Dilemma re dad (cognition and mental illness)

I am not sure how to handle a difficult situation with my dad and wondered if anyone has any tips or advice.

He has been in hospital for nearly 2 months. He went in originally for a UTI but his other pre-existing problems (including mental illness and cognitive impairment) have made things more complicated and now a social worker and best interests meeting are needed. At the very minimum he would need a care package to go home but is refusing carers (my parents have refused carers consistently over the last year or so and reached crisis point 3 months ago, at which point mum went into hospital and then a care home due to the level of her needs).

My dad is very unstable emotionally, has “lack of insight” and no one is able to reason with him. He fluctuates between being very upset and being really angry and full of rage and paranoia. He blames me mostly for the situation they are now both in. He has told my brother and me twice in the last month or so that he doesn’t want anything to do with us. He has come around after a while but is much more ready and willing to reconcile with my brother than me.

My dad is desperate to leave hospital but, as he won’t accept carers, that isn’t happening at the moment. He has told us (via my husband) to tell hospital staff that he is fine to leave hospital without carers (he also told me never to call for an ambulance for him again). It wouldn’t be right for me to say that he can go home without carers but I don’t know how to handle that conversation when I speak to him. Eg if i say “I have to tell the truth and you need more help at home” he is likely to become more agitated. My brother and my husband are able to be more frank with him than I can (dad is more willing to accept what they say but I’m expected to just go along with whatever he says, which is how our relationship has always been). Could anyone advise on how I could handle that topic when it comes up?

Also, I don’t feel comfortable about visiting him on my own at the moment, because of him being so full of anger and rage and the fact that the worst of it has been directed at me. My brother and my husband agree that it isn’t good for me to visit on my own because of how he is but I feel I should do even though it’s difficult. I know I’ve always got the option of walking away but I don’t feel strong enough to take what might come my way, especially after the last 3 months of stress and trauma.

FYI - we’ve applied for LPA for finance which is due any day now (it took my parents over a year to see the need for it). We don’t have LPA for health and welfare.


A Best Interest meeting is the way forward, especially as dad is so angry you fear for your safety.
There is no need for family to try to reason with him, just say “It’s not up to us, it’s up to the doctors”.
Doctors MUST make sure it’s a “safe discharge” as in some circumstances the hospital will be fined if it all goes wrong quickly!

What you describe could be called a Revolving Door situation. He goes home, neglects himself, goes into hospital, round and round again.
It’s not your fault, or the family’s fault.
Whenever the medical profession put pressure on the family, just keep saying it’s THEIR job, not yours, to sort this out.

Thanks Bowlingbun. I will try the line you suggested, “it’s not up to us, it’s up to the doctors”. Thanks for your other advice too.

I’m happy to help, just wish I had someone to help me when my mum was in and out of hospital for years, nursing staff and doctors trying to bully me (bad idea) never knowing that I was recently widowed, and disabled myself, with a brain damaged son to look after.
Their only real interest is getting dad out of hospital and getting their bed back asap.
You are quite entitled to say to them that you feel they are putting their desire to have their bed back before the duty to ensure that he has a safe discharge.
Be sure to look after yourself through all this, it’s really horrible.

Walker. Hi
I used to say it’s up to the doctor, then depending on his frame of mind at the time ( dementia) I would add I wish he would hurry up! Hubby would then feel I was on his side and become less agitated. Some things are worth a try.

Good luck. You are in my prayers.

Gosh Bowlingbun, you went through such a tough time for so long. I bet it all took it’s toll at the time. Yes, I’m trying to look after myself best I can although its summer holidays and I’ve got a 12 year old autistic son to care for too. What makes it worse is that mum is struggling in the care home. It’s a lovely home but she keeps saying she wants to go home (and she keeps trying to pack to go home). She also sometimes thinks she is in prison and she doesn’t know why. It doesn’t help that my dad manages to speak to her over the phone, stoking the flames as he talks about being in prison and just wanting to go home (with mum too!).

The hospital was talking of possibly sending dad home with a 6 week rehab team package at one point as they wanted to move him on as quickly as possible but now they’ve realised that they need to get a social worker in place which obviously takes longer.

That’s a really good tip too Pet. Thanks.

Thank you Thara. That’s very kind.