How to deal with an elderly parent going senile?

April 1, 2012 8:33 PM

Suggestions for dealing with an elderly parent who appears to be going senile?

My 84 year-old father, who has always had at least a borderline personality disorder, has recently had major trouble coming up with words, gets lost easily, and has apparantly spent $17,000 on a new roof for the house he lives in (he lives alone), purchased from a door-to-door salesman.

What have others done when a parent starts to lose his faculties? He is stubborn and is not willing to let my sister handle his financial affairs. He lives in Washington State.

And yes, you are not my lawyer, etc.

posted by Napoleonic Terrier to human relations (10 answers total)

IANA physician. There are a lot of potential causes of sudden cognitive decline, many of which are treatable (medication interaction/side effects, urinary tract infection, electrolyte imbalance). Get your dad to the doctor first of all.
posted by gingerest at 8:50 PM on April 1, 2012 [4 favorites]

I agree with gingerest and suggest you do it asap. Knowing more precisely what you're dealing with helps with treatment, and also gives you a better sense of what to expect.

I'd also get as in synch in possible with your sister and other close relatives, both for support and ideas, and also to ensure that if you have to take radical action (ranging all the way to having your father declared incompetent), that you do it as a team.

Does your father have friends he trusts? They might be helpful members of an impromptu intervention team.

The Alzheimer's Association also has support resources.

(My mother, now in her nineties, has lived with us for five years. She is in the middle stages of Alzheimers. I asked her to move from a thousand miles away because she'd had various health misadventures, and I wanted to know what was up. Luckily, financial and medical powers of attorney were already set up for us and she was mostly cooperative. It's a hard road, even still.)
posted by alittleknowledge at 9:17 PM on April 1, 2012

Make sure that his estate is in order. Alzheimers plus an unclear will can cause immense problems down the road.
posted by Winnemac at 9:25 PM on April 1, 2012

Thanks for your answers. To follow-up, my sister is a family med doc, and she suspects Alzheimers. My father refuses to go to the doctor for any reason, and he has no friends. I don't live nearby and rely on my sister's description of my father's behavior.
posted by Napoleonic Terrier at 9:52 PM on April 1, 2012

i went through a situation with my father, over a period of 15 years.
look into a term: sundowners. the person is pretty perky in the morning hours, but as the day progresses they go downhill, repeating themselves, reading the same newspaper five or six times, becoming delusional in the afternoon, and thankfully retiring relatively early. These folks are easy picking for scammers, even and especially relatives. (i do believe there is a special place in hell for these people) i would suggest that you or our sister take charge of the situation, it's difficult because they (my dad anyway) were always independent. Waiting will turnout to be something you will regret. contact me if you'd like, for my experiences and suggestions. i'm smarter now although the ordeal aged me 20 years.
posted by goutytophus at 9:56 PM on April 1, 2012 [3 favorites]

If due to mental illness or dementia, your father refuses all assistance that he might actually need, you're really looking at a legal question about how to determine whether you should be allowed to make decisions for him over his objections. I think it may be time for you to speak with an elder law attorney about preparing for the time when your father is not competent to manage his affairs. If he indeed has Alzheimer's or some other degenerative form of dementia, that time is either already here or will likely come quickly, and you'll want to be prepared. You need to find out what you need to do to safeguard him, physically, medically, and financially, and how you can do those things in his best interest if he doesn't want you to, but isn't competent to make those decisions for himself.
posted by decathecting at 10:01 PM on April 1, 2012

Getting permission from your father for power of attorney is going to be pretty critical - it was with my grandmother. If you can get power of attorney, try to segment his bank account, and create some sort of firewall that prevents others from stealing from him. Document all financial transaction that you do on behalf of your father. It's a good idea to get power of attorney before social services declare him incompetent, as, depending on local laws, the state will then step in as administrator, levying a hefty fee for its services, before appointing one of the children as administrator. So that would be what I would try to achieve first.
posted by KokuRyu at 10:37 PM on April 1, 2012 [1 favorite]

Well, we went through hell with my dad when he came down with FTD -- frontotemporal dementia, a type which in the beginning involves losing judgement and social skills more than memory. (In the end all dementias look more and more alike.) If you can't get a willing POA and transfer of the finances, home ownership, and so forth, you'll have to seek guardianship, and that can be expensive as well as heartbreaking. We were preparing to go that route when a hospitalization led to him entering a nursing home. At 84, Alzheimer's is the most likely type of dementia by far, but there are also treatable types. You will need, almost certainly, a full neuro workup, which may include a brain scan.

Look for an Alzheimer's related social service agency, both locally and in your father's city. Do not hesitate to seek advice and counseling for your own emotional rollercoaster: just knowing others have been there before you is tremendously relieving. They can also help you arrange for home nurses or aides as he transitions from full independence.

There are many good books about Alzheimer's from a caregiving perspective, but the one recommneded more than others is The 36-Hour Day, which will be especially applicable if your dad ends up living with one of you.
posted by dhartung at 2:19 AM on April 2, 2012

Alzheimer's Association
Aging and Disability Services - Washington
Washington State Elder Law Information

If you can get your dad to a doctor, a neurologist would be the one to see. My dad has Parkinson's and dementia and it was his neurologist who diagnosed him and is helping to alleviate those symptoms.

The ideal would be to have someone as POA right now, or at least get POA while he's still (at least somewhat) competent. It's a much stickier wicket when he's already incompetent to manage his affairs - I have talked to friends who have been in this position, and my mom was in this position with my grandma. With my mom, she got a letter from my grandma's doctor saying grandma was incompetent to manage her affairs and then drew up a POA with a lawyer. In that case, grandma knew she'd lost her marbles, trusted my mom, and was willing. In another case I know, the man in question was resistant (he thought he was OK), there were dueling siblings and the whole thing was a court-case mess. Going to court for guardianship usually means a legal (not to mention emotional) slog.

tl;dr Neurologist and lawyer if at all possible. Good luck to you and your sister.
posted by Rosie M. Banks at 7:15 AM on April 2, 2012

You need to get him to an MD who's not your sister. I know from close experience that medical professionals can be completely off base about people they're close to. In fact, in the cases I'm thinking of, their medical experience was a hinderance, as it was harder for them to see other possibilities.

Is there any way you can guilt him into going? Tell him how worried you are and doesn't he love you, or something like that?
posted by small_ruminant at 3:20 PM on April 3, 2012