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My sister and I are on vacation. While we are gone our other sister is caring for dad who has moderate dementia and serious sundowning. Caregivers are assisting her, but dad refuses their help and tells them to get out of the house. Our sister cannot handle him alone and has already hurt her back (knees hurting too). She had a melt down last night and we are only half way through our trip. Any suggestions?

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Update - a couple days later and it seems that the twice daily phone calls are making a difference. With each call we review where we are, when we will be home, and that having caregivers is essential to sis3 well being.

Increased Zoloft dose may also be working as well as familiarity with the caregivers as well as their awareness of situation while in the house.

Thank you again for your support!
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Reply to SistersCare
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Is the doctor aware of what describe as his "serious sundowning"?

Once you are all home again, think seriously about a consult with a geriatric psychiatrist (if the prescribing doc is not of that specialty).
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Reply to BarbBrooklyn
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We agree with eyerishlass. We had a long talk with dad, one of the skills i learned from this forum - speak calmly, dont sound like you are upset. i explained to dad that sis3 cant care for him alone, sis2 and i have each other and sis3 needs the help. its only for one more week, bringing in help keeps him in his home vs a facility, we love him, want him to be safe and
kept our of the hospital (he is extremely afraid of hospitals) etc.

additionally, his doc increased zoloft dose and put him back on his blood pressure meds temporarily.

we agreed to call twice a day ( think this may reset his mind if only temporarily) and set phone alerts so we dont forget. he actually said ‘i understand and i surrender’.

our 2nd call yesterday was at about 12:30 their time and his spirits seemed up, he offered that he needs to keep his anger in check. caregiver help was to arrive at 1:00.

we’ll see what today brings.

i love this forum and have always found great tips and information, sometimes tears, but always wonderful support.

thank you everyone!
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Reply to SistersCare
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I am surprised at these responses. With moderate dementia he cannot be left alone. He could wander off never to be seen again. And he very likely could be terrified.

How much time is remaining of your vacation? Is there another person that could be with your dad? Think about getting him to the hospital and they figure out how to deal with him.

Did this sister ever care for dad, alone before? A vacation is not the time to experiment with his care or to see if another care arrangement or caregiver would work. A better idea would be to have found a facility to provide for him.

Contact his doc, maybe a med will help, but that experiment isn't a good idea now either. What about a Geri psych hospital so they can get him stabilized. It could be that he has developed a UTI while you have been gone.
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Reply to gladimhere
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Is Dad at his own familiar house or is he staying with your sister for the duration? If you moved him temporarily it may be making his behavior worse. Are these new caregivers hired just for the vacation? Is he normally like this? Maybe you and Sis2 are just used to it, but Sis3 isn’t?

I certainly don’t recommend leaving him to his own devices. She has to impress on him the caregivers are there to help her, not him, and they are nonnegotiable.
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Reply to rocketjcat
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This is horrible...your sister has hurt her back and knees? Please do tell her to leave. I also like the idea to tell him the consequence of this non-cooperation with caregivers is that he will be placed into a facility.

I am so sorry that this is affecting your vacation with your sister.
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Reply to CTTN55
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Your dad does not get to refuse the help of caregivers. They are there to make life easier for his daughters who are devoting their lives to caring for him. If he doesn't want the caregivers in his house then he can opt to move into a nursing home.

While your dad should be treated with respect and dignity, firing the caregivers is not an option. Everyone's pitching in to help your dad, he also needs to do his part.
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Reply to Eyerishlass
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Don't cut your vacation short. If the remainder is less than a week, get your sister out of there and leave him to manage on his own. A week on his own is unlikely to kill him (and an accident that he causes himself is not something you should blame yourself for anyway). Phone him and say that if you come home and he is not caring appropriately, the three of you will together put him into care.

It can be very difficult to pick between controlling behaviour and a side effect of dementia. This one sounds a bit like 'how dare you leave me'. Your sister who is still there may well feel able to check on him in a couple of days, which might make you feel less guilty if you do decide that it is dementia.

The episode might help you to work out what is going on. One way or another, you and your sisters shouldn't be putting up with this.

PS you don't have to take any notice of this - it's just one approach!
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Reply to MargaretMcKen
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What meds is dad on? Does he take meds to help with combativeness and sundowning? If so, have sis call his doctor to get advice about how to adjust them while you're all away.

Do you think this might be a wakeup call that he needs placement in a good care facility?
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Reply to BarbBrooklyn
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