Dad has mixed dementia, no insight, and even the professionals seem unsure what to do next
Hi everyone,
It took a full year of pushing and fighting for testing, and finally dad received a diagnosis. He has Moderate Major Neurocognitive Disorder, likely mixed etiology, with behavioral disturbance.
His report listed possible contributors as alcohol-related neurocognitive disorder / possible Korsakoff’s, vascular issues, and possible behavioral variant frontotemporal process. It also noted severe executive dysfunction, impaired judgment, disinhibition, compulsivity, and loss of independence.
I am posting because I feel like the “mixed” part makes everything harder to understand. It is not one clear dementia path where everyone seems to know what comes next. His symptoms overlap in confusing ways, and even the care professionals involved sometimes seem as unsure as I am about what the right next step should be.
The biggest issue is that my dad has very little insight. He believes he is healthy and independent, but that does not match reality. He can barely walk or get up safely. He insists he can manage his own pills, even though he was recently hospitalized after an accidental overdose. He thinks he can handle bills and finances, despite impaired judgment and impulsive spending. He wants to keep driving. He has tried to fire personal care help, even though he clearly needs support.
I have POA, but without his cooperation it has only helped so much. I know guardianship may be an option, but I am severely disabled myself and can barely manage my own care on a good day. I cannot become the full-time caregiver for a 69-year-old man who thinks he is fine while making unsafe decisions. The battle between us is effecting both of our health.
I guess what I am really asking is: has anyone else had a parent with mixed dementia where the causes and symptoms were all tangled together? Did it make the progression harder to predict? Did it make it harder for doctors, aides, family, or agencies to agree on what level of care was needed?
How did you know when it was time to move from “help at home” to stronger intervention, guardianship, or placement?
I would really appreciate hearing from people who have lived through something similar. I feel like I am trying to make huge safety decisions in a fog, and I do not want to underreact or overreact.