How do you even do that? He is the only remaining kupuna, pater familia. Thank you very much. Aloha.

My mom to her annual physical, whispered to the doctor the symptoms I was observing so he asked her screening questions, told her the results (which she pushed back on) but he kept on it and why.... Referred her to a neurologist which took her through a series of tests before diagnosis. S0, basically I thought it best for her to hear from a professional, not me who she would argue with. My two cents

My mom to her annual physical, whispered to the doctor the symptoms I was observing so he asked her screening questions, told her the results (which she pushed back on) but he kept on it and why.... Referred her to a neurologist which took her through a series of tests before diagnosis. S0, basically I thought it best for her to hear from a professional, not me who she would argue with. My two cents

his vision or balance.

Any change in his medications?

What stories does he keep telling you?
Sad, happy, childhood content?

He is not coping well in the care facility?
Have you asked him how he is doing there.
Could there be some problems?

Yes referral to neurologist is in order.

Edit to add, I would ask the staff first to do a blood panel to rule out infection, etc as
suggested by another poster here.
You may not need a neurology consult.

For a while there his stories were about a big fight he got into when he was a kid, which he was fixing on even before the fall,but yesterday‘s stories were about different challenges he is facing in his medical care there and with the administration whom he takes issue with on several points. They are 20 minute . mini lectures which it are difficult to get through, but to get through the same one over and over is really freaking trying. He is not remembering follow up care that he’s receiving, some of which is very important.
We are all working, some of us at more than one job and it’s not possible to be there when the doctors drop in which is occasional. His beautiful wife has her own problems and goes to see him regularly, but isn’t the one to be taking notes or keeping a record of what is going on. It’s all a really lot. Thank you.

Tell her your concerns.

Ask about the medications he is on, can they cause neuro/psych problems?

How about some blood work to rule out an infection, dehydration as pointed out by another poster here.

It sounds like he is unhappy in the facility and his stories are angry stories.
For a person who is stubborn and strong, it is hard to be "incarcerated" in a nursing home.

What issues does he have with his care? Are they legitimate issues or irrational ones?
Maybe he is angry for a good reason? This is important because we need to know if he
actually has some points that are legit, or if he is totally irrational at this point.

I would address some of his issues one by one.
And see how he does with that.

I would not let him go on for hours with these angry rants, I don't think that is good for him.
I would say grandpa, you have told us these angry stories before. Let's talk about something else now.
Or change the subject.

Or tell him that you had talked with the charge nurse about his complaints.

I have sympathy for him. I had a serious fall some years back and had to have surgery, was on pain meds,
was immobilized, felt like a captive in a nursing home. Ran into some bad care and mistakes.
I think I went a bit nuts too. It is all very overwhelming especially for strong stubborn people.

But the fall, surgery, pain meds, nursing home, long recovery sent me over the edge.

But we still don't know what is going on with your relative in terms of physical problems.
So we need to rule that out with labs and talking with nursing staff.

But yes he is under a great deal of stress.
What kind of a fall did he have?
Is he immobile now? Or can he walk and move around?

And he had some other things going on that required other interventions surgically. He did not hit his head when he fell. I can tell he’s trying to be patient, but the staff is also really trying regarding dealing with the forgetting problems.

see if a doctor can check for things like a urinary tract infection or dehydration. Those things can initially manifest as cognitive confusion.

ETA: Also, did he need to have surgery? Anesthesia can take some time time to work through your system when you’re older.

And urine lab work, etc.

This would indicate possible infection and dehydration.

Yes my mother got very squirrelly after surgery when she was older.

So I don’t imagine it is the anesthesia but you’re completely right about that and also I hadn’t even thought about the possibility of a UTI. That does cause cognitive symptoms sometimes. Thank you.

issues to struggle in a strange environment. Their daily routine is completely disrupted. Sleep is often negatively impacted. Talk to the social worker where he is about his discharge plan. They will have the best info for local resources.

age related I'm sure but it may be something that will get progressively worse. Once in a while my sister will mention to him that he already told me that story.

Urinary tract infections can have cognitive effects on the elderly. It's hard to believe! But I've seen it in older relatives. Fortunately, these are easily remedied.
There are new medications which can help dementia in the earlier stages. A gerontologist or a neurologist will give you good info on that.

You have a big heart.
You both need that right now, because it can be grueling.
Wishing you all the best.

Good luck!