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His kidney doctor is fine with ending the home dialysis and the social worker at the clinic gave us some documents for a health directive/health agent/dpa. We just need to see legal aid and get things notarized. Unfortunately, my father isn't sleeping neither during the day nor at night and is literally confusing his dreams with reality; and accusing us of trying to harm him along with making open threats to kill people.
Yes, as mentioned do get him tested for UTI. Also, you can start assessing your client's mental capabilities by having a basic dementia/cognitive test done by his regular doc. You can request it discretely. You will also need your client to sign HIPAA waivers for each doctor otherwise they cannot legally share any information with you, no matter what.
His primary doctor is aware of his condition and how long we've been caring for him, along with his kidney doctor and doctors as the hospital he used for years. I've also talked to my local legal aid and they told me it's possible to amend the current DPA to add health-related coverage, given we're both legally able to sign for him, due to the issues with his vision and hearing. I honestly do not want to leave his care to the state, due to the horrible experiences I've had when my mother, prior to her passing away. I'll contact his primary doctor about doing a basic dementia/cognitive test.
As for the UTI test, he'll be going in to see his kidney doctor tomorrow, for his bi-weekly checkup for his home dialysis, so with his usual 24-hour urine and blood-work, I'll ask them to check for a UTI, though it honestly doesn't seem like it since this has been going on for over a month and getting progressively worse. As for your other question, my brother is his only living child and there's no other relatives in this state who are willing to help.
Testing with a neurologist might help nail down what is going on but getting him into alternative care can take time.
Should he have to be hospitalized for any reason, refuse to bring him home but know that depending on your state, placement may be difficult without spending a period of time on a waiting list. So best to look into things now. Let us know how things progress.