My father in law’s dementia has gotten progressively worse over the past few years. We’ve been able to work around it, but now his safety is compromised. As well as the safety of his wife. She is now asking for help from us adult kids. He has conceded some help paying bills and managing his finances because he was careless and spending in discriminately to the point of not having enough money. How do we approach this when he won’t recognize it himself… or discuss it?
FIL's condiction means he is losing ability but also lacks insight to see it. Or does see it.. but is determined to fight it.
This is the time MIL, who does have ability & insight, needs to take the reins. In finances, arranging care, making decisions.
A great mountain of support will be needed for MIL to accomply the takeover. From FIL's point of view - he may well feel ganged up on so stealth, trickery & therapeutic fibs may be needed. I dislike suggesting those - but you cannot reason with unreasonable people. The reasonable people must lead.
There are some that allow the takeover, this shift in powers, who are happy to trust their family & accept this stage of life with grace. There are others that will holler & shake their first (& worse) keeping an iron-like grip on control. From their point of view - they are FINE. It is OTHER people being bossy & controlling!
Be guided by safety & FIL's temperament. Do what you have to.
Tell him that he needs a physical as per Medicare, let the doctor's office know in advance that he needs cognitive testing and that it's part of "the physical," and go from there. Once you have a doctor's diagnosis, the power of attorney can be activated.
If you don't have POA, then you've got problems. You could ask the doctor to counsel him on allowing the kids to handle the finances, but don't count on that working. Try to get him (and his wife so he doesn't feel ganged up on) to set up POAs and plan for the future. That'll only work if he's not so bad that he seems incompetent to sign the documents. They'll have to be witnessed and notarized, so if the notary or a lawyer (if you use one) doesn't believe he's competent, they may refuse to do them.
Is his wife a co-owner of the accounts? As a last resort she could add one of you to the account as a signer, and she could require two signatures, or she could close the accounts and reopen them in her name and one of the kids's names only.
The problem is, that you can’t always have a rational discussion with someone whose judgement is impaired. Accept that you may not be able to reason with him.
And, if you - or even a doctor - gets a point across, then your father-in-law might very well forget the discussion.
You are very lucky that your father-in-law has made concessions on the finances — but set up safeguards. You cannot guarantee that he won’t forget and do something reckless again.
Same with the driving. Even if a license is revoked, and even if a doctor says that he cannot drive, your father-in-law may forget or deny, and pick up the keys and go anyway.
Remove temptation. With respect to driving: hide the keys, park the car elsewhere, etc. If he needs to go somewhere, then have a competent driver accompany him and take the wheel.
It’s a lot of effort - but necessary. It might be a good idea to think about having a helper come in to keep on top of things and to support him and his wife.
Definitely have regular family communication and check with his wife. Talking to him might be fruitless and frustrating (on both sides), depending on his stage of dementia.
Has there been any discussion of moving them both into an assisted living situation where help might be available on call?
My late husband had Alzheimer’s, but never acknowledged it. He insisted that he was capable of doing all sorts of things (driving, working with tools and machinery, etc) that were no longer safe for him. We’d talk - I would turn my back to do something - and he would forget the discussion and return to unsafe activities (to the point where I parked the car at a friend’s, took the blades out of saws, and got rid of things). As the dementia progressed, he became frustrated and sometimes violent, In the middle of one night, he walked out of the house and was missing when I woke in the morning.
All these things are possibilities. The more safeguards you can put into place, the better. There sometimes is no warning before a new behavior begins.
Set up your support system, take shifts, and stay in touch. If you haven’t already, you might discuss with his doctor whether there are medications (e.g. exelon, namenda) that might help for a while.
Very best of luck to your family.
He does not need to acknowledge or understand his dementia. That's OK. No one should continue to explain it or reason with him, etc. It just doesn't matter.
What does matter is his safety. Knowing that he is a danger driving, that has to be stopped. Yup, he'll be mad. That's OK. It's not right to let someone drive when it is very likely they will have an accident. If only they would get hurt, then I would be pretty OK with that, but of course he could hurt or even kill someone else and his family can not let that happen.
I took a passive approach on this with my mom. Bad winter roads helped and then I loaned my car to someone and had to use her car and took her keys in case she got it in her head to take a drive. Luckily she didn't try to sneak out! Her geriatric doctor finally told her NO more driving. She was angry. But has complied and accepted it. Not easy but had to be done.
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