getting help with mgmt of delusions
My 68-y-o father-in-law was diagnosed with PD in Spring 2010 (mild tremor at that time), and started showing marked personality changes after Thanksgiving--mostly disinhibition, as he got very talkative and is normally reserved, and also spending. 2011 has brought delusions--mostly about former co-workers (he recently retired) who he felt God wanted him to get fired, but also about his health being worse than it really is, buying a car he couldn't afford, and other things. He does not take any specifically PD meds, so we can't "go off" them to reduce the delusions. He's taking Exelon and Zyprexa, and they do seem to help, but because of a brief period of hospitalization that was required to get him stabilized, I think he persists in his paranoid thoughts about the family wanting to "put him away" or "leave him to die in the hospital" etc. Last week he stopped the Zyprexa against medical advice and the horrible delusions started all over again--calling everyone he knows to suggest that my MOTHER-in-law is ill and needs to be taken to the hospital, etc. He is very angry at his children, as he thinks they are all bad kids because we think he's crazy when he insists that not only is he not crazy, but his relationship with God has never been better, and God is telling him how to live.
From everything I've read, I understand that the doctors are treating him about as well as anyone knows how to treat someone with these symptoms (acetylcholinesterase inhibitor, atypical antipsychotic), and that it's possible he has Dementia with Lewy Bodies rather than PD. We hope that the delusions will get under control if he will persist in taking the meds.
HOWEVER, the real problem we are having is that we have NO IDEA how to help manage the day-to-day existence with someone with delusions. The hardest part is that we are having to take car keys and credit cards/checkbooks away to protect their limited finances, and that further worsens the relationship although of course we have the best intentions. We are struggling with how to arrange finances, and do we need to think about legal guardianship, and how do we make Dad understand that he really is having delusions? He is not one of the people who has delusions but has retained insight about it! He doesn't really even believe that Parkinson's can lead to delusions, although I've shown him several books with this information. He continues to insist that Parkinson's is strictly a motor disorder.
We are not certain where to go for help. I'm thinking a parkinson's support group would be a good start, esp for my mother-in-law even if my fathr-in-law won't go, as I hope she'll find caregivers who can help with advice on managing day-to-day life with someone who is mad at you and having delusions.....but are there other resources we should be considering? Do we need a Geriatric Care Manager or some other kind of community resource that could advise us on how to handle the financial and legal issues we're starting to have (eg, Dad recently bounced a $15,000 check because he neglected to transfer the money from his savings into his checking account first....)?
Any advice on resources would be much appreciated!!!