What next please with 92 yr old father

I sympathise, I really do, currently going through this with MIL who admits she is forgetting things but will not allow us to put anything into place to help.

She is 89 and is obviously not doing any cleaning as the kitchen is grubby but refuses a cleaner, lost her key and was locked out as only son with a copy was miles away but will not let other son who live close by have a key.

Will not entertain POA either. She is obviously to us in the early stages of Dementia but will not see a doctor.

I guess we will have to just wait for a crisis, she is also still driving, MOT had run out and insurance and she hadn't realised either!

So frustrating aren't they? Just waiting for the next phone call.

FIL didn't have dementia and was generally on the ball but often got instructions totally wrong because he panicked and heard blah blah kidney scan blah blah 9am tomorrow at the surgery and sort of filled in the rest. What he thought was he was having a kidney scan 9am at the GP surgery. What the GP actually said was " It's a UTI. I'll check with your urology consultant but you've had a kidney scan very recently so he probably won't want another. But I need to check what antibiotics because of your other meds so the prescription will be available at the surgery 9am tomorrow".

Could he have misunderstood the GPs instructions? My mum has alzheimer's and gets very confused about what she's been told. If you tell her not to do something/ to do something quite often gets it the wrong way round.

He's probably having withdrawal symptoms from the drugs

Both medicines I would absolutely be tapering down for someone like your dad, just stopping them is abit wreckless clinically in my opinion. I get the justification for mirtazepine i.e better for anxiety/good for appetite and sleep however can also make older people drowsy and more prone to falls. No wonder he 'feels like he's going to die', I have experienced many older people have extreme rebound anxiety and increased behavioural symptoms of dementia on reduction or cessation of these medicines, anecdotally especially when they have been on them for many years.
I think telling a 92 year old man living alone with dementia to stop these drugs immediately (if that's the advice that was given) and start a new one without very close follow up is not great tbh. It would be reasonable to discuss this with the GP and what plans/support/follow up have been arranged around this. Otherwise I think he might benefit from a referral to the older peoples mental health team.

meds such as amitryptilline are not good in dementia as they are anticholinergenic and can make it worse

When persuading older people to claim AA I usually name the current prime minister/Chancellor and point out they'll only waste the money if it isn't claimed.

Works 99% of the time.

Thank you for your suggestions! Unfortunately we've tried that, he stayed for a month last year in the lovely local residential care home and absolutely loathed it, we took him out as he just kept going home every day... honestly you couldn't make it up...^
^

My DF that too, escaping from really lovely and extremely expensive care home, that was the only place I could get him into locally for respite care. They had pristine white tablecloths and served a choice of wine with dinner. Sherry in the afternoon with cake.
^
Except he would call a taxi, charged it to his room, and the staff were so worried they sent a member of staff with him, also charged to me.

It's funny now. ^

^At the time it wasn't.
I was tearing my hair out.^

Thanks @Dogwitjstripes

Elderly parents can be so utterly selfish.

Is there a Community Support in the area? We are so fortunate that the one where my mum is (who sounds v much like your dad) will organise things like community transport to hospital appointments, arranged a key safe and falls bracelet, does Meals on Wheels etc.

We’ve finally managed to get DM in for a couple of weeks respite care at a local residential home - she wasn’t taking her meds, eating or drinking and was having hallucinations, and it ended in all three emergency services attending and having to break into the house. My DSis had seen her 10 days before and she had been OK. Things can spiral out of control so quickly.

You have to be firm OP when you speak with him, no matter how difficult, and you may have to end the call if it gets nasty. You have to explain you and sibling live too far away to provide regular care and he needs help that you can’t give. If he chooses not to have this , it’s on him, but you have offered. It is unlikely he will let social care in to do an assessment by the sound of it, but I would tell him you called them and this is what is happening - it’s up to him if he refuses help. It’s sad situation, but I think I you have done all you can.

The care home my mum is in does day care for a few elderly people. Could you see if the one in the village does? Then, he could go for a few days out there maybe driven by the cleaner as a favour and paid for by you?

If it's a nice place he might then see that his home is drab, quiet and lonely and be more amenable to trying a residential stay. If that goes well he will be living there and you can start the declutter of his home.

He can also just sign a letter giving the GP permission to discuss his medical history with you without having to do the full health POA registration. Then you and your sibling can get up to speed on your dad's health.

Would a pendant or watch personal alarm perhaps help with his anxiety ?
Although he'd need a keysafe to give emergency services access (probably a good idea anyhow) and someone close by to act as a contact....

Age UK or Adult Social Services should be able to suggest some companies- there may even be ones specifically local to his area,,,,,