My father is 86 y/o. He has always been mentally ill with a delusional disorder, he had a TBI in his 20's, and is on the Autism spectrum. My father's memory, mood, behavior and judgement has always been impaired due to these problems.
I became involved in managing his life 9 years ago after my mother died. I'm the only involved family member.
My mother organized everything in the household and his life, as he was never capable. I live one hour away. Throughout my time dealing with his life, there are medical issues, crisis situations, and practical matters that require my constant attention. At times he is difficult, stubborn, and nasty.
In recent years , he shows signs of some cognitive decline with increased confusion and short memory issues. He often doesn't sleep at night, adding to more functional impairment. His driver's license was revoked last year following an incident in a grocery store where he defecated on himself and spent hours in the store bathroom, after binge eating at various restaurants, and was transported to the ER for evaluation. The inability to drive has made him more dependent upon me for various aspects of daily living.
He now has a variety of medical and personal care services in the home, which is helpful. I'm still acting as his mental health counselor, paying his bills, transporting him to some medical appointments, grocery shopping, coordinating periodic home repairs, etc. There's always some issue or incident that requires my attention. I feel obligated to see him weekly and check in with daily phone calls.
Yesterday, he sexually harassed his home health aide and became angry and verbally abusive when she refused his advances. I'm not sure if she will return. She is wonderful and will be difficult, if not impossible to replace. This, along with 9 years of him being a constant burden on my time and attention, has brought me to a place of absolute burnout. I want to remove myself from this situation. But I don't know what options are available. Sometimes I fantasize about dropping him at the ER and leaving him there.
I think it’s possible you could also call adult protective services and express your concerns. In my experience with my mother, who had a lifetime of depression and anxiety and ended up reappearing in my life After a mutual 10 year estrangement, adult protective services will not act in a way such as removing the person from the home if they are mentally competent. In my mother‘s case, they had spoken to her PCP office and decided she still had capacity to make her own decisions. In those cases, they won’t do much of anything. But by that line of thinking, if your father has already displayed a lot of symptoms of cognitive impairment, I see this as a potential path to call APS. Tell them everything you have discussed here, raise the cognitive concerns, and see what they can do to help. If you currently have power of attorney, you would need to formally resign that in writing. Probably best to consult an elder attorney for advice on that. I’m sure others here will have lots of opinions and experiences.
In the end, my mother ended up having undiagnosed dementia that was pretty well hidden and masquerading is just her usual mental illnesses, until a medical issue put her in the hospital and the dementia was fully uncovered. She progressed quickly to end-stage within about six weeks.
He can have his groceries delivered to his front door, can call an Uber(or the like) to take him to any appointments, and hire outside contractors to do any home repairs that may be needed, all on his dime obviously.
You can then call APS and report a vulnerable adult living by themselves and that you're just not mentally able to handle his affairs anymore and they will come out and do an assessment and take over his care if necessary. And in your case that would be a Godsend now wouldn't it?
OR...you can try the ER drop. You have him taken to the ER by ambulance under the guise that he may have a UTI or something else, and once there you let the doctors, nurses and social workers that your father CANNOT return home and that he is an unsafe discharge, and that you can no longer give him the care he now needs. You keep using the term "unsafe discharge" until the social worker agrees to find placement for him in the right facility.
No where is it written that it has to be you who looks after your father and his care, so I hope you'll now remember that you and your mental health matter in this situation too.
If you are neither of these things, do as others have suggested and step completely away and report him to APS. Or, do the ER drop-off. Tell the discharge planner that you're not his caregiver and don't wish to be. Don't believe any threats about taking him home with you. Do not bring him back home for any reason. Ask to talk to the hospital social worker and maybe they will be able to discharge him directly into a facility.
If he doesn't have a PoA or legal guardian right now, the court will assign him someone. At this point you will no longer have access to his home or insights into any of his accounts. Do be cooperative with the county -- they are working in his best interets and the more helpful info you can give them, the better his experience will be since there won't be anyone else to fill in the blanks.
Bless you (and your Mom) for helping him all these years. May you receive peace in your heart.
I think based on what you've said here, it sounds like your father needs to be in some kind of supervised living situation like AL or NH. At his age (86) a group home for people with mental illness and autism will not be an option. Group homes don't take people his age. Your best bet would be to talk to his doctor and explain his situation then ask them to put you in touch with a social worker. A social worker can help to find him placement somewhere he will get the supervision and care he needs.
You recognize that you have caregiver burnout and realizing this is a good step forward. You cannot provide the level of supervision and care your father needs. You can resign POA by going to the probate court in the city/town your father lives in. The will give you a form to fill out. This is how it's done in my state anyway. Where your father lives may be different. Go to the probate court or call and ask how to removed as a POA. They will help you. Based on your father's conditions and behaviors you've stated, I don't think homecare is the right choice for him. He needs a higher level of care in a structured environment that is supervised 24/7.