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My 93 year old father has recently been diagnosed with Alzheimer's although he's not yet actually had a face-to-face meeting with a doctor, to tell him (he's had 2 appointments with Memory Nurses). He's due to be prescribed anti-depressants. He lives with my 83 year old mother and is making her life a misery. He's miserable and bad-tempered (but to be honest, has always been like this) and expects her to wait on him hand and foot. He will not be left alone at all now, so follows her to the bathroom and around shops. She has to help dry him after the shower, do his medications twice a day, she does all the shopping, cooking (that's another thing - he will barely eat anything and is afraid of choking) and takes him to all his medical appointments (sometimes 4 or 5 in a week). She has no life. No time even to watch the TV. He's been into a home for respite (only because we nagged him until he agreed) 3 times now but every time he comes out, everything goes back to where it was. My parents shout at each other and fight constantly (he won't wear his hearing aids most of the time). My brother and I are trying to persuade him to go into a home full time. He was on the brink of doing so but then the home said he would have to go into their dementia unit (last time he stayed he'd upset other residents with his rages, to the point that they were refusing to go into the dining room when he was there). He doesn't want to go into the dementia unit so is refusing to go into a home. Meanwhile, my mother is miserable. He's also blocked her way out of the flat a couple of times, when she just wanted to get out for a few minutes peace (I was there once, so witnessed this). I have come to the conclusion that the only course of option open to us now, is to tell him that we are taking Mum away, that she cannot cope with him anymore and that he will have to either stay in the flat on his own (which he wouldn't/couldn't do), or go into a home. I don't want to take this course of action - he will be furious, for a start - but see no alternative. It feels like getting my mother out of an abusive relationship (one that I should have removed her from years ago). Any advice/help? Has anyone been in a similar situation?

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hellymart - any update?
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I think now definitely time for you to consult an elder law attorney and get orders of protection, and some control for caring for your Mom
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Does anyone have Power of Attorney (POA)? If so, look at the POA, see what it takes to spring the POA into action. It will be one of three things;

1. One doctor declaring the individual incompetent,
2. Two doctors declaring the individual incompetent or
3. The POA is sometimes immediate

If the POA does not specify one of these three then unusually it requires two doctors to declare the individual incompetent.

Once the individual has been declared incompetent the POA makes the decisions. The POA can move the individual into a facility. It is no longer up to the individual.

If the individual does not have a POA and is not competent then you are looking at getting a guardianship for that individual. A guardianship is a court procedure. If this is the case then you need to contact an Elder Law Attorney.
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hellymart May 2019
Thanks but no, no one has POA because although we've tried in the past to get my dad to do one (he even got as far as going to a lawyer), he has point blank refused. He's always been mean and cagey about his money - kept my mum short of money all their lives - so there's no way he's now going to hand it over to anyone. It's caused rows with all of us and him and now we've just left it because we can't take the stress. At some point, yes, we will need to resolve it because I think he's too far gone now, with Alzheimer's, to take one out, even if he would agree.
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I separated my parents for both their sakes - Dad was 89 & being caretaker while being an ostrich about her dementia - Mom was angry so was saying he was stealing all her things because she was hiding them & forgetting that she had

Tell your dad that your mom needs medical help so she must leave to get it & that he must go to a home while she gets the help she needs - once he is there then your mom can go back but don't tell him rather let him believe she is still receiving help - this gives him a face saving that she didn't leave him except for her health issues - good luck
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Sounds like your Dad is aware that he's failing and he's acting out - in fear.  Just a possibility, but my own Dad told me he was frightened when he started losing his ability to walk.  You need to make a decision regarding your Mother's welfare, because she's in a very precarious (and potentially dangerous) situation.  You cannot change what is happening to your Dad, but you can intervene and help your Mother.  God bless you - what a terrible situation for all of you.  Hugs and prayers.
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Sorry, I do not know how to "reply" to a specific message, so hope the moderator displaces this as may be appropriate.

My message is for the person: jacobsonbob, in speaking about eating and getting food into the esophagus (Lungs).

Let me begin, I had all those symptoms a few years back. Here in the USA (I assume is similar in the UK). The culprit to our body, it is called : Achalashia. There is supposed to be a symbiotic arrangement between the throat, which helps the food to get to the stomach.

This partnership failed on me, and the food would stack up to the back of the throat, and heaven forbid I should need to sneeze, exhale loudly and forcefully (yes, I did) and on the next Inhale, some food would get to the lungs. There are (AFIK) three options for opening up the throat and maybe helping the damaged muscle to the stomach, as epitomized in GERD.

One method, and needs to be redone occasionally is with a long balloon-like tool that is placed in the throat, and filled with, I suppose air to stretch the throat open. I am currently 81 years old, so I had the balloon method about 25 years ago in a doctors' office. I had a the Heller Myotomy about 5 years ago.

Second is a process to cut tiny bands into the muscle.

Thirdly, is a process described as "Heller Myotomy". But before doing this surgical procedure, they first sent me to a throat specialist who has a tool to examine the throat and see if there were any cancer cells present. If so, they would not do the surgical procedure.

As a result, I still chew my food more than before, I do not have one iota symptom of GERD, and steak is not problem as it had been. It has been about 5 or so years since.

In support of the "jacobsonbob, one of my problems was I could not swallow "Al Dente" white or brown rice. I had GERD, and often had a problem with that burning sensation. I had the displeasure of being "literally, filled up" in my esophagus and had to attend to the mens WC (men's toilet) and evacuate my esophagus, and often times my meal would also toss up (throw up, puke, evacuate) the food from my throat. Everything had to be chewed to the point of liquidizing my food, even the Steak and Lamb Chops. As a result, my eating time would extend way beyond other folks and guests.
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May be Time to Call in ADULT Protective Services....
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IMHO, mom can't keep this up AND SHE SHOULDN'T! He needs to be placed in another living situation with medical professionals NOW.
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What is key here and not explained is exactly how your mom feels about all of this. Her wishes are the most important factor, not your dad's. If she wants him to remain at home, then, everything possible must be tried to accomplish that first. If she voices that she doesn't feel safe, then, that fact must become first and foremost. Sometimes, one can be so "used to" a situation, they can be literally unaware of how dysfunctional or unsafe a situation can be; they lack the perspective. There are ways to open her eyes about this, but it must be done with tact and respect for both of them.
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hellymart May 2019
Thank you for your sympathetic and kind response. I have been with my parents today and discovered - because they both have bruises and marks on their arms and wrists - that my dad has been physically restraining my mum on an 'almost daily' (her words) basis and that she has to push him away (this is when she tries to go out). I wanted to take her away from him there and then and called my brother to help me but she will not leave. She says she 'has nowhere to go' , she feels embarrassed that the other residents of the apartment block will know and he will tell them all that she 'abandoned him' and also, she feels responsible for him and knows he could not cope without her. (I think this is part of her being so used to the sitaution that she is unaware of how unsafe/dysfunctional it is). I called Social Services and someone filled in an 'adult safeguarding' report with me on-line but then a Social Worker called me back (difficult to talk because I was then back in my parents' apartment) and told me it actually wasn't a safeguarding issue but that she had some advice for me. I couldn't talk any longer (I don't want them to know I've called Social Services) so she's going to call me back tomorrow. Tonight my dad was calm and rational and I talked to him about respite care and getting carers in to help my mum. He's agreed to both, in principal but by tomorrow morning he may well have changed his mind.
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Certainly things need to change, however given his Dx, taking mom away and leaving him to 'fend for himself' can be viewed as neglect or abuse.

I don't have the answer you need (our mother was living alone and when we needed to move her to MC, she refused to move ANYWHERE. In the end it had to be a ruse/fib), but just leaving him there alone is NOT the answer for many reasons.

You say mom doles his meds - can the doctor add some anti-anxiety meds to calm him? Can the doctor see to getting him admitted, perhaps to the hospital and then transported to a care place? Can the eating/choking issue be used to say he needs to go to have it evaluated?

I don't know what the equivalent is to POA here in the US, but even that was not sufficient for moving our mom, despite dementia. Our attorney said we can't just drag her there and staff often tell me that they are not allowed to force anything, meds, showers, etc - they can only keep coaxing trying to get compliance! You may have to seek guardianship, or whatever they call it in the UK. That was what attorney suggested, but the care facility we chose wouldn't accept 'committals .'

Meanwhile, can someone move in temporarily with them, to try to 'keep the peace?' It will possibly make whoever does that a target as well, but you can steel yourself for the onslaught! Take turns with brother if possible, but get working on how to move HIM (he shouldn't be given a choice or option, or be told the 'respite' will be in the MC unit.) Best to get that moving along and make it permanent when legally possible.
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Zdarov May 2019
Super response.
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Hellymart, I was in a similar situation. I also am 10 years younger than my husband (he is now 80, I am 70). He was diagnosed with Alzheimer's a few years ago. Even before the Alzheimer's, my life was hell, as he is a narcissist and was very controlling and verbally abusive. After his diagnosis with Alzheimer's things even became worse. He was no longer allowed to drive but did so anyway. So after I hid the keys and he found out, he went into a rage. I had three options: leave the house and stay at my daughter's for a few days, do nothing and worry about a possible violent attack, or call 911. Staying with my daughter would only resolve the situation for a few days, as I would have had to return home with the possibility of more verbal and/or violent attacks. So while shaking like a leaf I went outside to be out of his sight and called 911. Police and an ambulance showed up. They evaluated him and questioned me and decided to take him to the hospital for a more in-depth evaluation. He can be very charming and talked very nicely to the police and ambulance attendants, and luckily went willingly with them. After they evaluated him I received a call from the hospital informing me that I could pick him up as he had calmed down. In talking to his neurologist before this call, he informed me, knowing my husband's condition, not to pick him up, as things would even escalate more and my life could be in danger. The hospital did more tests and decided that he needed to be placed in a home where he is now since December 2017. On the advice of the nurses and doctor, I haven't visited him since September 2018 because of his manipulation that he keeps up when he sees me, which upset me tremendously and agitated him. He is regularly visited by my daughter and husband to whom he is friendly. After many months of anxiety I am finally able to live a normal life and do the things a normal person can do.
So, in your case, if your mom feels threatened, she should call 911 and have him taken out of the home and refuse to take him back home. She should not be the one having to leave her comfortable surroundings. Your dad has an illness and the best place for him is in a home where nurses can provide the care he needs.
Best wishes for a positive outcome for you.
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INMO, this is a dangerous road you're traveling. Unless you are trained in this profession, I would advise you to seek professional counseling. I'm guessing this is not your field or you wouldn't be asking. It's wonderful you're asking for advice, but again, IMHO I think you need professional advice.

I would never have separated my mother from my father and she wouldn't have wanted me to.
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CaregiverL Jun 2019
Ray, in this case, it was necessary since the mother was in danger of being assaulted by her husband.
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Do it! Now, while your mother still has some life left in her. The fact that your father's Alzheimer's behavior only reflects an intensity of his 'normal' behavior, indicates that your mother has 'put up' with it for a long time. This does not mean she truly chooses to be there. Recipients of abuse stay for complex reasons. But, you have it in your power to help her now. Just 'leaving' your father in their flat alone would be unkind and dangerous for him. But take him back to where he will receive proper care and allow your mother to have a more peaceful existence.
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You say "I should have removed her" years ago. It sounds to me that A) this is the relationship they have had all this time and B) her own wishes aren't really being factored in. Your Dad will never want to go to Dementia Care Unit. If your mother agrees, then the best step to my mind is to put him permanently in the unit he had as respite. If your mother will not do this you are helpless in the matter. Social Workers however can guide you in both getting a bit of assistance for your Mom and in learning some coping skills through counseling for yourself. So sorry for this sad situation, and for what you are going through.
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After reading all this, and not having experience myself - I’d like to pitch in that the fear of choking therefore not eating could be the pivotal item for you. He should be checked in to wherever’s appropriate because of this. That way you would skirt somewhat around the mental component. Not only is he not doing great, he’s malnourished and that’s big. GOOD luck, sorry for this very challenging path you’re on. 💐
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jacobsonbob May 2019
That's a good point, Zdarov; my father started getting food in his esophagus, and at one point he couldn't dislodge it and had to go to the emergency room. Making sure food is cut up into tiny pieces should provide some level of prevention, depending upon what the specific cause is. If it's the risk of inhalation into the lungs, then that's another very serious matter, too. Of course avoiding food prevents these problems but creates its own. I wonder if this man has a specific reason to fear this (e.g., something has happened in the past, or he has a habitual tendency to get food "stuck" or "going the wrong way"). Perhaps he should be eating soft or semisolid foods. In any case, an evaluation of this issue (to add to "the list"!) appears to be warranted.
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This is not a decision your dad can make.
For his safety and for your mom's he needs to be some place where he will be safe.
Shadowing is common. Even though they bicker he knows she is a safety line for him. He knows her and she is the one constant he has so he follows her to be sure of where she is. And I am sure he gets frightened if she leaves.
He can not be left on his own. So taking mom away will not really help the situation. Is there a way you can get caregivers in to help mom? They would give her a break so she can get out.
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I have my 93 year old mom living with us. It’s a challenge.

It’s a transitional time for all of you. You’re on your way. You’ve reached out for help. That’s a great start.

When things hit us out of left field, we are stunned for a bit. It’s easy for others to say what they would do but often they aren’t walking in your shoes.

So read the advice given carefully and use what applies in your situation. Lots of people on this forum do have vast experience and knowledge with the situation that you have and can offer valuable advice. I do not. I am not in your situation. My mom has Parkinson’s disease, without dementia. Some Parkinson’s patients also have dementia so I may face this issue one day as well and will be seeking advice for my mom.

I would like to offer support and lots of hugs and warm wishes to you. Take care and let us know how you are doing.
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So sorry for your mother’s situation. I think you should be safe not sorry. I feel you should quietly remove your mother from the house asap
Then let things fall where they will
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Take care of the doctor (neurologist/geriatric psychiatrist) issue IMMEDIATELY.

It is possible that Father’s conduct can be temporarily altered by medication, both for his comfort and your mother’s safety.

IF/WHEN you have a printed statement indicating that your father is a potential danger to himself and/or others/is not competent to care for his own needs, you and your brother will need to assume management for him, which means ignoring his violence and if necessary, involving legal man’s to get HIM to a place of safety FOR HIMSELF.

It does not matter if he’ll be furious or delighted or any other emotion- his emotional reactions arise from his dementia, not from what happens to him or around him.

What he’s “always been” is NOT what he is now. If you think it is safer, design a care plan for him, including residential care if recommended by a professional trained in geriatric care, AND DO NOT DISCUSS IT WITH HIM.

Your situation is enormously difficult and painful, but in no way unique. It happens to many of us. Sharing experiences here can be helpful to you. We are with you.
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Hi Hellymart -

for the a) - he'll be paying for it - doesn't matter, sort this out with the home's admin. people. As your father's diagnosis is pending and the question of his mental capacity is very much moot for the time being, you won't be able to take over his financial affairs, of course; but all the same *nobody's* situation is ever unique and they will have come across this before. They'll advise you what to do.

for the b) - he's going to respite care as before. Is the "home" one of the continuing care developments? Do you mind my asking who the provider is?

Again, people in the care industry, for want of a better term, are perfectly well aware that Alzheimers hides for much of the time in the earlier stages and won't be fooled by your father's apparent normality. The home's records will be helpful in this - if his rages impacted on other residents, there certainly should have been a report made at the time and it would be worth asking. You need to collect the evidence because it sounds as if the time for LPA might have passed, and you will be looking at other ways to represent your father - go to https://www.gov.uk/make-decisions-for-someone for the lowdown on that.

Who are the 'memory nurses' attached to? Community team or outpatient clinic? Is your parents' GP in the loop with everything, too?
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Yes, I'm in the UK. Thanks for your advice. Not that simple to book him in for respite care as a) he'll be paying for it and b) he'll insist on knowing where he's going to be and therefore won't be happy at being in the dementia unit. (He has refused to do POA, by the way. We managed to get him to go to one appointment at the solicitor's but he cancelled the next. He was suspiscious and thought we wanted his money - his words). He is perfectly compis mentis (sp?) a lot of the time. He does listen to my brother though, more than me and he may be able to persuade him to go. I agree, better furious than getting violent. I am actually worried that my mother might be driven to be violent herself.
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I have to go out so I'll assume you are in the UK to answer quickly -

It is excellent that you have an established relationship with a good care provider. Work with the home's management. Book him in for respite care, like previous stays, only this time he will stay in the memory unit (you don't tell him that beforehand). While he's there, you work with the home's Admissions Manager, your mental health nurses, any memory clinic he's booked in with as an outpatient, and his GP to get his care plan agreed.

He will be furious. All of these people together will help him, your mother and all of you to get through it. Better furious than violent with your mother or a risk to himself.
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Hellymart, are you in the UK?
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