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My dad has lost a lot of weight in the past six months, but says he doesn't want to go to the doctor. He often seems confused. Mom, who is an oppositional alcoholic, refuses to take him to the doctor. She was very ill earlier in the year with a giant abscess on the back of her head; I had to threaten to call an ambulance to get her to go to the doctor. She recovered well, but now says some odd things, like "I think I turned into someone else" or "I'm someone else now." That someone else is angry, aggressive, narcissistic and oppositional. Her alcoholism is not helping, nor are her delusions. She has decided on her own that dad has alzheimer's and she's going to handle it by herself; she refuses to even discuss going to a doctor. When I say I will have to take action if she doesn't, she says there is nothing I can do, she's in charge, mind my own business, go home and never come back, and the like. She's a bit of a handful... Dad absolutely needs to see a doctor, even the neighbors are asking about him as it is so obvious he is unwell. I called the family lawyer who was no help, he says my parents have not updated their documents since the 1990s, but they have told me several times they did so in 2003 when my brother died of a heart attack, so either they are misremembering, or the lawyer is trying to stay out of it. I have been advised by a friend who is a retired police officer to ask the police for a home wellness check which will trigger a social worker visit and may result in dad being taken to hospital, but mom has said if I call an ambulance she won't let them in, she'll refuse to let them take dad, and so on. I visit them 4-5 evenings per week after work, but have a suspicion they do not eat dinner on the nights I don't visit. Mom is naturally stubborn and aggressive to start with, and once she's had one drop of alcohol she turns verbally abusive and spends entire evenings reciting a long litany of resentments (mostly imagined) that stretch back to her infancy. She falls frequently and blames the dog for knocking her over, even if he isn't in the house. She can still balance her checkbook and pay the bills, and has a pretty clear idea of what's going on in the world, but cannot drive -- and I suspect this is the primary cause of her not wanting to take dad to the doctor -- he drives and if he goes to the hospital she will have to rely on me to get around, and she simply has never liked me very much - my brother was closer to her, but he had a heart attack and died when he was only 41. So it's up to me and my niece (who is in grad school in another state right now) to sort this out. I would like to help them stay in their home as long as possible, which probably means getting them some home care, but I'm worried if social services gets involved, that we lose the ability to determine what sort of care they get. I have read so many articles that I'm hopelessly confused about where to start, how to deal with an oppositional parent, how to get dad to the doctor. Advice?

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" but I'm worried if social services gets involved, that we lose the ability to determine what sort of care they get. "

I don't understand your reasoning here.

If you call their local Area Agency on Aging and ask for a needs assessment (and make sure that you are there to let them in and make sure they get factual information), they will be able to tell you what your parents need and point you in the direction of resources.

If the neighbors call Adult Protective Services, you might be in a whole different ballpark.

If I thought my dad needed medical attention and mom was digging in her heels, I'd go to their home, call 911 and let the paramedics evaluate. I'd have THEM ask dad if he wants medical attention.

If dad refuses, then your hands are tied and you need to walk away and bide your time until one of them falls, or some other disaster strikes.

I'm so sorry that you're faced with this terrible conundrum. It must be heartbreaking.

Another thought is to have mom "Baker Acted", i.e., an involuntary psychiatric. She sounds mentally ill, to say the least. I'm wondering if you got her out of the picture and into treatment temporarily, you would be better able to get dad what he needs.
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She has simply never liked me much...

It does sound, if you don't mind my saying so, that that is entirely mutual?

I should go for that wellness check request. Your mother saying she will turn anyone away and her actually doing that - when these skilled professionals who have met plenty of difficult ladies in their time are on her doorstep and using all their wiles to get in - those are two different things.

I wouldn't assume that your father's reluctance to see a doctor is all your mother's doing. She may be aiding and abetting him, but even once you've got her out of the way you should be prepared to *listen* to what your father wants. He may already know more than you are aware of.

And the documents thing - maybe they went to a different lawyer.

And this bit: "I would like to help them stay in their home as long as possible, which probably means getting them some home care, but I'm worried if social services gets involved, that we lose the ability to determine what sort of care they get. "

Who do you mean by "we"?

Social workers are trained in the difficult balancing act between autonomy and safety. They won't necessarily agree with you about what's best, true, but they will work with your parents to get as close as possible to what your parents want.
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Getting social services involved in a situation that is deadlocked could be the best decision you make.

Paramedics and police officers don't really let little old ladies stop them from doing their job. Your mom's threat to refuse to admit them into the home is only going to convince them more that your parents need assistance. And when they do get in and begin assessing your dad nothing your mom says will make any difference if the paramedics feel that your dad needs medical assistance. They'll take him to the hospital regardless of what your mom wants.

For your dad's sake I think you should force the issue and call the police to do a wellness check. You can also opt to call social services directly to do a wellness check but it might take longer than calling the police. And if your mom is adamant about not letting anyone in the police will get in but I'm not sure how forceful social services would be. If they're denied entry they may call the police themselves.

I think you should act before any and all decisions are taken out of your hands completely like if your mom injures herself when she falls. Or your dad has a medical emergency as a result of whatever is going on with him that is causing him to lose so much weight and become confused. Dad needs to be seen by a doctor immediately whether you take him or he goes to the ER by ambulance.

I know this is a lot on your shoulders and I hope you can take the advice offered and come up with a plan that will help your dad and get your mom settled down a bit as well.
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Thank you for your responses. I love my mom, but yes, I clearly feel immensely frustrated by her behavior. And yes, Countrymouse is correct that they are covering for each other, and I do recognize that is out of fear of losing control over their own lives. We, my niece and I, hope they can stay in their home and be comfortable in their own surroundings. It sounds like getting someone out to check on them is the best option.

I would be surprised if they saw a different lawyer, as they have always said to "call Fred" if anything happens to them, but families are an unending series of surprises in my experience! Thankfully, most of those surprises are delightful ones.

OK, I'll post a follow up once I get things moving. Thank you again, Kimiad
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