Is it time for a nursing home?

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We are trying an in home caregiver but I went by yesterday the day after she was there. The toilet was a disaster, dirty dishes in kitchen. My dad was asleep in the chair with no pants on. He doesn't know what day or month or season it is. He has gone downhill so fast I don't even know what to think. He's incontinent both ways and I find towels with feces on them like he's tried to clean up all over the house. I'm at my wits end.

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Yeah,, he might actually have thought he went to the store and picked up his meds.. who knows ,, he might actually believe hes eaten the things he has I have no idea ,,, but the downward crash has been fast.. On another note my brother just informed me he has Durable Power of Attorney for health care so I don't know if that's whats needed for placement in a nursing home or not ??
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Sorry for the duplication of information on UTIs. I take a long time to tap my messages out on the phone but you get the idea it's a good thing to remember to check on.
This can all be overwhelming but you'll feel better about it when you learn to recognize what's going on.
One other thing about lying. Unless your father has always had a hard time with the truth, read up on confabulation.
What he says seems real to him even if it sounds like a whopper to you.

https://en.m.wikipedia.org/wiki/Confabulation
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cwillie,, I'm going to scream now ,, I just this second received an email from this cargiving association that the caregiver now will not go back into the house because of the urine smell WTH ?????? I have to start a new post over this one
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"Keep in mind my brother never calls my dad (maybe 1 time a week if that) and hasn't seen him for 3 weeks."
Sorry but I had a good chuckle over that, my family is quite close but so many others on this site would be able to substitute the word years in place of weeks. I'm glad you are working together to find a solution!
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Hi Didgens
Check these websites out on ADLs. Activities of Daily Living.
These are fundamentals for all of us. Notice that hygiene is the first thing to go.

Then the next link is a checklist for ADL. This helps you evaluate where dad is on the different activities.
This will help you figure out how much help he needs and make it easier to discuss with doctors and care takers.
Look for a geriatric psychiatrist and a geriatric doctor to get him assessed.
Medicare will pay for a nurse to check on him weekly, help him organize his meds. and take his vitals. They can get an aid in to help him with baths, changing  his sheets, brush his teeth, etc. (some states offer more help than others, ask your dr to order it).
They ( home health ) can also have an occupational therapist ( ot) and a physical therapist ( pt) evaluate him. Therapy is very beneficial. He can have this in his home if they find areas they can help him in addition to checking his house out for safety issues. Hold bars in the bath etc. 
ALSO be sure to have him checked for a UTI as this can make an elder appear to have advanced dementia without their having typical bladder type sypmtoms or painful urination. The right antibiotic will make an amazing difference if that's the problem. 

https://en.m.wikipedia.org/wiki/Activities_of_daily_living

http://www-tc.pbs.org/wgbh/caringforyourparents/caregiver/pdf/cfyp_adl_checklist.pdf
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he has not. He lied to me and my brother saying he had gone to the store some months back and gotten his prescriptions and some other things, only for me to check his medication to see that he had not gotten it filled since December. so we got it filled but he doesn't take it and quite honestly I don't think he should anymore, I'm pretty sure his medication needs have changed. He has refused to go back to the doctor and I have no way of getting him there. I did call his doctor and she told me he could now get in home health visits but that she would no longer be his primary doctor. when I mentioned this to him (some months ago ) he said "oh no I don't want that" ,,, its taken these last few weeks for me to realize something is definitely "not right" with dad ,, because he covered it amazingly well. I had to really force my brother to see it and he just got it last week when he was talking to my dad and the answers weren't adding up. Now he is on board and we can be more aggressive on who/what we're are bringing in to help him. Keep in mind my brother never calls my dad (maybe 1 time a week if that) and hasn't seen him for 3 weeks. So its really all been on my shoulders. I now call him 3 or more times a day and have driven over there 8 times in the last couple weeks. Ive called him twice today and he was asleep both times. I think he must sleep constantly
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If he was doing reasonably well 3 months ago this is a radical change and could be related to a new health condition, UTIs are notorious for causing dramatic declines, or he may have some other hidden infection or there are a host of other things that can knock the elderly for a loop. Has he seen the doctor since all this has been happening? And if he has, were you there to make sure the doctor is getting the full picture?
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Don't knock the cheese with pancakes until you have gjetost with waffles, yummy. Yes it sounds like a higher level of care is due for your dad. Also sounds like dementia. Have you had him checked for brain related illness? If not, it is time.
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HI cwillie,, thank you ,, ( I have a profile ?) I guess I should check that. Its so bizarre because 3 months ago he knew what day it was, what time it was, if I was at work or it was my lunch time. Now this very short time later hes asleep almost every single time I call. The care giver we just started with is only 9 hours a week 3 days 3 hours, because he will do bizarrie "normal" things like fix stew, or yesterday he unmade his bed and put it all in the wash (hiding something ? ) but then he will eat a pancake with cheese, and yesterday told me to put the pancake syrup in the oven. I watch him struggle and he will flat out say " Oh I don't know anymore,, its so hard I cant remember" or "I'm loosing my mind" ,, its so heart breaking,, but I can only use so many chlorex wipes to sanatize his house. He now pees (sorry for the graphic description) into buckets he has placed around the house because he doesn't want to get up to go to the toilet. Ok tomorrow I call the caregiving people get more hours and contact in home nursing and get some medical professionals involved. its to much
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Well it sounds pretty obvious to me he can't be left on his own any more, but I don't know whether a nursing home is the answer. How often is the caregiver there? Can he afford around the clock care?

I just checked your profile and you say he has general age related decline...uh, people can live into their 90's (and even beyond!) and still differentiate between the seasons and keep themselves reasonably clean, there is nothing normal about his level of cognitive functioning.
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