doesn't help to make them feel ambushed by a group, insulted by uppity children (who are usually over 40!), and told what to do.

For my mom, it was better to work with solving some of her immediate problems. She had a nice long list of things that bothered her, and all the changes were about taking care of those problems.
==Being afraid in her home alone. This happened a lot.
==Worrying about burglars and being attacked
==Don't you want to stop buying groceries?
==I know you are afraid of getting lost in the house. Let's fix that.
==Would you like somebody else to do your laundry?
==How great is it there's a security guard here! Wow!
==I just noticed there are no stairs here, and there's two elevators!

Mom also lived in this fantasy world where she was the Grande Dame of Society with a constant stream of cocktail parties and game nights, suppers, and shows every night of the week. And making her sisters jealous. The truth was she was a recluse in a hoarder house with zero visitors.

The other card I played was about that.
==Imagine all the fun you'll have here.
==Look at how beautiful it is. So clean!
==I bet you'll have Gentlemen Callers in a week.
==You can go to the beauty shop as often as you want
==Every night has a club meeting, movie, game night, entertainers. How fun! When was the last time you had any of that?
==I bet you can't wait to send pictures of this place back to your sisters. They'll be pea green jealous. It's definitely nicer than their homes.
==That lady is petting a therapy dog. You've always loved dogs haven't you? You haven't had a dog in how long?

Honey catches more flies than vinegar.....
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Has he signed a Durable Power of Attorney, Healthcare POA and Living Will? If so, I would discuss your concerns with them. Is that person your sister? Does she attend her dad's doctor appointments? I might discretely advise the doctor of what the family is witnessing with your dad. He may conduct tests and order evaluations to see what the cause might be. Try to rule out infection, depresson, medications, etc. If it's dementia, he can help explain what to expect with that as well. Your dad might benefit from medications to help with anxiety or depression. Dementia can make people forgetful, aggressive, accusatory, and cruel. Keep in mind if that is what is causing it, the person cannot help themselves. Their brain is not working right anymore.

If it is dementia, your dad won't be able to live alone for long. Convincing someone of that can be difficult. There is persuasion with the help of the doctor and there are ways to petition the court once you think you can prove his is incompetent. I would consult with an attorney about that.

It's not your sister's fault. I would discuss this with other family members and agree on a plan to find the cause and help your dad, even when they don't realize they need it.
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Has she talked his doctor?
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Do you live nearby? Does she want help?
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