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I live far away from the situation but my brother and his family are just minutes away from our father. Our Dad's behavior has been changing over the past 6 months or so to now include paranoia. A little history, Dad has never been ill, takes no medicine at all,and is capable of remembering the most minuscule details from his past. He lives alone, still drives, and seems quite capable of normal daily functions. He has always been a bit OCD with his possessions and his apartment but his appearance and personal hygiene have taken a huge dive over the years. Showers that were too far in between before have basically become nonexistent and he hand washes laundry once in a blue moon. He has been told to help himself to my brothers enormous machines. Dad makes excuses to avoid going anywhere. He has little social interaction with anyone except my brother and myself. I talk and text with him daily but lately even that is getting difficult.
Over the past several months he has become paranoid.He truly believes that the tenants upstairs are "out to get him" he thinks they can see him through the walls with "special equipment"? He says they are reading his texts and spying on him. My brother has been over there and checked thing out...there is nothing wrong. Dad listens for every sound that they make above him and he insists they are trying to aggravate him deliberately. He thinks there is drug activity there and they are trying to implicate him. He has even gone so far as to (repeatedly) call the police. My brother is getting calls and texts from my father at all times of the day and night....super long crazy texts about the neighbors actions. I get the texts too but they are so ridiculous it's hard to even respond. The situation has escalated to my father wanting to retain an attorney and demanded that my brother call in to work(dad said he was more important than my brothers job) and take him to the lawyer. My brother can't do this. He and his wife are caring for their grandchildren full time and both work fulltime jobs. Their hands are full! We have advised him to contact the senior housing people and see about getting into a new apartment. He refuses....he feels it's his right to stay there and will not be inconvenienced.

Dad has made many mistakes over the years. I am sure he is carrying a lot of guilt over some of the choices that he has made. He cheated on mom after her diagnosis of MS and then left her, he has never been a father to us kids. His needs always came first! He has shown excessive jealousy with a long string of women after mom and ended up with several failed relationships and another divorce. His poor social skills and self centered ways have left him alone in his nasty cigarette stinking apartment. He spends his days watching tv and reminiscing about the good old days. He doesn't drink anymore but I have noticed how quickly his mood changes and he can really become nasty and irate. He has never shown an interest in his three grandchildren and probably couldn't tell you their names or pick them out of a crowd. He hasn't spoken to our sister in over 8yrs. Petty jealousies with his sister ruined that relationship 15 years ago. His one best friend from childhood passed away a few years ago. That relationship was strained at the end due to dads selfishness and his buddy passed away before it was really ever mended. He is alone now. His bad choices and lack of interest in all of our lives have alienated him. Dad wasn't really involved in our lives all these years (all three of us are in our late 40s) and we all have gone on without him, by his choice. Now he is aging fast and the relationships aren't close. So what to do?

This new paranoid behavior has us worried. It is becoming obvious that he is losing his grip on reality. His social security check is tiny and he won't be able to live at that apartment much longer. I'm embarrassed to say this but none of us will extend our homes to him due to his poor social skills. So what do to with an aging reclusive self centered father that has never been there for anyone but himself? What could be causing this sudden paranoia? Getting him to a doctor would be impossible. He hasn't been to one in over 20 years. We are afraid he will do something rash to the neighbors upstairs and end up in trouble with the law. His temper is bad and he becomes very aggressive. What to do? Where to begin? We are new to the issues of the elderly. We lost Mom to MS over 10 years ago. We all had a great relationship with her and learned to help her with her issues as the path unfolded. Dad is like Pandora's box and we are all at a complete loss with what to do. Any help would be greatly appreciated.

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If something does happen, and he becomes aggressive with someone, then maybe he will get the help he needs. Maybe if they could put him someplace, he may fight it at first then end up liking it there. I am sorry that you and your family have to deal with this, and sorry for your father too.
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Not trying to sound foolish- sounds like my former spouse. Yes, bipolar is a possibility; some infections can lead to metal/behavioral issues too. The comment above about temp psychiatric eval. is a good start. It's to be helpful, not insulting. If he's not bathing, not eating properly, could be manifestation of a kidney issue. From my person experience (22 years) parathyroid (hotmone) issues kick into kidney issues; and parathyroid abnormalities (inflammation, infection) manifest as bipolar, narcissistic, and paranoia. Has he ever had kidney stones? Call the Health Department in his county. They may have a provision for a social worker to 'drop by' as an assessment. Keep a notebook of names/numbers whom you've called and when. If you don't receive a callback, advice, help, keep on it. The squeaky wheel gets the grease. Good luck to you - let us know how you are doing.
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The fact that you live very far away, is going to make it very difficult to oversee any real.change. best bet is to have a local Guardian appointed--if your brother can't do this, the courts can appoint someone who can oversee moving your dad to an appropriate facility, get doctors to assess him, etc. At this point it seems like your dad isn't able to appoint any POA, it has to be a state-appointed guardian. Best thing you can do for your dad, since you live so far away, is to get Adult Protective Services involved, and let them do their thing.
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BTW, remembering minutia from the past is typical of some types of dementia; may not have any relationship to real-world abilities.
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Son should tell him he has to move as the building is going to be renovated and get him into a facility before he hurts someone or himself, if all he has is SS, apply for Medicaid for him to live in his "new" apartment- he is definitely very ill mentally and needs to be treated for it in a facility or in home assistance. If you can get him on meds to control his behaviors then you might be able to take care of him in one of your homes, just set rules. After all he is still your father, don't let him continue to live the way he is living. If he is a Veteran, each state has a Veterans Home.
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I walked this mile with my mom and know it well. Your father is likely creating "confabulations" which is a delusional construct based on reality - distorted reality - but reality nonetheless.

The bad news is that these delusions can be frustrating to deal with, often involve calls to the police (who are more familiar with this behavior than you might guess), may get him evicted, and are a symptom of dementia.

The good news is that after a couple of years your father is likely to lose the ability to construct elaborate delusions and they will mostly fade away from his everyday life.

Agreed that there are medicines to manage these symptoms, but they all have the side effect of significantly zoning out the patient. In your father's case that may or may not be a bad thing.

The dementia road is not smooth, consistent, easy or fully predictable. Walking it with someone that you resent and don't particularly like or respect makes it even more difficult to traverse.

Regardless of how your father feels about doctors he is going to be evaluated eventually. Whether that happens with him as a willing participant or as a result of being arrested and put on a psych hold is open to question.

I wish there was a better, happier answer, but since you are not dealing with a child (over whom you can exert legal control), this may get a lot worse before it gets any better.

Your brother definitely should get some legal advice on this matter. This could get very ugly very quickly.
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Something is definitely going on with your father whether it's dementia, mental illness, etc. As others have mentioned, the poor hygiene, the paranoia, etc, can all be symptoms. I think Zdarov's suggestion about telling him he has to see a doctor as part of establishing a drug case against the neighbors might be worth a try.

As for Power of Attorney paperwork, I would guess that dad is not going to voluntarily sign any legal paperwork related to power of attorney, etc, based on his alienation from the family. And, I agree, family members might not want that responsibility. In Arizona they follow a Medical Surrogacy Statute for individuals who don't have POA paperwork. It lists the order of family members that have the ability to make decisions if a family member becomes incompetent and there is no POA paperwork. I don't know how many other States may have this.

It may be that this will go down the hard way with the police getting involved. That might not be all bad as long as you don't think your father would seriously hurt/injure the people living above him before they could intervene.

As for no one wanting to offer dad their home for care.....I may be "hard", but the reality is that Dad created this distancing through years and years of negative behaviors that had nothing to do with you. He hasn't changed and has only gotten worse. No remorse or attempts to change on his behalf. Unless you have a belief or value system about "turning the other cheek"...again and again and again, I don't see why you would want to take him into your home. He would probably be miserable and make life miserable for everyone. I do know families who have done this, but it's beyond me. I also want to support you and your brother in that at least you're trying to get some help for your dad.
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Hi...yes you need to get your dad to a geriatric psychiatrist for an evaluation. The paranoia and personality changes are signs of dementia. I had no idea of that until aging care supporters pointed it out to me. The doctors have a variety of medicines that can help with the paranoia. Also have you contacted an elder care attorne?? You need to make sure that all your paper work is in order. This is very important. Good luck.
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Dad may have something medical going on, he really needs a complete checkup. Many illness can cause dementia like behaviors. Dementia related behaviors can include paranoia, refusal to bathe, decrease in social skills, self isolation, etc. Maybe dad would allow someone to come in and assist with bathing and chores, at least someone can be there to do laundry and clean. Speak with his doctor and see if you can get him in.
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Get your father to psychiatrist immediately. It sounds like he either is suffering from bipolar disorder or schizophrenia. Both can be maintained (not cured) with medication. Call the police and tell them he is a danger to himself and others and they can put him on a 72 hour hold in a psychiatric hospital, time enough to have him evaluated. Best of luck getting him the help he needs.
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Kandk, people on here often talk about an 'elder services' bureau in every locality, why not try to find the one in your father's area and talk to them. See what types of info they have. The lack of hygiene is a big warning signal. And don't be embarrassed that he's not welcome to live with you, people on here with what we could call better relationships with their parents even say this isn't often the best choice. See if elder services can rec a few good aging-care doctors and then tell dad that seeing the doctor is a necessary step in establishing his case about the drug activity in his bldg? He has to follow conventions such as physical care before the law will help him with that situation? Just a thought. This is very trying for you all, but you are trying to take care of him despite your history together and I think that's great. Good you found this site; others will have more and better replies. Good luck.
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It sounds like your dad has dementia or some other neurological dysfunction and won't be able to continue living on his own much longer. It's hard to say since he hasn't been to the Dr. in 20 years. For all you know he could have a brain tumor.

Since he exists on a tiny social security check he may qualify for Medicaid but the acceptance process can be long. Once accepted though he would be eligible for some in-home help or even a nursing home.

The other alternative is to wait for an emergency that gets him to the ER (like a fall) and utilize the services available to him such as a social worker.

But if he continues to call the police his choices and your choices for him may be taken out of his hands if the police call Adult Protective Services.

A third alternative is for your brother to gain legal guardianship over your dad however this would be a lot of responsibility on your brother and it would be very stressful based on what you've told us. But with guardianship your brother can get your dad into an assisted living facility or better yet, a nursing home. I think that's where he's headed.

Or you can just wait and see and try to put out fires as they occur and they most certainly will with someone who has dementia.

I hope your brother has power of attorney over your dad. Someone needs to. If not, he'd better get it ASAP before your dad becomes completely incompetent if he's not already.
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