Caregiver: Dealing with delirium, confusion after long hosptial stay

My father had a stroke in January 2023 and spent 2 months in the hospital/rehab. He has been home now for just over a month. While in the hospital, he developed severe delirium. Now that he's home, he's still dealing with some confusion, agitation, paranoia, etc.

I am his one and only caregiver. Family is not around and hasn't been for many years, he doesn't really have any friends (we realized that when he had his stroke and no one checked on him).

He spends his days sitting in front of the TV, not knowing how to change the channels or the volume. He gets up to sit outside on the veranda and he truly believes he sits there to have a cigarette (he does not). He refuses to bathe and has slight incontinence issues. I don't know how to convince him to wash up and change his clothing because there is now a lingering smell near him and it's embarrassing.

He hasn't smoked since his stroke (even though he doesn't believe that) so he replaced his cigarette cravings with drinking 2, sometimes 3 cans of Coca-Cola every day. He does not eat vegetables and very little fruit. He snacks on cakes, cookies and brownies. The only reason we still have this stuff in the house is because I'd rather he eats those sweets than nothing at all. Even when I make a homecooked meal, he barely eats it unless it's fried food. He does not want to drink Ensure or any other drinks similar to that.

He walks very slowly. He gets slightly out of breath when he climbs the stairs. He sleeps a lot less than he did pre-stroke. He drinks water, but probably consumes more Coke as his main liquid.

My father has a list of medical issues such as chronic obstructive pulmonary disease, coronary artery disease, ischemic cardiomyopathy, peripheral vascular disease, hypertension (his blood pressure was still high while in hospital and on medication), dyslipidemia, has smoked 2 packs of cigarettes every day for more than 60 years (quit recently). He had two heart attacks in his lifetime, an abdominal aortic aneurysm which was repaired less than 10 years ago.

My biggest concern is that, due to his confusion/delirium, he does not take his medications properly. I bring his medication daily and he will most often set them down on the table and claim to "take them later", but most of the time, those pills are still sitting there the next day or sometimes he throws them in the garbage without realizing. He has gone days and weeks without the medications. I try to encourage him to take them as soon as I bring it to him, but again, because of the confusion, he doesn't understand the importance of it and doesn't understand why I'm insisting. When I explain why it's important, he says "a few minutes later won't make a difference". He will eventually get very fed up with me and angry, so I'm forced to back off.

I know most people will encourage me to think about putting him in a home where he can be watched 24/7 and have nurses around just in case. But, he would absolutely never in a million years agree to that, he would put up a fight if I brought it up and he would resent me if I forced it. He's enjoying being at home where he knows the environment. But I also worry that I will find him lifeless one day because of his poor cognitive function, his lack of health eating, lack of exercise and worst of all, lack of medication.

His doctor already performed a test to check for any infections to explain the delirium. He has no infections. His doctor also explained the importance of everything mentioned above. My father is and always has been very stubborn and prideful and at this stage, I don't know how to handle it.

I have never been so stressed and sad in my entire life. He is my only remaining parent and I fear he will not survive very much longer.