this post was submitted on 05 Sep 2023
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My great grandfather moved in with me as he is having a hard time living alone and his cognition is starting to fade he is incredibly rude and claims false things due to his lack of senses in his older age and has fallen multiple times. I am starting to see that this situation could get worse and I am not sure how to proceed. I am thinking it would be best to have him stay at a facility that is properly equipped to handle him though I fear the family backlash from such a situation may be seen as taboo. Is there anything I should do to properly handle this situation? Do I need specific documentation or anything? I'm new to this and not sure how to proceed he wasn't always like this he was a good person when he was younger but I fear my kids may be negatively impacted from how he acts towards them now. Please help, thank you

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[–] [email protected] 33 points 1 year ago

Anyone who gives you backlash is welcome to take over your duties.

[–] [email protected] 21 points 1 year ago (1 children)

I'm afraid if you are looking after an older person you have to have an eye on the endgame and that might involve going into a care home.

It's best to be open about this and have a discussion with the family, and himself if he is capable.

Have you got all the relevant medical information? Has he been tested for dementia and other issues? All this would be important for that discussion as well as this:

Do I need specific documentation or anything?

You really need some kind of Power of Attorney but his cognition may have declined beyond the point he could consent to this. It would be worth getting legal advice though.

[–] Relentless_Blinky 7 points 1 year ago (3 children)

What if they are resistant to being tested for dementia.

[–] [email protected] 12 points 1 year ago

That would be a bad sign in and of itself.

It depends on where you are, but when I took my Dad it wasn't pitched as a test for dementia - it was at a local Memory Clinic and was done to establish a base level for his cognitive abilities to make sure they spot when they start to decline (he passed with flying colours). The clinic was also able to prescribe pills that his GP couldn't, so they sold us on all the benefits.

His GP (or regional equivalent) can do some quick tests - I took my uncle to the doctor once and she ran a few by him like drawing a clock, part of the test at the Memory Clinic (my uncle failed badly, which was quite an eye-opener, you think everyone can draw a clock, until you see someone fail and fail very badly). He was a cantankerous sod but still went along with the tests.

[–] givesomefucks 6 points 1 year ago

What country and even state you're in starts mattering a lot at that point.

But as far as your personal situation, tell your family you believe this is a concern and that he won't go to doctors for it.

It sounds harsh, but if the family denies it's a problem, let one of them experience what he's like on a day to day basis. He might be able to fake it around them for short times, but wouldn't be able to keep it up for a week long stay.

It's tough love, but at a certain point you have to say you can't take care of him anymore. It won't get better

[–] SgtAStrawberry 4 points 1 year ago

That, what documents you need and what resources are even an option, is hevely dependent on what country and place you are in.

[–] [email protected] 8 points 1 year ago

If the resources are available to you look into some home health help, preferably of the sort where you'll be getting visits from the same person each time.

If a nurse or PA is around your great grandfather a couple times a week (and is seeing patterns) they can offer some insight or at least give you an in-the-loop person to talk things over with. And you can potentially share their evaluations and opinions with your family to help make your case.

[–] Vodik_VDK 8 points 1 year ago (1 children)

You may want to take this opportunity to educate your children on the relationships between lifestyle choices, old age, atrophy, and death, but also to ensure they understand that who they see is not who he was.

[–] [email protected] 6 points 1 year ago

educate your children on the relationships between lifestyle choices, old age, atrophy, and death

As long as the relationship is described as “You will get old, sick, and die regardless of your lifestyle choices”.

The way that’s worded it almost sounds like lecturing the kids on how Grandpa chose this for himself, which isn’t true.

[–] foggy 7 points 1 year ago

To hell with what family outside your home thinks.

You have family inside your home, and a problem in your home that's affecting them. That takes precedent. If anyone outside that has a problem with it, it's their problem to have, not yours. You can't please everyone and that includes family.

I don't have any advice other than letting this hangout go.

[–] WorldWideLem 7 points 1 year ago (1 children)

What are the ages of the generations here? I'm just curious because it's rare enough to have a living great-grandparent, let alone a great-great-grandparent (in relation to your children) in the same house. And how did this end up falling to you?

[–] Relentless_Blinky 9 points 1 year ago

We all had children at a pretty young age around 20 or sooner my parents died when I was young and my grandparents died within the last 2 years great grandma died about 7 years ago.

great grandpa is in his 80s

I'm in my 20s

An odd situation for sure.

[–] [email protected] 5 points 1 year ago

There’s an escalating approach to the level of additional care that you can consider. I’m not sure what’s available in your country/area, but you can find in-home caregivers that can come as many times per week as you wish, either to augment what you’re doing or just to give you a break. You could probably use a hand around the house as well since more of your family’s time will be spent caring rather than cooking or cleaning.

Similarly there are care facilities which are better equipped, and those also have a number of different levels of care available. They range from independent living to full time care.

Socialization is really important and it should be considered. If your great grandfather has friends or a support network outside of family, he should be encouraged to keep in touch with them. If he’s in a state of decline where that’s not feasible, then you might want to start considering a facility because that’s getting into the border of what someone can take care of on their own.

Also, just as an observation, “great grandfather” staying with you seems to be skipping multiple levels of care unless you already live in a multigenerational household.

[–] FarFarAway 2 points 1 year ago

Assuming you are in the US. We just went through this with a family member. Her mental decline happened in the matter of a few months, following an accident. They had a prior TBI, and something just snapped, I don't know.

I can't attest to how to get a dementia diagnosis. Their decline was completely atypical of regular dementia, but it did meet the technical definition. They were admited to the hospital and it took a long time for the doctors to really pick up on it. Instead of answering the questions, they would just get hostile. Eventually, things would slip, but we had a really hard time getting a straight diagnosis, even though staff treated her as a dementia patient.

As someone else mentioned here, you need to find out who, if anyone, will be granted power of attorney and medical power of attorney, if he is diagnosed. Technically, if he is diagnosed, they will have complete control over his finances and medical decisions. If he has made no plans to transfer POA / MPOA, you / your family will independently need to pay for any and all care. (Although you may have to anyways, as rules will vary state by state, for who is responsible for the bills). I would consult a lawyer that specializes in elder care. There may also be a regional government elder care department that maybe able to give you some information.

Getting a guardianship can take years, and emergency guardianship only lasts for a few days. If there is no one designated, and your grandfather is not willing / able to sign the forms... as someone told us, "Oh, your in a pickle." If it comes to this, he will have to have progressed pretty far with the disease for any doctor to sign the paperwork. Guardianship means that all rights are stripped from them and given to someone else. Even though the guardian will have to submit to regular audits, people still abuse the position, and the doctors also have a responsibility to safeguard against this.

If he has dementia, medicaid will help cover costs, but you need POA to apply for him. If he has retirement money, you cannot access it without POA. If you can not pay, no place will take him. Full stop, unless someone takes pity on you and you can work out a deal of some sorts.

Medicare will pay for about 20 day in full, and up to 100 days partially, with stipulations, if there is a 3 day hospital stay involved. Fyi. Hospitals in the US must discharge to a safe place. If the home is "not safe" they cannot force you to take them home regardless of what they say. They will threaten to kick them out of the hospital, they will threaten guardianship, they will try to guilt you. If you can not care for them, then refuse to take them and tell them it is "not safe". Do not sign discharge papers until you consult a lawyer.

Care homes will need to specialize in dementia, or they will not take him, so your options will be limited. Hobestly, I think it ultimately has to do with fire safety.

I'm sorry if this is scary, but it's been a nightmare for us, and I don't wish this on anyone else. The sooner you start preparing, the smoother it will go once the time comes. You really have to be at the top of your game to navigate the (again US) medical system, if your trying to care for someone else. Of course, in this country, it all comes down to how much money you have.

Good luck.