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I diagnosed his dementia one day 3 years ago (he asked me what day it was 4 times in an hour. It was almost amusing the next week or two as I had no idea what was going on: 'Where are we?' he'd ask in the supermarket. I slowly realiused there was a problem.) With hindsight, the problem had manifested some years before, unnoticed, e.g. not paying a telephone bill, sleeping a lot, not paying bills (I had no idea), only going out to 'trusted' places. I told his family, sons and sisters, but they don't see what I saw. They assured me they would check things out, so to speak. What happened was he was able to appear 'normal' for their visits, apart from the filthy house which they severly castigated him for. Two strikes there. In my current role, I treat him as OK and 'getting there' after his 'hiccup' as he discribes it. I try and be positive but don't know whether I am making it worse. I am in two minds: 1.) Tell his family to buck up and DO something OR let 'nature' run its course (none of my business). He is 70 and looks and acts like someone well in his 80s; this is a man I had a relationship when he was 63 and already ageing badly but with a wonderful mind. He still has that mind, but it is fading fast. Does it matter? I feel it is not my responsibility BUT I also feel that if we were such good friends, I should be actively fighting to save his sanity.

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Again, thank you everyone for your helpful input. What I have done, for now, is contacted his doctor (who is mine too. I usually take this friend to the doctor anyway and the doctor phones me back with test results, etc. so he kind of understands the seeming breach of confidentiality is necessary.) In the doctor's opinion, his family MUST step in. Easier said than done. I have again notified his family by email with a long breakdown of the problems. I haven't had a reply (its been a week). He also said I should not contact social services myself. He is also going to contact this friend and suggest a 'follow up' visit as was apparently discussed last time. I will keep you posted over the next week or so. Unfortunately, I have also suddenly become very busy in my home business so can't dive in right now. Again, thank you EVERYONE. I read each comment with care and can honestly say everyone has been helpful and thoughtful. (Watch this space for a list of my problems and requests for dealing with them, LOL! Kidding)
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You can't stop the train wreck. And it is a train wreck in slow motion. One of the few things you can do, and that with no guarantee of success (with success defined as getting this man a healthier home and stable help and care to live as decently as possible) would be to contact Adult Protective Services. Sounds like family is either in denial or does not care. Maybe print and mail them this conversation too so they know it is not just you that thinks the situation is not OK.
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OK, so a few notes (from experience).
First - Decide if you willing to become responsible for him. If the answer is "no", and the family is also sidestepping responsibility PLEASE contact the local authorities, anonymously if necessary. There are enough people around that he won't necessarily pin it on you unless you tell him.
He's certainly not the only intelligent person to whom this has happened, and while the authorities aren't necessarily the first choice they are certainly better than allowing things to continue until he harms himself or others (had the veggies caught fire...? Would he have an appropriate response with a stove fire or a problem with the gas furnace? Running into the street in front of moving cars? These are first-hand examples....).
Please get him help (probably against his will). It is possible that there are some underlying issues making the problems worse (vitamin deficiencies, UTI) that can be taken care of.

Is he using you? Um, yes and no. The dementia is real. It affects his judgement. He will have lost some of his social skills, so he may become verbally abusive (striking out at others in fear, etc.). Again, judgement is damaged. His brain is broken. It may be that he still cares for you as a friend, but his judgement (there's that word again!) about what is appropriate is badly flawed.

Please continue to do more research about dementia. IMHO a number of the "pushing people away" behaviors are practically diagnostic for dementia when combined with the other issues you have described. They fear that if people are too close they will spot the problem and step in (again, the bad judgement rearing it's ugly head). As a quick note in your friend's defense -- in the earlier stages of dementia the person IS able to pull themselves together to appear normal, but it requires a great deal of effort, so that when they get home they fall apart. He's probably not faking the confusion when he gets home, it's more likely that his brain has "runs out of gas" so to speak. BTW, the ability to go to the pub is not any gauge of how well he can function, but it MIGHT point to a vitamin deficiency, as alcohol can interfere with nutrition as the body gets older .
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There's a good possibility that his family simply cannot help him. Spouses are not always willing to take on an elderly and ill patient. Tending to a memory patient in your own home becomes a full time job as he is constantly looking for companionship and answers.

Social Services has access to a wide range of services. If he is a qualified veteran, the VA can provide a daily companion to come and do basically what you have been doing. They can help him find legal, medical, and domestic help. Insurance and/or medicare will pay for a lot. If he has any kind of retirement income, there are plenty of "independent living" homes that he may be able to afford..

The independent living homes can be supplemented by home-visitation services. They can help with meals, house-keeping, and medication. You and/or family members could still visit and help him in between, since home visitation services don't usually work 7 days a week.

I spoke to a director of a local independent living home who was most helpful. They know all the ins-and-outs of dealing with someone who is not really able to take care of himself, but is not really a candidate for lock-in mental care either.
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If this person's financial state is this bad, and he cannot handle it himself, then contact Social Services. This is their business. They will send someone out. If you cannot get a response, then you wait for him to do something far outside the norm. Let him "get lost", then call the police to pick him up. When the police come, tell them that you believe the person has severe dimencia. They will contact Social Services.
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PS: GardenArtist, I have been in an abusive situation before myself. It's not easy. Time is the only healer. Once, shame on him. Twice, shame on you. I was thrice shamed. This is possibly another aspect to this situation; that I often allow myself to be 'used'. But that is another issue. The current one needs to be clearly cut. How much time do I need to spend on him? I get zero as an answer. But it's so very hard for me as I thought, just a month ago, that he was my best friend and we were 'in it' together. That, now that he has dementia, I would help, same as I would help if he broke an arm (which he did last year). Except, one of you guys wrote about faking it. I don't think he fakes, but, yes, on reflection, he makes it worse to get attention. For instance, he asked me recently to go and fetch his son's car from mechanic. He acted absolutely normally. But, when we got back, he became 'ill' again. Couldn't remember if he had taken tablets, etc. To my mind, this is a fear or something and I can't 'blame' him for it but I also can't keep doing it, keep being there for his fears. I have a job and life. I am exhibiting obvious: not wanting to appear selfish but having grudges and annoyances deep down. LOL. Thanks again everyone. Really, your comments have made things so much clearer!
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Thank you so so much everyone for your comments. I will write a little more tomorrow with an update. But I am quite overcome by the intelligent and kind responses I have received. GardenArtist, you consistently read everything and pull no punches. Thank you. I just need a bit of time to think things through. It's been a bit difficult to sit back :-). I always want to go and see what is going on. But I haven't and won't. I promise to keep in touch.
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TimeOut, congratulations for taking the very difficult step of extracting yourself from the situation. It's extremely hard to make the announcement, then step back and not waver.

I sense you have the feeling you were being used. That might be the case, and it's good that you recognized it. But it is also to your credit that you were the one who stood up to get help while the family did not.

Be assured that you've done all you can. If the man continues to go out drinking, he's making his own choice. Rereading your original post, I think this man is going to be needing a lot of help fairly soon, but it's the responsibility of his family to take the lead on that.

Your post reminded me of a friend I had several decades ago who was always complaining about her husband and his abusive treatment. One night she called me frantically, said she wanted to leave him and asked if I would come over to pick up her and her possessions. Like a fool, I thought I was helping her.

When her husband figured out where she was (and I never knew how he did that), he came over to my apartment, and she went back to him. Although I was polite to her from then on because we worked together, but that so-called friendship was over and I never got involved like that again. I was embarrassed that she had fooled me, and disgusted that she was too immature to solve her marital problems herself.

Again, congratulations for recognizing the situation as it is, for being true to yourself, and for having the courage to move on.

Best wishes to you, and thank you for sharing your insights.
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I would make a call to the local government group (council?) in charge of vulnerable adults and report him. Here in the US, they are required to investigate in person by law.

If he has been known to attend any church nearby, you can let the clergy know this man needs a visit and may be in over his head.

Lots of people have family who don't care, or who appear to not care. There could be some ugly family history where nobody is willing to come to the rescue anymore or respond to him due to events of the past. My mom ran off everyone in her family by being mean, loud, rude, abusive. No surprise she had zero help when she got old enough to need it.
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If and when you step back in, you might want to consider talking to his doctor prior to an appointment and the doctor can give him a simple test and then notify his relatives of his need for help/assistance. You've been a good friend and tried to do what is right. Seems many times the family doesn't want to hear it. The other issue is that the person somehow can fake them out (which seems to be a common thing). He won't be able to do that with the doctor.
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if he is still going out every night drinking, finding his way there. Finding his way back. And if you expected him to retrieve, process and answer a text message? And still think he has a problem? You're right to step back. I suspect you're wrong about his mental state.
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Thank you for your response. In the past few weeks, I have decided for a number of reasons to step back from the problem. I realised only a week ago that I am not a friend. I am someone who can be relied on to help in situations that don't actually require my help; situations that should be handled by friends and family. When I told him, admittedly in an SMS and I am ashamed of that, he didn't bother to reply. I wrote: 'I'm not popping in again for a while. You need your family to take care of you.'. He hasn't bothered to answer but I know he goes out every night to the pub. Nothing has changed. Thank you everyone for reading and responding.
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Thanks for the thorough explanation. I can see now that you're a concerned friend, concerned not only for this man but for the fact that he has no family support.

I think you're wise to keep your distance. In his confused state, he will reach out to someone who is available to help him, and you could be drawn further into responding to his needs. I'm not suggesting that you be cruel or ignore him, but just that you do have your own life and there are, and should be, limits to what you can do.

I get the impression you're in the UK. Do you have an adult protective service that could intervene to get him some help before something drastic happens?

CountryMouse, Jude, you probably have much more knowledge of what could help this man than I. I'm hoping you see this post and offer better suggestions than I could what this friend's options are.
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Hello and thank you very much for your very valuable reply. Gave me some food for thought. In answer to the points you raised:
1. I understand I can't diagnose him but it is pretty clear and has been observed by others. 'Where are we?' he asks in the supermarket. 'We did the shopping this morning.' (We didn't.) He hasn't paid his rates bills for 4 years, I discovered a few months ago. His revolving credit balance went from 0 to $35000 in two years and he doesn't know what he spent it on. He can't come out on his monthly pension anymore; doesn't know where the money goes. He now has to sell his house. He steams veg and falls asleep (took me four days to soak and clean the pot.) He defrosts a chicken in the freezer and forgets for 4 days to cook it. He repeats himself all the time. He baths less than once a week, sleeps in clothes. He doesn't know what his medication is and must be prompted to take it (didn't finish the last course of antibiotics.) Each event is pretty normal for most people (we all forget stuff sometimes) but in total is disturbing.
2.) No. I hold no power of attorney or any other right or responsibility.
3.) I am asking for nothing. What I would LIKE is that his family organise a maid and regular check-ups, and take care of his pension/ finances so he can live on his own and enjoy his life unaided but knowing the important things are taken care of. I'd like that his kids visit once a week and take an interest. I take him to the doctor, for instance. Nobody in his family knows that he has been diagnosed with emphysema, that only one lung is functional. He tells them he is 'fine'. When his kids need something, e.g. a lift to fetch their car at the mechanic, he calls me, interrupting me from my work, saying other family members are 'busy'. It is annoying.
4.) I agree but I think the way things are, the train is travelling faster than it should. His house smells as he doesn't wash. His sister comes to fetch the linen every few weeks. The fridge is only emptied of rotting food when it starts to smell. This is not conducive to any kind of healing.
5.) I can't speak to his family. I have tried and won't again. They have their heads in the sand. In fact, the sisters are negative to him, calling him lazy, etc. They won't acknowledge dementia. The kids are 'too busy'; they are selfish and their wives, in both cases, don't drive.
6.) No. I can't be his family by proxy and I am not able to care for him financially. I want to be a standby as I live a 5 minute walk from him, and to be a non-judging friend with whom he can feel 'normal'. I think I do that. He can tell me openly that he can't remember stuff.

Thank you!
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There are several issues here...

1. No offense to you but typically diagnosis is done by medical professionals pursuant to specific criteria. You may have observed and suspected, but I don't believe a lay person's observation is considered a diagnosis. ...Just to clarify in the event you've shared this "diagnosis" with his family.

2. Beyond being good friends, do you hold any powers of attorney on his behalf?

3. It sounds like you're trying to involve his family but they're not responding. What is it you would like them to do? Does he need full time care? Does he need financial assistance? Is he living with you or you with him? If so, are you asking for care or financial assistance?

4. I don't know if someone who really does have dementia is in a position to have his or her sanity saved, unfortunately. There are treatment and coping methods that can help, but sometimes dementia is like a freight train - it just keeps coming regardless what's in its path.

5. Do you have specific plans for this friend? If so, I might consider having a family meeting, sharing your plan concepts and ask what role they will play. It's not clear to me though what you want from them.

6. I think a big question is what will you do if his family won't step up to the plate? Are you prepared personally and financially to step in and be a proxy family, especially when the length of time you'd assume this role is likely to be indefinite?
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