You can apply to become his legal guardian and so have control of those
things he can not manage and it will get worse. It's a slow and maybe a
difficult course of action but if he refuses to recognize his needs (and
that's a common denominator of Alozheimer's) that may be your only route.
Check with legal aid for help if you can. This is a familiar story to most
of us here and we wish you the best in your efforts. Just remember that you
are not dealing with the father you once knew but to a man whose personality
has been changed by this disease. Good Luck.

Bud

I your father frightened of the people he sees? If not then what is
the problem? Giving the elderly  medicines can be extremely dangerous,
even if recommended by a doctor. Based on what you have written, I
side with your father. As people get older, they do things that the
outside world thinks are strange. I say, so what!
The next step after an assisted living is a nursing facilities.

Before you consider a guardianship or conservator ship, please go to
www.halt.org and get the brochure that they have for you to download.
You can also find interesting and shocking information on youtube
about abusive guardianships and nursing homes.

If you are wanting to be your father's care advocate then you need to get
powers of attorney, both medical and full. Your father obviously needs a
high level of care whether he realizes it or not. I'm sure he probably
thinks everything is just fine but obviously assisted living would be a much
better situation. I'd go for a medical power of attorney first. If push came
to shove you and you had to go to court, given what you have already said,
you could already easily obtain full power of attorney. If you do not get a
power of attorney from him willingly and get some help for him started then
your only other choice is to wait for the crippling event, car wreck,
accident or whatever that hurts him enough that he becomes so incapacitated
that he no longer gets a vote in his caregiving future.

You are in a tough part of the road of being a dementia caregiver becasue
the early stages are often the suspicious & paranoid stages. Contact the
social worker, this Dr and whomever else might be in a position to help and
ask them for advice on how to get started. I'm sure they already know he
desparately needs help and will appreciate your active participation.   good
luck.   AW

I'd like to some more notes about assisted living.

Some AL facilities have different levels of care ranging from
complete independence in what is very much like an apartment
hotel to complete, locked door, Alzheimer's care.

Facilities like that have some nice advantages for early stage
Alzheimer's patients.  They can live in a more independent
section of the facility for as long as they are able, perhaps
making friends with people who function at a relatively high
level.  Then they can move to a section with a higher level of
care if and when they need it, without moving to completely new
and unfamiliar surroundings.

This can enable an early stage patient to enjoy a higher level of
functioning than he could in a strictly AD environment, and stay
there longer.  When he is introduced to the facility he will find
the people and the environment less disturbing than if he moved
to a facility where everyone has AD.  He is likely to find the
place much more acceptable.

These issues should be discussed with the intake person at the
facility.

I would also ask to meet the director of each facility you
investigate.  A good director doesn't guarantee an ideal
facility, but a bad director means there will be a lot of things
wrong.

There are more things I'd like to say about what to do once your
Dad has moved in, but they can wait.  You can only do so much at
once and have to take steps one at a time.

Best of luck.

   Alan

Marilyn, I'm wondering if he actually has Lewy Body dementia, since
visual hallucinations are one of its hallmarks, along with the balance
and gait problems you mention he has. I would urge you to talk to the
neuologist to determine if they have considered this, since Lewy Body
has some different features than AD, although they both end up in the
same place. Knowing for sure what the cause of his dementia is can
help you be prepared for odd behaviours and give you a better feel for
what to expect.

My advice is to take advantage of his confusion/memory issues where
you can - which sounds terrible, but he'll never say yes. If you wait
for him to agree he's impaired and needs help, you will be frozen - he
can't see his own problems, even if they are readily apparent to you
and everyone else. Not only can he not see his own deficits, his
ability to reason is going down hill, so even if he did realize he was
in trouble, he wouldn't be able to think up a solution, much less
figure out how to implement it. He's also terrified of change, since
his grip on what is going on is so tenuous, and he can't learn new
things very easily.

Arrange whatever you need to arrange without his permission, and take
things from there. The priority has to be keeping him healthy and
safe.  I'd start with meal delivery. Try to be there the first few
times they are delivered - you may be able to convince him that he
agreed to give it a try. I'm thinking he might not say no when a hot,
tasty, premade meal is right in front of his face i.e. might as well
eat it as let it go to waste. And in a couple of days, he might think
it was his idea in the first place. My mother in law protested the
meal thing as well, but it didn't take long for her to start to
actually like it. Preparing nutritious and appealing food for one can
be a chore even for someone who is NOT mentally impaired, and what's
not to like about a nice tray just showing up, poof!! No effort
required, and no kitchen clean up either (they take the tray back next
day when they bring the next one).

In the early stages, we had a housekeeper come in half days
(mornings), five days a week. This person did her basic housework,
laundry, and made sure there were some groceries on hand (plus keeping
an eye on everything, which was probably her most important job). The
housekeeper made sure my mother in law ate breakfast, and made her a
lunch (i.e. some sandwiches on a plate in the fridge). Then Meals on
Wheels brought her a good dinner, so we knew she was getting three
reasonable meals a day.

We sold my mother in law on the housekeeper by telling her it was a
favour for us. We went on about how we were worried about her on her
knees trying to clean, and how it would make us feel so much better
knowing she didn't have to worry about all that stuff etc. etc. And
golly, we knew she was perfectly fine, but if she'd give it a little
try it would be a real gift to us, and weren't we silly, blah, blah,
blah, as we lied through our teeth, soothed, cajolled, patted and
fluffed!!!

When she got to the point we had to move her into a facility (when
being alone even for part of the day was just not an option anymore),
we again took advantage of her confusion and her inability to initiate
rational action. We just arranged it - we did tell her, but she
constantly forgot she'd been told, so eventually we stashed her at her
sister's place for a night for a nice visit, and we all ran around
like nuts to move the necessary items and set up her room at the
assisted living facility. We then retrieved her from her sister's, and
took her to the new place. At that point, she couldn't really have
organized an escape - i.e. thinking through where she was, how to get
home, packing, etc. would have been beyond her.

If you really questioned her about going home, she'd start talking
about her girlhood home, so it wasn't the apartment she'd been in -
her brain had deleted most of her adult life in terms of specific
ideas about place.

Mary G.