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My name is Jane. For two years now my son and I have been living with my parents after my husband and I separated. My father is a Vietnam Vet and retired New York City detective, a recovered alcoholic, has a bad heart, and has had diabetes for the past 25 years. He has needed to take insulin for 25 years and until recently has done so at his own discretion. Taking his insulin when he saw fit. Because he never controlled his diabetes it is now turned into brittle diabetes which means his blood sugar is either very high and he becomes hyperglycaemic or extremely low and becomes hypoglycemic. 3 weeks ago he was hospitalized for pneumonia and congested heart failure to be honest we didn't think he'd make it through the night. He was there for 8 days and since then he has been in and out of the hospital four times due to his diabetes. Now he's been home for a week we have noticed how much his behavior has changed. Because I am now overseeing his insulin intake and constantly having him take his blood sugar and feeding him the proper diet he is very angry with me and my mother. He insisted that I was not giving him enough food when actually I have given him more than he should actually have finally we got a diabetic nurse in here to make sure he can have even more food. Which I abide by. The other day he woke up and could not keep anything down an hour after that he became very confused and didn't even know who he was, silly things like using the phone as the television remote control. His physician told us to get him to an ER right away that it had nothing to do with his diabetes. Once he knew he had to go back to the ER he became very abusive both physically and verbally out of control. So much so that we could not go with him to the ER and being that no one was there the doctors did not know about his confused state and released him the same night. He could of had a stroke for all we know. When we went to pick him up he had asked my mother for a divorce told me I was good for nothing and that he would leave and never come back that's not getting into detail but again very abusive. At this point he does not want to go to any doctors or have the nurses come to our house anymore. Today the nurse came and he completely lost it went to go hit me in my face right in front of my son with his nurse standing watching all of this. He became angry with me because the nurse asked to see his blood sugar levels which have been crashing on a consistent basis. All we wanted to do was speak to do her about getting him a pump being that it's so hard to take ccare of him let alone give him shots. I know something is going on with him mentally and do not know what to do. He refuses to see a doctor because he doesn't want to end up in the hospital. How do you take care for grown man who is this abusive, I know he needs help but I don't know where to start. We have these nurses that come and know full well how he is with his rage and give us no options. All we've been told is to do the best we can. So what do we do when he's looking to hit me and he's screaming all these terrible things to my mother and I? I'm affair he could be dealing with dementia or something worse. Short of becoming physical with him or calling the police to have him taken out of here when he's this out of control I don't know what to do. The nurses won't help, he refuses to see his doctors or go to the hospital? I cannot have my 7 yr old seeing and hearing all of this. I'm getting to the point where I'm so angry I'm yelling at him and yes I'm scared at what he may do. If anyone here has any advise it would be greatly appreciated. Thanks for listening.

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Immediately contact his police brethren, preferably someone he knows and trusts. They will help you, they never forget their own. He will respect them more than family.
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Next time your Dad is totally out of control, call 911 on a landline in your Dad's home [so the ambulance can be leaving the bay while you are still talking to the dispatcher] and tell the dispatcher you have a *violent diabetic male*, the EMT's and the police will know what to do. And please, someone needs go to the hospital, either ride with the ambulance up front, or drive yourself, or take the subway, whatever, to explain to the doctors what has been going on. Before you leave home, grab all the meds that your Dad is taking and put into a zip lock bag, so the meds can be recorded at the hospital.

Hopefully the next trip to the ER will be more productive.
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Both EXCELLENT suggestions!! Also, you need to let his dcotor know what happened at the ER. You might want to find out which hospitals in the City have psychiatric ERs (Kings County and Bellevue for sure, not certain about any others) where they might understand better what is going on.
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Does he still have his gun and ammo? Please get rid of both, for your and his protection.
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Thanks for getting back. Pam you're right as sad as it is he'll listen to them over his family my brother called his partner hopefully he can get him to go get help. Ba8 You know I just assumed that all hospitals had a phych ward we're in Queens he's been going to North Shore hospital but I will absolutely look into it. His revolver and ammo I removed from the house and will give to his partner. I see calling the police would be what I'd have to do in this case. Having said that it's hard calling the police especially being that he was one for 30 yrs but if that's what has to be that's what we'll do.
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Calling 911 may not work, because responding officers will NEVER subdue and arrest a retired detective. It just isn't done, mostly to prevent bad publicity for the rank and file. Work within that thin blue line, the other men he served with WILL HELP.
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Northshore does have a Geriatric psych unit. I would call them and describe the symptoms that you're seeing. Work the partner angle and maybe he'll agree to go
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He's been retired for a while now. Half the men he served with are long gone. I don't want him to be subdued or arrested for that matter. We're talking mental issue here not just a bad day and let's be honest no one on the force is quick to jump in on that. He was a drinker while still on the job and a bad drunk at one point in his life NO ONE wanted to help. Until one night he was so bad we had no choice but to call on him.
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Jane, please don't beat yourself up over the fact that he won't listen to family. C'mon, NO ONE listens to family! We hear this over and over again here. Many years ago, my elderly never married great aunt was discovered by my parents to have developed dementia, was living in filth and suffering from malnutrition. My dad, her much beloved great nephew, could not get her to understand that she could no longer live alone, but my dad snagged a good looking young beat cop and enlisted his services to "escort" Auntie to a "party". She took his arm and allowed herself to be escorted to the waiting police car and lived out her days safely in a secure facility.
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He's partner said he will see what he can do which is all I can ask for at this point. I pray he'll listen and we can get him the help he needs. If not and he gets to out of control we'll have to do whatever we can whatever way we can as much as that sucks. No one can live like this anymore including him and no one should have to. It's sad.
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If his doctor can't talk him into getting this stuff checked out (was he checked for a uti at the hospital? Those can cause erratic behavior), you might call APS and or your local area agency on aging. Call 911 if you have to to keep you all safe. Consider that Child Protective Services might find this an unsuitable environment for your son.
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Oh, and the next time he goes to the hospital, you DON'T pick him up. You and your mother tell the discharge people that you can no longer care for him at home.
They will attempt to guilt you into taking him home. For your mom's sake, please don't.

You should get in touch with the VA and talk to them about placement.
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This is all excellent advice.

In our experience, we called 911 when our LO threw us out of the house and wouldn't let us back inside to care for the LO. We got two cops and three ambulance guys within minutes. They gently coaxed our LO out, and away in the amublance to the ER to get checked out. I followed along behind to ensure that the docs had the right story, but stayed completely out of sight. That was the last time our LO was at home.

Quick points:

VA: Does your dad have a service connected disability? If he's a Vietnam vet, his diabetes and heart disease should be considered connected to his exposure to Agent Orange. For the VA to do much, they'll need to establish service connection. There is a process, it's not instant, and you may need help from an organization like the Disabled American Veterans. Someone on the force probably knows how to do this.

Protecting yourself: My all means, do not put yourself in harm's way and especially your son. We had to modify the way we deal with our LO because of our child and the potential for hostility. As important as your dad is, your son is first. The best way to address this is to call 911. Our LO lived in a small borough in a busy county in NJ. If these guys can do the right thing with a medically unstable older person, then NYC ought to have a gold plated response - at least you might think so. No one tackled our LO. There was really no problem. It worked out wonderfully.
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My heart goes out to you. What an awful situation for all concerned.

You have been given excellent advice by those who have been in your shoes.

I hope that his partner can help. If you have to call 911 perhaps calling the partner too would be a good idea. If he could meet them at the ER or come immediately to your home, that might calm things down. But he no doubt has a life, too, and may be limited in what he can do.

Somehow you need to get Dad into an environment where he can be helped. Even if he doesn't want to be helped, you need to have him removed for the safety and well being of your mother and your son. Probably the most likely way to have him removed to a healing or at least safe environment is through the emergency room.

Be sure the ER has a clear picture of the hallucinations and violent behavior.

Insist that he cannot be returned to his home, because nobody there is able to care for him and he poses a safety risk to himself and others.Resist all attempts to guilt you into taking him home.

Expect your dad to be angry about this. But he is angry now, so you have nothing to lose.

My heart goes out to all of you. This crisis is not of your making and yet you are faced with coping with it. Best wishes to all of you.

Please keep us informed with what happens. We learn from each other, and learning helps us give better advice in the future. Tell us how this progresses for you, and help others in the future.
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His partner is your lifeline. If anyone can talk him down, it would be the partner he bonded to. His partner knows when to call for back up, and when he does, the PD will give it all they have.
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It sounds like it is to the point where, as much as it sucks, you DO want - no not, want, but need - him "subdued and arrested" if that's what it takes. It does him no real good to be allowed to continue to do what he is doing either.
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JedStar, your father's behavior doesn't surprise given his long history with uncontrolled diabetes. People who know diabetics know they can get crazy when their sugar is too high or too low. Something that is being studied here in Birmingham and in other places is what is called metabolic dementia. When people have repeated hypoglycemic episodes it can impair the brain and cause temporary dementia. If the hypoglycemic episodes continue over a long time, the dementia may not be reversible.

Your father's violence suggest to me that he is reacting to his present glucose levels and his brain may not permanently be impaired. This is what I hope. His diabetes, diet, and behavior also suggest to me he may be having some vascular events in his brain that can lead to serious long-term problems. I am not a doctor, but I would get him into a hospital where they can get his sugar stabilized and scan his brain for any signs of recent damage, e.g. ischemic attacks. If the doctors can get him stabilized, his behavior may improve. I don't envy you, because I know your father may try to fight you all the way.
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Here is a bit about metabolic dementia from NIH.

http://www.nlm.nih.gov/medlineplus/ency/article/000683.htm
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My Dad has slowly over the last several months been starting to become un-focused, forgetful, and irritable. And, the last month he has made a few decisions that are 'way out there' and can have profound effects. I am the DPOA for both my folks but my Dad is the 'old-school' THE MAN and he thinks he can do/say/decide whatever HE wants....he did these bad decisions without my knowledge and I am just beside myself because he's trying to hold onto his 'head of the family'....I am SO aware of him being Dad, and I have constantly told him he IS the head of the family no matter what and I have tried extremely hard to maintain his dignity. He is the one who is unaware of that I have kept from him that when he suddenly became ill 3 yrs ago that at that time he was declared 'incompetent'...I have made his financial people aware of this, and somehow one of his decisions had to do with an annuity that he still has !!! I cannot reason with my Dad on any level whenever he 'has made his mind up' as he says...I know that he is trying to hang onto who he is/was....I know that is all he feels he has left, but when it starts to affect the medical care of my Mom (who has moderate-severe stage Alzheimers) and some really far out decision with his annuity, I am alarmed !!! I will be contacting his insurance people, who by the way were AWARE of his situation, and possibly contact my Dad's lawyer....I am just beside myself ...he is also getting paranoid and more selfish and at times extremely difficult to reason with. I want to maintain his dignity, but I want to also make other professionals aware of this. I am also going to contact his PCP who he has a follow-up appt with next week. But when my Dad goes to see one of his doctors (he's a diabetic and heart patient) he smooths over these things by joking around, and finding all sorts of excuses for his behavior...if anybody has any other ideas or has faced this already please let me know....my older brother lives with them but he is very easily manipulated by them and is of no help to me. So, they do not live alone, they live in their same house owned now by my brother, and all of their needs are met. And, if anyone suggests someone coming in to their house to visit, they will have that person running around with their head cut off with all sorts of pointless and unnecessary things...I am older and know all their idiosyncracies ....wow, the stories I could tell you !!! Please, any other advice ??? Let my Dad's drs know and see what they say ???
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We went through some difficult times with my dad's dementia. The biggest help we got was when we contacted the family doctor who called ahead to the hospital where they also had a geriatric psych unit. Dad was completely checked out physically and then transferred to geriatric unit. Released after two weeks but all of this later paved the way for us to move dad to a safe, secure memory unit later on. My advice is to take advantage of all avenues of help and document well. Get letters from doctors as needed and most important...get the POA and other documents in order ASAP!
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If you Dad ever gets so out of control that he does hurt you, you may want to contact Adult protective services. Calling 911 may not be able to help because they won't be able to restrain him. Your other choice would be to let his attending physician know and perhaps he can write an order to have him evaluated at a psych hospital. They can help him with therapy as well as with psychotropic meds which will help contain his violent behavior as well as subdue him enough where he can get help for his diabetes, etc.
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Jane, sorry about your father - it is sad to see behavior changes in our parents and it is scary too. My mother has dementia and on occasion will get angry and throw a towel or something - never anything dangerous though. I was wondering why some sort of medication - like a sedative - has not been prescribed? Even if it makes him drowsy, at least he will be a lot more peaceful. If he goes to a psych ward, they will most likely give him something there especially if he is violent.. You can slip the meds in his food if he refuses to take them. Older people get very angry when they lose their independence which is where the anger stems from I am thinking. Keep vigilant - talk to doctors and don't give up till you get this resolved, obviously your father is unaware of the harm he can cause you, your mother or himself. Hopefully soon things will work out for all.
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Make a list of all of his medications - Name (generic and presecription); dosage; frequency as prescribed; and when he takes them (if prescribed at once a day, does he take it morning or night). Keep a chart of his glucose readings - date, time, numbers, also noting any behavioral issues. Also list his various hospitalizations, what happened at the hospital and what is happening at home. That info. needs to go with him in the ambulance, and you also have it on hand for any health professional who inquires. Let 911 take him to the hospital, with that list ( make a copy, fold it, put it in a baggie and label the bag with his name and "medical information". You get there some other way. Don't be in a big hurry to get Dad home. If nothing else, YOU and the FAMILY need some time without him to recover. As much as you love him, and as hard as you are working to make things better, you need to remember that HE behaved his way into this situation, it is a result of years of self abuse, and at this point you can only deal with symptoms. Lastly, check with the hospital or a community center for a support group so you have a place where you can vent.
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Please please watch this video, you are Dads advocate his mouth piece. Teepa snow has tons of videos that were a god send to me and my mom when she was alive. Please let me know if it helped. thanks Judy.click link or copy paste title in youtube
link --youtu.be/9kSjHtHSJCw
Title --Late Stage Alzheimer's Dementia Care: How to Recognize Pain" with Teepa Snow - Part 1
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I agree with everyone else.....phone 911 the next time he gets violent and have him hauled away. Your own life is in danger - and possibly that of your son.
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Video tape the behavior 24 hours a day. Do NOT trust the police to protect you. The police are falsely arresting family caregivers and you can be charged with elderly abuse. False accusations by people with dementia and uneducated police with financial incentives are arresting family caregivers in record numbers. Tape record EVERYTHING!
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Speak to his doctor about putting him on a 72 hour psychiatric hold. I agree, the diabetes should not be causing these rages. Do it before he really injures you or your son. In one of his rages, you could call the police and they would put him hopefully on a psych code, and transport him directly to a psychiatric hospital. Do something quick.
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call 911 and tell them he is not acting his usual self, is very confused etc. He may have some dementia, his behavior could be a side effect from medication or he has something else medical going on. Anytime there is a change in behavior(s) it is an indication that something has changed. Although people can be very stubborn and being a diabetic can be difficult for some people. I see lots of clients refuse going to the doctor or hospital, they don't like tests etc. Wait for a time when he is more rations then try to relay how worried you are about him. If that time doesn't happen, then he needs medical care to determine what is happening. I hope the advise given in this site has helped. I'm sorry you and your family are going through such a difficult time. You can also look for a support group close to you, it does help to discuss caregiving issues with others. You are not alone in your plight. Good luck.
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