What next please with 92 yr old father

[Dogwitjstripes]

Asking for some sage advice from the Elderly Care experts on here please.

DF is 92 next May, living independently and has been widowed for 25 years. Has coped remarkably well for the most part, still cooks for himself, dresses, no carers and drove until relatively recently. Rarely has falls but has been diagnosed with mixed vascular dementia and alzheimers. He doesn't present too badly with it for the most part but he's suddenly become frantic about dying and not coping.

I have a sibling and we get on very well but both live a distance away in two different directions, neither of us get on particular well with DF, I have had a very torturous relationship with him all my life but he's on his own so....

He trialled a care home last year for a month but hated it and came back out again, he's refusing carers and only wants the two of us in the house, it's impossible for us to go very often to visit but he's not bathing for fear of drowning, emailing us every night begging us to go down (can't phone him as always ends in horrific hours long arguments). I know I should probably post this on the Stately Homes thread in a way because the poor relationship clouds what we can or are prepared to do but does anyone have experience of what in general can be done or what is likely to happen next? He has a cleaner and she takes him food shopping occasionally, he refuses to let me organise an on line food shop, refuses to allow a taxi to take him to the shops (he has the financial means).

I've read loads of threads on this board over the years and most seem to say that it won't change until a real emergency occurs, is that the case for the most part do you all think?

TIA

What’s he asking you to go there for?

I did not have a good relationship with my mother, and she has had dementia for ten years so I have had to deal with that (I'm her only living relative).

I wanted to ensure she was safe and cared for but I was not prepared to do that myself, so I bought in care for her. She had money to self fund, and she gave me LPA, so that was relatively easy to organise.

If you do not have LPA or other access to your father's money and/or he will not let you buy in care, then ... yes, you have to wait for a crisis. Which generally is the person becoming ill/injured and ending up in hospital and coming to the notice of Social Services.

He sounds like he’s doing pretty well bar the anxiety. My mum was prescribed anti depressants when she was suffering with mixed vascular dementia and Alzheimer’s. Maybe his GP could prescribe him something for his anxiety.
Practically, I fitted some cameras at my mums house. Overt visible ones, one in the living room, one in the porch, one in the kitchen. Obviously I told her about them, I wasn’t spying on her but they connected to the wifi and an app on my phone and it allowed me to check on her when I wasn’t there. If I could see she was struggling with something or lost, I could call. They were from Amazon.
But yes, to make it simple, you probably all muddle along until something goes wrong and then you have to reconsider your care options.

Everything really, his house is in a state of disrepair as he's neglected it totally, all his friends are dead, he's fallen out with all his neighbours,he just wants to moan for hours, not exactly sure what he wants and don't think he knows either tbh

You can ring his local social care service and ask for an assessment which they MUST then do.

tell them what is going on and tell them you are unwilling/unable top provide any care or support.

I think he's having panic attacks and not coping and also think anti depressants or anti anxiety medication would help enormously. He's on every pill known to mankind, statins, sleeping pills etc.

We have an LPA but not needed to access finances yet as seem ok but god who knows, how would you know if he was giving away ££.

Ok that's interesting thank you, surely they can't force him to accept care though or do they talk it through with him? We can't get him to see sense, he says he's far too unwell to cope with carers ...

My mum was also on a lot of meds which meant that carers became essential as she had to be helped to remember to take them all. The pharmacy dispensed them all together made up for each day of the week, and a carer would come in the morning and help her take them. It was the only care visit she would accept which was a relief.

@@Dogwitjstripes they operate on the basis of his ability to consent, tend to be very sensitive and will help him.

He does his own meds atm although again we don't really know I guess. We took him to the GP last week and they did blood tests, ECG etc. he is frequently at the GP and nothing else wrong with him that they can find.

That's very useful thank you 🙂

As he is seeing the GP regularly send them.an email with details about his anxiety. He is unlikely to raise it as an issue himself but it will enable the GP to consider whether medication will help when they next see him.

This will get worse and probably quite quickly. He must know that, but can't cope with the thought, so he's taking the ostrich approach.
I would get SS involved so they can have the difficult conversation. Ring them and give them the full background. The it's not coming from you.
If he's showing real signs of being a danger to himself, they can put a 'Deprivation of liberty' order on him to take him into care. I think that's a last resort though. Hopefully they'll talk sense into him before that though

Get the legal stuff sorted. Do you also have Health & Welfare PoA? You're going to need that with a dementia diagnosis. Is he in receipt of AA? If not, get that sorted out asap.

AgeUK website is a great resource for next steps. If no family locally, you can ask SS for an assessment, but if he's over the threshold, they will just tell you to find private help.

If he is living in a mess he might feel better if things were organised better. Difficult to achieve though unless you are willing to help and he is willing to let you. Could you take a few days off work and supervise a deep clean and repairs to the house? I imagine it feels overwhelming for him.

I will, when we took him last week they got obsessed with his irregular heartbeat which he's had for ages, I had mentioned panic attacks but she wasn't interested and I didn't want to pursue too heavily in front of him

Definitely procrastinating to a degree you cannot imagine, it's so frustrating

He won't let us, we've tried numerous times and it just ends in heated arguments which are just horrible for everyone and unfortunately achieve nothing. He has actually got a cleaner but there's 40 years of stuff plus his parents stuff in the loft that he never dealt with. He used to laugh that we'd have to sort it out but now he's saying he's got to stay there to deal with it all otherwise we will have to which is hilarious really.

Its so frustrating when they won't accept help. I would say to him that its best that you help him declutter now because if he goes into a nursing home and loses capacity you will be sorting all his stuff out and will have no clue of the worth or value of objects. We had the in laws 4 bed detached house and double garage to sort out and we chucked so much away. They hoarded everything and kept their parents things as well. If I see one more set of bowls.

It sounds like he’s panicking about the reality of independence slipping away. He’s making excuses as to why he can’t leave the house. The house is familiar to him, you and your sibling are familiar and so that’s why he wants you both. His dementia is probably advancing, and he’s realising it.

I don’t really have any answers as if he has capacity he can refuse carers/assessment etc. You almost have to wait until it’s advanced to a stage you can activate the POA. Speak to your sibling and work out a plan for when that happens (what care home/ sorting out the house etc.)

I think you're right and although I've always had a pretty bad relationship with him it's very upsetting to witness 😔

I think he'd just go into orbit if we tried that now, it's both too late and too early if that makes sense?

So to be practical:

-establish POA for health and welfare as well as finance, this is essential for things to go smoothly later on (if he will at all consent).

• search if you have an admiral nurse (dementia specialist) in your local area and get in touch with them, they provide support to you and most importantly your dad and are really well versed in this kind of situation

• sounds like gp's are still treating him quite proactively which is making me think he comes across as quite well generally? I wonder if you taking him to appointments is actually hindering adequate response as no one is seeing the reality of his life. Would he be housebound if you didn't/couldn't take him? I.e meaning gp/district nurses would need to visit at home?

• when was he diagnosed with dementia? If still under memory clinic they would be very well placed to review his anxiety which is a really common symptom of his condition and treat accordingly. If remains under them you can ring yourself, if not would need re referring - ideal opportunity to bring this issue up with GP.

• is he self neglecting? You can raise this through your local safeguarding adults route through the council meaning they will assess his situation, his capacity to live as he is/make unwise decisions etc and go from there re care decisions. Someone needs to check he's taking his medications correctly - again he needs someone with eyes on to see him inside his own home.

• you can book a free safety visit from the fire brigade which he may accept to double check the safety of the home

• don't feel bad about not wanting to be massively involved or have a fantastic relationship, it is very frequently the case and not unusual at all. I admire those who still ensure parents are safe after difficult relationships.

I had a great relationship with my father but I still couldn't manage to do more than you are doing right now . The lack of control over your life , home , status are so overwhelming in the elderly. Uncooperative behaviour is a common theme here . He wants only you and your sister as he might feel that he will have some say over his affairs . Strangers that he doesn't know or trust must be frightening for him.

You have had some very useful advice here. This is a whole new path for you all but the professionals have dealt with this so many times before . He will be made aware of his options and hopefully he will allow a care package to avoid residential care . The carers won't have a problem with the state of the house provided it is basically hygienic enough .