My dad with dementia is talking about exiting the place and that the people there want to do away with him. What can I say to him?

Thank you everyone it’s always good to hear everyone’s experience. I realize there’s a few details I left out -I was just visiting (was there for a week) and my mom lives there too. He’s definitely not being mistreated and no one else has disappeared/moved/died. When he first got there at the end of July he really liked everyone and has so far-until the last two weeks or so. Prior to this he had an experience in the hospital where he was also very paranoid and didn’t realize he was in the hospital. He was at my sister’s and similar paranoia Eventually developed. It’s not an entirely new behavior I would say I even saw this sort of thing pre-dementia- he does not trust many people. The care home told me he suggested my mom go to jail-they often call me to calm him or to distract/listen to him. In general my mom does not have cognitive issues and she definitely agrees with his paranoia- but she gets very agitated she is in chronic pain And she doesn’t always want to be around him which makes him think he’s not wanted there. The caregivers actually handle it really well.

we had him tested for a UTI and he’s also getting some blood work done this week so hopefully we can see if something is just out of balance.

My dads dementia progressed to the point where he started getting paranoid and delusional a couple years ago. I lived three states away at the time and it was difficult managing my folks care in assisted living.

With dad, fibbing and diverting worked to a point as he has no short term memory but with the paranoid delusions it took calming meds to settle him down. It took a little while to get the meds adjusted but the staff at his facility did a good job. He was still delusional but was no longer thinking people were after him, stealing from him and so on. And he was not a zombie.

Dad is 90 now and I moved him near me about a year ago. I’ve had to work with the staff here to get his meds adjusted but he’s doing well, all things considered.

I don't usually think that fibs help. Your Dad will be distracted and desperate with your promising you will get him out. He will focus on this, and it will prevent any adjustment. To be frank I think lying or withholding truth does great harm.
As to where medication is in this, that is for you (hopefully someone is POA for health) to discuss with a doctor. There are many medications for anxiety and Dad's dementia has moved into paranoia and hallucination. The thing is that these drug cocktails are try and try again, hit and miss, work now and not later recipes, and are anything but an exact science. The brain is the thing we know the least about, and all mental health and aging brain dementias vary in all individuals. It is worth a try. Hard thing with that is that you are dependent on those who manage the care home.
I would start with more honesty and fewer calls. Do let the care home know what you are doing so that THEY can call you when there is a need. You will soon know if calls make the breakdowns better or worse. And I would move then to asking about meds for anxiety. I sure do wish you good luck and hope you'll update us.

First, consult the staff and managers. Find out how your dad is when he's not on the phone to you.

Assuming that he is fine, they are able to manage him kindly so that most of the time he is not agitated and anxious, then just let your dad say what he likes to you. Listen actively so that he knows you are taking his issues seriously, and then instead of agreeing or disagreeing or proposing compromises (what do you think his promise not to leave until you get help is worth in actual reality?) ask questions to try to lead him round to a better perspective.

Also, have "reasons to go" ready so that you can bring his call to a natural, friendly end when you run out of head space.

I'm sure they are, I don't want to undermine your confidence or anything like that, but how do you know that every caregiver is wonderful in this place? In particular, are you sure that every caregiver is always tactful in how s/he responds to your father's fears? The reason I ask is this: he has a right to private conversations. If a caregiver, just for example, were to say something like "How could you tell your daughter that? You know we would never lock you away!" and he comes to suspect (rightly) that he has been overheard - then he's not being paranoid, is he. His conversations are being "tapped," only not how he thinks of it. The caregiver is aiming to reassure him but may inadvertently do the opposite.

There often are grains of truth, or at least triggers, to what even demented people imagine. Say, again for example, that a resident died recently and your father has asked where this person is, and for very good reasons - such as client confidentiality, as well as not wanting to spread alarm and despondency - nobody will tell him. Then that resident has been "disappeared" and suddenly it makes more sense that he might be afraid he's next.

To try to find the end of the thread: *what* does your father think "is crazy"? Have you explored with him what isn't making sense?

Not to be rude, but how do you know what is actually happening if you don't go there?

My dads caregivers could talk a good talk and the reality was far from the story they gave me. Maybe it is time to find dad another place to live. Just because he has dementia doesn't mean that he should be forced to stay somewhere that makes him believe they are out to get him and make him disappear.

I know how difficult this situation is and being in a different state makes it impossible, but please don't just disregard his feelings for the word of a caregiver.