He will refuse any medical help. When he is questioned, he says that "they" have gotten to us. We can't be trusted. He is otherwise relatively healthy. He can still take care of basic needs. He's just causing all kinds of problems with his delusional thinking and I'm worried that something will happen to my mother who still lives in the house with him.
A likely scenario is that his paranoia will spill over into anyone attempting to care for or protect your Mom. Is your Mom a vulnerable person?
Is anyone the PoA or legal guardian for your Dad? If someone is, they will need to get him diagnosed and then hopefully treated with medication to reduce his paranoia/agitation/anxiety.
An able-bodied man with paranoia can be a dangerous person. Does your Dad have firearms in the house? If so, these need to be discretely removed.
Does your Dad have Parkinsons? Lewy Body dementia can come with Parkinsons and cause this type of delusion/paranoia.
If no one is his PoA, consider going to visit him. When he starts to wind up call 911 and report that he is delusional. They may be able to take him away for a psych workup. You may need to be ready to care for your Mom. If he gets to the ER talk to the discharge staff to make sure they know he is an "unsafe" discharge, or needs a social admit. Tell them you think your Mom is not safe at home with him. They may direct you to a social worker on site.
My SFIL had Parkinsons and Lewy Body dementia. He had paranoid delusions. He was 6'4" and had firearms we had to remove from the house. He wouldn't assign anyone his PoA and the county eventually wound up acquiring guardianship of him. He was placed in a county Medicaid facility. My MIL was vulnerable: she had chronic back pain and impaired memory. It was a mess for a while. The goal is to keep your Mom safe and get care for your Dad. Hopefully your Mom won't tell EMTs that your Dad is "ok" or go get him out of the ER, if he makes it there.
I would call APS, along with your Mom and her permission, for an assessment. This may get some intervention so that Dad can be assessed and diagnosed. At that point you will need to decide it guadianship or temporary guardianship (sometimes more easily gotten by a social worker calling a judge) is needed so someone can step in and assume the financial work for Dad and decide if placement is needed. You don't mention physical ailments and I am assuming he is physically well.
For your own information start educating yourself on how to serve as guardian so you will know who in family is capable of or willing to assume this DIFFICULT job with all its record keeping. Decide if you would otherwise prefer a guardian of the state with an appointed fiduciary. Know the symptoms and warning signs and so on. Alz.org is a place to start online. Though do understand there are many different types of dementia and they all vary.
If you can afford it reach out to aginglifeprofessional at www.aginglife.org or ask them if they can recommend help you might be able to afford in your area. Do know that APS is FREE, and can also guide you.
NCCDP.org (National Counsel of Certified Dementia Practioners) may have a list of doctors that you could consult to try to find out how to get Dad in for an exam. A licensed Social Worker in private practice may help with this as well.
I am afraid this is a lot of online and phone leg work to start. But do start with APS and the problem as you state it to us. If Dad ends up transported to hospital for ANY reason call in the social workers at ONCE to get the wheels turning for referral and diagnosis while hospitalized. It may ease the process though in these times that's hard to predict.
I sure do hope you have some luck with this. If you have any community elder care facilities a stop in and chat may give you more ideas. If you have a faith based or other community begin talking with others who may be facing these problems and may help point you in the right direction. I surely do wish you luck and hope you'll update us with what you learn as you go.
I would consult an attorney if your parents have any amount of finances that could be at risk. You may need court action for guardianship or conservatorship.
Delusions and paranoia are common with some types of dementia.
You mention "Age related decline" but nothing else.
If you do not have POA or if your parents do not have all their "paperwork" in order it may be past the time when that can be done.
If there are real concerns about bills being paid it is time that someone steps in. If mom is responsible she can do things as a spouse that might be difficult for you to do.
(if your dad has never set up on line banking you might be able to get away with doing it since you would be the one to set it up with the passwords and the security questions (that can be answered anyway you want to).
Time for an appointment at a Geriatric Neuro Psych Doctor. Could be the beginning of Lewy Body Dementia. Be sure to check out all doctors' on your local State Medical Board.
Sometimes hallucinations and paranoia or even loss of peripheral vision can be the start of something--Lewy Body. They can put on good show with a structured routine but you know something is not right.
Is he still driving. Is his balance, gait a bit off. Does one hand shake? These are all signs. Is their spatial awareness off.
Also, check for an infection. Could be a UTI, etc. Men can get them too.
Sounds like something is coming on...One day they could be fine, the next different people and so on.
Elderly get them too frequently and yes men do too. It does not display with pain but with odd behavior, delusional and sometimes paranoid symptoms if left untreated.
I would suggest getting him to doctor for urine culture to determine if he does have one and then be treated with antibiotics. It happened to my mom a few times and she had no idea she had one but was acting in a way that was not her at all but developed paranoia and refused to take meds, etc. Something happens to the brain and nervous system with a UTI in the elderly. UGH.
Good luck - never easy to navigate all these issues.
P.S. Don't let him watch the news - it's toxic and will only fuel his paranoia. It happened with my mom.
If this is a medical diagnosis (paranoid delusions), he likely needs to be on medication.
* That you are worried something will happen to your mother tells me it is time for you to take action. Do not wait for something to happen to her.
I haven't heard of a person having paranoid delusions and otherwise being able to take care of basic needs. How do you know?
You need to have him officially diagnosed medically to be able to have legal management of his finances.
* If his wife, your mother, is taking care of financial matters, you need to have a serious talk with her. At some point, you will need to manage her finances.
It is important (for us) to know the degree and quality of involvement of your mother.
* Does she 'think' he is 'otherwise' okay? Is this where you are getting your information or do you know first hand how he manages self care.
* Your mother needs to understand the levity of the situation
* And understand what he is OR COULD easily do (i.e., being vulnerable to scammers, moving money around in a bank or investment firm, buying things on the internet) - and God knows what else.
* After you get medical documentation of your dad's condition, perhaps it would be best for you and your mom to see an attorney (dealing with elders / trusts).
Gena / Touch Matters
I had noted she was not taking her medications (and bloodwork at the doctor's office confirmed it). I tried to set her up with a visiting nurse to set up her meds for her; after the first visit, she refused to accept phone calls from the nurse to set up the next appointment, and she continued on not taking her meds. I was able to get her into memory care (long and scary story), and her meds are monitored and administered regularly. Since then, she has not been having these delusions.
Is your dad taking medications? If so, please see if you can determine if he is taking them on a regular basis. Easier said than done, I know, but it could be at least a part of the problem. My mother has been much calmer and is not having the delusions about the mysterious "they" any longer.