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My 75 yr old mother-in-law has begun wetting her bed, leaving the house and lying about her whereabouts, saying she is dying and not eating, continues to make up stories and in general be angry and disconnected to family. Recently, she went to the hospital and the doctor said she appears to be in advanced stages of dementia. When reading online about legally obtaining guardianship it says she must be deemed incompetent. Is this something the court will do in the process of the hearing or is this something the family must do, i.e. have a Licensed Social worker and/or doctor make a diagnosis?

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First, what is it that you want to accomplish that you feel your need her to be declared incompetent? It's likely that you won't need to go through that process (often lengthly and expensive and not winding up the way you planned).
Being declared legally incompetent is, as it should be, subject to very stringent requirements. Judges don't take away a citizen's rights without looking very carefully at the situation.
However, whatever it is you want to do, it can likely be done without going to that extreme. Does someone have power of attorney? If not, you'll probably want to get Adult Protective Services involved (or whatever it's called in your county).
Given your MIL's behaviors, I'd try to be very careful to let the 'experts' be the 'bad guys'. If you try to reason with her, you will only wind up frustrating yourself and could cause her to distance herself further from family. Let the doctor, social worker, etc., dictate the plans.
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Dear Worried, Incompetent is a very harsh word. The approach I took was along with all of her medical symptoms, the wondering and disappearing I had become intensely afraid for her. I stated that she had become unable to comprehend finances. So I spoke with the Doctor who new of all the medical problems and also mentioned the financial and asked him if he could help me with a letter stating all of the above. He did not use the word Incompetent, he simply stated that due to her health issues(which he mentioned) she was just simply no longer able to take care of herself and her finances. With this letter I was able to move forward with POA, etc. You also need Medical POA as well. There is a difference in the two. I hope this will be of some help to you. Best to as you move forward in this process and the caregiving for your Mom. God Bless!
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This would be the route to go, if she hasn't assigned POA to anyone and you are caring for her.

The first step is the medical evaluation by her doctor(s). Just get a letter with their opinions of incompetency in writing. Next, you will have to hire a lawyer and go to court to 1) get her declared incompetent and 2) get legal guardianship. The second one could be contested by anyone who might be interested in her care who feels they could do a better job. Of course, the legal fees will escalate if guardianship is contested. More than likely, you will be given temporary guardianship first and then full (health and financial) guardianship at a later date. It is done like this so it can give whomever time to contest it. Limits may be put on any or all of your powers by the judge depending on several things, like your abilities, her financial situation, etc. You will have to make a couple of dozen copies of the final guardianship papers and show/send them to any doctors, hospitals, banks, credit cards, utilities, etc. that are in her name so that you can deal with them. They won't talk to you unless you have those papers filed with them. If you haven't done so, get named as her payee on her Social Security and/or retirement. You can usually do this without having guardianship or even POA.

This will take several months and a couple of thousand dollars (at least). I had to go through this because my husband didn't want to let go of his control and give me POA while he could legally do it.
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If your mil is in fact in advanced stages of dementia, she cannot legally grant you a power of attorney. She must be of sound mind in order to do this. If she is deemed competent, it sounds like she may be too combative to grant you a POA. If this is the case, a determination of legal incompetency is your only option which would lead to guardianship. As the previous person stated,a court will make this decision, and at its most simple, will cost several thousand dollars. The court will appoint a guardian ad litem to represent your mother-in-law and she will also give her recommendation as to guardianship. If there is any disagreement in the family about any of this, it can become contentious and expensive.
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Hi Worried:
If someone is declared legally incompetent then the question of guardianship immediately follows. However medical and legal incompetence are not the same thing. You need however to start with the medical and get her evaluated by a neurologist and psychologist if available. If not a GP can fill in. They will write reports with diagnosis that you can take to court and petition for guardianship. It is simple if there are no objections from family members and costs a few thousand. If there are objections, all hell can break loose legally and financially. If she has money, it can get contentious. Good luck!
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MIL can no longer stay by herself. With what your Dr said, nursing home placement is very close. Who has her Power of Attorney? These steps would be better than having to obtain guardianship.
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If you can talk to her, see if she will sign a POA and health care directive before taking the step toward guardianship. It sounds like she cannot be trusted to live alone and needs in home assistance or a facility and you can make the decision to pay for that using her funds with POA.
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Forget the POA, she can't sign anything now. Get a lawyer and get Guardianship for the person and the property. You need a lawyer and you do go to court. I am a Guardian in NY. You are in WA, but the rules are similar in each state. The MD gave you a warning most MD's would hesitate to give. Don't ignore it.
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Here in ireland she has to deemed incompetent by 2 doctors then papers signed by a lawyer thats it here?
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What about if one parent is caring for the other but the caregiver is really not competent to take care of that patient and does nothing that the doctor has said to do. The caregiver has alienated everyone from the patient and the patient has not improved at all, and now is not talking much. The patient is very skinny and is not keeping regular scheduled diaylisis appointment, because caregivers says that she don't need to go three times a week and that patient ends up in the hospital every time. I need help and answers how to move my Mother to Wichita, Ks with me and my children to take better care of her.
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