One other thought. Kind of along the lines of “the chicken or the egg”

It seems likely to me that high high blood sugars are adding to his memory and cognitive challenges.

Get his blood sugars under control for a few days and then determine what his mental situation looks like.

^^^^Yes...

Yes, he has been for a long time.

Sorry for your stress, Unclebilly. Unfortunately, sugar is a VERY powerful addiction. And common. His blood sugar level can be managed, but probably only by force. At least that is the way it sounds, from your description.

Few of us are following doctors' orders to the letter. I drink too much, and am struggling with smoking cessation. If you told me I should quit both, I would agree. And possibly ask you to stop helping me with your suggestions.

I watched this stuff being drained from my fathers lungs while he was dying of smoking induced lung cancer. Please...for the love of life....stop.

http://forums.pelicanparts.com/uploa...1654213573.jpg

You've been smoking since at least your mid teens.

You've tried everything to stop over the years, nothing worked.

When you are off the cancer sticks you don't feel "normal".

People will tell you that it's just the withdrawal and you'll get past it but it's not and you don't.

You've never been diagnosed, maybe, and are unaware, maybe, that you are on the ADD/ADHD spectrum but if you really think about it you will acknowledge you are.

Nicotine is your Aderall.

They have similar properties.

You've been self medicating the whole time, you just didn't know it.

Find a less risky Nicotine regimen.

PM if you want to know more.

This is exactly what we’ve done. His sugars have been not terrible and some readings within the normal range. He’s better until he isn’t. Today he wanted apple pie despite having his sugars close to good so he isn’t 100% there.

I did take him to see our kids spring concert at their school this evening- this is the first time he’s ever been to one of these. He enjoyed it.

Reminds me of when I was having a stent put in two weeks before triple bypass and the cardiologist, looking at the video monitor asks, "Are you a smoker, sir?"

Never have puffed another.

Now my heart is not what it was. It's damaged.

I wish I had known smoking was bad for your body.

Stomachmonkey makes some interesting points about ADD/ADHD. I have ADD. I'm not an expert in it but I do remember a Dr that I went to that specialized in it's treatment said lots and lots of smokers. He also said money problems and weight control are very common. However, just talking.

The deal with ADD is one does not assess the consequences of their actions.

.................................................. .........................

On topic. I take Metformin in the morning and night for Type 2 diabetes. After losing 30 lbs I am 6.8 down from 7.1 A1C.

If I eat cardboard the night before and skip breakfast before sticking myself, I will have 120 blood sugar (with the metformin). Under 100 is normal.

If I eat a decent balanced meal without metformin I will be at 225 which is getting closer to your dad's unfavorable numbers without eating any sugar bombs. With a quart of ice cream I would be right with him.

I say keep working on him. Good idea on the school concert.

It is sort of like dealing with a little kid

His cognitive function should improve with better control of blood sugars. Anything you can do to get him up and moving will help with that, outside is better than inside the house.

Is an insulin pump an option? Doesn't address the bad habits, but might at least help keep him stable.

My girlfriend's mother is Type 1 diabetic and a heavy smoker, and we have similar struggles getting her to take care of herself. We just moved her in to a retirement community with an assisted living option. Unfortunately we were only able to convince her after several accidents and noticeable cognitive decline. We hope the social interaction and activity helps bring back some of her old self, but time will tell.

i got nothin'
except - wishing for a positive outcome.
take care.

Oh yeah, something like this dexcom glucose monitor works with a phone, or one of those Dick Tracy watches they have now.

Rather than a finger stick, it is a pad you stick on, lasts a week maybe, something like that. Constant monitor, pick up your phone, 14.7, he has been to Tim Horton's., 3.0 and grumpy, he should have some juice right now, maybe a hard boiled egg.

I have badgered my mother to get one for dad, but she does not want to watch it that close. He abused himself for years, it is what it is she says. She checks prior to giving him meds, naturally. He smoked, drank martinis when he played cards, ate a lot and did not exercise enough and is 87. Nobody in his family ever took care of themselves, all lived to ripe old ages.

I do not count golf using a cart as exercise

I was a bit confused since I know that a regular blood test is often supposed to be <100. So I was wondering how the other numbers worked. Now I get it.

Sugar and the subsequent diabetic crash is his junky"high"

You....alone...can do nothing from 700 miles away.
Not without the state legal authority.
Backed by all siblings united.

In the meantime try to get him a visiting nurse once a week to check with his well being.
Tell him in advance. All of you.

He might be resistant at first.
That is always his choice.

Has he told you how he was going to rewrite the will?

I'll say, an insulin pump is likely a bad idea. In the past few years, progress has been made in terms of "closed-loop"...getting feedback from a sensor and then adjusting rates, but it truly is a constant battle, and unless the patient is truly involved and has ownership stake, it absolutely becomes the worst kind of roller coaster ride.

And, way more variables than he will handle. pump batteries, insulin in the reservoir, adjusting various rates and settings. and then replacing sensor, calibrating when needed. tangled tubing, feeling like you are connected to this thing forever, getting alerts, frustrations, etc.

Sensor, much better idea. replace every 10 days, no big deal (Dexcom is fantastic yet expensive, freestyle Libre seems like a great solution)....they stay well stuck, out of site, or directly in sight if the nurse wants to monitor....and then you can get updates on his readings.

Whatever the case, he will need to be onboard with the idea because it involves technology, it involves maintenance, it's a process, and somewhat invasive, but the pro's outweigh the cons by a long shot.

As a type 1 diabetic, I've avoided a pump because of some of these comments along with being active and enjoying our hot tub. Giving myself 4 to 6 shots per day seems easier.

I have used the freestyle 14 day sensor system for a few years. I believe Medicare now covers them. It has worked really well.

Can you get him a pump?

I appreciate the ideas and thoughts.

There are a handful of things at play here…

1. He doesn’t think his diabetes is ‘that bad’. His words.
2. He refuses to take control of the situation and take his meds on his own or check his sugars or take the insulin without us urging him to. It’s a fight every time.
3. He has a sugar addiction and when we don’t let him have a sugar fix (donut, chocolate bar, icercream), he gets upset and abusive.
4. The dementia is adding to the issue - he thinks he’s been away for months (it’s been a week). He thinks the cruise was several weeks long, (it was a week). He forgets that he was home for 3 days between the cruise and coming to Calgary.

I think he’s terrified that we are going to toss him into a nursing home and throw away the key. I think this, combined with the sugar addiction, is what’s motivating him to be uncooperative now. We have decided to stay the course and get the mental cognitive testing done and based on the outcome and the doc’s recommendations, we will either take him home and set up care (for the 3rd time) or get him into a facility close to where my brother and I live.