My dad's youngest brother has some form of dementia or something I am not exactly sure what that requires a caregiver when my aunt leaves the house for any reason. Now it seems to be happening to my dad.

My dad has been married (to #3) for a considerable amount of time and last August she told him to get out, she wants a divorce...these things happen I know.

For some reason or another (divorce laws in New Jersey regarding abandoning marital property before legal stuff is done???) he hasn't left and he sleeps in a spare room at night that she uses during the day for a home business office. He appears to spend most days at a local mall. He reports he has has some fender benders. He had a beeper thing put on his car that beeps when he is backing up and beeps long when he is about to run into something while backing up. He has vision problems in one eye. Yet he is still driving and he gets lost when not in familiar territory around where he lives.

We've gone to see him a few times and he seems to be able to hold things together better down that way. Though he did get lost on the way to his sister's funeral and a serviceman from Fort Dix had my dad follow him to the funeral home.

Dad says he does not wish to move up here to New York State with us and then sometimes says he isn't and sometimes says he might have to. He says he is broke (the given reason for having to move in with us) yet he spends 100 bucks a month to get his nails buffed and shined. We have a bedroom prepared just in case.

Dad has come up twice to see us.
1. Mate says he appears "vague" and is hard to understand in a conversation.
2. Dad spent much time talking about a dead brother and his days in the military and other little memories of his own life.
3. From the living room, Dad cannot figure out which door will get him to the bedroom he sleeps in up here.
4. He has gotten lost coming here and going home. He says he does not understand that the thruway changes it's direction and route number.
5. The first time he came up, he erased the phone numbers from his cell phone accidentally and wound up at the police station. Fortunately the desk sarge was able to find our phone number in the log books.
6. He has a divorce lawyer who does not know him from before. He cannot remember the name or town when asked.
7. He has a doctor whose first name might be Marie, no last name or town forthcoming. I am ready to call all of the doctors' offices in his county.
8. He went off of all of his medications (names or conditions unknown to me) a couple of months ago and he claimed his cardiologist affirms his desire to just take 81 mg. of ASA daily and his blood pressure was 120/80.
9. When I asked about him maybe getting a check-up from his primary care doc (he fell here once, has a tremor now, keeps getting lost while driving in unfamiliar places, and doesn't understand why the route on the way home went from three lanes to two lanes), the story becomes that the primary care doc says his heart and everything liver kidneys all checked out perfect.
10. When talking about a health care proxy and perhaps the two of us visiting his doctor or lawyer together to set one up, he told me he has Medicare and AARP medi-gap insurance.
After a bit of explanation, he told me his new will is in his safe deposit box.
After more explanation, he told me he is an organ donor.
After even more explanation, he said next time he drives up here to see us, we can sit and talk about funeral arrangements and stuff!
11. He had extreme difficulty backing out of my driveway. I lost him on the Thruway (was having him follow me past the troublesome exit).

Thoughts?
BrainJam

Dear BrainJam,

What a very difficult and challenging situation to be in! I am very sorry to hear of your struggles with your Dad, though I am glad you have found the Alzheimer’s Association Online Community. I hope that you will find the support you need here.

Driving is a serious yet very difficult topic for many older adults and persons with Alzheimer’s disease. Driving is such an important part of our lives and is often the only method of transport. However, from what you have written, it sounds like your father is in danger while he is on the road. One option for you is to notify his local DMV about his recent driving problems and his current health condition. Explain to them your worries and fill them in on the details of the situation. Also, call the local police officials in his area. Notify them of the danger your Dad may be on the road and his probable dementia, this way they will be better equipped to handle a potentially unlawful situation he may get in to.

It is clear that your Dad is in need of a full examination by a physician. You will need to find out more about your Dad’s health to know how to help care for him. It is probably going to be very challenging to find his current doctor, so in these sorts of situations it is best to start fresh. Take him to a new doctor, one that specializes in Alzheimer’s disease and can do a complete work-up to understand his health situation. You will need to go with him to the doctor. And from the look of it this could be difficult. The trick is to be very creative, and find ways you can approach your Dad’s health care without being so direct. Instead of approaching it as if something is wrong with him and that is why he needs to go to the doctor, perhaps acting as though he has his regular annual check up to prove he is doing great, is a more appropriate option. It may be best at this time, if he is still in his hometown, to visit him and accompany him to a local doctor. Some other creative ways caregivers have gotten their loved ones to the doctor that you could try includes, telling your Dad that you need him to go with you to your doctor’s appointment because you need his help. Or tell him that you have a special day planned and you will go to eat at his favorite restaurant, then stop by the doctor real quick, and finally you both will go do his most favorite activity together. In this last suggestion the idea is that he fixates on the good parts of the day like the food, and once at the doctor’s he can be excited for what is to come next.

When a loved one first exhibits signs of dementia it can be quite frightening for everyone involved, especially the loved one we are concerned about. Your father is facing a potential threat to life as he knows it, and that can feel overwhelming. The defensiveness he is exhibiting is a normal response to his situation. Your father may be in denial that anything is wrong, and this, too, is normal. Denial is a natural defense mechanism that we use to help protect us from thoughts or feelings that we may not be able to tolerate. Often times when there is a family history of dementia, it can be very frightening for someone who might recognize similar symptoms or changes in themselves that they have witnessed in their loved one. If your father witnessed your uncle’s experience with dementia he may be afraid he will experience a similar outcome, and this may contribute to the denial and resistance that you are seeing.

My first suggestion is to be supportive to your dad, and this may mean supporting his denial initially. If he is not ready to face the possibility of having dementia, do not force him to do so. Try approaching the issue from a different perspective. If he insists that nothing is wrong, do not challenge that belief. Instead validate his fears, but still state your position. For example, you can say, “I know you are healthy, and you feel you don’t need to see a doctor, but I would feel better knowing that you have a clean bill of health.” Offer to go with him to the doctor for a check-up "just to assure that everything is okay, and then we can put this all behind us once and for all." The important thing is that your father knows how much you love him, and that, no matter what; you will be there for him. Take things one-step-at-a-time and continue to support him. It is important to be compassionate and understanding of his situation.

In regards to your dad’s legal situation, I recommend that you find an Elder Law attorney in your dad’s hometown. Speak with the Elder Law attorney about your dad’s current legal situation, his health problems, and stress your concern for your dad’s interest. It may be hard for you to locate his divorce lawyer, but due to his health changes it is important to keep him safe and protect his interests.

When it is time to have him move in with you, which may be very soon depending on his care needs, and his legal situation, the key factor to remember is creativity. Similar to getting him to the doctor, try not to be so direct. Do not approach it as his inability to take care of himself (he has to come live with you because he is sick); instead, present it in a way where he is helping you by coming to your home. Consider your father's remaining skills/talents and come up with ways he can be of help around the house. He may be more likely to move to help his family, and it would provide him with a sense of purpose and importance. For instance, you could say, “Dad, I really need your help around the house. I was thinking to remodel the kitchen but I need your expertise. We will come pick you up on our way back from (a place by his house).” Have him visit for an extended period of time under the impression that he is there to help, when he begins to feel comfortable, or when the time is right, you can then begin to move him in completely.

There are many things to keep in mind, but some of the main themes are to be supportive by offering positives, be creative, and offer sensitivity to help him through his fears of his failing health and possible dementia. Also, do not forget about your own health. Always make time for yourself to relax and unwind; these complex situations can be very overwhelming and exhausting.

If at any time you have more questions are in need of addition help I highly recommend that you call the 24 hour helpline and speak directly with a Care Consultant. Call 800.272.3900

Thank you for participating in the Alzheimer’s Association Online Community.

Sincerely,

Jaimie E.

Alzheimer's Association
Care Consultant