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He appears fine most of the time but there are other times when he is clearly having problems. No doctor or friend will help us. We are fearful that something could happen as he lives by himself in a different city.

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I would start by contacting Social Services in the county where he lives. Or call the hospital he would use in case of an emergency and ask to speak to a medical social worker. Explain the situation to them. If you can arrange an appointment for a time when you can visit, that would be best. Present it to your dad as a community service program being offered to seniors. They will come out and tell him about any services and programs available to him.

Even without an official medical diagnosis, if you can tell there is something wrong from your distance, then he needs some help. I wouldn't use the D word with him, and certainly wouldn't mention Alzheimer's, but if there is any way you can talk him into a health checkup that would be very useful!

I know there are some articles on this site that address this very common issue -- how to help parents who don't want help. Do some browsing and searching and see if any of their tips might work for you.
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My father is very much the same way. He doesn't go to a doctor at all unless he is near death. Luckily we had to support of his family doctor. The doctor's office called him and set up an appointment for a "checkup". When dad arrived at the office they did a mental status exam. As we suspected dad had a great deal of difficulty answering the questions on the exam. The doctor diagnosed him with advanced alzheimer's dz and put him on medication. We had to be a little sneaky to set this up but at least now we know what his issues are. He is still very non compliant with his medications etc. It's a daily battle. If there is an upside to our situation...it has made us more aware of his and our mother's living conditions. We now know to look for the things that they had kept secret from us in the past. Our communication is much better than it used to be. We have started planning for their future pertaining to the possibility that they will need placment in a memory care facility etc. If you have not done so, get his power of attorney as soon as possible. I know it will be hard to go against your father's wishes but there will come a time when you will have to make decisions for him and you will need it. Hope this helps!
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I'm in a similar situation. He refuses to have people come in to clean/cook for him. My father is verbally and mentally abusive and manipulative (he was to both my mother and his second wife who I think finally died of the stress). I work in another state and the only option I have is for him to move down here and live in a nursing home, here. Because of his abusiveness he cannot live with me. I am leery of calling social services for fear they would find me negligent in caring for him. I also think he would be abusive to the nursing home staff and they would ask me to move him elsewhere. I do have the legal documents (Power of Attorney, living will, will, health care proxy), but cannot force him to do anything without getting a legal guardianship which would end the minimal influence I currently have. I checked with an elder care attorney and he told me it was a months long process and would require multiple court appearances. The court would appoint an advocate for him to represent him against me and my claims. I also am interested in the answers you get.
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Thank you so much. I will check out the other articles also.
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TammyGo -- Good for you that you were able to trick your dad into going to the doctor. I wish I could do the same. HIPAA regulations have made things more difficult for those of us whose parents are secretive or deceptive about doctor visits. I do not have DPOA, because my mother won't give it to me or to anyone else. The only way that will change is if her health deteriorates to the point where I can ask a judge to grant it (although I am tempted to ask that it be granted to a court-appointed guardian instead of me).

My mother refuses to put me on any forms as a contact person, so medical professionals (including pharmacists) can't talk to me about her and her issues at all. She has told me in the past that she was going to a sliding-fee clinic when she was sick and also that she had been hospitalized, but I have no idea if she is telling me the truth. She is very bad about medication compliance, claims that she "can't take pills", and never gets prescriptions refilled. I did take her to a Minute Clinic last year to be checked out for nausea. I was surprised that the doctor did not pick up on her obvious COPD. If she gave her a mental status exam, my mom must have done well enough to pass it. I took her to the pharmacy to get 2 prescriptions filled and when they ran out, she claimed that they hadn't helped (contrary to what she told me soon after starting them) and didn't get them refilled.

snowwhite -- If you have the legal authority to help your dad, that is half the battle won already. Social services in his county would be able to get you started on how to get him to an exam.
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My mom was the same way...I just told her she needed a check up and brought her to the doctor's office..just like the poster above
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I sympathize with each of you. My mother ended up going to the doctor, however she has to be willing to take the mental exam. She was not willing. As long as she is able to make decisions, I have to respect her wishes. She was also put on Aricept, however she is refusing to take them. Her brother takes it and it has helped him tremendously. He is on the 5 mg which is the lowest amount. My mother insists on wanting to live at home, but it is a battle to get her to change her living conditions. The house is a wreck because we spend so much time taking care of my father who is in a nursing home. How can I get her to address this problem? She is so depressed about my dad being in a nursing home. Should I get Social Services involved?
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I want to thank all of you for your time and help. We called social services and when they visited him he was fine. Social services yelled at me for doing this and then my Dad really got angry with me. I called his doctor and Dad went for a check up and his doctor said he was fine and I don't think anyone believes my sister and me. He must be in the beginning stages. Is this how they are in the beginning? I spoke to his attorney on the sly and he told me that it would take and act of God for us to get any legal control in any way. Their state is very elderly protective. I feel so impotent. My biggest fear is he will be driving or flying and have a problem and end up hurting someone else and/or himself. Did anyone else go through this?
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We did, so hard. My mom called me a snotty little brat & 2 mind my own business- in my mid 40's at the time! She was always mean but able 2present well to doc's & very smart & shrewd. As got worse, starting telling and sending notes 2 md's. They can receive info, just can't confirm patient or share info. Some friend have arrived at good outcome by playing on authority of doc, pastor or Fam friend to act as more objective go-between- make sure they will say important 2 see what doc thinks and all agree 2 do what doc suggests. That helps remove u as bad guy. FIL was clearly showing signs, Fam resisted/denial, crazy stepmom. Eventually FIL was in car wreck. Got RN aside, told her exhibiting signs of dementia for few years, Fam denies and I want note entered in chart of my concerns so doc becomes aware. She thanked me /said they had concerns but wife denied all signs repeatedly N they were unsure where baseline was b4 accident. I asked for further eval b4 Dcharge. That did happen N wife then blamed cause of ALZ as car accident, but that got treatment started.
With my mom, we waited, and revisited as opportunities arose. Began 2 give our contact info to friends, neighbors, Sr Ctr, w guise we wanted someone to be able 2 contact us if any emergencies. Made more visits, sent brief notes to doc stating signs symptoms noticed, thanking them for care and interest , asking them 2 consider further eval. Eventually that worked. Was about 2 send in geriatric care manager fo eval, but didn't have too. Wished later we had done more, sooner. 50 50 hindsight. Earlier tx means better preservation of brain function in dementia. Perhaps short of that, Encourage healthy cardio-vascular lifestyle, next best thing until u get diagnosis. We used APS w FIL and was huge disaster but we had 2 try when all else had failed w crazy 2nd wife. She had control issues, was neglectful and verbally abusive, but that's a whole mother issue! Good luck, do all u can. No real wrongs if u keep trying. Feeling ur pain.
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I am sorry that calling Social Services didn't work out for you. Many people with early dementia can "showtime" for brief periods and do so for visitors and especially in doctor offices.

Perhaps make a list of all the symptoms you observe. Could they have another cause? For example, might he be drinking? Mismanaging his medications? Send your observations in a note to his doctor.

If this is dementia, a time will come when he can't showtime any more. I know that you worry about what might happen before then. My heart goes out to you.
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