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Old 07-26-2015, 07:03 PM
 
Location: Southwest Washington State
21,568 posts, read 14,187,164 times
Reputation: 30177

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Such a fast decline might be due to a physical problem, and he needs to be looked at ASAP by his doctor.

The running away is a symptom of dementia. It happens so often in the evening, that there is a term for it: sundowning.

You need a diagnosis of whatever dementia he has, or even if he has it. Is he taking a new medication, for instance? Does he have a UTI? If he has dementia, you need that diagnosis for several reasons. One reason is for the doc to know if there is a med for his condition.

In terms of keeping him at home for the rest of his life, ask yourself whether this is fair to him. He will be kept probably by a series of caretakers with various levels of dependability and not allowed out because he could harm himself. If he goes to an ALF, or to a memory care unit, he can have some social contact with caretakers and other residents. He will have his own room with a TV, for when he wants to be alone. If he has a medical emergency, he will have a nurse with at least some training available to act or call emergency services. He will be able to have decent or better meals on a schedule, and his meds will be dosed regularly.

You have to ask what is best for this old man. You also have to ask what is practical and what is affordable. You and your husband will be responsible for making these decisions. It isn't up to him any more.

I want to wish you good luck in this journey.
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Old 07-27-2015, 06:27 AM
 
3,758 posts, read 10,596,841 times
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Quote:
Originally Posted by silibran View Post
Such a fast decline might be due to a physical problem, and he needs to be looked at ASAP by his doctor.

The running away is a symptom of dementia. It happens so often in the evening, that there is a term for it: sundowning.

You need a diagnosis of whatever dementia he has, or even if he has it. Is he taking a new medication, for instance? Does he have a UTI? If he has dementia, you need that diagnosis for several reasons. One reason is for the doc to know if there is a med for his condition.

In terms of keeping him at home for the rest of his life, ask yourself whether this is fair to him. He will be kept probably by a series of caretakers with various levels of dependability and not allowed out because he could harm himself. If he goes to an ALF, or to a memory care unit, he can have some social contact with caretakers and other residents. He will have his own room with a TV, for when he wants to be alone. If he has a medical emergency, he will have a nurse with at least some training available to act or call emergency services. He will be able to have decent or better meals on a schedule, and his meds will be dosed regularly.

You have to ask what is best for this old man. You also have to ask what is practical and what is affordable. You and your husband will be responsible for making these decisions. It isn't up to him any more.

I want to wish you good luck in this journey.
Everything you've mentionened with LTC (which, when you're talking about 24 hour care is what you're talking about, not an independent living "senior apartment" as a true ALF was originally billed) is possible at home.

As far as finances, if I recally correctly, the gentleman is quite financially sound - so finances won't likely be the deciding factor in this.

Agreed that a decline that quickly seems unlikely for something like alzheimer's dementia - could be medication related, or TIA, or some other unknown infection. Any time there's a sudden change in behavior (which this would qualify as) - get a full neurological check to see if anything's happened.

Best of luck to the OP and to her husband and FIL. At 93, I just hope whatever time he has left (be it weeks or years) is good time.
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Old 07-27-2015, 05:08 PM
 
Location: Southwest Washington State
21,568 posts, read 14,187,164 times
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Quote:
Originally Posted by Briolat21 View Post
Everything you've mentionened with LTC (which, when you're talking about 24 hour care is what you're talking about, not an independent living "senior apartment" as a true ALF was originally billed) is possible at home.

As far as finances, if I recally correctly, the gentleman is quite financially sound - so finances won't likely be the deciding factor in this.

Agreed that a decline that quickly seems unlikely for something like alzheimer's dementia - could be medication related, or TIA, or some other unknown infection. Any time there's a sudden change in behavior (which this would qualify as) - get a full neurological check to see if anything's happened.

Best of luck to the OP and to her husband and FIL. At 93, I just hope whatever time he has left (be it weeks or years) is good time.
I don't think we disagree. I do wonder if staying by oneself in the home is best for people, although many elders seem fiercely decided on doing so. I don't think this person is a candidate for independent living, but possibly might be for assisted care. (I can't remember if he is bed bound.) Certainly, he sounds as if he might need a memory care unit. But since I'm not there, I really don't know.

I think the OP needs to look at other options before deciding, at the very least. And, there is no one right way to give care to an elderly person.
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Old 07-27-2015, 06:17 PM
 
Location: Boca Raton, FL
5,136 posts, read 8,658,042 times
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Smile Always an escape artist

[quote=silibran;40571674]Such a fast decline might be due to a physical problem, and he needs to be looked at ASAP by his doctor.

The running away is a symptom of dementia. It happens so often in the evening, that there is a term for it: sundowning.


He was one of 4 children. His own father was a tyrant. My FIL would take the beatings and take the blame for his 3 sisters (his sister told me all this about 4 years ago). It answered so many questions.

When he would get stressed, he would get in the car and disappear. When my husband was 15, he thought he was going to the store with his dad (it turned out it was a week in Pittsburgh) - 2 days away from his home!

My MIL was furious and even had his favorite tree cut down in the front yard. Usually, she was submissive.

He would show up for work but other than that, he would just take off for a day and no one knew where he would go. He was a loner in those days but I think today, he regrets not having more friends.

My husband usually just obeyed him. He got beat himself until he was 16 (he had been watching TV) and that was a no-no. Finally, his mom found her voice, said "that's enough" and it was never again done.

I've been in conversations with him and he will just turn around and walk out of the room. Now, I understand more why. (They were years ago).

He does seem to like the caregivers.
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Old 07-27-2015, 07:13 PM
 
300 posts, read 406,066 times
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He can probably stay at home. If it gets to be too much and he is expected to live less than 6 months, he can go to hospice. I believe all insurance plans pay for hospice.
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Old 07-28-2015, 03:43 PM
 
Location: Fredericksburg, Va
5,183 posts, read 13,299,098 times
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What did he want, before he became incapacitated? Did you all talk about this stuff?

Our family has...everyone knows what I want...I know what everyone else wants.....it makes a HUGE difference!

If he can afford to be at home with 24 hour care...great. If not...don't feel guilty if you have to move him elsewhere. This aging business sucks the big one, doesn't it?
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Old 07-28-2015, 04:41 PM
 
Location: San Antonio
7,629 posts, read 14,339,010 times
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Quote:
Originally Posted by Bette View Post
My husband was rather shocked as how passive he was and he did everything he was told and agreed to everything.

We are playing it by ear, day by day. He will not be alone.

At lease, he will not be driving and a danger to others in that way. That was my biggest concern.
LOTS of potential factors: meds, dementia, cancer. My father in law was fine (or so we thought) until he drove into a snowbank on the side of the road, walked to the house of a family he has known all his life and asked to use their phone (not knowing who they were) introducing himself and explaining what happened.

3 days in the hospital revealed he had lung cancer that had metastases to his brain. He was gone in 4 weeks.

I am grateful you are willing to ensure he has the round the clock protection and care he obviously needs now.
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Old 07-28-2015, 07:54 PM
 
6,606 posts, read 3,806,188 times
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From the variety of posts here, it's obvious there is no simple answer for an elder's care. One thing that I would stress, wherever he is, be sure a family member drops in unexpectedly at different times to check on things. Even in a facility, people get the best care when family oversees it all. He is lucky to have you all looking after his best interests.
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Old 07-30-2015, 11:49 AM
 
Location: Las Vegas
13,841 posts, read 25,219,256 times
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Sounds like a stroke to me. It doesn't often happen so quickly/dramatically with dementia alone.

As long as the patient and the caregivers are safe there is no reason not to care for him at home. Assuming he can afford it. My mom and I cared for my father at home for a decade. He spent the last 6 weeks of his life in a facility because he became increasingly combative and frustrated about his inability to communicate. He clocked my mom and went after me too. Behavior I could not tolerate in my home.

However, I wonder if that's really the best option. I often thought my father would have been better off in an environment that allowed him social interaction with others. Too much isolation at home. Too much sitting in front of the TV. Maybe you could do adult daycare a couple days a week and see how he does.
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Old 08-02-2015, 11:59 AM
 
Location: Boca Raton, FL
5,136 posts, read 8,658,042 times
Reputation: 6103
Smile Slight update

We have had the 24 hour care now for just over a week. We'll see how it goes.

Some slight improvement in his balance. He was always a good walker so this is quite evident. He uses a cane; has a walker; refuses to use it. He is very tall.

One of the caregivers who is out right now herself (hip surgery) will be back in 2 weeks. She is the best at taking him places and getting him out. We think he misses her.

We tried so hard to talk about what he wanted; we know he wanted to stay as independent as possible in his own home. When his sister was alive, she had her will updated in 2013 along with necessary POA info. He did that also. We have copies and originals.

My husband has crossed that bridge - it was so hard for him to take over certain duties and the reality of it has been very hard on him. His dad never wanted to talk about it and if there was a small window, you tried to do what you could.

I am just happy the car is gone; that was my biggest concern. I feel my prayers were answered. He has 2 kind neighbors if he ever needed anything plus 3-4 caregivers that will run around plus us. He does have a good support system and that's all we can hope for.

Day by day.
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