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My dad is 89 and has demonstrated increasing signs of dementia over last 2 years. He had health issues that resulted him being in care facility from Apr-Jul 2013. During that time he was prescribed by physician at facility with medication to address depression and agitation. Now he is home and mostly bed-bound. His behavior and outbursts have gotten worse recently. I think his meds need to be changed. He no longer has a primary care physician (doesn't trust the old one). I had taken him to neurologist when initial signs of dementia appeared - he claimed he had no problems and refused to take medication after 3-4 days. How do I find a doctor to see him? With his current state, will doctor be able to determine what is normal versus dementia-impacted behavior? We are in northern NJ. He is increasingly verbally aggressive, and vehemently denies that he is experiencing any cognitive abilities. It is almost impossible to try to rationalize with him He feels that he is in control and that others are just out to get him.

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By the way, I used to work at Morristown Memorial...... It still is one of the best in your area.
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If you want fast care since you no longer have a primary care doctor. Take him to the ER. Tell them his mental status has changed. This is quick way to have labwork, xrays and evaluation done. They will probably do a cat scan of head too. Believe it or not sometimes confusion and behavour change can be caused from a UTI (urinary tract infection). They will run a urine test. If they admit him, they will be able to monitor medications, prescribe something he needs. You can request a neuro/psycology evaluation while he is in patient, if admitted. They may do it or schedule after discharge. They may send to rehab to get his strength back. This will give you time to find a primary care doctor. Many geriontologists treat the patients at rehabs/nursing homes. You can call these facilities and ask they recommend a gerontologist.
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Get geriontogist referral from former physician and make appt with request for full medical and mental health work up. Next start documenting all your observations of dads behavior over the last year and send the written document to the dr ahead of the appt so he can review and get a background on dad ahead of time. I did this with my mom and it helped tremendously with the diagnosis and prognosis.

Talk candidly with dr about meds. If dad refuses to take them, they don't do much good and depending on his state might not be of much benefit.

Start thinking of your boundaries, his long term prognosis and care needs and what you want to do going forward. Research dads finances and your options.

This is going to get worse, not better; meds or no meds. You may need in home care, respite care, daycare or combination of options that work for your family. It is not wrong to place dad if that is what it takes to preserve your family and sanity.

Educate yourself by reading thru this forum, and reading "36-hr day"; the departure zone, and other dementia and ALZ related info. We all reach a certain "bankrupt"point where we are emotionally or physically bankrupt and can't care for our elders or cope with their escalating needs.

Better to know that sooner than later for sakes of both the care giver and loved one.
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Identify a gerontologist in your area. He/she will do a full work up and assessment of current meds and side effects. In addition, if he truly has dementia, he is unable to reason in the way you do. It is difficult but stop disagreeing with him and stop pointing out his failings. He feels them himself and is likely scared out of his mind. Your role for now is to keep him calm and safe. Get him in for a medical assessment and then take it from there. Come back with additional thoughts and inquiries as needed.
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You call his primary back and ask for a Visiting Nurse who can come to the house and do an assessment. It may be time for Hospice to evaluate him.
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