This last two weeks have been very trying for me dealing with my uncle and his behavior. I am both medical and financial POA so the SW loops me in to issues when they occur.
My uncle truly believes he will be able to leave the NH in a few weeks when he is able to walk. That's not going to happen due to worsening dementia and being wheelchair-bound. It has been since February 2024 since he was "independently" living (the kind way of describing his living status).
He has been a terror to staff and family because of the worsening dementia since his quarterly Medicaid PT accessment. But, he can sure showtime (to an extent) when family visits that haven't seen him or know all the details. So they are not truly understanding the situation and always have the answer (uhh, no they don't).
He will throw food during meals, make bathroom messes if he thinks he has not been attended to fast enough, curse at aides and makes very racist comments to the staff of color. It is bad. I have instructed them to increase and trial/error anxiety and depression meds. But, what else should I be doing? My weekly visits are becoming a chore where my mood is altered and I don't like to be that type of person.
As POA, will this become my direct responsibilty to deal with? Or is it the medical providers at the NH that should be initiating and dealing with this behavior from him? Just when I thought I had time to enjoy the summer with my family, this occurs.
Any advice at all would be appreciated. Thank you.
You tell family that his has been found incompetent and needs 24/7 care. If one of them feels they can take care of him 24/7 on their dime, then go for it. And keep telling yourself that you are POA with all the control, you now make decisions for him no one else.
Here are four key steps you can take if your uncle is acting out in his nursing home and trying to get himself discharged, even though he has dementia and can't safely live on his own:
1. Request a care plan meeting.
Ask the nursing home to schedule a meeting with staff, including the social worker and possibly a mental health consultant. Explain that your uncle has dementia and may not be acting out intentionally. Work with them to create a plan to manage his behavior.
2. Request a psychiatric evaluation.
Ask whether a dementia-aware psychiatric or behavioral health evaluation can be done. This can help identify whether he needs non-drug support, gentle medication, or changes in routine to reduce agitation.
3. Get the Long-Term Care Ombudsman involved.
If the nursing home talks about discharging your uncle or seems unable to handle his behavior, contact the Ombudsman. They are neutral advocates who can mediate and make sure he receives appropriate dementia care.
4. You may not need conservatorship right now.
Since you already have power of attorney for both medical and financial decisions, that may be enough for now. But if he tries to leave the facility, refuses care, or is discharged unsafely, you may need to talk with an attorney about conservatorship.
I hope this helps.
In the meantime, cut back your visits to every other week. Don't torment yourself and put your own mental health at risk dealing with a person like your uncle. Check in on him maybe every other week in person and let the social worker and facility give you updates.
Their Seroquel helps them. Haldol is only given as needed for agitation, but rarely, and has helped also. It results in a very long, but much needed, nap.
I hope you find what works for you.
I agree that increased meds are in order and you don’t have to visit him. An elder care lawyer could tell you whether the facility is required to keep him or a discharge him for such behavior.
You cannot talk logic to a person with dementia.
If I were you, I would take a hard long look at the POA responsibilities you have taken on and decide whether or not you want to continue. It sounds like he is too much for you to deal with, which is understandable.
Do not visit weekly and ask yourself "Why am I visiting weekly?" Do you feel you have to? (you don't as far as I can tell).
When you become a person you do not like, that is a major RED flag - one that I would definitely listen to. You need to love yourself. I do not know if you feel you 'owe' him anything, being your uncle.
Ask administrator how facilities deal with a person exhibiting this kind of behavior.
See an attorney to discuss how to be relieved of your legal responsibilities. He might become a ward of the state of no one else steps up. If it were me, I would value my self and how I feel about myself before all else. This doesn't mean I wouldn't feel torn, confused, unsure ... it means I know I want to like who I am and if I am in a situation where I feel so diminished as a person, I need to run the other way.
Do not do anything out of guilt.
His behavior isn't unusual; staff/facilities are used to these situations. Ask management/administrator how to handle it. See if medication helps. Bottom line: take care of yourself. Do not let this situation take you away from the woman you know you are inside (kind, caring, loving, compassionate). And / or perhaps this situation presents itself to you so you have an opportunity to learn how to love yourself more. Once you are aware of this gift, it is up to you to decide what to do with it.
At the very least, stop visiting weekly.
Perhaps shift to once a month for a very short visit.
Do not be alone with him; defuse the energy in the room.
See how meds do.
My heart goes out to you. I know this is really hard. I'm on your team.
Gena / Touch Matters