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My dad is 76 yrs old and in denial of his opioid abuse and alcoholism. He no longer has narcotics, but he still drives to the liquor store and drives around while drinking. I have called the police who have never found him and didn’t really seem too concerned. I have called Arkansas state social services who told me there’s nothing they can do when addiction is involved. They advised I call the county prosecutor who could mandate rehab. Dad is terminal as he refused heart valve replacement (currently outlived prognosis) has infective endocarditis, COPD and we are waiting on a neurologist for him to be evaluated for Parkinson’s, rehab can’t handle his medical conditions, nor can someone be helped who doesn’t want it. I was also told by the hospital that withdrawal is very dangerous for elderly. He is currently in a nursing home getting IV antibiotics due to the vegetation on his heart and getting sepsis along with Covid in March. Dad also has a broken neck (fell while under the influence in 2020) they actually didn’t operate on him for several days as they weren’t sure he would survive withdrawal. He has chronic pain & spinal degeneration as a result of the neck break. The nursing home has him on time released OxyContin that he gets every 12 hours. He says it doesn’t do anything (he means he doesn’t feel high) but I have noticed drastic improvement in his pain. I’m terrified of him being discharged and being cut off from pain medication, going into withdrawal and binge drinking. Since he’s considered of sound mind, I strongly disagree but the facility says he has MCI, I can’t take away his truck. Disabling the truck would buy temporary time, but dad use to rebuild cars and is very knowledgeable on how to repair. He would also just buy another vehicle if needed. He has already had an accident that he doesn’t remember. He told the facility staff and myself in his care plan meeting that he will not stop drinking and driving. I reached out to our estate attorney who said there’s nothing I can do and I have to let him deal with the consequences of his actions. I understand that, I really do, but I don’t know what I would do if he hurt an innocent victim. Dad also falls very frequently as he’s also in denial about his lack of control over his body movements, then add alcohol to that which makes it worse. He has convinced himself that alcohol helps his tremors and weakness. He fell 5 times, that I know of, from 2/2-3/13, ending up in the ER with his head busted open needing 9 staples. The impact knocked two of the screws loose holding his neck hardware together. My husband and I offered to buy him a home down the road from us as he currently lives over an hour away. He refused. We set up home health and he told her to leave. He refuses absolutely everything. I broke down in the NH care plan meeting, as he accused me of lying about his living conditions. He sits in his excrement all day, refuses to rinse plates or dispose of food. Maggots are often present in the kitchen. I go over weekly to clean and shower him which he fights. I told him his choices are destroying me and I can’t continue to watch him do this. He told me I don’t have to come around, which I obviously know, but I can’t flip a switch to stop caring. I would worry about a stranger in this situation let alone my own father. For context, I had an abusive mother and my dad was my safety and sole source of love. I feel in a way I owe it to him to protect him like he did me. I have been brutally honest with him that he is going to severely hurt himself and likely suffer in pain as he also refuses to carry a phone or wear any devices. He doesn’t care, the addiction is the only thing he can think about. Even being 6 weeks sober. I realize this is mostly venting but I need to let it out to others who understand. I feel absolutely helpless and feel like I have exhausted all efforts to prevent him from hurting others.

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Your father can't possibly be of sound mind. He sits in his own excrement, tolerates maggots in his home, is in denial about his lack of control of his body, had an accident that he doesn't remember, and denies opioid abuse and alcoholism when it's clear that he's an addict. THIS IS NOT SOUND MIND!

You could possibly have him picked up for a 72-hour mental health hold and observation. This is called the Baker Act in Florida and has other names in other states. Treatment proceeds from there.

I'm really sorry you are dealing with this.
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Hdybas Apr 19, 2024
You’re right and I agree 100% that is not of sound mind. I realize addiction makes people not care about these things but it’s awful. Since alcohol is legal and he refuses help, also his right, our hands are tied. Ugh. He’s also a very functional alcoholic. Most people would never know based on speaking to him. He has cognitive evaluations 5 days a week and has been evaluated by an attorney 3x. He’s perfectly coherent. I’ve wondered if he truly doesn’t care about the filth or is so deep in denial that he chooses to not see it. He father and brother were also alcoholics but they eventually became sober. I have lost hope for dad.
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More info from your profile:

"I am caring for my father David, living at home with age-related decline, depression, heart disease, and mobility problems.

I am currently helping with both my terminal parents and occasionally my brother who has a TBI. I have a wonderful husband who has been my #1 support system"

First order of business: Remove his truck completely (and hide it) and tell his other relatives, neighbors and friends that due to his alcholism and opioid addiction they are to never lend him their vehicle. Don't discuss this with him, just do it.

Next, call APS and report him as a vulnerable and dangerous adult.

Next, if you think he is abusing his opioids I would call his doctor and maybe even the pharmacy to inform them.

Does he have firearms in the house? No social worker or police will go in there if he does. These would have to be removed. Again, you don't have to discuss this with him. Have an ally take him out on an errand or something then get into his house and get the truck, keys, booze, etc.

You are not responsible for his life and choices, but you are in the best position to stop him from hurting or killing others.

If you or someone is his PoA this is the person who should be doing this. Otherwise, after securing his truck to keep him off the roads, you can step back completely and allow the county to refer his case to a judge who then may appoint a third party legal guardian and they will then be responsible for him and take care of him, whether he likes it or not.

So sorry for the distress this is causing you. You didn't create this situation, you cannot fix it yourself, but there are other solutions -- it just doesn't need to be you.
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Hdybas Apr 19, 2024
Thank you for your condolences.
I am the POA of both parents who are of sound mind.
I was told by the attorney and law enforcement I cannot take his truck away as it’s theft of personal property and I could be arrested. We did give his truck away to my brother when he was recovering from a broken neck but he bought another one on his own.

As mentioned, I did call APS, who said they were is nothing they can do when addiction is involved as “it’s a choice” This isn’t true for all states but it is for Arkansas.

He no longer gets opioids due to his past abuse. He hasn’t had any (outside of hospital and nursing home) since 2020.

There are no firearms in the home. We removed them all but he could easily purchase if desired.

A POA cannot enforce anything if the person is considered of sound mind. Nor can they legally be held liable per attorney.

I unfortunately live in a state that has very little resources and laws that seem to prohibit those who want to help.
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You say that your father is currently in the nursing home?
Did I get that right?
He is on medications there you tell us, withdrawal being almost not an option at this point.

Is your father lucid enough to discuss the possibility of in-facility Hospice care?
It seems to me from all you are saying that this is basically currently palliative or end of life hospice care, in which case your Dad would get the medications he required to stay pain free.
He would, from the sound of his current condition need in facility care. I would ask the doctors for guidance about hospice care at best or palliative care otherwise.

Your profile mentions a mother and a brother also having need of care.
Is there a Medicaid Social Worker, or any social worker to help you get some options together.
I don't see how you can continue alone in this manner. It simply is not doable.
Have you contacted APS and told them you have more than you can handle?

All of this is so unbelievably complex. I honestly cannot even begin to imagine all you are going through and I am so very sorry.
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Hdybas Apr 19, 2024
Thank you for your kind words. Yes, dad is very lucid. He is getting out of the nursing home on Monday 4/29 as this was a temporary stay for rehabilitation and IV antibiotics for the infective endocarditis. He has refused staying there which is what he needs. Hence why I’m terrified of his withdrawal from pain med when he gets home. He only uses a wheelchair in the facility and can’t use a walker without assistance. We discussed hospice but he would unfortunately have to come off all his antibiotics as they are considered life extending. If he comes off of them, the vegetation on his heart valve will inevitably dislodge and cause a stoke and or sepsis. Dad isn't afraid to die but terrified of having as stoke and doesn’t want to do this.
My mother has blood cancer and my brother has a traumatic brain injury. My relationship with mom is very complicated, but I do take her to Dr appointments and help as needed. My brother’s brain injury affected his emotional reasoning and short term memory. He has become very paranoid (convinced the world would end on the eclipse) and refuses any kind of guardianship or for me to be his POA. If you were to talk to him you wouldn’t know anything was wrong. It’s very situational. I took him to the dentist as he has an abscessed tooth. His BP was 188/110 both Dr and I explained how dangerous that is. He has refused BP medication and refused to check his BP at home. The Dr is my past employer of 12 years and was going to do all his work for free. He was dropped from Medicaid as they say he makes too much on disability. As a result he has no health coverage. It’s a mess. When I talked to APS the social worker was very kind but said there’s nothing can do in this situation.
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If your father is in a nursing home tell them that he is an unsafe discharge (use these words) because there is no one to care for him at home.
Considering his age, and his age-related decline he could be considered a vulnerable adult and the nursing home would not release him.

While he is still in the nursing home, go to his house and take pictures and video of how he is living. Then visit a lawyer (first meetings are free) and ask how to proceed with getting conservatorship/guardianship over your father or how to get the state to appoint someone.

I don't think you'd be refused conservatorship/guardianship over him because you are his child and he is a vulnerable non-thriving adult. People get conservatorships for reasons other than a person having dementia.

From what you're saying here, you love your father very much but he needs to be in a care facility permanently. It can't be his "choice" anymore because he's not fit to make that choice anymore.

Please, visit a lawyer or go down to the town's probate court and ask about petitioning the court for conservatorship of your father. They will explain the process to you and direct you on taking the next steps.

Good luck.
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Hdybas Apr 19, 2024
Thank you. I didn’t nursing home team that and they also agree. They said they would also report him to APS for wellness checks and I truly hope they do. I did inform them that I did that and what I was told by the social worker assigned to our case. I do have pictures and videos of everything. The attorney told me since alcohol isn’t illegal, nor is being drink, and he’s of sound mind at every meeting, there is nothing I can do. Dad refused guardianship as well, honestly I think it was due to the attorney fee and process. I will definitely see if I could petition the court for conservatorship. I have another care plan meeting with the nursing facility on Monday. Fingers crossed!
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Got it, thanks for the clarification. It seems like discretely disabling his truck in a way that he can't easily fix is the only action you can take, if you chose. I sent you a private message with more info.

Don't do anything else to help him as this is just enabling. Consider attending AlAnon so you can learn what others do to keep healthy boundaries with addicted parents. You might want to consider resigning your PoA because of all the stress in dealing with him. You can inform him that this means when things get bad enough the county will recommend a court appointed guardian, who will then control everything, not you.
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Alanon for you.
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JuliaH Apr 30, 2024
I like the idea. What people need is good support from those who have been there, done that. Sink or swim is usually the answer,don't let yourself be weighed down by a person who refuses to help themselves. Caution though as recovering alcohol/drug users attend and might feel very comfortable with an enabler.
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A thought here..
Do you have photos of his living conditions at home?
Is it possible to say that to discharge him to home would be unsafe as there is no one that will help him.
If they can not keep him then I am sorry to say that Another cognitive test maybe so that he can be declared incompetent. otherwise I think the info you have been given is correct. And at that point maybe consider giving up POA. (Is POA in effect now if he has not been declared incompetent? If it is in effect how "responsible" are you for his actions? I would ask your attorney about that.
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Your dad is very much like my brother was. The big difference is that my brother didn't drive when he drank. That is such a huge worry for you and would be for me too. Sadly, there is very little you can do. Call APS and see where it goes from there if the nursing home can't help you get further help for him.
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Hdybas Apr 19, 2024
Thank you. I should have clarified that “state social service” was APS who said they cannot get involved when there’s addiction as “it’s a choice.” The social worker assigned to the report is who told me told me my only option would be to call the county prosecutor who could mandate rehab. Dad justifies drinking and driving by saying he only drives backroads. He is well off and very frugal. I told him he could be sued for all of his assets if he causes an accident hoping this would motivate him $ but he said it wouldn’t happen. :/
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You don't have to be his PoA, you can resign and allow the judge to eventually appoint a guardian for him (and when he's found incompetent it won't matter that he doesn't want one, he'll get one if the judge rules that he needs one).
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MCI = Mild Cognitive Impairment which means he is NOT OF SOUND MIND.

Mixing opioids with alcohol causes brain damage like you cannot imagine. Has dad had a brain MRI? I seriously doubt his brain would be intact on an MRI.

Disable his car daily if necessary. Giving him 4 FLATS a day will take lots of time, money and ingenuity for him to remedy. Lets face it. Sure, he can still get booze delivered, but he can't DRIVE on the road and kill innocent people. Dad has every right to kill himself but no right to kill others, regardless of what the police choose to do or not do.

Go to a few Al Anon meetings and find support and coping mechanisms for yourself.

I'm sorry dad is putting you thru this living nightmare, you don't deserve it. It's too bad addicts are so damn selfish.
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