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Hi, I am a nursing student that has been a caregiver for a 78 yr. old elderly man for a year. His 9 children are completely out of the picture due to his difficult behaviors. I believe it's early stage Alzheimer's and latent mental illness that has never been treated (I get the distinct feeling he's bipolar and a huge reason the kids have left). He's now raging, crying and become violent with other caregivers. We managed to get so much done for him from new dentures to eye surgery in the hopes of making his life better. We are concerned about his safety and his memory decline. I have tried social services to get help and he refuses. We are trying to get him to a neurologist in hopes of getting him a MMSE and possibly meds for his memory and scary outbursts. He's refusing to go. We almost drove him to ER today due to a 3 hr. rage before getting him to an eye appointment that HE INSISTED we take him to. I've studied tons of abnormal psych and can only conclude his brain is being ravished by AD and his personality issues and/or possible mental illness are now at full throttle. The other scary issues is LOADED GUNS IN HOME. I have hidden them and he's raging about this, too. FYI he's in a wheelchair and also thinks he's still a gun instructor though he hasn't done this in over 4 years but insists he's also going to drive meanwhile he cannot walk unassisted. Any advice, please. We want to honor him staying in his home but we are truly terrified that if he doesn't get psych treatment now he'll be 302'd--and worse for being in the system. His one son says, "I want to stay out of it, I don't care if he dies".

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Thanks everyone. I work for this man privately and formerly for an agency with him. Believe it or not after he fired the agency, I felt bad for him so I went back. Wow. It's been a long year. Back in Oct. I called APS and social services and reported the situation. The social worker left paper work...went nowhere. Then in Nov. I got him an RN visiting nurse and PT to try to help. Nothing was done and he fired them to boot. Now last week tried the neurology appointment. He refused to go. So, I am done. I am actually very, very afraid to go back and I won't. I was supposed to do live-in this weekend and called him to say I cannot. Then I called one of his kids and left as message explaining the situation and that if something isn't done a tragedy will happen. I have also called APS again and the local police to check on him as he's presumably alone (bet kids won't go over). I feel terrible about the whole thing. but I'm safe, sane and alive. Happy Easter.
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Concerned, if you're still out there, take heed of all the advice given here. As to the guns, don't discuss this with this guy. I went through the gun thing with my dad. At the least the guns should be disabled and unloaded. If you're still involved find someone to help you with this. Honestly, in this case the guns should go away. This may not be your battle. Inform someone in authority of all you are seeing here and get out of this situation.
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Who is the "we" you're talking about? This man needs an inpatient psych evaluation. Now.

You don't drive him to the ER, you call 911.

You need to talk to your clinical supervisor about this case. You are in over your head.
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Concerned, let me add a caution here - you are a nursing STUDENT. You are putting yourself in a risky professional position by making medical decisions without benefit of the credentials. If something happens to the father, you might be surprised how quickly the children will care and file suit against you as a caregiver that edged into professional misconduct. And that will not be something you will be able to successfully defend. If you have not already, google "mandatory reporters" to see what might result from your failure to get the proper care for a client. Eye opener.
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So just how & why are you involved in this?
Who is paying you?
If You work for an agency, you tell them or do whatever reporting required to the agency that it is an unsafe household to send you to work at (due to firearms and owners mental state). If its family who is paying you, you send them a certified letter as to the situation. If you are doing this as part of training as you said you are a nursing student, then you contact your school or program.

If none of the above fit and it's the elder who has hired you, then you contact the police on his next outburst and tell them there are firearms in the house and you exit the house and wait for the cops. Let police /APS & courts take over.

Firearms & dementia are a tragedy waiting to happen.

His family - based on what you wrote - have abdicated any involvement as they have decades of experience with him and basically know better than get involved anymore. If he shoots you or hurts you or even kills you, you have a pretty indefensible situation as you knew he had mental health concerns yet continued to enable him. You sound young and idealistic which is wonderful but dementia and firearms need a reality check. You need to be all about your own safety first and foremost.
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Thanks...I posted above. We have avoided calling 911 as he wants to stay in his home but as time progresses this seems less and less realistic. We thought meds may clam him and enable this to happen. The problem is that even when he was hospitalized once for a fall THE CHILDREN FLAT OUT REFUSED TO CALL THE HOSPITAL BACK. I suppose he will end up a ward of the court. It is so sad. I could use a hug and a prayer. Thanks for your advice. It will probably happen.
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When he goes into the uncontrollable rage, call 911 and get him taken to the ER for evaluation. Hopefully they will admit him for a 72 psych evaluation. I am surprised APS didn't help you get this done.
His son can file a Petition for Guardianship. He doesn't have to be the Guardian, just petition for one to be appointed. APS can also do this.
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