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hellymart Asked May 2019

Need to get my mother away from my father ASAP. Any advice?

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?

PandabearAUS May 2019
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

Countrymouse May 2019
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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AnnReid May 2019
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.

ANightingale8 May 2019
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.

NeedHelpWithMom May 2019
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.

Grandma1954 May 2019
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.

Countrymouse May 2019
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?

hellymart May 2019
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.

Zdarov May 2019
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. 💐
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.
lynina2 May 2019
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.
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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