My father had delirium following a surgery last October. After months of hospitalization and a recent major setback, he was diagnosed with dementia with behavioral disturbance, epilepsy, and panic disorder. I am my father's POA, and after a brash (cruel, 100% inaccurate) accusal re: bill paying this past February, I turned his finances back over to him since he'd mostly recovered. However, with these new diagnoses, I have had to step in to pay his bills once more. This is along with finding an appropriate facility, purchasing furniture for it, communicating with family members, and monthly travel (I live 1100 miles away) has completely wiped me out. I'm exhausted, and his first week in MC he called several family members to pick him up, take him to the house, take him to the bank, etc. For now, I've requested that only family members be allowed to sign him out as he has threatened to:
-take all of his money out of the bank and give it away;
-kill a man in MC with a pistol;
-drive;
-cross the major highway to shop at a local grocery store; and
-punch my brother.
This is especially challenging given his narcissism--he's great at making himself a victim. On the good side, he's planned well for his care and financially has the means, long-term care insurance, etc. However, he does not want to spend $ and I am concerned that another accusation may mean that I give up altogether. You can imagine that he often guilt trips, speaks ill of people, accuses, and gaslights.
I have a brother who marginally supports and little other family assistance.
Help!
1 - Listen but do not offer help.
2 - Everybody may report aberrant behavior to you via text or email - you do not need a million phone calls.
3 - Work with the staff in the facility, his neurologist, his geriatric psychiatrist, and his medical doctor to provide the best physical care and control of his impulsivity.
4 - Make decisions that support the rules above - whether it comes to finances or medical decisions.
5 - Every and any time your father contacts you and rants, remember that he needs to live where he is for his safety. Then, call staff and let them know he may need a sedative.
In addition to the above, and telling your other family members that your dad is not safe to be alone at home, etc., turn off your cell phone or put on "do not disturb" at a certain time at night until morning - give yourself a break overnight. You may get a big voicemail during the night, but the next day will dawn and you'll deal with it then. Try to empathize with your dad's unhappiness but then redirect after a moment or two to another topic or tell him you're sorry but you have to go now. Don't waste time trying to argue or convince him that he's in the best place or things are fine.
Wishing you luck!
It's sad to know that people are being stressed out by these behaviors, but it's comforting to know that I'm not alone.
Personally, I'm seeing a counselor to help me process this transition. I don't know if you are a parent yourself, but someone said that this process is much like leaving your toddler at daycare. They will fuss, fight, and cry, but ultimately, it is better for them to interact with their peers.
I haven't slept well this entire time, but each day gets a little better, followed by a few days that are bad. I do believe that it will ultimately get better overall. At least she is too busy during the day to call me. I am an only child, so I have all of the responsibilities and accusations. It's tough, but sometimes I just don't answer her calls. I know she's being watched by others, so I just have to leave it at that.
Good luck to both of us. (sigh)
Also, I got guardianship/conservatorship of my mom, so all of those money issues are over. She still complains and accuses and wants to be involved, but she can't touch her money and mess it up now. It's still hard work with all of the reporting that I have to do, but at least she can't move it (which she has done) and her bills are being paid.
With his diagnosis you are now in charge of his finances. He can no longer make informed decisions concerning money. It is no longer what he wants, its what he needs. As his POA you can tell the AL he is not allowed out of the building on his own. The one Mom was is I think actually made the decision on who could go out and who couldn't. Its their responsibility to keep residents safe. There is usually an area set aside for people to go outside but has no outlet.
found a suitable placement for your father
furnished it
moved him in
been given a professional assessment of his mental condition which authorises you to manage his finances (you do also have all the appropriate legal documentation, yes?).
Well done! "To a good port hast thou rowed..."
So there actually isn't a problem. Or, rather, the only problem is that your father is making threats and accusations, none of which poses any actual risk to anybody, yes?
Assuming that this MC knows what it's about - and presumably that's why you picked it - then if any of your father's behavior becomes a problem the staff will let you know. Meanwhile I should let them get on with it. Your dad has only been there a week, and they'll need another month or two to establish a good working relationship with him. When are you planning to visit next? Is anybody else going to see him meanwhile?
Hang in there. You've done the right thing by placing him in a facility where he can get the help he needs. Depending on where he is in his dementia journey he made eventually develop an appreciation for being there but don't count on it. His "acting out" behaviors will diminish some over time but they may never go away completely; you may develop a thicker skin and they will not bother you as much. Tell yourself Dad is where he needs to be getting the care he needs. If he needs to tell you how much he doesn't like being there to maintain his sense of independence, then let him talk.
But I think there is so much good advice here.
That transition period where they will beg and plead to anyone who will listen to take them out and back home has got to be the hardest time for everyone involved. I'm resolutely not looking forward to it and at the same time am anxiously waiting for it because I know we will be moving in the right direction finally. They DON'T want to be there. They DO want to be home. But they are in the right place. Home is not safe anymore. They need to be where they can be safe and where there is someone 24/7 that can look after their needs. More than one someone. Where the environment is set up to accommodate them. Where there are plenty of eyes. Where there is always help.
It is uncomfortable. Unfamiliar. It isn't home. But it can be. That takes time. And they are angry. Confused. Unhappy. They want to blame anyone who won't fix it for them. They don't have a lot of options. So they call anyone who will listen. And the complain and rail and blame and cajole and do whatever they can and guilt anyone they can.
And if anyone gives an inch they think they've won.
And as I sit here in my infinite wisdom having never done this before LOL...my own mantra becomes, if you give in to any of it you lose. Because you work so hard to go forward and do what is best for them and make them safe. And they make you feel like you ruined their lives. And if you give in when you've come so far and you bring them back home, you lose and worse they lose because they are no longer safe and you are no longer safe and no one wins.
So I keep telling myself - all of it, all of the complaining, and guilt tripping and threats and anger and badgering from well meaning family who have not dealt with what we have for the last 5 years will all be worth it because he will be safe and well cared for. Plus...he is already unhappy and miserable at home anyway. He'll just miserable and unhappy somewhere else now!
Epilepsy?? That's a pretty drastic diagnosis, and with that goes some pretty strong medications. Get the doctors on the same page on his meds, because that one diagnosis has me really scratching my head.
Your job should be to get his finances locked down. Take your POA and the letters from his doctors indicating incompetency, and do what needs to be done to prevent him from giving all his money away -- or any of it.
Just deal with the money for the time being and take as much of a break from Dad as you can for a bit.
You will find that the side effects of the medication given for both and dementia & seizure disorders match to the aggression, hallucinations and disorientation you describe
Additionally review the side effects of morphine and other narcotics in the same drug class usually given after surgery for pain management. Know as narcotic psychosis. I am sure this accounts for delirium post surgery.
Particularly as he had no previous history
In the elderly poly medicines lead to toxic levels in the blood in the majority of cases...due to reduced elimination with aging. Also due to lack of movement/exercises the drugs accumulate in the system
In summary the elderly persons mind becomes confused and disoriented due to the build up of highly toxic medications in the system
You can google medical studies on this situation
You might consider speaking with his case doctor after you have reviewed the above.
I would recommend that you strongly request the dr to reduce medications he is on to an absolute minimum. His health physical & mental will improve.
With all due respect narcissism is a spectrum, not a condition. Most men who are strong & capable I find fit on this spectrum. Some higher on the spectrum than others.
Perhaps he is self centered & 'playing the victim'. However he may also be trying to communicate the frustration and fear he is experiencing that his life is now completely out of his own control
Having less medications in his system will allow him to think more clearly & recover his balance.
This would defiantly be a major step in the right direction.