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He is alone most days because his ex-wife, whom he lives with, continues to work at 80, not out of financial necessity but her own personal needs. I visit him once a week but that’s not enough interaction. He is in need of a new neurologist. I have given them both the name of a well respect Parkinson’s specialist months ago, but no appt. He depends on her for Drs. and schedule. I feel helpless because she and their 2 sons who live out of town on on his medical directive. Looking for advice. Thank you.

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You have done what you can. You have provided suggestions. But it is up to the wife and sons to manage the care as they see fit. Whatever our own experiences are it is important to know that your brother's own experience is as individual and as personal to him as his own fingerprint. Do know that any family dissention or bickering is about the worst thing he could possible experience now as anxiety always makes these things worse, so attempt to support his family in his care. If you wish to suggest a doctor, do so, and then leave the rest up to his family.
Often being in this state is a case of being between the devil and the deep blue sea. There are many medications that help with balance and often make delusions worse. Then there are medications that help with delusions and hallucinations and make the balance worse. That is to say there is no easy answer and it becomes difficult to assess what drugs or "drug cocktails" work best for any given individual. I am so sorry your brother is going through this and wish you both the best.
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"...she and their 2 sons who live out of town on on his medical directive..."

Are you saying all 3 of them are his medical PoAs? If they are only his Medical Representatives (as would be assigned by father on the HIPAA form), then they are privy to his medical information, but not legally able to make *decisions* on his behalf. Only a PoA legally makes decisions for someone.

Semantics: a "medical directive" is usually also termed a Living Will or Advance Healthcare Directive. This document only outlines what medical care and procedures the person wishes to have if they become incapacitated. Again, this does not give another person legal authority to make decisions for them. You need to clarify just what documents/authority you think the wife and sons have.

Before talking further to the sons, I would consult with an elder law attorney to see what your options are in this case. Then maybe you can have a diplomatic conversation with them. Maybe they don't really want to be burdened by his care and will be happy to hand it over to someone else.

At 80, his wife certainly could be a candidate for memory and cognitive impairment herself, so this should be a factor to consider in why your Father's care seems lacking.
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I don't agree about Medical POA. Once Mom was found incompetent to make informed decisions, I made decisions for her based on her wishes in the Medical Directive. It read like a living Will. I made the decision to call in Hospice. If a procedure was suggested it was me who made the decision to carry it out or not.

Your brother should not be left alone IMO.

My friends mother just retired at 90 and is bored. So she is volunteering with disabled children.
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My father had PD with hallucinations and delusions. Sadly, there is not anything I know of that can prevent them, a new neurologist or specialist is not going to be able to significantly make a difference. PD is progressive and decline is inevitable. Your brother definitely should not be left alone now. I would advise you to do what you can to ensure his safety, and if they can't afford to hire someone to be with him when she is not there, and if she is not providing enough support for him, I would contact APS.
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yeah, two of my friend, including my husband see imaginary cats a lot! Lately, my husband thought that homeless people were setting up camp in our front entryway. Also my husband had a terrible reaction (paranoid shooters and horses racing in the hospital hallways) to high doses of prednisone in the hospital after a fall when his blood pressure spiked. I've decided to not have him kept at the hospital, even if he has to go to the emergency room. I don't want to have him experience the dislocation and delirium that set in. We've been finding all sorts of videos on YouTube for Parkinson's subjects. Try to laugh together about it. Drugs are either causing it or might be prescribed, but unless it's frightful, I'd just "check out the hallucination" and move on. Unfortunately, dementia is part of advanced Parkinson's.
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