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Dad and 91 year old Mom live alone in their own home. His delusions focus on Mom and are painful for her to hear. He has always been stubborn, but is pretty argumentative now. He refuses any testing or medication because he believes there is nothing wrong. What’s my next step? Mom’s doc gave her anti-depressants to help her cope. I’m stuck and trying to support them emotionally is wearing me out. I live in CA and they are in VA. Help!

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One practical suggestion for navigating the forum posts -- You need to start with the "Oldest First" order of replies. I think you started with the "Newest First," replied to those, and then as you got down to the very first reply (which was by AlvaDeer) you thought she hadn't read through the replies you had made to other folks when in reality, she was the first to reply and therefore there were no other replies for her to see. Does this make sense? I do find this forum does not work like others I have used over the years.

Your father sounds a bit like my husband. My dh does not remember later the crazy things he says. His words are very hurtful, and reminding myself that it is the dementia speaking really doesn't take away the sting. I was offered anti-depressants by my doctor and I told her that I was not medicating me because of my husband's problems. Do the meds really do anything to help your mom? It doesn't change her situation in any way so I question why she should be taking them.

Two days ago I repeated back to my husband something he had said to me last week while in the hospital when no one else was around to hear. (He is always "charming and funny, an entertainer, the star of the show" when others are around, they think he is just the greatest guy ever, the nurses said his room was the best room to come into that week because he was such a jokester.) I repeated back to him the name he called me (not suitable to post) when he demanded my presence (he is a very controlling man), I said, "Well, here's your '*** ****-*** South Mountain *****,' " he looked at me with shock and said I should never speak of myself that way. I looked at him and said, "Why not? That's what you called me last week." He denied it of course.

I have no doubt that he doesn't remember saying these things, just as he doesn't remember many other things. And he creates memories of things that never happened, which sounds like what your father is doing. Or accuses me of things that I have not done. All said with a quiet voice, seldom is he loud. (Except when preaching [he used to be a pastor], then he could really yell the judgment and condemnation. I was never sure why people liked his messages. I always felt like a bucket of manure had been dumped over me every week.) Verbal abuse can be done in a quiet voice. Your mom is being verbally abused.

Unlike your mom, I would be glad to be separated from my husband. I had my chances over the years and didn't take them.

No one answered your question about what APS is. Adult Protective Services.
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Twooffiveminus2 Mar 2021
You are right, and I just did it again. Thanks for the reminder. Learning to do what I can as long as they are both “safe”. I’ll take care of as much as I can, let mom talk to me, just watch, wait, be as supportive as I can. Thanks for your thoughts.
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If you can't get your dad to a doctor, therefore can't get him any meds to help with delusions (and meds need adjusting and may not initially --or ever -- be a solution) and your mom is sticking closely to him... then the only 2 possible solutions I see are:
1) use an agency to provide in-home care or a companion to your dad so that he is distracted. I use Visiting Angels (a national franchise) and have been very pleased, but it may take more than 1 person to find the right "fit" or schedule.

2) see if your mom is willing to move with your dad into a care community that has a continuum of care levels and on-staff medical team. He will be distracted and she can escape his delusions within their residential wing,

Is your dad "sundowning"? Are his delusions mostly late in the day or early evening? Is your mom on board with solutions of any kind? If she isn't wiling and flexible you'll be banging your head against a wall.

Do you have the contact info for their neighbors so they can give you an honest assessment of what's going on?

Your dad won't level out, he will continue to decline. If you can't get your mom to agree to reasonable solutions then you will need to let the chips fall where they may until there is an "incident" that sets other wheels in motion. I don't say this flippantly -- I totally understand getting an even bigger knot in the stomach over this thought.

I manage care for 2 very senior aunts who are 1000 miles away. After making no headway with getting them to accept much needed care I finally just asked what I could take off their plate to make their life better, rather than trying to force my solution onto them. When they were ready for the type of help they desired, they called me up and I had already done all the research on an agency. But waiting for them to come around was so incredibly frustrating and stressful. I wish you much success in finding solutions, and peace in your heart no matter how things unfold.
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Beatty Mar 2021
Excellent advice.
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Twooffiveminus2 - if it's any consolation I recently had similar experiences on this forum. Like you, I probably mostly needed to vent and get some validation. I got a couple, what felt to me, harsh responses along with good advice.

You're not being overly sensitive. You need support and kindness right now. Having done the Cali to the east coast thing before going (granted, being there was way worse - but this isn't a competition on what's more stressful), I also know it can be very stressful having to deal with things from a distance.

Last thing probably answered already: APS is Adult Protective Services.

Sending you strength and validation.
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Twooffiveminus2 Mar 2021
Thank you. I’m trying to glean what I can from responses and integrate them with the particular circumstances that exist for my parents and me. And recognize that people at least think they are being helpful and that no ones knows all the bits. I guess knowing we are all living in tough circumstances would have engendered more compassion. So thank you again.
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If you cannot get your Dad to a doctor then you and your Mom may have to wait until an ER event to occur. If he is abusive then call 911 and take him to the ER. Once in the hospital be sure to address this with a geriatric psychiatrist.
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Twooffiveminus2 Mar 2021
Yep. I’m learning I can’t fix anything...
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Two of Five;

Have you considered getting mom and dad to go TOGETHER to see a geriatric psychiatrist? Under the heading "therapeutic fib", they go together to see if there is help for mom's problem.

This allows the doc to examine the extent of dad's delusional thinking and give advice (to wife and child) about how to manage this awful situation.

On a side note, I hope that mom IS taking advantage of the antidepressants AND talk therapy. Living with an insane person takes a toll on one's mental health and mom needs all the support she can get.

Those of us who have been in this sort of situation can tell you that is usually NOT the impaired person who goes to therapy/gets meds; it's the "healthy" one.

At least in cases in which the healthy partner is not willing or able to leave the toxic situation.
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Twooffiveminus2 Mar 2021
I think I’m written out, but thank you very much. I’m trying to get her to see somebody to help her cope. Dad will have to have a different crisis to get help. No way he’ll agree to anything. Only got him into the doc by asking him to do it for me.
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From my experience, there is only one option:

1. POA for healthcare.
2. MD diagnosis - incapacitated = cannot make own health care decisions.

This is quite common (I'm going through it now).
You need to talk to attorney in elder law / health care issues and MD.
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Dementia is a beast. I am sorry this is happening.

Councelling for Mom - so she can learn to understand it, start to grieve, adapt to now & plan for the future. All important things.

To also learn to ignore any hurtful delusional talk & see it for what it is - symptoms of his brain problem. To get a safety net around her, an emergency plan of who & how to get help if needed strait away. This is most important: to be wary of situations of stubbornness escalating into violence. Eg a close neighbour she can run to & call EMS.

It's a big shift in a marriage, going from spouse to carer. That's what my Dad said 😞.

It can also be a big shift in thinking for adult children too. Doing what is NEEDED for Dad, rather than what he wants. He may not WANT a neuro psych eval, medication or in-home helpers - but those things will help him stay in his home, with his wife for much longer. Sadly, he may not grasp this. So make it simple for him "See the Doctor & follow his/her orders. It will help Mom.
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Twooffiveminus2 Mar 2021
Thanks for your thoughts. Luckily, and I should have said this, Dad isn’t violent. There isn’t likely to be a police intervention, at least not that I can see. Though I’ve talked with Mom about what to do and about staying prepared (cell phone charged, money in her purse, call 911, go to the neighbors, etc). It’s complicated and hard for her to understand and for me to support her emotionally and logistically.
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The antidepressant will only help the very tip of the iceberg.

Unless your mom is decades younger than your dad, she may be developing physical manifestations.

Can you hire help? Even if she is physically strong, to keep her emotional bearings and protect her health, she needs mental breaks.

Can you arrange for someone for her to talk with? Support groups, friends or family, in person or via zoom will be her lifeline.

Before Covid, Mom’s church paired her with a young family for support. She would take the mother to lunch and they became wonderful friends.

If your mom is isolated and/or has few of these options available, consider moving her close to you.

Your time together is precious and irreplaceable.
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Twooffiveminus2 Mar 2021
Wonderful COVID. And isolation. Luckily they have amazing neighbors. And also that he does not show ANY signs of violence. He’s not even verbally aggressive toward Mom. It’s the content that is painful. He introduces the topic with her by saying he would like to talk about her problem with promiscuity in their home after he goes to bed. I’m figuring out that I will give them all the help all I can with the mechanics of daily living, try to get her to take care of herself by talking with a therapist or a pastor, and look for resources for additional help at home. I can’t blow off her wishes in this.
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The sad part is, the more your mom gets frustrated with dad, the more sedated doctor may make her with meds. Doctor is treating the wrong person. (A kind of comical situation to explain my thoughts)- A relative when took her spouse to doctor because he was becoming increasingly meaner in things he said, aggravated all the time, etc. Dr talked to both of them. He handed an Rx to the woman. When she went to the drug store, it was a medication for her. Things got worse. They went back to the doctor and he talked to both of them again. Again, he gave her a prescription for an additional medicine. Husband continued to act like an a$$. She did say that the meds were relaxing her and his outbursts didn't bother her as much, but she was going to go one more time because husband was getting even more explosive. My reply: Well I think I'd find another doctor before he has you in a comatose state and husband gets more out of control. He's getting angrier because you don't react anymore because you're drugged. In fact, if they keep medicating you, husband will eventually become physically and you won't have the wherewithal to fight for your life. Her: I never thought about that. Hmm
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Twooffiveminus2 Mar 2021
Mom is on a very tiny dose of anti-depressant and she went to her own doctor to get some help. She’s sad - grieving the end of a 70 year marriage. Dad does refuse treatment - in his mind, he wants to help her with HER problem with promiscuity and he doesn’t need treatment. They keep recommitting to enjoying their final years and then he decides he needs to discuss her problem with her. So for now, helping Mom cope seems to be the only approach she’s willing to take. I think I’ve figured that out over the last couple weeks.
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Have mom come out to visit you to give her a break.

Doesn't Dad have a regular Dr's Check up? If so, speak to him before the appointment to let him know what's going on.

It could be Dementia.
Also, if your Dad has a UTI (Urinary Tract Infection) or if he is dehydrated that can be causes of his mood changes
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missmacintx Mar 2021
It could also be a brain tumor, or endocrine imbalance causing delusional thinking, agitation, and the negative personality changes. We should not assume. Dad needs a thorough medical exam with full blood work up/urinalysis, and possibly a CAT scan or MRI.

The way to get that is use the contact with police during the next outburst of threats of violence or actual
violence for a 72 Hr civil commitment hold. The police may choose this rather than domestic violence related charges and a trip to jail when they have reason to believe the issue may be medically driven. Ignoring this issue is not an option...secretly sedating him without a medical exam is abusive IMHO...your mother needs direct help before her life and health is damaged or destroyed.
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