My father is 84 and making bad decisions all of a sudden. These decisions have resulted in him being exposed to theft and possibly being drugged. I need to determine if he is of right mind.
When my husband was suspected several years ago of being in early dementia, his internist suggested that he see a neurologist, who in turn recommended an evaluation by a neuropsychologist. That evaluation took into account his history, his benaviors, his deficits, and the functioning of both sides of his brain, and concluded that if he was suffering from any form of dementia, it was not Alzheimer's. And in retrospect, I know that assessment was accurate, because we have only recently settled on alcoholic dementia as his actual diagnosis. Accordingly, I encourage the use of a licensed neuropsychologist.
Gwen.... One thing we learned about having a designated person who would handle our legal/medical issues, is to always have a back up person in the event the first person named in the papers becomes unable to do so. Having a second person named, alleviates the need to change these documents at a cost later on. Glad you made it through your near death experience! It makes one realize what is important in life, and trivial things are just that.
glibbon, along with Vegaslady I'd like to know more background about your situation. Could you supply a few more details? That would help us give more specific suggestions.
I died and was revived a few years ago. A couple of years later, my child turned 18, we had a legal consult with Legal Aid lawyers. She has been my POA since then. Prior to that my sister has been my POA, for legal/financial, medical/mental health, the executor of my estate, and we filled out to make a Living Will & Advanced Directive. My money skills and judgement regarding trusting strangers has been a brief problem. Solved by these documents and my loving sister. I'm grateful that I am able to communicate and understand my circumstances, when she explains to me how I'm at risk by my own choices. I've had to relearn everyone is not safe or honest. My future is unpredictable, but I trust my family to care for me. Life is unpredictable for everyone, so get some legal advice, and get your documents in order should the worst happen you will be in trusted hands. I learned these lessons from my husband who developed dementia. After all is said and done, I believe in most places, the court system must declare a person incompetent, using the information from the doctors reports and findings. My family does not qualify for legal aid but I do, so my documents were drawn up and recorded for very little money. Many of the comments have the answer of where to start, this may be how to complete the process If your family member is resisting your control of their life choices based on their best interest of the ill person. Best wishes to all involved.
Do start documenting what you observe; the info will be of use to any doctor doing the dementia eval (which can be started by PCP but often goes to neurology & neuropsych, depending on how advanced the symptoms and the PCP's abilities).
The info will also be of use if you ever need to seek guardianship. For more details on what to document, see the AD8 informant interview list; it covers the domains that we need to consider during a dementia eval: http://www.alz.org/documents_custom/ad8.pdf
Agree with DKOBrown that in older people, there are often multiple things going on. You want the doctors to help you spot and reverse the things that are making the thinking worse (med side-effects, thyroid, depression, etc).
You need to take to a Doctor and they can be tested sometimes it hard they can be back and fourth so they need to spend time with him. We had to show and tell them because it does get worse if you don't stay on top of it. They will take off and then someone who is bad can rob them or kill just don't burn out you may need family to help you
Lots of good answers here. What are the circumstances that "expose him to theft" and "possibly being drugged"? I'm assuming you have tried unsuccessfully to talk to him. Is he concerned about his bad decisions? Has anything bad happened to him? Has anyone else (siblings, friends, etc.) noticed a change and expressed concern? Does he live alone? Has his living environment changed, worsened or become dangerous? Who is trying to take advantage of him? Have you seen signs that these things actually happened it is this concern based only on what he has been saying? Why do have to prove dementia and to whom?
Mother complained to her MD herself about how she can't remember anything, and getting confused, etc. So he had her tested by qualified psychologist, and then (at my request) ordered that her meds be administered by the ALF, as she is nearly blind and can't read the labels, plus forgets if she took it already or not. Sounds good, right? Wrong Even though the results showed early dementia or Alzheimers', the doctor put it to her so gently that "at 92 it was normal to have memory loss". Kind of him, but she absolutely refuses to admit to having any deficits now, intends to ask him to allow her to give her own meds again, made an apptmt with an attorney to change her will, and though the changes were small and unimportant, he did it, so she still thinks she should be in control of everything. So what good did any of this do? I have POA, but she still thinks she should make these kinds of decisions until "they declare me incompetent". None of this is easy.
I am sorry for your situation and your dad's decline.
Dementia is not the only diagnosis to pursue. Other conditions that change brain function & decision making are: **Age. The brain atrophies and loses some function in the normal aging process. ** Falls. Any bump or injury to the head can damage brain tissue and impair judgment. ** Medicines. Side effects of some commonly used meds can mimic dementia. ** Other illnesses. Thyroid disease and diabetes are examples of illnesses that effect the brain. Depression, mental illness and anxiety disorders are additional examples.
My mother's diabetes and hypothyroidism are controlled. She also suffers from depression, anxiety, dementia, brain atrophy, and mental illness. Some side effects of her meds definitely look like dementia, and she has had countless falls, hitting her head.
We have had all the tests, some twice. Bottom line: In the elderly, the brain typically changes due to a mix of several causes. My mom's psychiatrist says it is not even possible to sort it all out and figure exactly what is causing a particular symptom, like decision-making impairment.
My suggestion is to form a good rapport with a general practitioner who can then make referrals to psychiatrists, neurologists, counselors, and psychologists who do testing. That general practitioner becomes a hub to receive info from all of the specialists, and he/she can sort it all out so that the best care can be determined for your dad.
Power of Attorney is helpful in some cases, but guardianship is a more secure route. My mother has memory and judgement problems from a stroke and I have POA. The problem is - POA is very easily revoked whenever I make a decision she does not like (such as telling her she can't buy a car or live by herself). The last time I took her to the doctor they told me I need to apply for guardianship because her "poor insight" as they called it, is becoming a problem. She has revoked her POA before when she got mad at me (which would be great if there were anyone else to step in since she is and has always been abusive). She is currently determined to buy a plane ticket and move to Maine to live by herself. She is from Maine but really doesn't have anybody left there although it is highly doubtful she could even get to the airport she can't afford to make financial mistakes like wasting money on a plane ticket. I have POA and control of her finances but she could cancel the POA to access her money and since she has no savings and lives on her retirement and social security this would mean she wouldn't have money to pay for her personal care home.
By the way - office supply stores have a section with documents like POA forms. You can fill it out and find a notary or lawyer to just witness your signatures. You don't need to rack up lots of legal fees for that - save it for if you need to get guardianship as well.
glibbon: Primary care physicians do not do the 2-3 hour evaluation needed to determine onset dementia.The fastest and most accurate way to determine incompetency is to get a psych neuro evaluation done by a psycologist/psychiatrist who specializes in dementia/alzheimer's. The primary doctor can refer you to one and if a long appointment wait sometimes can ask for appointment to be moved up. Poor decision making is a sign of deterioration. I suggest you look up stages of alzheimer's. You may see symptoms which you did not know are dementia. There are other things which the primary doctor can rule out. MRI could show various signs of problems helpful for the evaluation. Lab work including thyroid panel is good. EKG could show arrythmia's which could lead to TIA's. Infections can also affect the elderly in ways such as increased confusion. I would strongly suggest he gets his legal papers in order before the evalution: medical directives, durable POA, and will. Our elders are targeted to scams and donations...... the thieves prey upon them. Good Luck!
Getting the Power of Attorney is easy. The difficult part is trying to get your dad to understand you have his best interests at heart, and want to make sure no one takes advantage of him. Doctors will only talk to you if your dad gives them verbal permission, or you have a Medical Release of Information or POA. Both can be found online. We went to legalzoom.com because they fill it out the way we wanted, but you can get them anywhere. Once you are able to legally speak to his Dr, have a written list of your dad's actions that are causing you concern. The dr. will do tests to determine how much memory loss has occurred. Wishing you good luck.
Get a POA quickly! If there are no funds to see a lawyer, you can go online to a site like LegalZoom. I used one of theirs and later, when I saw a lawyer for another matter, she took a look at it and said it was fine. The website leads you through the process. As for the dementia, bad decision-making sure is a big red flag, but you should go to a doctor visit with him. First, send the doctor a written account of what behaviors are troubling you. This is for two reasons: one, the doctor will have to make the letter part of your Dad's file (so much better than a verbal account) and two, you won't have to talk about your Dad in front of him.
This diagnosis requires an MRI, psychometric testing, testing with a neurologist who specializing in dementia, verbal testing and recent behaviors observed. Have him tested soon.
There are several pen and pencil, 10-minute screening tests. In addition, document the behaviours you believe indicate dementia. All this will help you gain an assessment. http://ontarioseniors.blogspot.ca/2012/11/screening-tests-for-alzheimers-diagnosis.html
Mak a doctor's appointment and arrange to speak to the doctor privately. Explain the situation to the doctor (you can even - in the presence fo your father - bring up an instance where he has shown poor judgement) so that they can have a better idea what you are dealing with. They will usually give you a psych referral for your dad to be checked out and then you can start looking into being appointed guardianship
What Teacup said. He needs a doctor's visit, like yesterday. The doc will then decide if he's competent or not. In the meantime, keep a close eye on him and on the people around him. If they seem shady to you, or seem like the type to cause harm, or the type that takes advantage, kick them out of his world and tell them not to come back. The doc should be able to steer you in the right direction in getting him some help. And someone will need to be POA if he is declared mentally unsound at this point. .
My future is unpredictable, but I trust my family to care for me. Life is unpredictable for everyone, so get some legal advice, and get your documents in order should the worst happen you will be in trusted hands.
I learned these lessons from my husband who developed dementia. After all is said and done, I believe in most places, the court system must declare a person incompetent, using the information from the doctors reports and findings. My family does not qualify for legal aid but I do, so my documents were drawn up and recorded for very little money. Many of the comments have the answer of where to start, this may be how to complete the process If your family member is resisting your control of their life choices based on their best interest of the ill person.
Best wishes to all involved.
The info will also be of use if you ever need to seek guardianship. For more details on what to document, see the AD8 informant interview list; it covers the domains that we need to consider during a dementia eval:
http://www.alz.org/documents_custom/ad8.pdf
Agree with DKOBrown that in older people, there are often multiple things going on. You want the doctors to help you spot and reverse the things that are making the thinking worse (med side-effects, thyroid, depression, etc).
Good luck; it's a tough situation to be in.
Even though the results showed early dementia or Alzheimers', the doctor put it to her so gently that "at 92 it was normal to have memory loss". Kind of him, but she absolutely refuses to admit to having any deficits now, intends to ask him to allow her to give her own meds again, made an apptmt with an attorney to change her will, and though the changes were small and unimportant, he did it, so she still thinks she should be in control of everything. So what good did any of this do? I have POA, but she still thinks she should make these kinds of decisions until "they declare me incompetent". None of this is easy.
Dementia is not the only diagnosis to pursue. Other conditions that change brain function & decision making are:
**Age. The brain atrophies and loses some function in the normal aging process.
** Falls. Any bump or injury to the head can damage brain tissue and impair judgment.
** Medicines. Side effects of some commonly used meds can mimic dementia.
** Other illnesses. Thyroid disease and diabetes are examples of illnesses that effect the brain. Depression, mental illness and anxiety disorders are additional examples.
My mother's diabetes and hypothyroidism are controlled. She also suffers from depression, anxiety, dementia, brain atrophy, and mental illness. Some side effects of her meds definitely look like dementia, and she has had countless falls, hitting her head.
We have had all the tests, some twice. Bottom line: In the elderly, the brain typically changes due to a mix of several causes. My mom's psychiatrist says it is not even possible to sort it all out and figure exactly what is causing a particular symptom, like decision-making impairment.
My suggestion is to form a good rapport with a general practitioner who can then make referrals to psychiatrists, neurologists, counselors, and psychologists who do testing. That general practitioner becomes a hub to receive info from all of the specialists, and he/she can sort it all out so that the best care can be determined for your dad.
Best wishes to both of you.
By the way - office supply stores have a section with documents like POA forms. You can fill it out and find a notary or lawyer to just witness your signatures. You don't need to rack up lots of legal fees for that - save it for if you need to get guardianship as well.
As for the dementia, bad decision-making sure is a big red flag, but you should go to a doctor visit with him. First, send the doctor a written account of what behaviors are troubling you. This is for two reasons: one, the doctor will have to make the letter part of your Dad's file (so much better than a verbal account) and two, you won't have to talk about your Dad in front of him.