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Welcome to CareNotes. In this special section we will feature a reader's letter and provide an opportunity for an interactive exchange that will help find some answers and possible solutions to concerns. If you wish to respond to this letter, simple follow the link provided at the end of the letter and add your comments and thoughts to our CareNotes Board.

This Week's Carenote - 01/15/13

 My father has been living with me for a year and half and has vascular dementia. He has not been able to handle any of his financial matters and WILL not seek any medical attention. He has become very mean and thinks the neighbors are always watching him. He recently misplaced his keys and became very angry, punching the walls because he believes someone came in and stole them. What concerns me most is he is still driving. His license was suspended twice, but with help from his doctor, DMV gave it back. His overall physical health is not good. Looking for some advice on how to handle my dad.

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Name: Cathy
Location: Hartford.
Date: 01/15/2013
Time: 02:49 PM


It is essential to get a few things in order. Power of Attorney and an advance directive for your father's healthcare is a good place to start. You or another loved one or caregiver will need to take your father to a lawyer as soon as possible and explain why-to help him manage his affairs. If you are able to get your father to a lawyer, make sure the documents are all correct. You will need them for the future and it is imperative that your fatherís name be correct and all documentation is legal. Having Power of Attorney is not enough though and is only valid while your father is alive. If your name is not on his financial accounts, I would encourage you to convince your father to add you; in order to sign his checks, pay his bills and protect him from others. Itís very important to know about all his financial sources; including hidden sources like a mattress, safe in the floor or any other source. This will prove invaluable as you try to orchestrate your fatherís care. Paying for healthcare can be very expensive and unless you are independently wealthy, it will be impossible to get help or care for your father without money. You mentioned your father has a doctor and you may be able to have your father checked out to ensure his dementia is not from something as simple as a vitamin deficiency or a side-affect of medication or medications combined. At least rule out the physical. Car insurance companies may even require a physical in order to insure your father. That physical may necessitate a Dr. visit. If you have to stretch the truth to get your father to the Dr. then do just that. Tell your father the visit is for a shingles vaccine or flu shot. Call his Doctor and explain your concerns. Hopefully, his doctor will allow you to manage his care. The Dr. should require your father to sign a privacy release form (HIPPA consent form) to allow access to his medical records. It would help for you to understand that your father cannot control his temper and it in fact it may get worse. Make sure he doesnít have access to knives and guns, especially if his anger escalates. He may also lose his ability to recognize even you and seemingly harmless situations can be threatening to someone not rationale. There is medication to deal with the hallucinations, but it means your father should be monitored and definitely not driving while taking the medication. Donít underestimate your fatherís strength and his need to protect himself from situations he would view as threatening. He may direct his anger at you at times or at someone else he thinks is taking his keys; possibly a neighbor or another loved one. I too had a father with vascular dementia. He was very "with it" at times but not always and you never knew when he would go off and imagine things. My father would actually tell me there was something wrong with his head. He knew he wasnít thinking clearing and he lost his ability to rationalize. He definitely didnít understand the repercussions of his actions and he took delight in outsmarting me. My father couldnít tell you where he lived, yet he was able to get his license renewed for 4 years after it expired. I would also recommend a support group for you so that you can stay sane. I would encourage exercise, for both of you. Itís good for the body and soul. I really didnít understand what dementia was until I had to care for my father and live it each day. The good news about vascular dementia is, clarity comes and goes. Unfortunately, thatís the bad news as well.



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