I'm the HC and Durable POA for a friend with no living relatives. Her dementia (diagnosed at least 3 years ago) has progressed to the point that her violent outbursts make it unsafe for her to live alone in her home. Attempts at getting her live-in help have failed (she's mean, belligerent and doesn't admit she has problems), and she still has access to a car! It's just a matter of time before she harms herself or others. Just last week, we had to call the Sheriff to get EMS to pick her up because she was having one of her tantrums against the caregiver and no one could calm her down. She spent 5 days at the behavioral unit at our local hospital, with everyone in agreement (social workers at the hospital, the head of our county DMH who knows the history, DSS, etc.) that this would be the perfect opportunity to finally place her somewhere. But the young doctor assigned for the final assessment, didn't agree, because she has an uncanny ability to become "perfect" for those she knows will benefit her most. So he released her! Was about to send her home in a cab last Friday, to no one to even check on her, because I was out of town and so was her other caregiver (unexpected funeral). I had to beg them to keep her until I got back and could make sure she was safe.

I picked her up on Monday, and she's had a series of violent, destructive outbursts since, and even though I have a HC POA that gives me the right to choose where she lives, I'm being told that I can't exercise it (because she won't go willingly for sure), without a doctor's letter stating her incompetence to make such decisions. Her doctor wrote us a note years ago indicating she did not possess the capacity to deal with her financial and legal affairs, but now even with pages and pages of photographs and written documentation of the various meltdowns and their aftermath, including an accidentally obtained video when she attacked her security monitor and set it to record on baby monitor mode, showing her as literally a wild animal, beating on the TV with her fists and head, stomping on the cable box, shattering a TV remote, and just in general going wild, the doctor is telling me she won't write the letter that's required for me to have a facility do an evaluation and take her in involuntarily if they agree. I've honestly never experienced such CYA in my life, and am so disgusted with the medical industry! It's no wonder so many people are killed by the mentally ill. My friend's problems may be exacerbated by her dementia, but it's my opinion, she's been mentally ill (and an alcoholic) for years prior, and now we have a triple whammy.

So the advice of "if you have a valid HC POA" is BS. Even that can't get you the help you need to protect them from themselves.

Any ideas? I'm in SC, by the way.

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She will end up in the hospital again. You need then to refuse any participating in taking her anywhere at all, and to let them know if they discharge her they are doing an "unsafe discharge" (use those words) and will be held responsible to that. You need then to put that in writing, keep a copy for yourself and ask a copy be inserted into the chart. You need to start keeping a complete diary. IF she is adjudged incompetent in her own care and that document is no longer good, this must be done again. I myself would not be capable of handling this and would give up POA on a friend you cannot possibly handle, ask for APS to begin the work of State Guardianship. This is about the only way to get thing done. There is little you personally can do in all this.
Helpful Answer (11)
Reply to AlvaDeer

Resign your DPOAs and formally hand your friend over to APS sending them all of the documentation you have accumulated. I honestly can't see any other way forward.

It isn't that you don't want to help your friend, or don't care what becomes of her. It is that you are powerless to intervene. So give the task to people who aren't.
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Reply to Countrymouse

You're a wonderful friend for sure! Bless you for that.

But, sadly, it looks like there isn't much you can do for her. Like you said, she is mentally ill and longtime alcoholic. I'd be worried about her attacking you, if she is this much out of control.

I don't know the steps to take with relinquishing POA or what the state does afterward, but many on here do. I'd think once state had custody, she could be placed somewhere for good. Likely won't be an ideal place, but at least she'd be somewhere.
Helpful Answer (8)
Reply to LoopyLoo

Call Adult Protective Services. Once you do, the ball will start rolling very fast. She will likely be removed from her home, if that's what they believe to be the only solution.
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Reply to ArtMom58

I'm really sorry you have to go through all of this, and I'm also sorry for your friend who is probably very lonely. Ask a social worker (perhaps next time in hospital or Department of Social Services), you want to relinquish your DPOA and get a court-appointed legal guardian instead. Especially since she is violent you want to remove yourself from this; refuse to pick her up. Sad situation for the both of you, and admirable you are willing to help a friend, but not to the point it completely disrupts your life. Sounds like she needs to be in a group home or nursing facility. At least in those places she will not feel lonely anymore.
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Reply to cetude

It sounds as if you may be dealing with the damage of long-term alcoholism, causing irreversible alcohol dementia, that is also overlaid by some other form of dementia (Alzheimer's, vascular, etc).

You are her Durable POA & have a physician's letter that she is financially incompetent - - use her funds to see a lawyer to file an emergency ex-parte motion for "conservatorship of finances AND person". Generally, a hearing is rapidly set, and the patient is advised to appear. If they don't, that's already an indication of a problem.

Once you get to court with the documentation you have, the judge may make a temporary order or, if there is "competent" disagreement (that is, the behavior in court doesn't speak for itself) they will likely appoint their own trusted doctors or other individuals to do an assessment evaluation.

Even if her funds are limited and she would be on Medicaid now or later, her intentions, when she was "of sound mind", were for you to act as her advocate. You won't be able to do that if you turn her care over to the State.

I have seen folks do that to family and friends and it wouldn't be my personal choice unless it's a last resort.

Unlike a POA, the conservatorship gives you to complete authority over decision making. Once you'd probably obtain that and install her in a facility, the institution doctors will likely find cause to medicate her which, in the long run, will help with her anxiety and make her more comfortable.
Helpful Answer (3)
Reply to CarolLynn
gladimhere Feb 18, 2020
States have different laws. In my state it is called a guardianship.
Will her primary care or neurologist write the letter to trigger the POA? I know my husbands pcp was reluctant but the neurologist had no hesitation. Best wishes.
Helpful Answer (3)
Reply to Franklin2011

Find another Doctor and/or call the State authorities that deal with self neglect of the Elderly.
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Reply to Samsung137

Switch Doctors.
Helpful Answer (3)
Reply to Compassionate5

I don’t know the laws in SC, but in Florida I was a geriatric care manager, and also performed competency assessments for the court which was used to determine if the court would adjudicate the person incompetent. If incompetent, then a guardian was appointed. Here there are two components of the guardianship, one for financial affairs and the other for “the person.” It certainly sounds like this friend would meet criteria for both. If a doctor will not complete paperwork to initiate an evaluation for competency, again here in Florida, two people can sign a form, obtained from the Clerk of the Circuit Court. Once signed, documenting observations warranting guardianship, the judge appoints a committee of three to evaluate the individual. Based on the evaluations the decides whether or not to deem the person incompetent and appoint a guardian. In my experience, if there is a friend who is willing to step forward as guardian, this typically happens. Given that you are her POA I would think this will strengthen the likelihood that you would be appointed.

If you want local SC information, I would contact the Clerk of the Circuit Court’s office. Another option would be to contact a local geriatric care manager - search geriatric care manager on the web. When I was a geriatric care manager I was a member of the National Assoc of Geriatric Care Manager. Since my retirement they have changed the name of the organization, but a search of the assoc above will get you the info.

Hope this is helpful
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Reply to JimSte

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