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sofistic8ed Asked September 2014

How can I get Dad re-assessed against POA decision?

My brother who is POA and Guardian has whipped my 77 yr old Dad up and put him in a home before he is ready. Two weeks ago my Dad had an infection and was bleeding from his penis. He went to hospital and while he had this infection he was also very hallucinatory. He already has dementia so this was not looking good. As he was getting better he was very aggressive and wanted to go home to Mum. His outbursts and trying to leave the hospital, even trying to get out a window, made him a high risk patient. All this frightened my 80 yr old Mother and she didn't want to take him home. It's so sad because the whole reason for his behavior was he wanted to go home with my Mum as he frets for her and she is the only person he remembers every minute of his day. He has now been put in a home and my brother, who has a controlling nature, did not have a family meeting to discuss Dad's care. He cancelled a meeting the Doctors were going to have with the family and refused to allow my Dad to go to one of my sister's to take him to her home and care for Dad. Now my sisters and him are in the hugest personal, tit for tat, vindictive, family feud. They won't be talking with my Mum and can't deal with seeing Dad in the home, so those two people will suffer for this. It is a mess. It is terrible to see Dad not understanding why he has gone into a hospital and then taken onto a home and never being able to return home with Mum and be with his dogs. My sister who wanted to care for him has a lovely country home with many animals and I would have liked to seen him given the chance to go there. I want to get Dad reassessed or examined by a medical professional of Dementia. My Dad is very capable, he can make his own coffee, wash dishes, shower and go to toilet by himself. He has said he isn't as bad as the other people in the home and he is right. They are really deteriorated. He said he feels like committing suicide. In Australia our laws are different to America. They may even be different in each state of Australia too but I don't know how to find out. I want to challenge my brother as he is so completely unreasonable and is very much enjoying telling us he is the boss of Dad and what he says goes. Someone please tell me what legal and medical help I can get to diffuse this situation. At the moment I am sitting on the fence to calmly look at all angles. I also don't want my brother to have any ammunition against me until I can research and get the advice I need.

sofistic8ed Sep 2014
Thanks Countrymouse for your encouraging words, and I meant to tell you that there i no need for apology either. I understand now your comment was a pun. Silly of me to not know that. Wish you well in your life with your loved ones.

Countrymouse Sep 2014
Supporting your mother is absolutely the right thing to do. Being able to rely on your total support will help her more than anything.

I'm sure she does have horribly mixed feelings about the decisions she's having to make. One thing it might be helpful to remind her of is that sometimes all of the available options are pretty rubbish. You can only pick from the ones that are there, and it is better to err on the side of caution. Supposing she brought her husband home, then had to pack him off again three days later? Or tried to care for him and injured herself, or fell ill?

The POA mess must be a huge pain but it's nobody's fault. Gosh how I love new systems! Sofis I think you're doing a great job - I learned a new Winston Churchill saying the other day which seems apt: "when you're going through Hell, keep going." At least while your father's being cared for things will have a chance to settle down, and then you can all look around and see if anything better is available. Best of luck x

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sofistic8ed Sep 2014
Sorry I didn't get to finish what I was saying I hit the wrong button. Now getting back to my being POA etc was because Brother is a Nomad and will take off and travel whenever the bug bites him. Example, immediately after becoming POA, etc, he went away to another state that is 5 hrs by plane to find himself and he was going to be gone for 6 months. Mum was concerned and when he came back she asked him to change POA to me so that he could be free to travel. This was agreed upon but we couldn't get the forms as they were recalled because some laws changed and had to wait 'til they were printed which didn't happen in time. As I said in the past letters, first time Brother stepped up and did his job. Prior to Dad falling ill Brother never rang parents or visit them. There are many grievances I have about Brother and his lack of participation in Parents lives but I will continue to hope Dad is okay and visit him and Mum regularly. I am to be Mum's POA and Guardian and at the moment she's doing good but I think she is doubting Dad being where he is. When Mum and I were there 2 Days ago Mum said to me that she is glad she never put her Mother in a place like this. I asked her "why, would Nanna not have liked it", Mum replied with "Nanna would have hated it". On our way home, out of nowhere Mum said she didn't think she could have Dad come home now because of POA decision. She must have been thinking about Dad. I immediately told Mum "she shouldn't have Dad come home with her as she gets too exhausted and she should enjoy her peace and quiet and Dad will adjust but I wish Dad could be in a place of his own with full time carer". We chit chatted but I think she is confused and doubting the decision that has been made. I don't want her to feel guilt in anyway.

sofistic8ed Sep 2014
Countrymouse Mum allowed Brother to have Guardianship as it seemed the right choice with him already being POA. Sisters and I also supported this decision when papers were signed late last year. He is Dad's only son and everyone believed it was a beautiful thing for him to to be there for Dad this way. In hindsight it was possibly not the best choice. I say this because just before Dad went to hospital the POA and Guardianship was being changed to me.

Countrymouse Sep 2014
Sofis I'm sorry, I shouldn't have been flippant. All I meant was we have lovely daydreams about our parents' latter years, but in the end we have to accept the mundane practical restrictions. Apologies.

I'm wondering why your brother has a registered active guardianship for your father if your mother is still living at home, and is fit and well, is she?

I know you said your sisters aren't speaking to your mother over this (heavy sigh) - but what about you? What's your take on what your mother is thinking?

sofistic8ed Sep 2014
pamstegman actually Dad told Mum he had blood in his urine, Mum told him to drink more water. 2 days later he woke in the morning bleeding profusely from his penis. Mum took him next door to Doctor's and Doctor told him to go home drink water and if it doesn't stop go to hospital. He is on Warfarin and bleeding profusely should not be taken lightly. Mum called a taxi and took him to hospital. Dad did all he could do and wasn't slack about it. While in hospital the infection affected him the worst as first told when I began writing to you all. Yes you are right and your Mum sounds very like my Dad. Each visit I will see Dad and will observe his behaviour closely. Brother has gone away working and won't be back for 2 weeks so I will ask more questions at the home. Thanks!

pamstegma Sep 2014
Sofistic,, mom wants to go home and insists she is higher functioning than everyone else at the ALF. That is a delusion. But at home she won't remember meds. Now when your Dad was home with a UTI, he didn't do anything about it, it went systemic and got to his brain. That was a red flag.
Mom was home and did not bathe and got a skin fungus. Red Flag.
Mom can tell me all about the Depression and the War and the 50's.
Ask her how she fell at the Mall and she has no idea what happened. Ask her what she had for lunch. She will ask when is lunch. Red flag.
You want Dad happy again? Be ten years old. Yah, I know, I can't do that either. Love him where he is and what he is and set the rest aside.

sofistic8ed Sep 2014
Hi Vstefans, thanks for your comment but I believe any man sane or with dementia, waking up in a hospital and being told he can't go home is going to be very agitated and confused and wanting to leave. A sane man being held against his wishes would go berserk. So are you saying when people in a home don't toe the line and behave erratically and want to get out of the place then this shows they are mentally unfit. Many things around us can set off our tempers on a daily basis and we don't behave appropriately but we are not considered unreasonable and unfit. Many old people in general can't make proper judgement, forget a lot and get angry with family, but they are not put in a home immediately. I don't agree with your comment in this case. My Dad went to hospital with a UTI and when he got better he was not going home. I don't think it's unreasonable for him to be difficult in this case. And it's fine to hope that eventually he will accept where he is but he will probably have lost his will by the time he does. When we visit him we are told to tell him the truth and then we are told not to reason with him but go along with what he says which is lying. If you ask me the help in the home don't even know the answers because not one of the nursing staff have told us how to explain to him why he can't go home. We are telling him we have to wait to hear from the Doctor's but he says no Doctor's come in to see him and that is so true. There's no pulling the wool over his eyes. As to the gifts and furniture articles to take Dad, I'm glad my family members are not that stupid to take something that would be dangerous or useless to him and I'm sure a recliner is safe as you can only sit or lay on it. He's not strong enough to pick it up and throw it out the window to escape.
ba8alou, yes, a small fridge is allowed, like the ones in a hotel. Lots of furniture is allowed. They tell us to make it as comfortable for him and as close to a home for him as we can. Dad's brain is not very broken at all. He just has short term memory loss with the Dementia, his long term memory is brilliant. He has lost a lot of use in his right hand since he had the stroke 3 years ago which is why I bought him a recliner that tilts a person up into a standing position. Dad was working on a Tomato Farm at the age of 74 when he had the stroke. Amazingly strong, hard-working man. He was always a worker-holic so maybe he doesn't have enough to occupy him and maybe this is the reason he won't settle.
Countrymouse, Sis is paying for the fridge with the right dimensions and I am delivering it as she lives in another state. It is her gift to Dad as she will not see him a much of us who are closer. Not sure where your comment 'But going back a bit, the image of your lovely, free father out there on horseback surveying the bush?' comes from, I haven't imagined Dad in a place like that ever but he did like horses and still draws them very well with a numb hand. The only place I want to imagine and see him in is a happy place without all the lies and without being surrounded by people worse than him. If I could have him in a place where he is with people who have the same Dementia like himself then I too would be in a happy place. There is not one person Dad can have a conversation with at the home other than the staff. I do hope there's a happy ending to his story. Cheers!

BarbBrooklyn Sep 2014
About the fridge, would that be allowed? Is there room? In my mom's nh, this would be against regulations. Has sis visited dad? In my family, brother has financial poa and I have medical. Both are daunting jobs and sometimes it's just so darn hard to explain to my sil that we can't alwsys do what mom wants because her brain is broken.

Countrymouse Sep 2014
Sorry, I forgot to say - I don't want to talk about my siblings. If we don't talk, we don't fight :)

Countrymouse Sep 2014
Sofis, about the purchases:

You and your husband bought your Dad a recliner as a present. Appropriate and very nice of you.
Sister wants to get a fridge for your Dad. Er, and who's paying? That's the thing. If she wants to buy him a fridge as a present, she needs to get clear specifications and make sure it's the right size and model - then it would be very nice of her, and not just a flaming nuisance. And if actually she's expecting to order the fridge for your Dad but claim the money back, then your brother is correct and she does need his go-ahead.

In other words, although there may be a dearth of diplomatic language right now, your brother is not control-freaking, he is anxious to do this very difficult job well.

Anyway, though, that's actually the easy bit.

Now look. There is a world of difference between challenging your brother's decision, and asking pertinent, reasonable questions - also known as taking a loving interest - about your father's care. What about having the delicate conversation with your brother where you set out the ground rules? I agree that you really don't want to start from "I don't want Dad to be in here, how often are we going to have him assessed so we can get him out?" - because your brother's got enough on his plate without having to cope with a huge helping of uncertainty. So: you act on the assumption that your father is currently in the correct care setting, you work with that to see what can be done to maximise his quality of life, and (keeping it quietly to yourself) you keep an eye open for evidence that his move has been premature. If and only if there is abundant, unambiguous evident of that sort do you then go to your brother, present it to him, and suggest that the care might want to be stepped down.

Most men like clear decision making in most things, and if you've got to do something unpleasant, like incarcerate your own father, you want to get it decided and done and no going back. This would explain why your brother is going at it like a train. If you can make it clear to him that you accept the decision and now aim to make it work well for your father (always keep the focus tightly on his benefit), maybe your brother will stop cutting you off in mid-sentence. Email can be useful! - he might delete it but at least he can't interrupt you :)

But going back a bit, the image of your lovely, free father out there on horseback surveying the bush? Enjoy the memories with him, stop pretending those days are coming back. It'll be easier on both of you.

pamstegma Sep 2014
vstefans has a good point. Mom has asked for a fridge, and #2 son wants to get her one. "Good" I said "You can be the one to eat all the rotten stuff she keeps in there". LOL

vstefans Sep 2014
Well, brother may be afaid what he would do with a phone or a microwave, and realistically so. I thik the recliner is probably safe, and some familiar items that would make him feel at home could be good, but run that by brother first too. If Dad is a flight risk, he's not funcitoning all that well cognitively or he'd realize you get out by being appropriate, demonstrating judgement and reasonable cooperation, not necessarily never objecting to anything but going through channels about things before trying to vote with the feet. And you are right - you want to be allowed to visit and make whatever good memories you can.

sofistic8ed Sep 2014
Hi Countrymouse, there is a 100 questions I would like to ask the staff but I have found out that they are reporting back to brother about any comments or questions that are asked. Though I am not afraid to confront brother I am afraid that if I get into a confrontation with him he would blacklist me from seeing Dad. He does not like anyone discussing his decision he has made as it was his right to do it. Case Closed. These are the threats he has made to sisters he is fighting with and this is the controlling side of him he has been displaying. Yesterday, I had a text from one of my sisters that wants to buy Dad a fridge. She wrote that brother said to her 'whatever is bought for Dad has to go through him first no contest and this is the law'. OMG my husband and I took Dad a recliner last Sunday and thankfully brother hasn't yet said anything about it. Not sure if it's only a scare tactic with the sisters he is at war with. Getting back to your suggestion of asking staff, How do I ask the questions without stirring suspicion? Brother is adamant Dad is to be in the home and I believe staff would go with his demands and not tell me what they really think. It is a very difficult situation and a first for me. Each day I wake up hoping Dad is more accepting of where he is. They have him in the secured area because of his insistence to leave but in the unsecured area the residents a more like zombies but in mobile beds. I can tell why they are not a flight risk because they are no longer walking. I really hate where he is. I just wish I was rich and then everything could be changed. However, I'm not, so I'll observe Dad and his care and research all that is available to me to educate me about his condition, not to mention the great help this forum gives me. I do hope you will be confronted with a more accepting situation if your Mum goes into a Secured area. It sounds like she accepted going into a home and is happy in the area she is in now. Did you have issues when you first took her there? You don't sound like you have a family that fights either so already your Mum can be in a happier place. Thanks for writing to me.

Countrymouse Sep 2014
Sof, what do the staff at the NH have to say for themselves? This aspect of things worries me terribly, too. At the moment my mother's ok to be in the residential wing of the care home we use for respite, but she's approaching the borderline between that and the dementia care unit. And I quail at the thought of what's going to happen when she first has to set foot in there. With her kind of dementia, it's likely that she'll have a good deal of awareness of her surroundings but be unable to stay safely in a non-secure setting.

But, we're very fortunate in that the organisation that runs this place is first rate. My heart might sink at the thought of my mother having a close encounter with the lady who wanders round with her knickers at half mast, but I also know the staff will cope with it well. Attitude is everything. If you have confidence in the people looking after your dad, ask them about keeping him under review. They're likely to err on the side of caution, i.e. keep him in rather than discharge him only to have to bring him back before long; but if he definitely shouldn't be there, then they are the experts who will know.

Really, really good dementia care units, by the way, aim to conserve quality of life for as long as possible. Let them do their job. Resist the urge to spring him!

sofistic8ed Sep 2014
Hello Everyone again, Countrymouse you ask about the nursing home. It is a lovely one but and unfortunately there is always a but, the inpatients look pretty bad, one walks around yelling another sings out loud and worse still while we were visiting one woman defecated in front of us. They are zombies to me too wandering into Dad's room thinking its the passage, I have to lead them back out to the office. Every time I'm there it reminds me of the movie One Flew Over The Cuckoos Nest. Funny enough Dad actually looks like Jack Nicholson. The inpatients are very advanced in their dementia. I know Dad will be like that too but he isn't yet. Addison, yes Dad had UTI which is exactly why he is now much better and back to who he was before he went to hospital. Mum cannot have him with her because the risk of infections making his personality change is too high and caring for a dementia patient, no matter how good or bad he is, is tough when you're 80. I will look into assisted care living in a residential care facility to see what is available but I doubt Brother will change his decision.You know I can accept all that is happening to Dad if I could just know that he will settle and accept where he is. While he is so about his wits just doesn't suit for him to be locked away with those types of inpatients. I do thank you all for all the comments and advice you are giving me. It does help me get a better angle on everything. Writing to you all is a big help in itself. Thanks !!!!!!

ferris1 Sep 2014
Not knowing laws in Australia, I can only say from a medical point of view, it sounds like AT THIS TIME, your father would be better off in the nursing home. Once he settles into a routine, your family has had time to cool off, then see if your brother will entertain the idea of your sister taking care of him. Does she have any medical background and training? If she does not, then leave him where he is because with dementia, it only gets worse, not better. So he is doing better at this time in the nursing home compared to the others, that does not mean he will continue to improve. Dementia is terminal. Your brother made a hard decision and I am sure it was not easy for him, but give this situation some time, and you will see how your father declines. Not easy for any family to deal with and your family is typical of feuding siblings.

Addison Sep 2014
Is it possible your father had a UTI, which would explain the blood and acting crazy. Is he acting much better now that he's out of the hospital? Did your brother put him in a nursing home, or an assisted living place? Possibly the assisted living would be better for him, he would still have some independence, and he wouldn't think the residents are zombies. If he did go home, would he and your mother allow a caregiver to stay during the day, this way your mother wouldn't have to deal with him 24/7.

Countrymouse Sep 2014
Sofis, what do you think of the home your Dad is living in? I'm just thinking, if all this kicked off within the last two weeks you want to give it a bit of time to see how your Dad adjusts. If the home is a good one, you could be in for a pleasant surprise. On the other hand, if - good or not - it's really not the right place for him, then as the dust settles that should become clear. There's no rush. Visit him, reassure your mother, and let your siblings squabble themselves to a standstill if that's how they like it. Best of luck to you, let us know how it's going.

Rocknrobin Sep 2014
Sofistic, It's time for everyone to take a deep breath. If dad is trying to escape, he will be a flight risk at your sisters house in the country. I'm hearing some real sibling issues even before dad became ill. When dad asks why he can't go home, tell him to ask your brother. It's obvious mom can't care for him. You all need to make an effort to come together and get along for dad's and mom's sake. You can do this.

Lucyboo Sep 2014
In Australia an enduring guardian can make all lifestyle choices, where the person lives, if they go to a home, what medications they take etc.
I suggest you make sure that your fathers doctor/ geriatrician is in regular contact with your father and brother so that you at least have another authoritve figure in the mix. And all siblings should put any alternative living plans to your brother and mother and so you can all workout what is best.
Your brother although controlling, may be thinking a home is best so that he is not laden with the caring role. If your sister wants to care for your father and that is what everyone else thinks is best for your father then your brother should listen and consider the option.
Good luck.

sofistic8ed Sep 2014
Thank you everyone so far who has written back to me. I visited Mum and Dad regularly before Dad went to hospital and always saw how much it got to Mum. When Mum and I were by ourselves I would ask Mum how she was and tell her anytime she was ready we could have Dad go into a Nursing Home. She was always reluctant about it because she felt sorry for Dad. I am certainly in favour of my Mum having quality time now in her last years. At age 80 she should not have to care for anyone anymore. Yes, unfortunately my Sisters think she is selfish to not let him go home but more so because she didn't support my sister's interest in caring for him. I don't want my Dad living with my sister because I don't believe she will cope but in the back of my mind I'm always haunted with wishing we had given it a go. What has been missed in this whole situation is the opportunity to meet together and discuss Dads situation, care and Doctors advice. I visited Dad yesterday with my husband and he also thinks my Dad is not disabled enough to be with, as my Dad puts it, Zombies. If I could I would find another solution to his care. I would love to see him in his own little villa with his own garden. Perhaps with a regular carer and Meals On Wheels delivering his meals. It is only when you see him that you realise how clever he is and it is sad because he is a man with many unanswered questions. What makes it worse for me too is I don't know how to answer his questions of why he is where he is. As to my brother. Well, honestly, this is the first time he has ever stepped up to the plate and done his job. Of this I am thankful. I don't believe, however, that he will continue to visit my Dad. His job is done. Oh well time will tell. For now I am there for my parents and I don't care for the pathetic sibling rivalry that has been going on. I am also becoming Mums POA so no doubt I will be keeping in touch with you all for further advice of this new position. Thanks Again.

vstefans Sep 2014
I feel for you, but I can also see the other side of the story. Once they are to where any minor infection causes delirium, it may be too hard to handle in a private home with only one caregiver, be it Sis or Mom - hopefully not Mom as she has realized she can't do it any more and she is almost certainly quite right. Brother can see where this has gone already and probably does not feel he can handle to drama of things being tried out with Sis and likely failing. Maybe he could be in an assisted living instead of skilled care, and really, ideally, should be allowed to do the things he is able, but the full time supervision part is key.

The really sad part is that the sisters won't visit Dad in the home and aren't talking to Mom - are they angry with her for not keeping Dad home? OMG, is there anything to be done about that? The estrangement of everyone is taking a tough situation and making it a hundred times worse for everybody. PLEASE, as Jeanne says, make sure your deep desire to avoid facility care is not based on wishful thinking...as hard as it is to see and recognize in your own parent, there is probably no way to reverse Dad's condition.

jeannegibbs Sep 2014
I don't know anything about the legal status of your brother's decisions. I agree with Pam and Maggie that you should do some research and also, perhaps, consult a legal professional in your father's location.

What I want to address is what I see as the key of your message: "my 80 yr old Mother ... didn't want to take him home."

You think that Dad was not ready for placement for round-the-clock care. But generally the criterion for when is it time for placement of a married elder is "when the spouse can no longer provide adequate care." In a sense, it is more about whether Mum is ready than whether Dad is. I took care of my husband at home throughout his dementia journey. I was in my 60s, not my 80s. It is a 24/7 constant demand high stress situation. It has rewards, certainly. I am grateful I was able to do it. But if I had not been there and able to do it, he could have (and would have had to) be placed in a care center the first year he was diagnosed.

You have two parents in a world of hurt right now. They both need your help, your understanding, and your support. While you are sorting out the legalities and Dad is in a care center, be sure that mother gets to visit him as often as she wishes. Find out if she can bring a dog to visit him. Assure Mom that you are so grateful she was able to care for him as long as she was. Don't do anything to feed her inevitable feelings of failure or guilt.

Your dad can be reevaluated at any time. It can wait until the legalities are sorted out. As the infection is totally cleared up and his hallucinations clear up (we hope) and he calms down, it is possible that an evaluation will conclude he could be cared for in a private home, perhaps with some in-home care.

But, Mum is no longer able/willing to be his 24/7 caregiver. Believe me, caring for someone with dementia is only marginally easier when they can toilet themselves and do tasks like wash dishes. They still have dementia 24 hours a day. And dementia get worse. Always. He may improve dramatically when the infection is gone, but he will still have dementia and it will very definitely get worse.

So ... let us say that Dad gets another assessment and he COULD be discharged from the home. Where is he going to go? You suggest that he goes to one of his daughters. Maybe that would work and maybe that would be a disaster. Has that woman spent a lot of time helping Mum take care of Dad? Has Dad spend some time at her house so that Mum could have some respite? Or is this being proposed out of the blue, and this would be her first exposure to 24/7 dementia care? Does she have family living with her? Will her house accommodate a walker? A wheelchair? (That Dad doesn't need these now says nothing about the near future.) What will she do if he tries to escape out a window to go back to Mum and his dogs?

"Oh Dad isn't so bad. He can still take a shower and wash dishes," is wishful thinking. He might be better off than most of the people in the care center he is in. Someone always is the least afflicted and someone is always the most -- but that doesn't mean they don't belong where they are.

Brother may be so controlling for the wrong reasons, but that doesn't necessarily mean he is doing the wrong thing. As you are sitting on the fence trying to evaluate this, try to focus on what is best for your parents, and try to leave brother's annoying personality out of your considerations.

MaggieMarshall Sep 2014
The fact that he was trying to climb out of window to go home indicates he's not thinking clearly. It's so hard. We'd like to think that when we think it's "time" to put our parent(s) in a nursing home that they'd acquiesce and agree with us that, "Yeah, I agree." Well, truth be told? They hardly ever do, NOBODY wants to leave home.

Listen to Pam. As far as I'm concerned, she's one of our site experts. My only advice to you is not to fan the flames. Continue to be as neutral as you can. There's enough animosity already. Realize that your brother is probably doing exactly what he thinks is the right thing. That's why your dad chose him. It's not easy for him either.

pamstegma Sep 2014
Look up "Guardianship Australia" and law sites will pop up. A Guardian has limited powers, they do not "put him in a home". The Guardian must, by law, consult with the doctors and get the Judge's approval for placement. He has to keep everything confidential about the person and the estate.
You and your sisters should continue to support your Mum, and do your research about Guardianship. It's really out of your brother's hands. He signs the papers, and that is a hard hard thing to have to do.

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