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!
This may come down to your needing to travel to Virginia to assess this situation if there is no other family there, or asking APS for a wellness check on your parents. So sorry. All of this is made so much more difficult with the distance factor. I wish you the best.
I drove from CA to VA in January (not willing to fly yet) so I could see what could be done, have a meeting (parents and me) with the doc and to support Mom. That’s why I found this forum to seek help.
What is APS? Dad is unlikely to do anything willingly or to discuss what he feels is a private matter - meaning that he feels Mom’s behavior in his delusions is something just the two of them should discuss, so he can help her with her problem. He told me that. So I wonder how they do an eval in those circumstances and what to do with the information. I wrote a lengthy reply to xrayjodib but in shorter form - Dad is pretty functional for a 90 year old. He does have dementia but it’s fairly mild so far, with only short bouts of being really lost. So it’s the delusions and their effect on Mom that I’m focused on.
I appreciate your kindness in the rest of your reply and perhaps I am being sensitive to what may have been said with no bad intent. If so, my apologies.
I do think that this needs to be taken care of ASAP or else instead of one patient (your Dad) you are going to have two (Mom and Dad). Even with an antidepressant, she is too old to be dealing with this on an ongoing day to day basis.
I’ve written oodles more on other replies and I’m guessing no one wants to read it all again. I wrote a very long reply to xrayjodib if you are interested. I acknowledge that partly I needed to be heard. Thanks for doing that.
Good luck.
Writing out my question and reading and writing replies has helped me realize my immediate concern is about the emotional toll of Dad’s delusions on Mom. Despite what he saying, he’s calm, as though he’s concerned about her “problem”. So we’re not dealing with violence or aggression, not even yelling.
The next concern is what to do if this gets much worse or unbearable for my mother.
So at the very least, I’ve clarified what I need help with.thanks again. Kindness always helps.
As Alva asked, do you or someone else have POA? If not, you need to obtain it! Seek an elder care attorney or speak with your parents local Counsel for the Aging. They may be able to point you in the right direction.
Sounds as though Dad and Mom need in home care if not assisted living/memory care!
Do some online research about "Therapeutic Fibbing ". You may have to be creative.
Dad is most certainly not going to get better. He is only going to decline. I imagine you already know this, but I apologize if that sounds harsh!!
I understand that it's a dignity issue with Dad, however, it's also a safety issue for both Mom and Dad.
Wishing you the best!!
(((Hugs)))
I will look up Therapeutic Fibbing for sure, thanks.
If his delusions weren’t about my mother becoming a prostitute and seeing clients on the sofa after he goes to bed, this wouldn’t be such an issue. It horrifies Mom and leaves her in tears.
If Dad were my adult child, I might have him admitted (undoubtedly against his wishes) to an inpatient psychiatric program in the hope of some improvement probably with medication. But at 90 in someone so resistant, that doesn’t feel like it makes sense. I don’t know - it’s making me spin in circles!
I blabbed more than I meant to - sorry and thanks for your kindness.
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.
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.
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
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.
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.
Sure, everyone knows that many times with elderly people they will make up intrigues and put on performances because they are bored and want attention.
When it goes beyond such things as asinine raving or made up health crises or staged falls, the spouse living with them is at real risk. She gets physical with the father and tries to hit him. That can very easily and quickly graduate from hitting attempts to stabbing him with a kitchen knife. Or smashing him in the face with a skillet when he's asleep.
My father was a victim of domestic violence the last couple years of his life. He met a much younger woman (she was 60 at the time and he was 87) who was a criminal and an alcoholic and he moved her into his home. My father was certainly not a feeble man mentally or physically. Totally independent and still golfed and bowled several times a a week. Then his behavior changed. He became nervous and withdrawn. We didn't see or hear from him as much anymore. He came here one time with a smashed up face and cuts on his hands. Of course he denied it and said he fell, but that wasn't the truth. I know well how a person gets those kinds of injuries. Men of his generation are reluctant to get help or even admit that a woman is abusing them. I tried to help him the best I could and he was starting to come around. He developed a blood clot and had a stroke shortly after that beating happened and was dead a few months later. Theresejenkins should not just leave well enough alone. Her father is in danger from her mother.
I am becoming very angry at her and sometimes I just have to keep my distance, as awful as that sounds....but it really upsets me and I have a full time job and have to take care of myself (divorced living alone no kids)....her horrible language makes me not want to be around her in the evenings at all, and then during the day having to listen to the same story about his cheating is the ONLY thing she talks about...I'm drained.
They got a live in caregiver who helped tremendously. She ran interference for my FIL who already had dementia and didn’t understand what was happening. She dealt with my MIL firmly and gave her a sedative at times. She did not let my MIL near my FIL when she flew into her rages and delusions and this helped him I believe.
in your parent’s case, if they choose a live in, I think I would ask for a man caregiver who is strong in case things get physical.
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.
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.
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.
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.
I really liked some of the advice listed below.
1. Do you have POA and Health Proxy?
2. Do you have a "Letter of Competency" on your father, the physician can provide it?
3. But more importantly are you venting, which is really healthy (your gotta be able to have a release) or are you wanting answers and direction?
4. The answers are to protect your parents mentality and physically as best you can and unfortunately let the aging process take place. Which is not easy to say or watch.
5. You will need assistance in VA with a trusted friend and/or social worker and/or senior service counselor, who understands the services and process available in the state of Virginia.
6. If you need more information feel free to email me back.
Stay Inspired,
This is no easy task for the faint at heart
Also, check for local support networks - hospital, insurance plans, community centers. Mom needs to know that others are dealing with similar situations.
So far, it sounds like there have been no consequences for your father's abusive behavior, so why would he stop? Another poster suggested geriatric psychiatric counseling with both parents in the room. I would urge your mother, with your support, to make it a condition that if he doesn't agree to counseling, she will leave temporarily (or forever) .