What are options for caregivers with completely irrational parents?


My father is 90, not taking meds, burned pots all over, house filthy and cluttered (took 2cleaning ladies 7 hours to get a 1000sf apt cleaned), paranoid about "children stealing everything" he has misplaced, (even after being on quetiapine(seroquil) for a month which calmed the constant yelling cursing and raging 24x7, is constantly packing to go back to the old country but can't figure out how to use the phone to call a travel agent, is going to sell the house for $30,000 (worth 30xthat) take all the money in the bank and go to Europe to spend it, but won't pay for the cleaning ladies, his supplemental insurance, real estate taxes due in 2 weeks. I have talked to (after a hospital stay for a urinary problem) several social workers, nurses, geriatric physicians, physical therapist, home health aid, an elder care lawyer, all of whom used the identical phrase "you have a problem". I see 7 options: 1) give up my life in another city and move in to take care of him (this is his solution because I am "cost free"). 2) move him to my home (sometimes he's agreeable sometimes not) 3) put him in a nursing home in his city (but he wont go voluntarily) 4) put him in a nursing home in my city (he wont voluntarily) 5) pay someone live w him (he will refuse to let them stay) 6) court battle for guardianship 7) walk away. APS will only keep him for 30 days if he is a threat to others (he isnt) and then release him. His older brother is 94 and his aunts lived to between 98 and 107. Guardianship means an end to a relationship w him. Means a court hearing, he gets say In Who the guardian is and if he won't accept me the court appoints one. Obviously, Guardianship is a last resort.

Has anyone else dealt with a situation like this and what did you do?

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Rock, v. sorry, had server prob & couldn't get back online. Good there r no sibs. I'm in CA & it will b diff than NY but l have some ideas l think will help. Yours is for sure a complicated situation. Getting 2 the bottom of it takes too long with back & forth Q & A plus I am unable 2 do lengthy typing on this site with my android. Drives me nuts and l don't need that!
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NY state. No siblings or other close relatives.

All the resources stated above have all said to me "you have a problem" virtually word for word after examining him or talking to him. I have another lawyer looking at the POA. His lawyer is sympathetic, understands the situation, and will help within the bounds of legal ethics, but his hands are mostly tied.

I'm on hold. I can't see a way out of this. I am basically waiting. In the last 3 days I have seen signs of change, and some consideration to calmly repeated and encouraging phrases. I found a website that advocates behavior modification techniques instead of drugs. There is no way I'm going back to no drugs, however the meds in combination with the behavior modification techniques, seems to be starting to work.

When he stops speaking in English I avert my eyes, if he continues speaking I avert my head, if he doesn't switch back to English after a few sentences, I get up and leave without saying a word (I'm sick of hearing myself say " speak in English" and this actually works better by not irritating either him or me. ) It also seems to me that he is more rational in English and less emotional.

Rewards don't seem to work very well--e.g cookies or other favorite treats.

Lots of praise, telling him how handsome he looks, how we'll he's doing, how healthy he is, reminding him he is 90 not 20 and he's thinking like 20 not 90 when he wants something his way. Sometimes that works, sometimes it doesn't, and I just have to get out of the house before I lose it. Neurologist did an EEG last week (which was an ordeal because the patient is supposed to sit still for 20 min) and I need to call for his interpretation.
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You have both general & health POA but seems not good the way it was drafted!
POAs expire at death and sometimes there isn't much time between uncinsciousness and death so these seem like fairly useless docunents for your purposes. Maybe that lawyer has retired (or died!). Maybe you can convince your dad that he needs UPDATED documents. But any lawyer should question the sifning of legal documents if your father is impaired. Did the lawyer also prepare a trust? You mention children stealing from him. Do you have siblings? If so, are any if them going to contest how you proceed? What state are you in, and him? So many questions. You posted 3 days ago; l'll wait 2 c if u respond before l ramble on.
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You obviously care about him very much and yes it does feel like nothing is out there for you. What does his primary physician recommend? If they are not helpful you can contact your State's Aging and Disability resource centers. They have great information and can refer you to the right organizations. They can explain criteria for a particular agency and how you would go about it. And, while on that subject does he have a social worker assigned to him? If so, what do they recommend? If he doesn't have one you can call your State's Aging Services and ask what the criteria is for one to be assign to him. They should be able to tell you what /organization/programs are there for our aging adults who are experiencing an decrease in their everyday level of functioning.

General criteria which may include: Depression, decreased memory, decreased coping skills, increased confusion, insomnia, increased isolation, paranoia, psychosis, mood disorders, anger, aggression, combative behavior, anxiety disorders, increased dementia, does he want to die or verbally say he want to kill himself. If he has a few of these symptoms he may qualify for a lot of difference programs.

If that doesn't work you could request a community resource booklet that have various organizations. It will not hurt to call some of these wonderful organizations because sometimes if they don't know the answer they sometimes know who does have the answers.

If you don't feel comfortable speaking to others ask a friend or family member for help. Sometimes they can see from the outside looking in and can help you with suggestions and I'm sure they could make phone calls, take notes, and get the help you need for Dad.

It sounds like he might enjoy bingo. Take him over to your senior community center. They also have valuable information and a lot of attractive ladies. Good luck kiddo!

B. Woods

Referral process consists of verbally assessing the needs of the inquirer, identifies appropriate resources, can provide enough information about organizations to help the inquirer to make an informed choice, and helping inquirers locate alternative resources if a service is unavailable.

Planning for care/services provides identification for needed services for the consumer. Under the direction of the consumer, assists in the development of a plan to meet your GP's needs. They also can help you implement the plan for services.
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You can't very well pick him up, throw him over your shoulder, and carry him off to a nursing home. Indeed he sounds irrational, probably with dementia.

Are you in a position to leave your life behind to move in with him? This would be a huge upheaval for you to move out of state.

I wouldn't exactly call it 'walking away' but can you try not to stress about this too much and do as much as you can do from out of state? If your dad is walking around with a ton of cash on him, dropping it everywhere, what can you do about that from where you are? And you know he's incapable of hopping a plane to 'the old country' so you don't have to worry about him doing this.

Is your mom still alive? Where is she in all of this?

If he refuses all of your options there's nothing you can do. I suppose you could travel to where your dad is, take the time to pack up his house, go through everything and give him absolutely no option but to move into a nursing home. Either that or be homeless. But from what you wrote you'd have to fight him every step of the way. That may be what you have to do. This would take so much work on your part, multiple trips, it would take months to plan and then there's the issue of your dad actually crossing the threshold of a nursing home. But take away all of his options and leave this one. Either in your city or in his, whichever is more convenient for you.

This must be very stressful and frustrating for you. I hope you have support. Any siblings? Other family? If it's just you and your dad I say take away his options and leave the one option that is easiest for you.
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I have POA, healthcare proxy, however those only kick in when he is unable (unconscious) to express his wishes (per lawyer). As long as there is a "period of lucidity" he can legally revoke those documents so it would not be smart of me to force the issue reminding him I have those docs.. " Taking charge"only makes him more resistant and determined to do what he wants at the moment. Without legal guardianship a person cannot be made to do what they don't want to, so I cannot put him in a nursing home or take him anywhere without his consent.

He carries 2-3000 on his person at all times, pulls out a wad of bills ($100s) to pay at stores and drops them all over. If I remove them he just goes to the bank and gets more. I cannot prevent him from doing that even w POA. I would agree it is dementia, if all of those characteristics had not been present his entire life, albeit to a milder extent. The dementia is in the confusion (he has short term memory) which seems to be increasing.

APS will not step in unless the person is a physical danger to others or himself. He has never been violent. At most they will institutionalize him for 30 days then release him.
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We all have problems, you just have a Whopper! You say Guardianship is a last resort, but that is where I would start. Do you have Power of Attorney over Finances or Healthcare for your father? If you do then you can do any of the choices you came up with, but if you have nothing, I don't know how much you can force him to do.

He sounds like he has dementia because he sounds just like my mother. I made sure I got Power of Attorney when I came home to find a man at her door taking money from her. When he left she said, "What was in that bag that I gave that man?" I freaked out and to this day do not know if she really gave him something or what. I did realize that everything was changing and I was now taking over to just try and keep her safe from herself!

I live with my mother and care for her, but I don't live in another city like you do, so my preference would be to put him in a facility in your city where you can see him and check on him as often as you wish. He is going to be mad, sure he will but he will get over it. At this point all you care about it taking care of him and his needs and making sure he is safe and well cared for and in the meantime you need to have him close because you cannot keep packing up and running to his town every time there is a problem and there may still be some even in a facility.

Bottom line is do what is best for him and you and don't listen to his yelling, he is no longer competent and it is time for you to take charge. He may still have many years left and you need this handled now for your peace of mind.
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So, sorry, sounds like you have lost your relationship with your Dad. It seems to me that option 4 would be thr best one. He won't go vountaily, but since he can't take care of himself and appears to at the least be delusional APS should force placement for his safety. You could have his Doctors explain the situation of his home and care. They can give him clear choices. If he won't let a live care aide come then his only other option is a nursing home. Again I am so very sorry these outcomes have been forced on you, so sad for you and your Dad.
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