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My dad has mild dementia and I manage his medication. He has run away from home a couple of times over the past 10 years. I was tipped off that he is planning another trip. He won't go shopping, fishing, sightseeing etc. because he claims that he is in too much pain. Yet he is planning a 700 mile journey.
Do I have any pre-emptive options? The stress of finding him gone and issuing a silver alert is too stressful on our family.

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Your profile says he is in independent living. If so, then what do you mean by "running away"? Do you mean he's planning a vacation? It's not the same thing but I understand your concern if he has memory issues or his decision-making is less rational. If he does not have a dementia diagnosis and you are not his legal PoA then you can't really stop him. How is he planning on traveling: by car or plane or someway else? Is he aware of the risks of covid? You'd need to talk to whomever will be hosting him at his destination to make sure he's safe.

If he forgets his medication would it be life threatening for him? Can you offer to go with him if he's really determined? How is he making the travel arrangements? Is someone there helping him? If you could provide more info it would help the forum participants to provide better suggestions.
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Oakley2021 Jan 2021
His last trip was an excursion on a 3 wheel single speed granny bicycle. He went 30 miles across a mountain on an unimproved road. He was found dehydrated, disoriented and spent several days in ICU. He claims no memory of the event.
This "trip", he asked a family friend for a ride. To my knowledge he doesn't know anyone at the destination. He is planning in secret and then just disappears without warning. We never know if he is in a ditch or on an adventure.
If he wants to travel, I don't begrudge him that. It's not fair that he leaves and worries everyone unnecessarily. Involving friends, neighbors and police in a silver alert/man hunt is terrifying.
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His last trip was an excursion on a 3 wheel single speed granny bicycle. He went 30 miles across a mountain on an unimproved road. He was found dehydrated, disoriented and spent several days in ICU. He claims no memory of the event.
This "trip", he asked a family friend for a ride. To my knowledge he doesn't know anyone at the destination. He is planning in secret and then just disappears without warning. We never know if he is in a ditch or on an adventure.
If he wants to travel, I don't begrudge him that. It's not fair that he leaves and worries everyone unnecessarily. Involving friends, neighbors and police in a silver alert/man hunt is terrifying.
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Your father has mild dementia now; but then you state that over the past ten years he has "run away from home a couple of times."

In what sense was he running away? Why wouldn't he have been willing and able to discuss these adventures with his family beforehand? I suppose I'm wondering why you can't just ask your father about his travel plans in the ordinary way.
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Your father is passed Independent living. He needs an AL where he can be monitored more closely.
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lealonnie1 Jan 2021
Residents of AL can come & go as they please; they can walk out the front door with no questions asked.
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Is your father so advanced in dementia that you cannot speak with him about this, that he cannot retain anything you say?
If he CAN understand I would explain to him that the next time he endangers himself in this manner he will have to go to a locked memory care facility.
If he cannot understand or retain, then in fact it may be that time. Such a trip could end in his death. Easily. My friend's brother disappeared, and was found across the bay very lost, and prey to all. Luckily found. Many elders are not found every year.
I am so sorry you all are going through this.
There are some police bracelets available in some areas and I would discuss with your local department. My brother's ex wore same when he was not in locked unit, used to disappear for alcohol.
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He seems like he is passed Independent Living. He needs Memory Care.
The fact is in Independent Living they can not stop him from leaving. He could very well "wander out" at night to go for a walk, go to the store, or anywhere he pleases.
If you, the family does not wish to move him to Memory Care then part of this is on you. Yo can place a "tracker" on phone, in his wallet or other piece of clothing. At least that way you can tell where he is. Some you can set to a particular range so if he leaves the area you will be notified.
But the only way to prevent him from leaving is to transfer him to a locked MC unit.
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lealonnie1 Jan 2021
My thoughts exactly. This is far more advanced than 'mild dementia'!!!!!!!!
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Does he own a smart phone? If so you can install a tracking app so you at least know where he is (police can get some idea of his location by the last cell tower it pinged even if the phone is turned off... this also is true for an analog phone, like a flip phone)

Does he carry keys? You can put a Tile on it that will also track him, just don't tell him what it is.

The title of your post tugs at my heart, I can't imagine the worry you are feeling. Was he an adventurer in his younger days?
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Based on your comment, "His last trip was an excursion on a 3 wheel single speed granny bicycle. He went 30 miles across a mountain on an unimproved road. He was found dehydrated, disoriented and spent several days in ICU. He claims no memory of the event.
This "trip", he asked a family friend for a ride. To my knowledge he doesn't know anyone at the destination. He is planning in secret and then just disappears without warning. We never know if he is in a ditch or on an adventure.
If he wants to travel, I don't begrudge him that. It's not fair that he leaves and worries everyone unnecessarily. Involving friends, neighbors and police in a silver alert/man hunt is terrifying."

You need to realize your father has more than 'mild dementia' going on, and nearly died on his recent 'trip' which you don't want to 'begrudge' him of. He does not have the mental ability to take these 'trips', to leave on his own, and if you continue to allow him to do so, he is going to die.

Dementia is a brain disorder; the brain no longer functions properly, as evidenced by his bicycle trip. Understand and believe this statement to be a fact. And, as such, treat it with the seriousness it deserves by placing your father in a Memory Care Assisted Living environment where he is unable to leave the premises.

Otherwise, his next trip may be to the morgue. I used to care for an elderly man with dementia who believed he lived across the street. His daughter 'loved him too much' to place him in Memory Care, and felt he was entitled to live in his own home & do as he saw fit. Which he was...........and he was also entitled to pay the consequences of his actions, I guess. Because one night, he left the house, fell in the street & wasn't found for a few hours. When he was taken to the ER by ambulance, he was too far gone to be saved. He had a subdural hematoma and died the next day.

Your father is not capable of taking a 700 mile trip. Do something to prevent it before it happens. Either that, or accompany him on this trip so you can care for him during it and make sure he's not doing something to endanger his life. He can't use reason anymore; dementia prevents it.

Wishing you the best of luck managing your father's care.
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Beatty Jan 2021
Our neighbour wouldn't put his Mother in memory care. She wandered at night, hit by car just around the corner, lingered a few weeks in a NH & died. Must happen all the time sadly.
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If he has access to a car, disable it completely ASAP. Make sure it is not something that can be fixed easily or cheaply. I agree he needs to be in memory care that is locked. I know that sounds harsh, but it is what I had to do for my Mother’s security. I was well advised she would not be safe in any facility that was not secured. I checked out a few before making the selection and it was quite nice and the best thing for her. She was free to walk around the facility wing. Walk out into fenced in courtyard, tv room and be apart of activities.

My brother in law and sister in law where moved to AL when their son felt their mental state was normal. It wasn’t. Wife’s Alzheimers state was worse then his, but he was in beginning stage of Alzheimers. On the 2nd morning, they did not show up for breakfast, so the staff checked up on them. Their car was gone. No cell phone. It was 2 days before they were found. Thankfully safe but confused.

When we lived in FL it was more then once a golf cart driver was found on Hwy 75 driving their golf cart in the lane of traffic, not knowing where they were.
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DrBenshir Jan 2021
People with dementia should not be allowed to drive. Take away the car. This is not an issue, it is a necessity.
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Does IL = his own home or is it part of a facility?
Does he have a car (sounds like no if he used a bike and got a ride from someone)?
Does he live alone (sounds like yes.)

Would he accept having aides in his place? If not and if he can't afford 24/7 or a live-in, it sounds like he really needs to be in a MC unit. He can still go out, with supervision, but not alone.

You don't need the stress and worry if he does "take off", nor do you need the call that they've found him... too late. He will likely say NO if you ask him to move. He will likely make a fuss when you do move him, but the choices really have come down to status quo or MC.

IF he's the type to make a big fuss if you plan to move him, make up a reasonable excuse for why he has to move, temporarily (you know it isn't, but he can think that), such as repairs needed on the home, etc. Blame others when you can (doc says..., repairman says... ) If the excuse isn't working, make plans for a nice meal out, arrange with the facility to have this meal, go to the area after the meal, make excuse for yourself, like having to use the bathroom and leave. The facility we moved mom to knew our situation (refusal to consider moving anywhere), so they said just get her here, we'll do the rest! They did use some anti-anxiety, mildest dose, initially, but only for that transition period (and once later for UTI sun-downing.) They suggested staying away for a week, better to stay away 2, to give it some adjustment time.

If you do get him to move and do take him out, make sure to watch him like a hawk and if you can get a tracking device on him, just in case, that would be good too!
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Seems it is time to make sure dad has round the clock care:

Home health aides can keep track of him round the clock - if there are finances available for this,

Residential facility - I'm thinking memory care unit - can also keep track of him. Most memory care units have different methods to keep their residents from fleeing.

Figure out why or where your dad wants to leave. Maybe he wants a trip to a specific location or he is tired of all the COVID restrictions. A short trip with a trusted family member may cure the desire to flee.
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It's so interesting that he is now planning this next trip in secret. I would interpret that as meaning he *does* remember something about his prior trip and that he has some understanding that this new trip must be kept quiet so it isn't thwarted. Is it possible he is suffering from some sort of mental illness rather than dementia? Based on his prior excursion that nearly did him it he seems like a candidate for MC.

When I was in 9th grade I remember a girl who was regularly called out of class so that she and her entire family could go search for her grandmother, who had dementia and lived with them, and would pack her suitcase and leave. No one was able to be home to care for her for a while. I remember the stress it caused this girl and her family.
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Probably a silly question, & wildly expensive, but are there escorted holidays for those with memory problems? With hired Aides? (They would have to have a very high staff ratio 🙄).

Someone suggested that for my relative instead of her plan of a totally unrealistic trip to an unsafe part of the world. A nice supported holiday somewhere else, more local.

She was actually happy with some days trips instead.

What does Dad like to do?
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BurntCaregiver Jan 2021
I've been an elder caregiver for near to 25 years and there is not one of us who is going to travel on a holiday with a client suffering from dementia. That's not going to happen.
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Sometimes go along a little bit with his planning of this trip. This way you can find out where he's "planning" on going and when he wants to leave.
Then when you know this information start talking to him about going somewhere else and that you'd really love to get away and go somewhere yourself, and how would he feel about going together on a family trip. Then his mind will be on a different trip.
This might work. Like you said, he had mild dementia. He refuses to do basic things because of being in pain. It could be that he just wants some attention and maybe a change of scenery with family that's closer than 700 miles away would do wonders.
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You got some good suggestions here (and some good questions. It might be that it is time for him to move to a secured (locked) MC unit in either an AL or a LTC provided he has be diagnosed with dementia. Not sure if finances are an issue but AL's generally do not have a lot of Medicaid beds so payment is private out of the individuals pocket. Many LTC facilities have secured units but you ideally want to have a unit that is certified. It means that the staff has to continuously take dementia related training and that the resident-staff ratio may be a little better.

In any event, trying to get placement anywhere in the midst of a pandemic is problematical so (without knowing where you live) I would suggest that you get in touch with your local Sheriff's Office and/or your state office on Aging to see if they have a monitoring program available. Mercer county in NJ has such a program and the tracking devices are available free of charge provided you have a verified doctor's diagnosis of dementia. The Office is run by the Sheriff's department. They come to the house, meet with the dementia patient and a family member, ask some questions, take a photo and then present the dementia patient with a lovely "bracelet" in honor of something they have made up. Thing is waterproof and goes on and doesn't come off without a special tool. Needs a new battery which they will come and replace every 60 days or so (my Mom used to look forward to their visits!). Although it has a fairly short range 3-5 miles, it has located a number of wandering folk here very quickly saving taxpayers, police and families a lot of worrying and anguish.
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Is there someplace in particular he is wanting to go? Maybe a road trip with just the two of you. It might be possible to do it by train and get a room in the train for extra covid precaution. You go to the destination, take a cab to a hotel and then make the trip home.

If this isn't possible and you think he may try it alone, he will need money and or tickets for a trip. Can you prevent him from getting the things he needs for a trip? If he has access to these things, watch for the signs he is preparing. If he still has a lot of time alone without supervision, it may be time to get some inhome caregivers to go in each day to clean, fix food, and have a set of eyes on him each day.
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Sometimes the planning of a trip can be as much fun as the adventure itself. While you don't know where he is planning to go, maybe you could suggest some places and plan a trip. I did this with one of my clients who wanted to go visit long-gone relatives in Italy. What about getting maps of any place or a road atlas. Spend time choosing routes, and change the final destination often. Sounds like he liked fishing, maybe plan a trip to a great fishing river.
Then bog it all down in the details! Get a couple guidebooks, look for interesting side trips. Choose a date of departure well in the future, then change it with some excuse. "Wait, we can't go there in February, it will be too cold. Let's go in August".
Make endless lists of clothes to bring, food to pack, fishing gear to repair, lures to buy. Peruse sporting goods catalogues together. Then change it from a fishing vacation to biking excursion. New lists, new maps, new destination, new departure date!
Hopefully you can get him so hooked on the planning that the trip itself never materializes. And planning a great trip together can be a fun activity to do with him.
Meanwhile do all the research necessary to plan his future arrangements.
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RedVanAnnie Jan 2021
I often plan trips for myself, sometimes just for the pleasure of the planning and anticipation, so your comment struck home. I love road trips, so I "plan" the roads I'll travel, I choose motels and campgrounds and restaurants and local attractions.
You're right. Even the planning is a lot of fun. When I don't really go on tjat trip, I save a lot of money!
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What happened when he did run away before?

I can’t imagine him being on his own now with COVID.

What reason does he give for running away?

What were his reasons for the last runaways?

Is he on meds? If so, do you think his meds need adjusting?
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With only mild dementia, why is he wanting to run away? If things are in his favor, he’s treated with dignity, has privacy & nothing is forced on him, if he’s eating his favorite foods, watching his tv programs & his caregivers let him be in peace, then he wouldn’t want that. Look at his environment. If you were him, would you want to run away? Maybe things at home need to be altered so he feels more happy & content ❤️
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RichCapableSon Jan 2021
Mom and I were taking hell. It was she who suggested we just leave. So we did. We left all the interference and wrong opinions behind and lived free as the birds on the coast of Florida and Alabama in beautiful condos for two years. She was considered late stage AD. After that two years gone, she lived another 8 years. She was turned 90 the first few months we were gone. With mild dementia, he may be facing an over-reaction by others. Social engagement, vitamins, minerals, going out every day to where they like to go, to their church, see their brothers and sisters out of town. Let them use the store wheelchairs to shop. Everything like that will keep them going and even improve their behavior and mental outlook.

Mom's gerontologist gave her 5 years to live in 2004 and 100 other patients that same year. They all died. In 2009 he called us in to tell me they all died and said mom's in the same condition and they had investigated all the records, but all were treated the same, but nobody had a son or daughter like me. What? you do this, that, take her here, there, etc etc. and all you do for her with her, every day, day after day, is why she's in the same condition, exact condition as five years ago. I'm supposed to give you the five-year speech again, but I know you now and she's going to be living a lot longer than five years from now. Since 2004, a hundred of his AD patients died every year like clockwork. 100 x 16 years. Just one gerontologist? 1600 patients my mom outlived. Multiply that by all the gerontologist patients across the city, state, country.

It was worth every moment. You only have one mom and one dad. If not for them, none of us would even be alive. Period.
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Does dad have access to car keys, checks, paper money and credit cards/wallet? Important info that someone can take. They dont have to mug him. If he's outside on the sidewalk somewhere confused, a person can say I can help you.... You don't want him walking out of the house with these items. Or having them in the house, where he can get to them and give credit card info over the phone.
Id also get him an id bracelet. U can get from Amazon. You can get a ring or other security an app that tells you if someone is at the door, or if he leaves. U need wifi.
I would try to get a companion or a carer to come in and watch him.. House stripped down if he's alone. But if he's got moderate dementia he shouldn't be alone. Make sure keys are gone and distributor cap off the car. Dont say your taking the keys and your not leaving! That will make him furious and more determined than ever. And sometimes they can have a long memory when they are mad.
And if he keeps trying to go, its time for a facility or someone needs to be there 24/7. My dad wondered off in the woods. Wasnt found for sev hrs. I didnt hear about it until months later. My mom was having cognitive issues of her own. Just didn't see situations that were dangerous.

I would say for safety reasons he needs a higher level of care. You dont know if he turns stove on, microwaves the oven mit with the food or starts a fire, leaves door wide open. He can also wander off in the cold and not be found for several days. I've heard of people in bad shape or not found until too late. If you can't afford a higher level of care then you need to get family involved or figure something out. Hes already wandered off several times. The 1st time should have been the last time. And of course you can say all the reasons why he can't go. Or tell him he's not going. He'll just be more determined.
Gold luck.
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RichCapableSon Jan 2021
She said it's mild dementia, not mid or late stage.
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Please get a second and third opinion on how to manage his pain because in my urgent earnest sincere honest experience , I have learned that medical management of humans health for the last 30 years has switched to using Petri dish corporate science, rather than doctor nurse, time tested, clinical, professional hands on, human health care . Once you get the health care team to switch to the root cause of pain, that’s when you’ll have a chance to stop the madness.

Get your dad to see a “functional medicine” doctor or do a virtual consult to start ASAP. Please. That’s what I did and my parents have zero pain now. No more leg and joint pain, no more hand arthritis pain, no more hip, back, foot pain ... nor more yo-yo diabetes blood sugar either and no more agitation from high blood pressure either and no more medication. Except for a little Metformin as insurance when my dad goes to parties or I can’t control the meals . No elder should be on a cocktail of drugs without a variety of health guidance and nutritional guidance. Food = Mood.
My mother also used to walk out the door . Once I got her to a doctor that knew the root cause of diseases, everything changed .
Or once I began to analyze first if the diet was optimal or not and his environment was engaging and fulfilling enough, then the meds are also addressed if not firstly.

Also get a male companion his age or younger disguised as housekeeper that will eventually begin chatting with your dad and get him to talk which will be a catalyst into doing other activities eventually.
what you can do in the meantime is calculate how much hydration he gets of “electrolytes” in his water and food choices. Check If he’s dehydrated (pinch the skin above his wrist and if it sticks together and doesn’t go back down fast, then he’s dehydrated) Buy super C or Emergecy C electrolyte drink at CVS and give half the dose to see if he calms down . You can also try CALM with calcium or by itself just CALM Magnesium but just 1/3 of the portion.
if you don’t have time to try these things which has helped too many people and elders and you can read about it in medical journals and the symptoms of dementia becoming unmanageable due to too many drugs and other lifestyle and nutrition factors.

Look online for the functional medicine practitioner website . Many MDs have switched to incorporating functional or integrative medicine into their practice but they might have stopped taking insurance because they focus or the root cause of disease instead of using drugs merely to stop symptoms .
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I think many of our loved ones go through this in the early stages of dementia. As time goes on it gets more and more impossible to execute. Unless you think there is a possibility that he could actually do it, I would just ignore it. Let him talk and fantasize about what he’s going to do. Eventually the day will come when he won’t be able to leave the house no matter what he says. Just be sure he is safe and doesn’t have access to large amounts of cash or credit cards.
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Sometimes they are going to the home of their childhood. I was home with my husband all the time. Once he got out as far as the mailbox and hollered at me that he was going for a walk. After that scare I put chimes or noise makers on each door. When I heard that I ran, If he wanted to go for a walk we went together.
That worked very well for us. I did have help. My teen grandchildren and family lived just a few miles from us so they came by and walked him too. They carried their phones and only had to call me once because he wanted to walk too far.He is gone now and I even miss that.
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1st, was wondering why he thinks he needs to run away?

Talk to him about it and let him know he doesn't need to run away, that if he wants to go on a trip, to let you know so you can help him plan it.

Then plan the trip with him and let him choose someone to go along with him if needed.
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IF he is competent he can do what he likes. He has rights, too. If you are concerned, you need to take this issue up with his doctor to evaluate his competency.
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There was a window with my loved one where he could still safely operate a vehicle, but often got lost. We put a GPS tracker on each of his vehicles. With the monthly subscription we got an app that allowed us to monitor not only where he was but also his speed. He kept his independence and we kept our peace of mind.
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Why not find out where he wants to go and try to take him? My mom had this itch to go years ago and how I wish I took the time to take her. Now it is impossible.
If you can swing it, it will be a nice memory for you.
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Convince him to take someone along with him.
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I worked with a Swami at an ashram during his hospice. He would get quite depressed and ask me to drive him away and leave him beside the road somewhere as he felt useless.

I alerted the head Swami as my Swami went as far as to get his coat and shoes on and ask where I was parked 😳

They did an intervention and had him go to a isolated meditation building and stay the whole day to meditate. I don’t feel like they solved the problem more like a time out but I didn’t want to interfere with their spiritual practices as he was also seeing demons. (As did my own grandmother)

Everyone’s end of life is different, something is driving them. My Swami needed answers not prepared statements or to feel useless. That’s where I saw his frustration, sometimes that constant reassurance goes a long way.
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What is mild dementia in your opinion per your dad?

In the past ten years? If he has mild dementia now, that wouldn't indicate he had much problems ten years ago, right? Could you elaborate on his condition ten years ago and what the problem was when he ran away or maybe in his mind it was a getaway, a vacation. (I remember when my mom and I were claimed not to be able to go even to Dallas. We left anyway and for the whole weekend, 300 miles away and back. Then we moved out of state for two years. Of course I was with her. You understand if your parent is not able to listen, to be advised, or accepts your advice, you can't do that. And certainly not for two years. But others were not being reasonable and our trip proved it. We made a LOT of friends where we stayed.) Help us to know your reasoning.

If he's taken off before, then the pain probably isn't the main reason he doesn't want to go shopping, fishing, sightseeing. Or it would keep him from planning and taking those vacations. We were also said to have run away, but it was a vacation, but yes, we wanted away from the severe restrictions mentioned by those who weren't around us caring for her. So I don't know if that's an issue here as well. Your fear could be placing fears on him. Actually. Is there nobody he trusts that can go to a movie with him. When you offer to go shopping with him, or a movie, do you include any of his friends? Could it be he's afraid you want to put him in a nursing home? Do you spend all your time with him or just drop in daily or every other day? You said you manage his meds, but what does that mean?

How old is he? When did he starts meds? Which meds does he take? Does he take any meds himself or only if you give them?

It's really complicated if you don't want just a pat answer one-size fits all. I'll be glad to help you but we'll have to communicate about it. Do you live in Texas? You can PM me. I'm definitely an expert in these things. Multiple psych degrees. Twenty years dealing with AD focused on one patient, so the depth of my understanding is deep and takes in all stages and situations from beginning to end, medical and sociological and psychological.

Why don't you go on the trip with him? that's also a question I have. If we are in the same city, I'm glad to speak with you in person and to meet your dad as well. If you are serious about helping your dad, there are many things you can do to help him. It's not always all downhill. Unless you use 50's style care, which is what you find in nursing homes.
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