He refuses to go to personal care. He has fallen several times and is not safe. He lives in a boarding room and access to kitchen and laundry is on the other side of the house and you must go outside. He doesn't clean his room and do laundry unless I come over. He can't get food unless I come over. I live over an hour away. He tells me he can do this but he has shown that he cannot. I am lost as to what to do. I have called Office of Aging and also he was just in emergency room for dehydration. He has also lost considerable weight of 20 pounds in 5 months. Both tell me there is nothing they can do if he is of "sound mind". I use that term loosely.
The laundry will probably still fall on you weekly.
If he can pass the dementia 'test'..they will do nothing for him. Maybe run a few bags of saline to hydrate him and send him home.
The weight loss is concerning--and you don't know why this happened. Likely he's just old and tired and doesn't want the hassle of preparing his own meals. My FIL did that. Ate next to nothing and drank coffee all day.
I'm afraid that all you can do is wait for the 'fall' that is almost bound to happen. I hope you have POA, or someone who cares for him does.
Dad may be at the point that he requires more assistance than these type of 'non-medical' situations can provide but you won't know that until you can convince him to get a full physical including a neurological assessment. See if anyone has his DPOA and medical proxy. Someone.... you or a highly trusted friend really should get these documents as soon a possible. Dad may know that he is slipping. Trust me ...... that knowledge is unbelievably frightening so one tries to deny it at all costs..... including your own safety.
He may have made friends in the area and may not wish to leave them even to move closer to you so the best thing to do is ask him how he sees his life and what does he want in a non threatening way. You might have to have several rounds of this because his first shot could be totally unrealistic but keep going. When either of you starts to get frustrated, take a break and breathe.
Good Luck and keep us updated.
As for who will make decisions for your dad, you and he have some discussions to have. If he would rather you be that person, please get to a lawyer to draw up legal documents, power or attorney for medical and power of attorney for financial. If you rather that another person do this, the courts can appoint a legal guardian who will do this.
He may be waiting to see if you'll offer to let him live with you.
You can't blame him for not wanting to go live at a Senior place,
they are understaffed and not a fun place to live, as you loose all your rights and are told what to do and when to do it.
He wojld be happier staying where he is if he doesn't have family he could move in with.
While he's staying where he is, You could install a camera in his room that he can be watched 24 7 by your cell or computer, in case he falls, ect in side his room.
He could also wear a fall necklace in case he falls outside going to the kitchen or bathroom.
He should have a small refrigerator and a microwave in his room.
He needs plenty of easy stuff to eat in his room.
You can basically cook and warm up anything in a microwave.
They have easy microwaveable meals for breakfast, lunch or Dinner.
He should have easy snacks to eat like Breakfast Bars, Cheese Crackers, Peanut Butter Crackers, Nuts, Bananas, Apple Sauce, Yogurt, Breakfast Drinks like Ensure. Easy Soups to heat up that you don't have to mix with water, Juice, Milk.
You may try to get him on Meals on Wheels and have a meal delivered to him once a day.
Prayers
He has indicated BY HIS CONDUCT that he is vulnerable to serious threat.
Get back to your Office of the Aging and ask if they offer an in home screening OR can refer you to a PROFESSIONAL who will do one. Tell Dad that you want to be sure he has what he needs to be safe, and that ALL of the people over 65 have to have one.
I have always been able to have cognitively questionable elderly Loved Ones assessed, in home OR in the office of their personal physicians. You also need to have AT LEAST a rudimentary screening of what his cognitive ability IS.
If he DOES have an ongoing relationship with a doctor, send a note marked CONFIDENTIAL, PLEASE DON’T DISCUSS WITH PATIENT” indicating a few of his threatening behaviors and your concerns.
Other agencies have no idea any more than you do, but YOU, as someone who KNOWS him, have the absolute right to know what you are dealing with.
If there’s a POA in place, check the language in it.
This is a VERY TOUGH SITUATION for those who are trying to care the vulnerable. One way or another, you WILL get through this, and so will be. Hopefully it will proceed somewhat smoothly.
Do not pick him up and take him home. Tell them when they call to arrange discharge that you are unavailable to care for him. Possibly a bit of time in Rehab might help him strength wise.
The "of sound mind" just means that he has not "officially" been diagnosed with any cognitive problems. If you discuss it with the doctor they might do some testing and see if there is a diagnosis that would allow him to get the help he needs.
Before you go down that road though it might be wise to talk to an Elder Care Attorney and begin the process of getting POA in order. You do not want him diagnosed with any type of cognitive problems then try to get POA, they will not do that you would then have to go the Guardian route.
Unfortunately it often takes a catastrophic event to get wheels in motion.
Is there a possibility of Assisted Living for him? He would have his room, laundry would be more convenient for him and meals would be provided and easier to get or he could make his own in his kitchenette.
I do not like "ignore him" advice because that much weight loss means something is drastically wrong and he really needs to be in the hospital--from there he needs to get a medical and a psychiatric evaluation, and social workers can do safer placement.
TALK TO HIM FIRST and get him to the emergency room. IF HE REFUSES, you MUST fight for him. It is time to take action and call 911.
DO NOT ASSUME IS HE IS COMPETENT.
IF that were my parent and under those conditions, I would call 911 and tell them you feel your dad is a danger to himself and has something drastically wrong.
If you feel he is a danger to himself you may want to get a psychiatric evaluation after ruling out medical reasons for the weight loss. In Florida this is known as a "Baker Act".
THINK SAFETY FIRST.
Instead of telling him that he should move as my MIL had significant dementia and was difficult to live with, I started asking him questions about what he envisioned for the future, how he saw the next few years etc. Turns out he understood he needed to move but he was stuck by all the stuff he had at his house. It was not that he was totally attached to it, he just could not figure out how to move and where to start. They had been in their home since 1957. He had the beginnings of vascular dementia and could not really problem solve. So maybe ask him how he sees his life going, especially if you stop coming over and enabling him. That may lead to a breakthru.
And then, on your own, start researching options for him that would be near you. His financial status is going to be important here but once you know how much he has, (or does not have), you can research options just so you are aware. If there are viable options for him other than emergency placement, you can possible show him and get him to agree. If not, you will have to wait for an emergency, and there will be one. But at least you will be prepared with some knowledge ahead of time.
Good luck; such a difficult journey.
You can try this at a hospital too but my RN daughter says they aren't under the same rules as Rehabs are.
If you stop doing those things, he will soon realize that in fact he does need more help then he first thought, and hopefully be more open to discuss his long term care. I wish you well.
That is the reality of trying to help a vulnerable adult who is still competent.