Both of my parents reside in my home. My father has always been difficult and argumentative, almost bordering on being mentally, emotionally and verbally abusive to my mother, and at times to me. Both have health issues. My father has suffered for some time, I believe, with an undiagnosed mental health issue. He does not process information well, cannot drive anywhere alone, and has my mother assist him with everything except bathing and using the restroom. Some of this, I believe, is just a part of his controlling nature. Some, however, seems to be an increasing mental decline. My mother has cardiac issues and after a difficult week with my father, is now in the hospital with elevated heart rate. She does not want to admit that his difficulty and verbal rants are not the cause. Although, they may not be the cause, I am certain it did not/does not help the issue. I do not know who to go to for help with this matter. He does not want to be evaluated for dementia/alzheimers and is extremely oppositional whenever he is approached about it. We cannot continue to live in this toxic environment that he perpetuates and my mother does not want to move out. Nor do we want her to.
Yes, I do have personal experience with this kind of situation. I worked for so many families who had exactly this kind of situation.
There does not have to be a medical diagnoses for placement unless the elder is living in their own place. Your father does not live independently in his own home. He lives with you.
You do not have to continue to allow him to live with you. There is one way to guarantee that he'll be evaluated whether he agrees or not, that will also get him permanently out of your house.
The next time he gets oppositional and verbally abusive to you and your mom, call 911. The paramedics will take him to the hospital. At the hospital, you ask to speak to a social worker. They will send one to speak to you. Tell them that you are unable to continue being his caregiver and that you will not allow him to come back and live in your home. The hospital will admit him and evaluate him for dementia. They will also keep him there until they find a care facility to place him in.
After the smoke clears, and there will be a lot, you can work from there. Do you have POA for your parents? I truly hope so. If not then you will have to petition the probate court in your town for conservatorship/guardianship. Then you can move your father to whatever facility you think best. When the hospital does placement, they don't tend to place in the best. This seems like a very harsh way to get it done, but sadly it's often the only way. There's had to be placement like this within my own family. It will work out. You'll see and all of you will be better off for it. Good luck.
What's going to happen when he needs help with bathing and using the restroom? Are you going to be the one to provide that help?
Do you intend to keep them both in your home until the end?
Your father has to move out. Caring for him will only get harder as his needs increase.
Talk to your mother and tell her that you're looking at assisted living facilities for him because you will not have him at your house anymore. Then let her decide if she wants to go into AL and live with him or if she wants to stay with you.
I've known many seniors like your father who will not budge about being tested for dementia. Who would become more oppositional and more abusive to anyone around them at the mention of it. When the families knew homecare or having them live with them were no longer options, they had to find the right facility, get placement, and then pretty much drop the person off. They could not even discuss it with their elder because of the stubbornness and abusive behavior that started up at the slightest mention. They just had to go ahead and do it. I think this is probably what you're going to have to do as well.
Since this is your house, your rules. You can tell him that if they are to remain he will see his doctor for an End of the Year physical.
Mom can not continue to be caregiver for dad, with her medical conditions this is not a safe thing for her to do.
It is possible that during a verbal rant if you call 911 and ask for a transport to the hospital because you are afraid it will adversely effect mom (very real possibility) they might admit him for a psych evaluation.
He should probably see a Neuropsychologist for a good evaluation.
With proper diagnosis and medication he might be able to remain in your home WITH caregivers that will help out.
You do not indicate if you are doing any of the caregiving and if so how much.
Looking for assisted Living or Memory Care for dad might be the best option. (AL if he does not have a diagnosis of dementia)
If mom is of sound mind she will have to be the one to make arrangements if it comes to that since she is spouse, unless you are made POA for him
* You do mention in your profile that he has Alzheimer's/dementia is this a "formal" diagnosis or just your label or suspicion? If he has a formal diagnosis it would be possible to place him in Memory Care.