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My great uncle, who is more or less a grandfather figure to me has started to have delusions as well as, not being able to remember where he is while driving the streets. He has drove 70 years of his life and he will be 90 in February. The other day he didn't know how to get home and should not be still driving at all. He would never ever agree to go to a home or have a caregiver come into the house. He has convinced himself that his house is full of bugs and has paid numerous exterminators large sums of money to spray these bugs that do not exist, but the poor soul is convinced they are there. He falls asleep while cooking and almost burnt the house down. I do not know the steps to take or what to do. He has no children and no spouse. It is just him, his sister who is also in her 80's, me and my mother who is also not in good health. I just feel so lost and not sure what to do.

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Hi Sara,

I so completely understand how lost you feel right now! I felt the same way when my father started to have delusions and couldn't drive anywhere but down the street without getting lost.

It is very hard to let go of the image you have of someone as capable and strong, especially when he has been a father or grandfather figure to you.
But take a deep breath, because now that you've noticed all of this, it's time for you to step up and be the one to take this situation in hand. There are definitely steps you can take to help him. Here are some suggestions:

1 - Take him to a neuropsychologist and have him evaluated. It will be about a three hour appointment, and the neuropsychologist will ask him a lot of questions. From there, a diagnosis can be made.

2 - Take him to a neurologist. They'll examine him, and possibly do an MRI of his brain. That way you can find out if there is anything organic happening that could be causing the issue. You can also have him checked for a UTI (urinary tract infection) if the delusions have come on suddenly. Sometimes UTI's can make our elders behave very strangely.

3 - You can remove his keys. If necessary, disable his car by disconnecting the battery. It is imperative to keep him off the road. This can be the hardest step, but it's absolutely necessary for the safety of your great uncle and of your community. (In our area, a man in his 90s crossed the median and caused a deadly head-on collision on the freeway just the other day. You do not want anything like that on your conscience.) If he does get diagnosed with dementia, his driver's license will probably be invalidated anyway.

4 - Because of the incidents with cooking and fires, you can call Adult Protective Services and report a case of "self neglect". They can send someone out to evaluate his situation, and can help you determine what steps to take to keep him out of danger.

5 - Call your local Area Agency on Aging and ask for a social worker to come out and do an evaluation of your great uncle's needs and environment. They can start to help him understand the need for more assistance, even if it's just having someone come into the home for a few hours every day to help him with cooking and basic chores.

If you feel overwhelmed, or if something comes up that you need help with, call the Alzheimer's Association hotline. There is an 800 number on their website that will take calls 24 hours a day. Trained staff will listen to your concerns and offer you practical advice. They aren't counselors, but it's amazing how much it helps to have someone who understands what's going on give you some practical steps to take.

Good luck. I know this is hard. Keep your chin up, and know that you're not alone. I hope you'll come back to this community for more support. There are some great people here who have your back. Take care.
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My first step would be to notify the county's Area on Aging (name can vary in places) and ask their advice about an elder at risk. Talk to someone there to see about getting someone out to do a needs assessment. Someone in authority will have more sway over your great uncle than family will. Elders can get very stubborn and don't want their lives to change. Sometimes we need to help them do things to make changes. To me it sounds like he might do fine for now if he had someone to come in to cook, clean, and drive him places. Do you think he could afford that?
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Have you not read any other postings here? Talk to his doctor, the licensing bureau, his POA if he has one. Maybe go for guardianship and take over for him as he sounds no longer competent. Don't dither around and let him be a danger to himself and others. I don't want my loved ones on the road next to him.
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Dear Sara,

Its so hard when elders get into their 90s. And especially for men they don't want to give up their independence or driving. But given what you have said it is critical he stops driving before he gets into an accident that could kill him or someone else. I would consult with a social worker and see what options are available. He needs to be assessed because its not right that he has delusions. It could be so many things, his pills, his diet, mental decline from age. You are right to worry for his safety and need to start making plans for him.
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I agree with all of the above. The Area Agency on Aging helped me get my mom out of the house (which seemed unthinkable to all of us) and into AL.

At the very least, take his keys and let the local police know what is going on.
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Many elders will put up a big fuss about leaving their homes, but when they do they are actually relieved and much happier to have someone else take care of the cooking and cleaning for them. (Provided you find a good place for them).
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I agree. First thing - someone needs to disable his car. If you have any relationship with his doctor or can forge a relationship, reach out and let the doctor know what's ACTUALLY happening. Let him be the bad guy and order no more driving. Also, convince him the insurance company wants his driving abilities assessed or he'll be dropped. (Therapeutic lies are sometimes necessary for the health/safety of a loved one.) Then there's the whole other hallucination issue to address. I agree that getting a social worker from the county in to do a needs assessment. Look at it as you're making arrangements/taking steps to protect him and lead him to safety without personal confrontation. Also, someone needs to get POA - the country social worker may recommend this if she knows the issues ahead of time? Find resources to intervene.
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I agree with ThisIsntFun. High quality care makes all the difference (as does good food), but I can vouch for this, as my mom went from objecting like mad and crying non-stop for the first week to thinking of her apartment as "home". She still misses life within her own four walls, because she wasn't ready to let go of that (my dad's condition forced the move, and she agreed to it, but then didn't acknowledge that she'd agreed to it and fought it all the way, it was just too big of an adjustment for her). But she does find life much easier now.
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Yes, have the car disabled and the stove. First, take him to his primary. Some insurance supplementals require a primary doctors order to see a specialist. All my Mom has is a neurologist who handled any medication she needed. If he won't go to a doctor, then you need to call in Office of the Aging.

So sorry you have to go thru this. Looks like you have enough on your plate. I would get his sister involved if she is of sound mind. My GF's mother was over 80 when she handled her husbands affairs and her SILs too. His sister is his closest relative. You can always help her with things she may not understand.
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I see many posts from people who describe their LO as someone who would "never agree" to having help in the house or moving. I totally get that. Hubs wouldn't ever have agreed to a caregiver but after he got so sick & his dementia was such that he was evaluated as needing 24 hour supervision for safety I hired a caregiver. Hubs kept saying we didn't need him but meanwhile I'd grown a spine and said "you may not need him but I do!" By then hubs didn't really realize how much of what he had been doing I had taken over (neither did I until he got sick--just kept taking on more & more myself in complete denial of what was happening to him). At some point you (hopefully with your durable power of attorney in place) have to override them as their decision-making ability has gone away. I know it's hard to do but for their safety and that of others you have to. Hubs was furious when I got the dr. to recommend he stop driving but he didn't argue and was just sarcastic about it (until of course the day when he forgot that he didn't drive--but that was later on...)
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