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My dad has a specific delusion with my mom having an affair with her boss who is more than half her age and now he thinks the store where she works at is a whore house. He would drive her to work and parked there examining these customers who comes in store for lottery and groceries and think that they are paying for sex. We had numerous arguments shouts and fights about this, most recent today where I was driving him pass the store and he wanted me to drive in to catch my mom in the act with this man who comes there regularly for lottery tickets. He even recognizes his car and previously marked down this man’s license plate.



Aside from above, other thoughts, speech, actions are normal. He is independent of all his daily activities and convinced he could and still drive.



His medical history: He was hospitalized last year in November for a bladder infection and was delirious while in hospital. Not until he went home that the delirium was gone but a month later developed this specific delusion. Two months after this I had to call the Ambulance cause he would not stop bothering my mom. They admitted him but only gave him antibiotics for a mild UTI. He was supposed to wait for psych cause my mom said he was threatening her, but psych stood him up two times and he left against medical advice because he began to be delirious if he stayed. The has refused any type of assessment including Geriatric. He drives cause no medical professions took his licence away.



I can’t put him in a home cause he is “functioning” apart from a specific delusion.



I can’t get him assessed because he thinks he is not sick and won’t go.



Every one or two days our family is arguing and yelling and fighting. This is not a way to live.



What can I do?

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Disable his car immediately. Don't drive him to your mom's workplace where he can foster this delusion any further.

The next time he starts carrying on, call 911 and have him taken to the ER for a psych evaluation.

Your mom can also call the police if he's threatening her, and they can send him off for an ordered psych evaluation.

I think you've asked this question before and have been given this same advice as well if I remember correctly.

It's a difficult situation and one I hope you can find a solution to.
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Carevdad May 2022
lealonnie1

I did call 911 once. In the ER a Nurse called home and said they won’t keep dementia patients but i told them at the time that he was threatening my mom. She said i have to lock the knives away or if there is a place where my mom could go/leave for a while. NO. They finally admitted him for a mild UTI and only gave him antibiotics. He was a low priority for them so PSYCH kept promise they will come and cancel twice and we left because he was getting more paranoid and delusional then when he was admitted.
Last week he refused to go to a Geriatric assessment and said he is not sick and that my mom and I should stop putting things in his head that he is crazy or threaten to call 911.

Yes i have posted before and you had responded.

The problem is he is “too all there” and “functioning” to be admitted or put in a home, he won’t, except ONLY this one delusion about mom.

It’s one or a few days then he is at it again reminding my mom not to do those stuff and to all the affair off.

I mean if we totally ignore this delusion and we have tried but it is difficult at time like today where i drove him to get food and he tells me to stop when we past my mom’s work place cause he saw “the car” and to catch my mom in the act. I just lost it!!!… so I did. Basically ended up arguing and yelling. Yes i know I know… but i can’t help it. I want to tell him to snap out of it… he is sane in everything else. Sorry but i lost it

He is not violent or threatening but it’s just constant talk of it driving our whole family crazy, more than he is.
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I'm sorry that you're in this distressing position. More information would be helpful:

- how old is your father?
- what state is he living in?
- are you (or anyone) his PoA?
- do you live with your parents or do they live with you?

If your father has a cognitive problem, you will not be able to convince him he is not acting "normal", so you will need to use other strategies when talking to him, like diversion and distraction. Your mother will have to do the same. If he has dementia, he is losing his ability to use his logic and reason and this is why arguing with him will be unproductive.

If no one is his PoA and if he threatens physical violence against your Mom you must call 911. When they take him to the hospital you will need to tell them what you've told us here and that he is an "unsafe discharge" so that they don't let him go. Talk to the hospital social worker. Don't believe them if they promise to provide help if you take him home -- they won't. See if they can do a cognitive test on him but do everything possible to prevent anyone from coming to get him, even warning friends and neighbors to not go get him.

FYI there is no one who will stop him from driving except his family. If he's a safe driver the DMV won't move to recall him for a renewal test. Stalking your mother doesn't qualify taking his car away by authorities. You'd have to physically hide his car, but I don't recommend this as you could be accused of theft by him.

What solution do you think will improve or help the situation? Your father doesn't see his illness (which is pretty common) and he isn't cooperative and now suffers from a delusion that's causing him to stalk your mother. He can't be "committed" without a diagnosis (criminal offense) that warrants it and someone is his legal guardian. The county can acquire guardianship of him under the right circumstances, so maybe you should talk to a social worker for the county in which he lives. See under what circumstances he can be removed from the home. Get him on their radar.
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Carevdad May 2022
Geaton777

Thanks.
He is 76
We are in Ontario Canada
There is no diagnosis, last November the discharge was confusion. No medical doctor took his licence away.
Can’t the Police? He was just in an accident last week in which he drove himself in a ditch somehow at night. The Police tow his car and drove him home cause he was unsafe to drive home YET they gave back his licence. Doesn’t make sense at all.
The time i called the ambulance the nurse called from hospital and said they can’t keep him cause they don’t deal with dementia patients. This is without anyone assessing him. They finally kept him for a mild UTI.
He does not go to any follow up assessment or any recommended assessment because he thinks he is not sick. He actually tells me that it’s my mom that needs one and not him.
No one is his PoA because we never set up cause he refuse to talk or sign or deal with anything regarding health and sickness.
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Keep pushing for that psych assessment.

Whether UTI, delerium, the start of a dementia or other reason, his delusions are;
1. Safety concerns - both to himself & Mother
2. relatively new
3. ongoing

Proper eval, diagnosis & treatment is needed.

I have a relative that started with delusions. A non-voluntary admit was necessary to gain dx & treatment. (Often called 'Baker Act').

If Dad is resisting & cannot reason, arrange it.

If it is the Doctor/Geriatrician resisting, then maybe another ER drop off is required.

Best of luck. You can only do so much individually. Hopefully your family can rally round & pull together.
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If he's threatening you and/or your mother, you two should leave until he's been admitted for a psych evaluation. Go to a women's shelter and ask them what to do.

Oh, and I'd sneak outside in the night and pull the spark plug wires on his car and toss them somewhere.
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Carevdad,
Maybe call health line in Ontario, they can possibly give you some advice how to proceed.
ER will not do anything, as they deal with health emergencies. Keep in mind privacy protection is strong in Canada I could not get some form at dr for my husband, all because of personal info protection act so even if dr and specialist get involve if your Dad agree, could be only beginning of long evaluation until some recommendations are made or family involved in decision making.
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We have Crises Assessment Teams here that will attend a mental health crises in the community (must be dangerous level) & ER will deal with psychotic bevaviour (funnel into mental health services). It's certainly not perfect & release to community is common, despite family wishes.

I also hope someone from Canada can assist before a worse crises arrives.

I think I would be the squeaky wheel - start driving my husband/dad to my Doctor's office every single day (if they would allow) or calling them.
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He is delusional because he is experiencing symptoms of mental illness. Call the closest NAMI office for assistance.
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Certainly may be mental illness, or an infection that is hanging on in his nervous system, or the s or possibly dementia. Take him to a geriatric psychiatrist who can look for all of these things. I doubt he will go for his sake. But ask him to accompany your Mom to the psychiatrist so he can explain the behavior he has observed in her. She should certainly bring up that things have been difficult since his UTI infection. IF he refuses, ask his family doctor how to check these things out in his office. It might be possible; not sure of the studies needed.
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TChamp May 2022
It doesn't have to be a geriatric psychiatrist, any psychiatrist knows how to treat a paranoid psychosis.
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Your father is psychotic, he has lost contact with reality and is paranoid. If he has no previous history of mental illness, the possible cause of his paranoia is vascular dementia from mini-strokes. Paranoid people can become dangerous when they identify an imaginary enemy. His paranoia may respond to antipsychotic medicine. He needs to be evaluated by a psychiatrist immediately or committed to an institution against his wishes.
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I am sorry to say but it is not productive to argue with a delusion. He can't help his brain malfunction. I would start with getting him back to the doctor. UTI in elderly people can cause delusions. Strange, eh? Wonder what is causing the infection?
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Is it a full service hospital? My Mum was in a memory care home and “lost it” on staff they sent her to hospital, (Royal Alexandra Hospital in Alberta)with nothing physically wrong with her. Eventually the hospital got round to doing the psych evaluation.
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I only recently heard of “The Othello Syndrome” as a diagnosis. This may be something to discuss with his provider. Many providers may not be familiar with the term so go prepared with printouts of articles to share. Just be sure your resources are medically sound such as National Institute of Health (NIH), Mayo Clinic, various University Medical Center websites, etc. Many providers put up walls when someone even mentions something they saw on the internet because there is so much wrong info there. So be sure the websites you use are credible and never refer to Wikipedia when talking to a professional.

https://pubmed.ncbi.nlm.nih.gov/23066764/

There are several references at the end of this article.

If he has a trip to the ER, go prepared with an article or two in hand. It seems he may benefit from a full medical examination because many times these symptoms can relate to a neurological issue. My husband has Parkinson’s and I have a few friends dealing with this.
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When my best friend's husband (who suffered from Dementia) started accusing her of cheating, we all found it humorous. When I moved to my new home, I read about a murder where the victim's husband had Dementia and he murdered her for cheating: there is no laughter anymore. Get a 72hr psych eval done on Dad and let them see what danger he presents. If you can record him stating his beliefs, the authorities may respond to it as a "real" threat. Getting Adult Protective /Services may be the catalyst for change.
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Why hasn't Mom called the authorities on Dad? She has implied POA as his spouse. She should also call the police when he starts acting aggressive. Get funds into Mom's name and out of joint accounts. Dad may have had a small stroke or may be developing fronto-temporal dementia. This is less common that AD or other dementias, and typically manifests as inappropriate behavior before the person has serious functional impairment. Dad needs a medical eval ASAP. If he won't get one start making contingency plans for the rest of you. All of you need to identify anything you are doing might be enabling. This can be the best way to force Dad to get a medical diagnosis.
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‘Bad, but not bad enough’ to trigger helpful responses. Perhaps you could escalate this (safely) so that it does get ‘bad enough’. Go with him into the ‘whorehouse’ and let him make a scene. Suggest they call the police. Let him follow the man who gets lottery tickets, start a shouting match, and then get threatening.

It’s not an easy suggestion, and it might be possible to warn the people in advance about it. It would be helpful if they don’t just shrug it off. But it’s not right for it to have such a bad impact on your family, while other people just wait for something bad – like a murder attempt.
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You have a history of UTI - which causes this very delusional thinking...commonly sex/affair type delusions. I would get him checked again for UTI and then on a regular basis. It's possible he got some antibiotics, but they didn't actually clear up the problem. Call his doctor and ask for a retest. His doctor may allow you to carry the sample straight to the office or nearby lab.

If you have home health care for dad - like nurse who comes by weekly. Ask the nurse to test him.
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Remember he is in Canada,
Privacy act here does not allow any disclosure of any medical or other info.
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Carevdad: I believe that your father may be suffering from the mental illness referred to as jealous subtype, where he believes that his spouse is being unfaithful. I suggest a psychiatrist.
Disclaimer- I do not profess to be a medical professional.
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Care, this is abusive behavior.

Would mom consider getting a restraining order? That would almost certainly trigger a mandated psychiatric evaluation.

Sadly, I think getting law enforcement involved is the only way you can force an evaluation.

You asked previously about medications for paranoia and delusions. There are anti-psychotic meds that can help.
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My uncle had a delusion that a man was coming to kill him. At one point grabbed the steering wheel when my cousin was driving because the man was in the next car. They got him to a psych ward and then to a lock down memory care. They were lucky. He wanted to stay in lock down because the man would get him at my cousin's. He eventually felt safe enough at lockdown that he calmed down and could go on group outings.
I guess my point is that he could be dangerous (grabbing the wheel) without even threatening you. Any number of things could happen because he is unstable.
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You can get home tests for UTI. Here is the one I have used...

https://www.diagnoxhealth.com/product/urinox-10

It is available from Amazon.

This way you can test without running to a doctor each time. If it is negative, retest... especially if there seems to be other symptoms (confusion, burning, smell, etc.) I only consider it a screening but if it is ever positive, I would definitely get him in to the doctor.
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If he threatens anybody, call the authorities. He will be involuntarily admitted for psychiatric evaluation and treatment. If not, try his usual PCP to check for medical issues.
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