Where to even begin?
My father has been diagnosed with early dementia and alzheimer's along with being bi-polar. (The latter explains a LOT about dad now)
I became involved with my parents care back in February of this year. My wife and I traveled down to Florida to help get my parents affairs in order. Both my dad and stepmother have dementia, and my stepmother also has a failing liver.
During February and March, my parents and I had a lawyer write up a new set of wills and PoA's to replace their outdated ones.
My stepmother is permanently in a nursing home, still in Florida as I have not been able to relocate her to Indiana due to struggling with my father. I was contacted the other day about seeking out hospice care for her.
On to my father. I took nearly 4 months of FMLA to return down to Florida to take care of my dads situation. He is highly combatative, feels he has no problems, claims doctors are playing God when it comes to his health, and refuses to accept any answers or solutions that aren't aligned with his point of view.
I was able to relocate my dad to a very nice ALF 15 minutes from my home back in late July. Things where good, until about a month and a half ago.
My father is a heavy chain smoker, very opinionated, and cares not for others if it interferes with his wants.
He had been growing more intolerant of the no smoking mandate indoors at his ALF. The director of the facility has given my father far too many chances that I am grateful for, but my father finally got his wish.
He just received his 30 day eviction notice.
In the past month, my father has clearly stated he cared not for the rules. He consistently got caught smoking in his room. After enough times and the first warnings of eviction, the director and I gradually made smoking inside more difficult for my dad.
Eventually, I had to take away my dads cigarette access and force him to get his cigarettes from the front desk before heading outside to smoke. That wasn't enough as he could drive his scooter across the street to buy more cigarettes. Then I had to take away his access to his money to keep him from buying more cigarettes to smoke in his room. Somehow he still managed this and has now received his 30 day notice.
He has tried to get himself his own apartment after intentionally getting himself evicted. Now I am in a mad rush to find him a new place to live.
But he has grown more resentful. He has now accused me of elder abuse, which I have already been cleared of. Since he is highly combatative, placing him in a new facility is difficult.
I should point out that last year before I became involved with his care, he shot my stepmothers dog with a shotgun, then beat it over the head to "finish the job" he was arrested, and went through all forms of legal matters.
This is part of the reason I relocated him near me, to keep him out of jail and to get the proper medication and care he needs.
As if that wasn't enough, he also exposed himself to an underage girl at Walmart in Florida, and was reported to the police and banned from the store.
So now im in a situation with a highly combatative father, who is still claiming elder abuse, calling the police on both myself and the facility, and starting to worry me about getting violent.
I have contacted a new lawyer in Indiana for help, but we are running into an issue of my dad passing his cognitive tests with flying colors, so forcing him to be evaluated again is proving difficult. At least from what I am being told by all the "professionals."
As if I dont already have enough to worry about with dad, my wife has serious illnesses herself. She is currently being checked for cancer, and since 2010, she has had 6 spinal fusion surgeries.
I am at my wits end.
I regret even getting involved with helping my dad as he seems beyond help. He still insists he can live alone, drive etc.
To me, the profesional help I'm seeking, doesn't seem helpful enough and I'm lost.
Your father has passed his cognitive tests with flying colours. He has been thoroughly evaluated. And it seems that he is not demented.
He might be bi-polar, he might be combative, he might be a right-royal pain in the behind, he might be plain nuts when not compliant with any medication that has been prescribed. But whatever he is, he is not demented, he has mental capacity, he is not incompetent in the legal sense, and therefore...
He is responsible for his decisions about his life and his care.
Not you.
Since you have no legal authority to carry out the range of actions specified in your new PoA, and your father it seems is deemed competent, you should step back from trying to solve his problems. Who at the ALF is working with you on this at the moment? You and that person had better explore what happens if you resign your power of attorney and leave your father to organise his life as the law says he has the right to do.
My private guess is that there would be a rapid volte-face and an emergency application for guardianship on the part of the state, but it's only a guess - talk to the ALF and your local social services professionals, but above all recognise that if you have no power in a situation, you must not accept responsibility for it.
PS I think I ought to explain more exactly why you must not accept responsibility.
It isn't because you don't care what happens to your Dad. It isn't because you're fed to the back teeth with him, or even that you just feel overwhelmed and defeated.
It's because if you accept responsibility, you stand in the way of other agencies and people who ARE able to use legal powers to intervene: social work professionals, mental health professionals, the courts, for example.
Even so, that test doesn't account for his physical abities, or evaluate any other mental impairments like being bi-polar
From a quick Google search, this is what I have seen.
"What is the Mini-Mental State Exam / Folstein Test?
-The MMSE is a 30-point test used to measure thinking ability (or “cognitive impairment”). If you (or your loved one) had reason to suspect that you may be developing Alzheimer’s disease or another dementia, the MMSE is a step toward making a diagnosis. The test is also used by researchers who study Alzheimer’s, in order to know a person’s level or stage of dementia. It is the most widely used test for assessing dementia.
-The test measures the following:
– orientation to time and place (knowing where you are, and the season or day of the week)
– short-term memory (recall)
– attention and ability to solve problems (like spelling a simple word backwards)
– language (identifying common objects by name)
– comprehension and motor skills (drawing a slightly complicated shape like two pentagons intersecting)
For clarity, following are some sample MMSE questions:
– What city, state, and country are we in?
– Name three unrelated objects.
– Repeat the following: “No ifs, ands, or buts.”
– What is this called? (Tester shows the subject a pencil or watch.)
A low score on the MMSE is not a guarantee of dementia or Alzheimer’s.
Importantly, the MMSE is not used on its own to diagnose dementia. A score below 24 is considered indicative of dementia, but it’s not enough alone to say that someone who scored 23 or less has dementia. A neurologist would factor that in with other analyses, like the results of brain scans, a neurological exam, an evaluation of medical history, and possibly genetic testing. In other words, no one should take a low score on the MMSE as proof that they have dementia. Instead, consider it a warning sign that means further testing is necessary."
I can print out this test and administer it myself, though of course I'm no medical professional.
I also feel the ALF is not entirely on my side and that they just want to be rid of this problem.
I actually have a full durable power of attorney for all things financial and medical. But the things I am hearing from the ALF director make it appear my dad is too alert for my PoA to trump his decisions. In which case, it seems useless.
The Adult Protective Services agent gave me a form to have a doctor use to examine my father for granting me guardianship. However, I'm extremely cautious about this as it seems it gives me even more responsibility, although the ability to fully override my father in any way.
Also, the APS agent told me that it appears mental disabilities like bi-polar, or schizophrenia for example, are not reason enough to have someone committed. He was recently handling a case where a mother was fighting for guardianship of her adult son so she could get him out ofiving on the streets with schizophrenia. He also dismissed the elder abuse claim, while also saying that my father seemed to competent to fall under his jurisdiction.
I just worry that attempting to get guardianship will backfire if he ends up being deemed competent. Additionally, theater im in talks with stated getting guardianship is a lengthy process, and their lawyers are unable to accept a guardianship case at this time as they are already dealing with one.
I still plan to speak more with a lawyer about my options. I want to determine if I set him up in any new facility, then revoke my PoA, the state has no legal recourse to come after me.
I also need to be certain there are no Indiana laws that would deem me responsible for my father once he declines further despite no longer having PoA over him.
And whatever happens (or doesn't), please do NOT agree to take him into your home for ANY PERIOD of time!
It is possible for a dementia patient to be LEGALLY designated “competent” when other more specific types of evaluation can indicate that the client is NOT capable of managing his own affairs.
His behavior can certainly be deemed “dangerous to himself and/or others”, and it would seem from his history that a trial of medication carefully chosen by a geriatric psychiatrist would be a potential first step, IF you chose to pursue that.
You have obviously worked hard to solve his problems, without much result. Would it be worth it to you to withdraw from active co tact with him for a period of time, to see if it would potentially it would help either of you to arrive at some change of perspective?
The quote implies that ALL these requirements must be in place before you are liable - 'and' not 'or'. The important bits are “The parent has a medical or nursing home bill which they cannot pay (the bill was acquired in that state)” and “The CAREGIVER has reason to believe the patient’s child has the money to pay the bill and SUES THAT CHILD”. At present, only the AL could potentially come into that category if F is not fully paid up. If you are not involved in setting up any new ‘medical or nursing home bill’, you are less likely to be sued by the facility, and a creditor is less likely to win – it will have been up to them to sort out payment, credit worthiness etc.
The other bit to note is “Federal and state laws permit Medicaid to seek reimbursement from recipients’ estates”. YOU will not be the RECIPIENT of his Medicaid payments, so that doesn’t apply to you. You probably aren’t hanging out for an inheritance anyway.
You say that F has ‘early dementia’, which may mean that he isn’t yet considered a senior. This might make it even less likely that you would be held responsible if you haven’t taken it on yourself. We are not normally liable to support relations that have mental illnesses, and the quotes seem to assume that this is about elderly parents in nursing homes, not younger people (and not AL or senior living for that matter).
You think your father has deliberately tried to get himself evicted. Perhaps he has plans about what comes next, or perhaps he (not YOU) needs to make some soon. You say that you want to find him accommodation and then more or less wash your hands of him. It might be a lot wiser to wash your hands immediately. Unfortunately many people have relatives who live in homeless shelters and who they cannot help. He may become one of them.
The online legal information coming from firms (presumably Geyer Law here) varies in reliability – some I’ve read seem more like spruiking for business. Get a second opinion, even if it’s only another online site, before you decide what to do.
In saying all this, I need to stress that I qualified to practise law in Australia and the UK, not in the USA, as stated in my profile. I am only commenting on a reading of what you have quoted. But it is well worth considering before you get yourself into a worse position. Yours, Margaret
I do believe at the time my dad was not in is right state of mind. I realize he was not properly medicated at the time, and I am in no way making excuses for him as what he did is inexcusable, but I felt at the time of my involvement at the beginning of the year, that I was going to be putting my father in a proper care setting.
Sadly, I now realize this was not the case.
I think the problem is that despite many attempts to enable him to smoke outside, he still continues to smoke inside, which is against his AL policy. Prob due to fire risk.
The suggestion to move & have his own space is a good one. Would he keep the home help services though? Or fire the home help/Aide instantly? What a gigantic burden for the OP to arrange - just to watch the home help be fired & the place burn down...
The last older man I met like this *his way & nothing else* found himself in hospital with no safe discharge address. Had kept firing the hired home help, calling a son instead. Son was at wit's end too. Had to step back. Man fell, #hip, into hospital, delerium + alcohol withdrawal. Refused rehab. State Guardianship applied for. When delerium lessened & neuro-psych test was re-done he was declared competent to make his own lifestyle decisions. (That bar must be mighty low IMO).
He finally accepted respite accom for 1 month & meds for his withdrawal symptoms. The plan after the month was *trial of least restrictions* ie home again with paid home help. If they were fired again, forced psych admit, more testing, if deemed incapable this time, locked ward then placement in Nursing Home (Geri psych ward).
I don't mean to be a Negative Nancy but to illustrate what can happen. That man had been a distinguished man with a law career. He knew his rights but alcohol & vascular dementia robbed him of reason.
As far as I have kept up with it, although I don't pretend to trawl the web looking for cases, the successful prosecutions have been of egregiously avaricious family members who have sequestered their parents' money and then run like the wind, leaving the state to pick up the tab for their parents' care.
The parents HAVE, or at least have had, money which ought properly to have funded their care. What the children have done with it seems to range from plain spent it on their own unconnected purposes to squirrelled it away as a kind of prospective inheritance; what they seem to have in common is a sentiment that the family should not be expected to pay enormous amounts of money for their frail parents' care. They think the taxpayer should instead. Because otherwise there'll be nothing left to inherit, and their parents worked all their lives, and it's not fair boo-hoo...
This most certainly does not describe you in any way.
What the filial responsibility laws can't do is make you solve your father's accommodation problems, and what no state that I've heard of even tries to do is demand that common or garden variety families go broke keeping their demented elders in the manner the elders insist on.
You have bust a gut trying to support your father and you can prove it. He has his own income, so you are not financially responsible for him. Your DPOA will not become enforceable, in the sense of making you capable of overruling your father, until your father is deemed incompetent; so you cannot use it without his consent to make workable plans for him. Have you asked your lawyer what would happen next if you resigned your DPOA immediately? - I've no idea, but I'd certainly ask.
Guardianship may be necessary, especially if he's going to go around shooting dogs and smoking in buildings where there are oxygen users, but you cannot be forced to be your father's guardian and if I were you I wouldn't touch it with a stick. Tell the court loud and clear to include you out. They have other, better-equipped options.
Sometimes we have to step away and let people fail all by themselves. Right now he is manipulating you and making you responsible for his choices. Don't accept that, make him own his actions.
If you dance to his tune now he will run you ragged with his antics.
Edit: how difficult would it be to get him back to Florida? That is what I would do, that way he won't freeze to death if he doesn't follow the rules and ends up homeless. This is a choice that many people make for their lives. As hard as it is to watch, he is a grown man that has a doctor saying he is capable of running his own life.
If he goes to jail, it's not your problem
If he ends up homeless, it's not your problem
It is not your job to take care of your father.
Its why I'm currently seeking legal advice about the matter as well.
It seems your Father may need medical help for the nicotine cravings at the very least. Suggest he see his Doctor for this - nicotine patches work quite well for some.
Explain his options to him in simple terms;
A: manage his cravings (get nicotine patches or similar) & stay in his home
or
B: continue to smoke & be forced to move
Can he understand this?
Can he weigh up his options?
If so, then he can decide & the consequences will be his. (However dire they may be).
If you are wanting to stay involved, I would go with him to the Doctor. Explain the situation & the options. Ask for other options too.
If it is shown he cannot understand his choices or weigh up his options, ask the Doc for what's next. Another round of neuro-psych exams? If he is willing... if not, it will be forced at the next crises - with the law or a health crises resulting in a hospital admission.
Some go meekly into their sunset years like a lamb, others fighting tooth & nail like a mountain lion.
Unfortunately, there is no reasoning with my father, its why he went to the extremes of getting himself evicted.
Honestly, I no longer want to be involved. However, I want to at least get him to the point he is placed into a new facility where I can then just revoke my PoA and hope that when he declines further, the state will just step in.
However, I need to be certain that there are no laws in Indiana forcing a child to care for an elderly parent even if they are not PoA.
EDIT:
Oh, joy! 😡
"Indiana is one of 30 states with their own filial responsibility laws requiring adult children to financially support their parents if they are not able to take care of themselves.
For filial responsibility laws to apply, medicalalertadvice.com explains, the following criteria would need to be met:
The parent must be accepting financial support from the state government
The parent has a medical or nursing home bill which they cannot pay (the bill was acquired in that state)
The parent is considered indigent (cost of care exceeds their Social Security benefits)
The parent does not qualify for Medicaid
The caregiver has reason to believe the patient’s child has the money to pay the bill and sues that child
There have been very few instances in which forced filial support has been imposed by an Indiana court. On the other hand, as we caution Geyer Law clients, Federal and state laws permit Medicaid to seek reimbursement from recipients’ estates."
So I guess I need to get him placed somewhere with Medicaid to avoid this.