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He is in charge of giving her meds, is making mistakes and will not listen to doctors when it comes to her care. He is very smart but not rational in his line of thinking. Both are 90. Is there something I can do other than seeking guardianship? I have POA over my dad medically and he has it over my mom.

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As far as how you gain guardianship, you need to see an elder law attorney in the county your parents reside; the first visit to discuss the case is usually free and then you will need to pay a retainer to engage the attorney to create and file the required paperwork. If you gain guardianship, your attorney fees are usually reimbursed.

In general you are going to need at least one doctor's statement that your parent is incompetent due to a cognitive decline of some sort. If your father is competent you are going to need evidence of why his POA for your mother should be overridden in favor of your guardianship so you will need to show he is risking your mother's health or safety by not allowing her medication management or not taking medical advise. It's going to be difficult to show he is endangering her safety while he has her placed in AL. When you file for guardianship, there is generally a guardian ad litum appointed by the court that will have access by court order to your parent's medical and financial information. The guardian at litum will also interview you, your parents and siblings and maybe others to determine if a guardian is needed and who that guardian should be. There will be hearing and the guardian at litum will make a recommendation the judge may or may not follow. This process normally takes several weeks or months to complete. If your petition states there is an immediate need, the judge may appoint a temporary guardian, perhaps you or maybe the guardian at litum.

The bill for court costs and the guardian at litum's time will be paid by the parent who's competence is being evaluated (your parent) in most states. If your father is still rational enough, the cost of this whole thing and the public venue may make him reconsider listening to the doctor's advise.

As someone who has gained guardianship of one parent and has defended the other parent against a guardianship attempt by a sibling (to override her POAs) I can tell you that it's not a process I would recommend if it's at all possible to avoid it. On the other hand, if you feel your parent's safety is endangered and guardianship is the only way to make things safer, then I encourage you to get in the right mindset and go see the attorney.
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Reply to TNtechie
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I am very surprised that an AL facility would allow your father to administer medication. My mother has been in 2 places and both are adamant that all medications are kept by them for the residents to administer either on schedule or as needed. I certainly think you could get their assistance. Is medication management being paid to them monthly?
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Reply to Riverdale
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Is it possible that you can tell your Dad that there is "a new policy" that requires staff to give medications? Or at least observe that the correct medications are given at the correct time? You could "blame" this on either a policy change at the facility or a new state code that the facility has to follow.
I know many AL facilities will start charging extra for additional aid with ADL's and that might be a concern of his that having them do this will cost more money. You might want to address that if it is the case. Tell him that there will be no added charge that might satisfy him to some degree if he is aware of costs.

If that does not work you have 2 options neither of them is wonderful
1. You need to seek guardianship for your Mom. This will most likely devastate your mom as well as your dad. And the possibility of having to gain guardianship of your dad as well if he is not making the best decisions.

Is he making good decisions for himself or is he failing in that as well? Possibly a transition to Memory Care for both is sooner rather than later. That would also take the medication out of his hands.

2. Continue as things are. Your mom will probably die sooner than she would but that is not known for sure as none of us have an expiration date stamped anywhere on our bodies. But you will not put either through the stress of a guardianship, you will not upset either by taking away the ability to do things for themselves. My Husband was on Hospice for quite a while and I volunteer at the Hospice and one of the things I have come to realize is at a certain point do a lot of these things matter. Quality of life is more important than quantity.

Not an easy decision to make anyway you go. And Guardianship is not easy. There are costs involved, granted they are paid for by your parents but there is time in court, paperwork, and a lot of what might be called silly rules that have to be followed. They make sense if the "guardian" is trying to profit from the guardianship but for someone that just wants the best for their loved one it can make things complicated.
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Reply to Grandma1954
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At my Moms AL they administered meds. No resident was allowed them in their rooms. Guardianshhip is not going to change how Dad acts.

Ask the Nurse if she could give him a note saying that State regulations now mandate that all medication has to be dispensed by a trained aid. No longer will residents be allowed to keep medication in their rooms. This includes OTC drugs. (In Moms AL, even OTC needed an order from the doctor)

Have you looked into the prepackaged pills. The aid could give Dad the packet and he could give the meds to Mom.

If Dad is making mistakes then I think your POA is effective here. There is some decline. The AL should be worried about Moms best interest not what Dad wants.
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Reply to JoAnn29
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I'm surprised the AL has not complained. Have you complained to them for their compliance with your dad concerning your mother's meds. Since they are responsible to do this, they could be held liable for not doing it if something went wrong with your mom because they did not administer the meds themselves. I'd tell them that too.

Without medical POA, you can't do much. You may have to see if each of them qualify as incompetent to manage themselves.
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Reply to cmagnum
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Judysai422 Feb 17, 2019
In some states, residents are allowed to self administer as long as they demonstrate capacity to do so. It is not always covered in the basic fee but might be additional cost.
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I agree with everyone else in that the AL facility is not doing something that is considered basic care.  How do the meds get in your father's hands?  Is there anyway the AL could doe out the amount to your Mom and then Dad could give them to her.
What kind of care does your Dad give Mom besides this.  POA really does not give Dad the right to be your Mom's boss and it would not give you that right either.  My mil has dementia and often she does needs to believe she is capable of doing some things for herself.
I would not worry about becoming the POA.  Perhaps it might be better to figure out ways to make your Dad feel he is taking care of his wife but, in reality, she is getting the care she needs from the AL facility.
Good luck to you!
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Reply to caringdil
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Sounds like you will need to go for guardianship then to really resolve your issues, maybe guardianship of both. Just remember making bad decisions isn't the same as being incompetent. Your father could be making lots of very bad decisions and still be legally competent. Not making good decisions for your mother or taking the doctors advise would probably be an easier path to override his POA and gain guardianship of Mom, assuming Mom's incompetent status is already well documented. Ask the doctor if he will write a letter stating he believes your mother is not getting her medication as prescribed.

In the short term if your father is a "value" guy you might try the approach that he is paying for the medication management service whether he uses it or not and he's wasting his money if he isn't using it.
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Reply to TNtechie
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Buy a med ready machine. It can dispense 28 dieses and you can set it up to 4x a day. It has a fairly loud noise to tell her to come get her meds. She sides the top back and gets her pills out for that dose. It's a great machine. You can buy one for about 150, or rent for about 30 bucks a month. Cheaper to buy!
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Reply to quiltinrealtor
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I would like to add to the conversation 1 thing unmentioned, < why does he think he has to administer the drugs > is it because he wants control it or maybe some other underlying issue, I think I would ask him if he thinks the facility isn't competent to do it correctly. My wife has had Parkinson for over 20 yrs and has been in and out of either rehab or for a short time AL . We had concerns both in the rehab and AL . Generally most Facility's are based on a 4 hr schedule for administering meds ; my wife for example takes 4 drugs , 1 for Parkinson, 2 for anxiety and depression, 1 for sleep, Parkinson meds are 5 times a day , anxiety meds 3 times a day , depression meds 2 times a day , and the sleep med of course at bed time which is flexible. The 3 meds are administered on a schedule of her awake hrs which is genererally 16 hrs , 7:00 AM -11:00 AM- 2:00 PM- 5:00 PM - bedtime . This schedule doesn't coincide with most facilities busy schedules , all rehab, AL, and nursing homes generally have their own medical staff that dont always make the decisions based on PPO decisions , their for a profit based institution and it makes sense their going to not always have the clients best interest at heart. When ever a decision is made to place a elder in a facility it may be wise to look at these concerns before hand . Your father may just be administering the drugs the way her PPO directed and that may not be the way the facility chooses to do it . Make your father explain his reason for doing so , and the facility is probably in violation for letting him do so which should be more of a concern even though your father may be right .
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Reply to youngonce
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Judysai422 Feb 17, 2019
In AL, it is not just the facility but state law that can allow windows for administering meds. The prescribing doc can be very explicit in sending orders, but often they do things like 3 x per day.
In a nursing home or rehab, the attending doc is on charge of orders, so that is the person you need to work with.
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My dad is 92 and I finally had to go the guardianship route. It is long and emotionally draining. Your dad sounds like my dad - trying to hard to keep control. It is like dad is just hanging on a cliff by his fingers some days, trying to keep that last little bit of freedom. He still lives on his own. We have tried and tried to get the med management away from him. We've tried different pill keepers but 'no go'. I am fairly computer saavy and what I have finally done and is working is to create a form in Excel. I create a new one each month. I title the drug at the top in bold letters and the dosage. Then for each day of the month, I put the date under the day of the week (just like a calendar) and then one or two checkboxes depending on how many times a day he takes the drug. The drugs are listed in order of how he takes them. This is several pages long. I actually also added a picture of each drug I found online. He checks off each one after he has taken it. It has given him the control to take the drugs himself but it also keeps track for him of whether he's taken it that day or not. Each week when I'm there, he shows me the sheets and lets me know he's taken each of his drugs for that morning or evening. I tried to attach an example here but couldn't get it to work. Blank calendar pages could also be printed off the internet with a drug title at the top of each one that would accomplish the same thing. This has worked for us.
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Reply to Babs75
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moecam Feb 17, 2019
Great idea on those papers - many could do this so thanks - I may do something similar when travelling
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