95yo Dad Not Accepting His Cognitive Decline

[Anonymous]

I'm grateful for these forums and have always tried to offer help, compassion, and advice in other areas where I've had experience (parenting, college apps, relationships, divorce). Now I'm in new territory and hoping I can get some guidance or input.

My 95yo dad has lived a long, productive, and impressive life as a lawyer, family man, father, and community leader. His brain was always the strongest muscle in his body. He reluctantly just stopped driving a few weeks ago. He has hearing aids but rarely wears them because he says he's fine (not even close to true).

But now his cognitive decline is significant to the point that he has a lot of trouble processing certain conversations, basic reasoning, and especially anything with numbers. As I really pay attention to what he says and does, it's clear that he's been "covering" for a long time about the fact that he doesn't always understand what's going on in situations, conversations, or in the room in general. He will laugh when people laugh, but I doubt he understands why people are laughing. He says "Ok, that's fine", or "Very good" as a way to end a conversation topic he isn't tuned into.

His investment house recently required that I be added as a co-trustee because they sensed a "capacity issue" when he would call in several times a week. That was a huge wake up for us. I am on the phone with him almost every day helping from afar with various things.

All this to say, the decline has been significant to the point that my siblings and I (who all live in different cities) are trying to get in into a senior community with step down care. We are also in the process of executing POA and similar documents.

He is at the point where he should NOT be handling his own affairs; appointments, finances, medical visits, etc. He has accepted our help with some things, but still insists on handling his daily finances. Over the last 2 years this has resulted in bounced checks, HORRIBLE record keeping, and significant debt unnecessarily accrued on his HELOC. When he calculated his income to see what new living options he could afford, the number was so far off it was shocking (he tried twice more and it got worse, so I'm doing it). His ability to work with crucial numbers is essentially over. This has got to be frustrating and scary for a guy who was working on projects and cases worth hundreds of millions of dollars during his career.

He does not and will not accept that he can't do this anymore.

My question:

What would you say to really get through to him and make him "turn over the keys" so to speak? Since we all live far away, there isn't really time to gently walk him to the conclusion, and stop by weekly to help out; I came to stay for the month of December in order to take care of a bunch of things and go with him to many appointments I helped schedule, but I need to set up systems I can manage after I leave.

What's the magic phrase or way to say it so that he "gets it" with out a lot of push back? Has anyone had a similar experience or been in a similar situation? What did you do that finally broke through?

We love our dad and just want to help make his life easier and clean up the mess he's making.

Thanks in advance for any help or input.

[Anonymous]

I don't think there's an answer for you. A lack of insight into his condition is a feature of the disease.

[Anonymous]

I think your phrase..."We want to make your life easier" is a great one.

[Anonymous]

First, give him the recent article about how not wearing hearing aids can increase dementia and take him to the ENzy (masked) for a hearing aid tune up if needed. Being able to hear is important.

Second, it sounds like he has resources. That means he can afford home caregivers. Look into agencies that can provide that. Memory wards are like prisons. Don’t do that to your dad if you don’t have to financially.

Third, it sounds like you are getting things in place. You’re a
co trustee of the bank account. Get POA in place stat which it sounds like you’re trying to do.

Beyond that, what is it that you are trying to do? Pay his bills? Set up automatic drafts for everything that you can.

[Anonymous]

He's 95, so think hard about what senior community is appropriate. He's not going to be there for decades and his needs will likely increase rapidly. Memory care doesn't sound like a good fit yet, but he also doesn't sound like he can't be fully independent. It may be tough to find something that fits his needs.

If he was a lawyer, can you use the line "This is associate work, let me do a first pass and I'll report back." Then take the time to walk him through what you did, if he wants to hear it.

[Anonymous]

You aren’t going to get through to him. He won’t understand. It will probably make him angry, because it’s confusing. Try to put alerts on his accounts (this is how we learned my mil was being scammed by mailing cash on shoe boxes). He will continue to get worse and then will lose the ability to fight you / intervene. But refusal to understand what he’s capable of IS dementia. Get POA, look at places with good memory care, even if he doesn’t need it yet. Recognize that he is probably worse off than you think—it’s harder, I think, for children to assess accurately their parents level of function than an outsider. My experience is that things can get bad very quickly (for example, a fall) so if you plan to move him, do it asap.

[Anonymous]

This is one of the many things that has done me in over the years with trying to help parents/inlaws.

First off, you are very fortunate that he accepts any help, he isn't raging or tantrumming at you and you and your siblings are on the same page and able to work together. My sibling just feeds my mothers delusions and gets financial rewards for it.

He needs a full assessment and I would just let you know you and your siblings want it for peace of mind and won't be letting up until he gets it. I would also get him to accept an aging professional visiting and assessing every few months so that you all can leave him alone and stop worrying.

Those are some first steps.

It really is so frustrating and challenging, but like I said, the fact he went along with anything means he is a lot more compliant than the elders some of us deal with so I hope he stays that way. Also, if you have siblings who aren't going to take advantage of him financially you are a step up.

[Anonymous]

Anonymous wrote:He's 95, so think hard about what senior community is appropriate. He's not going to be there for decades and his needs will likely increase rapidly. Memory care doesn't sound like a good fit yet, but he also doesn't sound like he can't be fully independent. It may be tough to find something that fits his needs.

If he was a lawyer, can you use the line "This is associate work, let me do a first pass and I'll report back." Then take the time to walk him through what you did, if he wants to hear it.

I just posted, but these are good points. He needs a CCRC where he can easily move along as needs increase. He doesn't need memory care now, but in the next few years he may and you don't want to keep doing major moves. I disagree with the part that it may be hard to find something that meets his needs. There are people in assisted living with very minor needs and the next year they have more needs. The more independent folks in AL tend to hang out with eachother so it doesn't feel like you are among people with greater needs. Before you know it, you need all that AL has to offer.

[Anonymous]

Anonymous wrote:

Anonymous wrote:He's 95, so think hard about what senior community is appropriate. He's not going to be there for decades and his needs will likely increase rapidly. Memory care doesn't sound like a good fit yet, but he also doesn't sound like he can't be fully independent. It may be tough to find something that fits his needs.

If he was a lawyer, can you use the line "This is associate work, let me do a first pass and I'll report back." Then take the time to walk him through what you did, if he wants to hear it.

I just posted, but these are good points. He needs a CCRC where he can easily move along as needs increase. He doesn't need memory care now, but in the next few years he may and you don't want to keep doing major moves. I disagree with the part that it may be hard to find something that meets his needs. There are people in assisted living with very minor needs and the next year they have more needs. The more independent folks in AL tend to hang out with eachother so it doesn't feel like you are among people with greater needs. Before you know it, you need all that AL has to offer.

He has money. They can afford care at home. That is usually better than being institutionalized especially during COVID. Op does not need to convince her dad to move into assisted living if he wants to stay home.

Op, you don’t need to knock him over the head with the fact that he is cognitively declining. Our state lawyer recommended we approach it as, Dad, you’re retired and you need a break. Let us help you with some things, mundane things like getting the bills paid.

[Anonymous]

Anonymous wrote:If he was a lawyer, can you use the line "This is associate work, let me do a first pass and I'll report back." Then take the time to walk him through what you did, if he wants to hear it.

Wow - great idea! Thanks so much. I'll let you know if this worked.

[Anonymous]

You will never get him to understand. Because even without cognitive decline, it’s difficult to wrap your head around aging. Hell, I still feel like I’m 20. (And I’m far from it!) But also, with dementia, you can’t remember what happened, so your brain fills in with what would’ve happened. So he can’t remember where the groceries that suddenly appeared in his refrigerator came from. So he thinks he did the driving/shopping.

So stop hinging your next steps on him understanding and accepting. You may have to use subterfuge to get him to do what is necessary. I tricked my Mom to come visit me and while she was at my house, packed up her house and moved her into IL.

And I’m so glad I did. My parents were 15 mins away for 2 years. And in those 2 years, they were able to build a relationship with DS. And I was able to help them as things declined rapidly. And I was able to be there as they started the dying process and until the end. I’d never have been able to do this if they still lived far away.

One thing that helped me convince my Dad (who did not have dementia), was the idea of having some control over the situation. I told him, if he got sick or disabled and I had to move him and mom closer to me, I’d be making all the decisions. He’d have no choice. And told him, the last thing he’d want to do while sick or disabled is have to move.

Good luck!

[Anonymous]

Anonymous wrote:

Anonymous wrote:He's 95, so think hard about what senior community is appropriate. He's not going to be there for decades and his needs will likely increase rapidly. Memory care doesn't sound like a good fit yet, but he also doesn't sound like he can't be fully independent. It may be tough to find something that fits his needs.

If he was a lawyer, can you use the line "This is associate work, let me do a first pass and I'll report back." Then take the time to walk him through what you did, if he wants to hear it.

I just posted, but these are good points. He needs a CCRC where he can easily move along as needs increase. He doesn't need memory care now, but in the next few years he may and you don't want to keep doing major moves. I disagree with the part that it may be hard to find something that meets his needs. There are people in assisted living with very minor needs and the next year they have more needs. The more independent folks in AL tend to hang out with eachother so it doesn't feel like you are among people with greater needs. Before you know it, you need all that AL has to offer.

The issue is that he may not qualify for independent living, but isn't yet in need of memory care. There can be a gap where the senior doesn't fit in any of the available categories.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:He's 95, so think hard about what senior community is appropriate. He's not going to be there for decades and his needs will likely increase rapidly. Memory care doesn't sound like a good fit yet, but he also doesn't sound like he can't be fully independent. It may be tough to find something that fits his needs.

If he was a lawyer, can you use the line "This is associate work, let me do a first pass and I'll report back." Then take the time to walk him through what you did, if he wants to hear it.

I just posted, but these are good points. He needs a CCRC where he can easily move along as needs increase. He doesn't need memory care now, but in the next few years he may and you don't want to keep doing major moves. I disagree with the part that it may be hard to find something that meets his needs. There are people in assisted living with very minor needs and the next year they have more needs. The more independent folks in AL tend to hang out with eachother so it doesn't feel like you are among people with greater needs. Before you know it, you need all that AL has to offer.

He has money. They can afford care at home. That is usually better than being institutionalized especially during COVID. Op does not need to convince her dad to move into assisted living if he wants to stay home.

I don't agree with you here. First, home caregivers are going to get very pricey very quickly if he starts to need 24/7 care. Second, it absolutely depends where you were living and what the facilities were like w/r/t nursing home death rates during the outset of covid before vaccines. We're not living in the same world now. Sure, absolutely, being elderly is a huge risk for covid -- but in my mom's independent living community she just moved to, their vaccine rate is almost 100% and people are not dropping like flies anymore.

Also, being alone is a huge risk factor for life-threatening issues like falling, not to mention it exacerbates mental decline to be alone and not with other people. My mom almost totally isolated herself in her single-family house for most of the pandemic to date and we saw her experience terrible loneliness (by choice, she didn't even want to get together outside for a long time) and experience further hearing loss and decline. She was so depressed, too. We managed to get her into a great place by truly herculean efforts on my family's part and it's like she has a new lease on life. She's making friends and has like fifty times the daily social interactions she used to.

Keeping your parent at home all by him- or herself is not necessarily a kindness if they are lonely and isolated.

[Anonymous]

If I were you I would choose between hiring people to care for him at his home or convincing him to move in with you or near you so you can monitor things easier from nearby. That would probably also require hiring some help but maybe not as much.

[Anonymous]

On matters of business and finance, appeal to his logical side with constant reminders that you are working with him (not in place of him so as to save his sense of dignity) to protect his assets. Always acknowledge his primacy so that he doesn’t feel like he’s losing all control. That’s why PP’s idea of calling it “associate work“ is fabulous. We have good luck with my father-in-law bye saying we’re “streamlining” things or “Setting up the online accounts this place now requires“ because he has no internet savvy. On a fundamental level he knows he’s losing control and that’s scary to him.