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Father started having more problems in July - memory, speech and emotional. Multiple calls from him and his ILF in late August. Took him to hospital for altered mental status, admitted. Diagnosis from hospital: progression of dementia. Went to skilled rehab for 3 weeks to improve physical condition, work on ADLs and speech/memory. Improved physical skills. Still difficulties with changing clothes and bathing regularly. Attending physician and team from skilled facility recommended memory care due to continued need for prompting, his wandering and memory issues.


Moved him to memory care for safety, continued evaluation and care. He has improved some, still has memory and language problems. His behavior is becoming a problem. He does not think “anything is wrong with him”. He is upset/angry because “I lost his drivers license” (it is not lost) and “ he can’t go out and do anything” and “he doesn’t have his car”.


He can’t remember my name, does not know his other daughter even though she was at hospital too. Sometimes can remember a few things, not able to learn new. Other times memory is really bad and speech is incoherent.


He is really not fit to drive a vehicle. It is very difficult to listen to his anger about this issue. Only trying to get him help he needs, evaluation of cognitive abilities and keep him safe.



Any suggestions on how to handle the nasty and angry, seething behavior. I try to visit every other day for a short time. It is a disheartening situation.



Thank you

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If he's in memory care, he really can't just pop out and go for a drive, right? Do you still have his old license? Would there be any harm in giving it back to him? Or making up something that is supposed to be his DL? Does he still have a care somewhere? Tell him his car is in the shop. It's probably doubtful that he will remember so tell him every time.

It's so weird to me that my mom gets fixated about this lack of being able to drive as well. She makes snarky comments about is. OK, fine, be snarky but there is no way in hell you are getting behind the wheel!

You could always say vague things to your dad like "I'll have to talk to the doctor about that dad and see what he suggests".
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Burnttoast Oct 2022
Thank you for the reply. Sounds like a good approach. I will be talking to the doctor after the rest of recheck testing this week.

He does not have access to his car, it is a good distance away and in locked storage…… for now. He can’t just get out to drive. I do not want to give him the DL, it is still valid and he has mentioned “I will just have to rent a car”. Luckily, he does not have his credit card…..
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The visits every other day are not productive in a positive way, it seems. Try going every three days, then every four. He’s not the same person he was, and you can continue to advocate for him without putting yourself in his line of fire. You need a break and the only way to get it is to stay away. Very sorry for the situation.
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Burnttoast Oct 2022
I have been considering backing off a bit with visiting. It may help us both at this point.

Thank you
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Your father is beyond the point of reasoning & logic now. He's not going to understand why he can't drive or go back home, and he is suffering from what's known as Anosognosia, which is a condition that causes someone to be unaware of their mental health condition and how it affects them. It's common in some conditions, including dementia. So, someone who has been properly diagnosed with dementia, but has anosognosia, doesn't know or believe that they have dementia. It won't change, either; my mother died with advanced dementia at 95 years old insisting there was nothing wrong with her & she did not belong in Memory Care AL.

Distract dad & change the subject when he keeps asking the same questions. If he is angry & seething at you when you do visit, you may want to stop visiting him so often, or even entirely for a while, until he calms down a bit. And if he doesn't, definitely speak to his doctor about calming medication. Chronic insistence on driving is a sign of agitation and calming meds like Ativan should help; they did for my mother who insisted her mother was 'hiding' somewhere in the Memory Care ALF and she just couldn't find her. It became a nightmare until Ativan saved the day.

I suggest you read this 33 page booklet (a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia.

The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2

Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience

The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment

Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Wishing you the best of luck with a difficult situation. I hate dementia with every ounce of my being :(
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Burnttoast Oct 2022
I know he can’t ever drive again, but it is not real fun being the “bad guy” all the time….. I am tired, emotionally and physically.

The information in the booklet is very insightful and helpful. I need to keep things in perspective, sometimes not the easiest…….

Thank you
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Is dad seen regularly by a geriatric psychiatrist?

Any sudden change in behavior and/or mental status should trigger suspicion of a UTI--they often cause psychiatric symptoms.

Second, it should trigger a call to the person (hopefully a geriatric psych) who is or should be managing meds for mood/anxiety/agitation and the like.

Is this conversation about driving happening just with you or with staff and others as well? If it's just you, consider that you may be a trigger and think about stepping back from visits for a bit.
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Geriatric Psychiatrist can prescribe medications that can calm him down and at least be able to listen to you (how to handle the nasty and angry, seething behavior). Also, you might want to get something in writing from an insurance company that warns of losing coverage if diagnosed with a debilitating disease. Make the insurance company the "bad guys" so you can be a supportive "good guy." I'm sure he said something like, "life isn't always fair." You could try using that on him.

Taking a patrol officer over to speak with him may help him understand the laws a bit better.
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I agree with:
- cutting down the amount of visits.
- considering meds for anxiety and mood.
- telling him a therapeutic fib that the "doctor needs to give him any approval to safely drive again".
- redirect the conversation if he keeps after the driving topic.

Everything about dementia is hard. I wish you peace in your heart on this journey.
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