My dad, 83, lives on his own in very small town. He has Parkinsons and also early dementia. He has a caregiver that comes in the morning to fix breakfast and I had just arranged a afternoon caregiver who would come in to fix an evening meal. He does not eat unless someone brings or fixes for him, even if he only needs to warm up. (Could be because he doesn't always remember how to use microwave.) He also suffers from syncope episodes (fainting for intervals as long as 6 minutes). Therefore he can not drive any more either. Problem is he is telling caregivers not come anymore. That he can take care of himself. I am trying to manage all this from out of state with very little sibling support; one is physically unable to help and the other is immature and resistant to helping. Question? What should I do?

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You say that in addition to his existing medical conditions that he also has dementia. Unless it's in the early stages, as you state, it's not possible for a dementia patient to live alone. There are so many dangers the person can cause or not be able to avoid if it occurs, such as fires, falls, eating spoiled food, strangers at the door, mistaking meds, etc.

I think I would make arrangements to go and visit in his home for a couple of days, realizing that he will be on his best behavior. Still, I would look closely at what he is able to do or not do. He may already been in a situation that is unacceptable. It could be the dementia that is causing him to not recognize that he needs help. Most dementia patients aren't able to see it. They think they are fine, but the family has to step in when they can and arrange for protection. It's not easy, but you can try.

Does he have a signed Durable POA, Healthcare POA and Living Will? If not, I would try to get them signed while he is still competent. Discuss the issue with the HCPOA and arrange to meet with him and his doctor. Explain what is happening and see if the doctor can prescribe that he not live alone. In the meantime is there somewhere he can go and live? Does he have the funds to pay?

Will he need Medicaid? You might consult with an Elder Law attorney who knows Medicaid law to see where he stands on that. You'll need to have his income and asset info with you. In some states you can apply for Medicaid on his behalf, even if you are not his DPOA.

If your dad refuses help, even when the doctor prescribes it, then I would discuss with an attorney the legal options for filing for Guardianship. An attorney in his county and state, will know the details and what proof you need. It's a last resort.

Sadly, sometimes it takes a real crisis to get the patient into rehab and then in rehab it's obvious they can't return home and they are then placed in Memory Care or nursing home.

I'm sure you'll get more responses here that may be helpful. It's a very stressful situation without many easy answers.
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