Please clarify ..... you live across the continent. So you are visiting? And your other family members won't let you leave? Seems to me any resolution is not your sole responsibility. It is primarily the responsibility of his primary caregiver, more so if that person lives with him. Does anyone have health care power of attorney?

It's a fluid situation when incompetence is not evident, the individual can do as he pleases. Doctors, nurses, home-care, family have influence perhaps but not control. Can you sit down with the other family members, a few sheets of paper, and reason this out? They know the daily situation more than you. List possible options and put some pros and cons to them. Whose care will he be discharged to when released from the nursing facility?

I'm his POA and named in the Medical Directive.

He lives alone but local family does his shopping and takes him to appointments. They have their own problems and have lost willingness to do this.

There is nobody here that can adequately care for him anymore.

If your parent is considered mentally competent and insists on self-destruction, remove your own liability and responsibility, and leave them to their own recklessness. You don’t owe anyone, no matter how close a relation, to harm yourself to deal with their pigheaded stupidity and drug use, when they are considered competent. The same holds if they become incompetent. Your job was to help if they became incapacitated. It was NOT to fight a self-destructive, legally competent adult for control of their own life.

Don't be destroyed by your parent and the toxic environment.

This happens all the time. Please don't feel guilty for what someone else is "voluntarily" doing to themselves.

the other family members to care for him? Really? Where is the love?

from a complete lack of experience, for which you should be on your knees in gratitude to all the powers that be. You apparently have NO FUCKING CLUE of the nighmare involved, so perhaps you could reserve judgement???

Nightmare situation for all involved.

returned when the parent needs help love and support the most? If you have kids, I hope they don't feel that way about you. I hope they still love you, try to empathize with how you are feeling, and try to give you the support you need. It may not be easy to be the child of a parent who is aging, may have a bit of dementia, and may do reckless things, but it's not easy being a parent of a sick child or a reckless teenager either. Sorry, to be old fashioned, but love is what holds us together in easy times and hard times. Maybe you don't feel that.

rarified height?

If I'm reading the OP correctly, their father is considered mentally competent by medical experts, but is engaging in reckless behavior. The OP doesn't seem to have any good options. They want to help their father, but he won't comply with the offered assistance, and medical and legal experts say there's no way to make him comply.

So, it seems to me that the advice to the OP to resign their POA and retreat to caring for themselves is right on target.

What other possible option is there?

and the OP is there fleetingly. It should be all hands on deck. I say this from experience of taking care of my mother-in-law with my wife, while wife's brother left us to do everything. When you are caring for a loved one, there ever day and changing their bed at three o'clock in the morning, you need the support of those who are part of the family. It's about love.

Tell the other family members trying to dictate that you stay and fix this, to go pee up a rope.

You are making a very good case that you CAN NOT fix this. The best you can do (if you haven’t already) is contact adult protective services and tell them about the illegal meds and the “friend” sucking your parent’s money, then go home and let the chips fall where they may.

If your parent is considered competent , there is nothing you can do so save them from themselves. Full stop.

It sounds like your parent is a drug abuser. Nothing you can do about that. Your parent, at 33, 53, 73, or 93, if they are mentally competent, doesn’t have to stop that, and the consequences are theirs, not yours.

Please set aside the guilt, and for heavens’ sakes, tell your siblings to shove their guilt if they’re trying to put it on you.

Sometimes they can put you in touch with the right programs, can facilitate getting assessments on mental stability, and even help get in-home help. Besides...what else can you do? The situation you describe sounds impossible, but something has to give. At some point, the doctors will not be able to release him to go home if there is inadequate care for him. He may be forced to go into a facility if he is a threat to himself.

I haven't experienced such my self, but read frequently that hospitals will not keep patients when they have deemed patient ready for release, and, apparently, many are sent home to be on their own.
I'm not defending such treatment, but have read of such, even here on DU, frequently.

…The doc might not release him to go HOME. He may only release to send him to a facility or with 24 hour care

I feel for you.

Only other thought I have is that Elder Abuse might get involved if the parent is being financially exploited. They will investigate, and that might facilitate some more prosperous help from social services. Every state has an Elder Abuse hotline.

Where I live (WA) you can petition the courts to appoint a caregiver. I had to do this for a sibling who was being exploited by many internet wankers. Sibling denied all, but the judge ordered an investigation. My claims were proven by a court appointed forensic accountant and several shrinks of varying specialties.

The sibling's finances are now managed by a court appointed attorney who specializes in such cases.

I researched like hell about this, and talked to many family law attorneys. Nobody had ever done this before, but they were all willing to do it for $20,000 or so. Instead, I went to the court house and ask the court clerks for help in filling out the forms. It cost me a few days off work, but the end result was worth it. Hopefully your state has something like this.

you mean that they've been doing what they can to rake care of him? Visiting him, checking on him, maybe helping with groceries. taking him to doctor appointments, hospiral visits etc? You must speak to them and share your concerns with them. Do you not have a good relationship with the family mermbers? Are they your siblings? Is there some resentment that you are usually out of the picture? I am guessing he lives alone? Is your mother still with us? Or does he live with another family member?

You are not clear. Are you saying family members do not have knowledge of the narcotics and financial exploitation? How did you find out? This is not your problem alone. While your father is in rehab, you all need to sit down and have a plan, both short and longer term. Does he have other medications? Is he responsible for those or does he have help or need help to organize his daily dosages?

Are you aware of how much ambian or narcotic medication he is taking? Does he have a shortage of those pills that may suggest uncontrolled addition? Is he in pain that isn't being treated? If so, maybe he needs to see a pain specialist. Yes, he needs to be confonted about the medication, but this isn't for you alone. You all need to talk and make a plan.

Is he aware that he has been financially exploited, or was it his choice through what he may perceive as kindness to a friend? As long as he is able to function without risk to himself and has the resources, external or family care he needs, there's no reason for him to be taken away from his home environment and put in a hell hole. What do you mean by you are "ill-equipped to be a caregiver." Are you disabled? What makes you ill-equpped, but not other family members who are dealing with him on a daily basis? Not being mean or anything, just trying to understand your situation.

Is he on Medicare and/or with supplementary insurance? You may be able to qualify for home health - in home visiting nurse care, although this is very limited. What are his daily needs? Does he have help preparing meals? Does he need help dressing, cleaning or going to the bathroom, getting in or out of bed or going to the bathroom, or help with medications? Does he have or do family members have the financial resources that could pay for carers who could help him for an hour or however long may benefit him per day?

Knowledge of the exploitation and drugs did not happen until I arrived (I am an IT pro, so it wasn't hard once I started looking at the clues). They did not suspect and were not opening his mail. While he was in hospital, two shipments arrived with 90 pills each.

He was on a lower dosage of the pain meds (5 mg), but was ordering stronger (10 mg). He used to have a prescription for Ambien, but his pain specialist took him off that. When he had a prescription it was for 5mg, but again, he was ordering 10 mg. The 90 hydrocodone pills just came in a ziplock bag. I had to take one to a pharmacy to identify it - but who knows what was actually in it.

As for hell-hole, he can afford a large apartment in one of the nicest, most popular facilities in the region.

As I mentioned, I have children and grandchildren in another state. I've made 3 trips across the country this year to provide what help I can. I do not have the physical ability to handle his needs, nor the training and experience to deal with his hallucinations and drug problems. The doctors at the hospital told me he either needed to be in assisted living, or if at home, full time supervision and all dangerous items would have to be removed from the house (92 years of being a packrat - I'm still looking for a possible hidden handgun).

But he obviously needs them. The medication he is taking sounds reasonable if he is in chronic pain. My family members have and have had a higher dosage or even moved up to oxy.

You all need to sit with him and not be confrontational, not judge him, but show him you all want to give him your love and support. Tell him he has no choice, but you or other family members are going with him to his pain management, and he needs to tell them he is in chronic pain, and the dosage they are giving needs to be increased. Obviously, keep quiet about his illegal pills, or they will never give him any and he will suffer forever and may never forgive you.

When they ask what his pain level is, he needs to tell them it's an eight at least. Some older folk in particular try to make out they are feeling better than they really are at the doctors. They put on a show, especially if they are used to not showing weakness. He needs an advocate to get them to increase his dosage. And your father needs to understand this is instead of the pills he is ordering online. From there, his pain medication dosage can be monitored by the professionals.

Really, the Ambien could be the bigger issue, especially mixing with narcotics and we don't know if he's sometimes taking too much. I'm guessing he has a bit of dementia, and at times he may be overdosing, forgetting what he's already taken. No wonder he's had hallucinations. Why is he ordering Ambian? Bless his souil, is he having trouble sleeping? Is it the pain that is keeping him up? Is he trying to numb the pain with that as well? Again, there needs to be a conversation to understand what is going on and why, and then he needs a visit to his GP with an advocate to talk about this, and of course with pain management.

Beyond that, he needs to understand it's not negotiable, a family member needs to take control of his medications and only give him a day's medication each day. If he needs more help than that, then more times a day.

He wants to stay in his own home. Understand that. It may not be the best decision, but it's his home. He's an adult. We all make bad decisions. He's an old man, so expect him to make them. Maybe there are memories there. If he is well enough to be taken out for a meal or something when he's better, maybe a family member could take a detour on the way home and say "Dad, this is an assisted living community, why don't we take a look?" He will argue, then reply. "I know, but we are here now anyway and we might as well take a look. Nobody is telling you where to live. It will be your decision and we wil respect that but what's the harm? Come on!" He might like what he sees, or might in time come around to see that he needs it.

A senior social worker could be an advocate to assess his needs and have a conversation with him to ask what he wants and to make suggestions about options available for him, regarding at home care, assisted living etc.

Also check any insurance and talk to the social worker at the rehab facility to see if he qualifies for any home health visits. My mother-in-law was able to get this every time she was discharged from rehab and they visited three times a week. Didn't do much to lighten our load, but every bit helps.

I would add, to try to go the extra mile to show your empathy towards the family members who are caring for him. As you say, they are exhausted. They need to see your compassion, understanding, and gratitude to them. It's draining. It's a roller coaster. It's physically and emotionally hard work. It's frustrating. It's sad. They may feel resentment that you are only there fleetingly. That isn't being toxic. Understand their emotions if they show their asses. They are overwhelmed and wanting support. They want to see you helping them and being part of the solution, not simply venting your own frustrations or presenting problems, and then leaving town. This isn't just your problem. It's a family problem. You aren't the knight riding into town to fix everything, before riding off again. If you feel that way, you are putting too much pressure on yourself.

might help. It might at least help to get a little perspective and reduce the stress levels.


https://www.forbes.com/health/mind/best-online-therapy/

to temporarily remove him from access to the drugs and exploitation by the "friend." Maybe there are some fun activities to engage him in as a vacationing guest. Maybe this will help break up the impasse you are experiencing and then you could start making some of the tougher decisions.

...just brainstorming here...you know your situation far better than anyone else...

Hey. Just want to say I feel for you. It’s awful and frustrating and frightening. All I can say is hang on. Nothing stays the same. Love and peace, ec

Can you have a wrap-around meeting with all relatives, doctors, other caregivers, and anyone else involved? With all the facts.
No one can do this on their own.
Bottom line: you have to care for yourself (and children, grandchildren) first. Your dad has gotten himself into a huge pickle and you cannot save him.
Please be as kind to yourself and your loved ones as you can.
Keep us posted.

If you have evidence of 1 and 3, speak with the County Attorney and see if they will help bring charges to recover some of the assets pilfered by the so-called friend. Most states have authorities they can use to help protect individuals against exploitation by "friends" or individuals who manipulate older adults.

Has your family considered an assisted living facility? They are quite expensive to say the least. But it might be possible to cobble together a significant part of the cost through Social Security payments, pensions, and other sources of revenue (investments, military pensions, rental income, etc.). Medicaid has stringent rules about assets before they will allow an individual to enroll in the program (typically around $3000.00 in liquid assets). Medicaid will cover the costs over and above the income of the patient for a skilled nursing facility (nursing home or assisted living facilities typically qualify). They (counties typically administer Medicaid on a local level) will then try to recover the total care costs if anything of value remains in the estate when the patient passes. Your family can reduce the overall costs by insisting that every hospitalization episode be billed to Medicare (could be thousands of dollars). You can also apply for special pensions like the Aid and Attendance pension through the Veterans Administration if either parent served in the military during an active conflict.

Best wishes as your family struggles through this incredibly tricky situation. I have been there too (with the exception of the substance abuse) and it is so difficult for everyone involved. But there are programs to help lighten the load for caregivers. The programs require a lot of paperwork. However, it is possible to get decent care for a loved one without completely crushing everyone involved.

after what all I went through with my own mom. She isn't competent, and she's very aggressive, combative, and mean-mouthed. She was never this way until the dementia. The last time she fell and was admitted to the hospital, we had her evaluated by the hospital's elder care psychiatric unit. They made recommendations and actually helped to find a memory care home that would take her. I don't know what we'd have done without that help. She had been living with me and hubs for almost 2 years.

I'd like to know how she was getting the narcotics and Ambien online! Was it through a telehealth service with registered doctors? If so, it seems like you'd have some kind of a case against them. At least being able to put a warning out to others...

I send you hugs... though I know it's no help to you in your mess right now. Try to keep yourself centered, even if that means withdrawing somewhat from the situation and letting the chips fall where they may. Realize, no matter how hard you try, you can't control the situation; especially since you have other family members involved. You can't withdraw completely, I understand. Been there, still there; I know what it feels like. But you do have to set some of your own boundaries and protect them. Otherwise, the whole situation will drive you nuts and into an early grave, yourself.

I know it's hard to think about, but try to do one thing nice just for yourself in the coming days. It won't change the issues, but it did help me address it the next day with a little clearer state of mind. Good luck.

one of my first thoughts was to get him to a shrink who can get him on some meds to stop the hallucinations -- why didn't his doctor put in an order for him to see a psychiatrist who could at least help him with that? and possibly depression?

ambien side effects can be daytime drowsiness, dizziness (contributing to falls), & hallucinations

maybe he'll kick the habit by the time he's out of rehab

if dr. doesn't return your call, can you talk to a nurse and see if they can help or what they suggest? can you go into their office and talk to someone?

I might be a little more concerned about the Ambien contributing to his falls, it sounds like he's been on that hydrocodone for a long time ad is probably quite used to it. In any case, you're not in control here, he is.

You might be able to run #3 by the cops, but you kind of have to be there to do it. Of course, if his friend is an online girlfriend in distress, it's time to notify the FBI, they take a dim view of catfishing and might be able to get it stopped.

Your dad is an adult and he's with it enough to make his own decisions, even bad ones. Yes, you can see the deterioration, but until he asks for some help, there's not a hell of a lot you can do except make him defensive and alienate him completely.

I grew up in an alcoholic family and it took me a hell of a long time to understand all of the above.

What do you do? It sounds like you have a full life where you live. If you lived your own life except to visit your family, I don't see why they expect you to uproot yourself and move closer.

Are you emotionally close to the elderly relative? If you aren't, uprooting your life won't be good for anyone.

Have you been helping financially? Sometimes that is all you can do, no matter how much you care about your family members. If you aren't helping financially, are you able to? If you help the elderly family member, don't give the money directly to them, because of the illicit drugs. Work with a utility company or landlord and make arrangements to pay that bill directly. You can use Door Dash or another service to deliver groceries. I used Door Dash this last year to send restaurant food to my sister and my friend when they were able to get to the store. Both live in different cities away from me. Call the loved one and if you can get a list of what they need or want, order and set up a delivery time.

If your loved one is abusing drugs, you might not even be able to do anything to help. My friend's Dad, who I loved like a father, had substance abuse problems, and it was difficult for her to have relationship with him. Her sibling became the main caretaker, and because they had a similar issue, they got along fine. It still wasn't easy, but it never is.

My Mom lived 1000 miles away from me for over 20 years. We were close, had a good relationship. She got very ill. While she was being diagnosed and treated, my husband and I went to see her. I wanted to take her home. A very kind nurse asked me if I were trained to give my Mom the care she needed-IV therapy, and so on. I wasn't trained and the nurse said "Your Mom is right where she needs to be and we will take good care of her." I didn't know my limits but that nurse did. My Mom later recovered and she came to live with my husband and me, until after several years, I couldn't take care of her needs. She spent her last year in a nursing home, and I visited her there.

You will feel better when you make a decision about what you can realistically do. Good luck.

If so, contact the nearest VA office and see what can be arranged.
My sister was given "relief" by the VA taking her husband for a week so she could have a rest.