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My father-in-law lives about 300 miles away in a smaller town. My sisters-in-law that live in the same town are at the end of their ropes. They've tried having him live with them, giving him a place to live while helping him, assisted living apartments, nursing homes, hospitals, etc. He gets thrown out of every place, or when living independently, does things that endanger himself and others. He refuses to follow rules, especially where smoking is concerned. He will smoke ceaselessly, anywhere, anytime, regardless of the rules. He also has oxygen at any given time, which makes smoking even more of a danger. Apparently, restricting his access to cigarettes doesn't even help. Or, he'll act out in other ways, such as dressing inappropriately, urinating in public or on the floor, etc. He refuses to bathe as well. If he has money, he will buy mouthwash or cough syrup to drink, if he isn't able to get beer or other alcoholic beverages. If you don't let him have money, he resents that, too, or will accuse you of stealing from him. He started at least one fire in a rental house after being there for less than a week. In the past when he's come to visit us, he will smoke in the house constantly no matter how often you ask him not to, and tends to leave doors open with the heat or ac running full blast because he "wants some air". This can get expensive and uncomfortable, not to mention risky for our pets and children.
He's been dysfunctional all his life, and dependent on others, at least financially, but he's gotten to a point where he's a danger to himself and others. He's always been pretty inconsiderate, too, but he's taken it to a whole new level. It's almost like an oppositional defiant disorder...and judging by the behavior of his other son and one of his grandsons, it may well be that. My poor sister-in-law is to the point that she's asking my husband and I to try finding him a place to live here, even though the rest of his five children live in the same town. None of them know what to do anymore. My husband feels bad that he doesn't want to have his own father live with us, but he's worried about the stress it would put on our family, and I'm worried about that and safety issues.

I don't even know where to begin looking for him a place to live...he can carry on a conversation and seems perfectly sane most of the time, and seems capable of taking care of himself to some degree. But when left to his own devices, he'll drink himself into a stupor, pee on the floor from the sofa, and start fires with his cigarettes. I'm convinced that this is why many elderly mentally ill people end up homeless...no one seems to be able to deal with people like him.

At the same time, my mother recently had kidney failure, and is about to try home dialysis waiting for a transplant...it's still a very dicey situation, but my dad is doing a great job taking care of her. I hope to be able to donate one of my kidneys to her, but don't know yet if mine would be a good match, if I'm healthy enough, or if my mom will allow it...she's worried I'll have the same problems, but I told her I'd just get another kidney from someone else later if I need it...lol. But, it is a possibility, and it would be major surgery. I also have a five year old to care for.

Needless to say, I'm feeling pretty overwhelmed by the thought of all this...any advice you can give about where to start, what kinds of homes would take him without throwing him out, who to call, what to look for, etc. is greatly appreciated.

Thanks in advance for your help!
Rhonda

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Look on NAPGCM dot ORG to find a certified GCM in Amarillo.
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Moxie1 you provided the best of the best information if the family can afford a GCM and really, they cannot afford not to hire one. I did and she has helped keep me in ways it would take a book to share. My husband's doctor just fired him (us) and gave him a 30 days notice to find a new doctor and the PT fired him two weeks later because he has delusions of grandeur and refuses to do the necessary exercises! If I had not had a GCM I don't know what I would have done but she found two doctors who were willing to take him and she explained exactly what they were getting, so if he blows through the one we see in two weeks, at least there us one more who has the guts to deal with the whole package. I have kin all over Texas so I was going to reach out to them to see if they knew any names, so thank you Moxie1 for doing that.
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The geriatric care manager sounds like the way to go. Also he may not have been seen by a board certified spec so you can go to the ABMS website and do a search for geriatric specialist in Amarillo. it brings up 13 in Amarillo. Also there is one Geriatric psychiatrist there. I have found that many family docs say they are geriatric docs but not board cert. Good luck.
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I appreciate all of your input so much...I can't describe what a relief it is just to hear from people that understand, and know what they're talking about!

I absolutely do NOT want him to live in our house, and I'm pretty sure even moving him here to a place in Fort Worth would be a mistake. I'm willing to take charge of getting him the help he needs and trying to find him the right place to live, even from a distance. Frankly, I'm better equipped to do the research and take care of the logistics than any of my husband's siblings...they're all a little scatter brained, not that they don't have good excuses for it. I've offered to help in that way in the past, but no one ever gets me the info I need.

The geriatric care manager sounds like a GREAT idea...I will definitely look further into that. In the meantime, I'm going to try to get copies of his records so I can at least know where he's been, and what's been done. I resent being asked to help without giving me anything to work with! I'll also talk to the MHMR friend just to see what he can tell me about having him committed, or whatever has to be done to get him the help he needs and a permanent place to stay without getting kicked out.
Again, thank you all so much for your help and kindness!
Rhonda
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Especially if he used to be sweeter than he is now, as you say (sweetER -- sounds like he was always a handful), you're talking about an additional layer of pure biochemistry here. His double addiction -- alcohol and nicotine -- is beyond a "behavioral problem". An alcoholic at the point of drinking mouthwash and a smoker who can't resist lighting up with an oxygen tank next to him is in the grip of a level of addiction that's not just a matter of being difficult or refusing to obey the rules. He needs medical intervention as suggested-- medical, not behavioral. You can't bring him to your home, and it's not just because you don't want to inflict him on your life. You can't bring him to your home because you can't provide what he needs. If his issue were a disease that required particular nursing care or medical interventions that it was beyond you to provide, it would be clear and simple: your home would not be the place. Thinking that way will change your approach, and help him far more, peeling away some of the otherwise inescapable layers of judgment at the same time.
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Rhonda,
I know all about Amarillo. I know lots of people there and I know about the social situation and how small town it is, to a great extent. I think what could help is to get a geriatric care manager in to assess the situation. There are 2 in Amarillo, listed here:

It costs $250 for the initial evaluation and advice and then usually around $100 per hour BUT Geriatric Care Managers are WORTH THEIR WEIGHT IN GOLD. They know ALL the right resources, they can tell you SIL how to solve the problem and consult on an ongoing basis. They can smooth the way when you hit a roadblock. My mother would not be on the right medication without my GCM.

Your SIL's husband is probably fed up with the drama. This is where hiring the right resource could make a huge difference and take the stress off your SIL.
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You sound like a loving and caring person which is beautiful. You sound like you are trying to talk yourself into taking on the responsibility of your FIL. Maybe you reached out on the site in hopes of others supporting you moving him to your town? I think you can see from those of us who have been seasoned in the role of caretaker that is not the support you might have wanted but the opposite. I too grieve for those who are taking care of him, it is an awful job and it sucks the life out of you but the picture you have before you is not all or nothing! I grew in Plainview Tx and know the area well. So, maybe you would want to have the family drive him down to the Dallas, Fort Worth areas for the needed tests and diagnosis and then take him back to Amarillo to live. He needs medication(s) but he will still require 24/7 care, just not in your home or area. Please read the posts in response to your concerns again. If he is brought down to your area for the tests and if he stays with you, perhaps you will get a taste of why you do not need another person to care for, especially someone with his personality problems. Do you understand you already ARE a caretaker? Your mom needs you and she will need you when she has the transplant and if you are the donor....play the movie forward and you will see all the reasons you cannot have this man in your home or in your area.
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Thank you all so much for your advice...I agree that moving him here is a bad idea...he would have to be seen by all new doctors, and I don't have a clue about his medical records or history. My husband works long hours and I stay home, so I would be the one to deal with him most of the time. I don't know how familiar you all are with Texas geography, but he's in Amarillo and there's just no other real cities nearby. I live in Fort Worth with considerably more resources. My SIL believes his reputation will keep him from getting any more help in Amarillo, and she probably has exhausted the resources there. I know he's been sent to the Psych. Ward a few times, but they never keep him more than a few days. It seems like they talk to him and he seems sane, and they let him go. Also, my husband is the one that talks to his sister all the time, and he's not good at filling me in on details, so my info is sketchy at best. I know he is/was being medicated for anxiety, but on his own he won't take medicine correctly. We do have a friend who works for MHMR, and I'm going to talk to him and see what advice he can give.

He used to be a very sweet man, albeit dysfunctional, but he's kind of gone off the deep end over the last year or so. He gravitates toward his oldest daughter, so she's the one who usually has to deal with him. Her husband is completely unsupportive, and the stress us tearing her apart. I really want to help her, just not sure what the best way would be.

Thanks again,
Rhonda
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Hmmm...some of the symptoms sound an awful lot like dementia or Alzheimer's - one of the causes can be alcoholism. I think your FIL needs to be evaluated by a neurologist to determine what is going on with him. He may need to be hospitalized for a Geriatric Psychiatric Evaluation (if he has not already). The purpose of this would be to get him on some medication to stabilize his moods and behaviors. He would be seen by a neurologist during the Geriatric Psychiatric Evaluation. The way to do this is to have his GP write orders for one, tell you which hospitals in his area have a Geriatric Psychiatric Ward and then, he would be admitted through the ER. The other option is if he acts dangerously or violently, call 911 and tell them you have an elderly man in need of a Geriatric Psychiatric evaluation. The police will come, but they won't hurt him, they will take him to the hospital ER where he will most likely be admitted (unless he acts so nice and normal the police think he is not a danger to himself or others.) The stay in the Geriatric Psychiatric ward will be 2 - 6 weeks. It takes a while to figure out what meds work best and the correct meds depend on getting a correct diagnosis of what is causing the dementia which is what the neurologist does. Your husband's siblings can tell the hospital social worker about their father's past and say that they cannot care for him at home. The neurologist can write orders that he cannot live at home. The social worker will help them find proper placement.

Drugs such as Risperdone often work in these cases. Sometimes they have to be adjusted up to the correct therapeutic dosage. Doctors typically start at the lowest dosage and increase the dosage from there until the optimal effect is achieved where the patient is neither totally zonked out nor agitated, but just somewhere in between, where they can have pleasant days without being miserable from the agitation.
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This sounds like an ideal situation for the state to get involved. I would say for your FIL to remain where he is, but to call in his county services to have him evaluated for state guardianship. He may be too much for the children to handle without endangering themselves and their communities. Good luck! I wish the pharmaceutical companies would come up with a "nice pill" that would cure such meanness. We just have to do the best we can.
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You stated the problem very well and it is a nightmare, he is a nightmare. You asked for advice so I must strongly advise against your bringing him anywhere near you and your family for all the reasons you stated. Your FIL needs to be seen by a doctor or a number of doctors to address his behavior and finding the right doctor can be a daunting task in itself but then there are a number of family members 300 miles away that can address the search for a specialist who will give a complete workup and diagnoses. Then when he acts out and is a danger to himself and others, call the police. In the mean time call Adult Protective services to come and evaluate the living situation and perhaps be able to suggest solutions. I don't know if it is possible but he sounds so awful, makes me wonder if Rx doesn't help him, then can a child divorce their parent? Just please do not bring him anywhere near your home…I am married to someone who has a number of personality disorders and is in an ALF…so far. My life and my health is being destroyed by the things he does and my trying to keep him in the ALF…you do not want this 'job' run the other way and tell your husband he has permission to have nothing to do with his dad other than offer financial support to those who live near him.
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Has your father in law exhausted all of the options for living in the town he is already living in? If not, I don't see the point in moving him to your city, especially since there are less siblings able to help out there. Perhaps if he has a bad reputation in his current town, maybe there are options near enough to that place (where no one knows him?) Has he had a psych eval? Perhaps if there is a dementia or syndrome he can be medicated so he can't harm himself. My father was an alcoholic, not a smoker on oxygen, mind you, but out of his mind drunk, peeing on the couch, calling 911 when he had psychotic breaks, possessed firearms (not allowed in assisted living facility!)- definitely a danger to others and himself. The docs gave him meds to calm him down (I think either Xanax or valium) so his oppositional nature was blunted. It made him much easier to deal with. I really don't think moving him to be closer to you is going to solve anything. It will be same behavior, different place. You need to get at the behaviors. Just my 2 cents.
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Are you suggesting we get him to commit a crime to get him into prison? lol Or are you just saying that it sucks that prisoners are so well cared for in our society, but so many elderly fall through the cracks? I wonder how bad the crime has to be that a judge would actually send a sickly old man to prison for any length of time...hmmm...;)
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If he commits a crime they have to take him in a prison???????
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