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Hello. I am my Mother's medical and financial POA. My Mom, 95yo, is wheelchair bound and has undiagnosed dementia. She has not managed her affairs since she suffered a stroke 18 months ago and went into full time nursing care.


I have managed all her bank accounts (I am joint on them), paid all the bills, and advocate for her. I will need to access her financial investments in a few months to continue to pay her monthly care bill.


The POA states two doctors must provide a letter of incapacity before I can invoke the POA to direct money for her care. Her financial advisor firm is requiring these letters in order to invoke the POA and speak with them.


I have asked her long time doctor to provide one letter. He flatly refuses giving me excuses and avoiding the request. Indeed, he's the one who recommended she go into full time care before her stroke. The doctor at her facility would only provide a generic statement of her diagnosed medical conditions, nothing more.


I am at a loss for how to find two doctors willing to provide the letters when I can't seem to get them from doctors who know her condition. Where do you find a doctor willing to do an assessment?


I'll add there is a 6 month wait to see a specialist for the cognitive assessment and I'd have to put her in an ambulance to take her 45 mins one way to the closest facility. She is totally dependent on others for her care: she can't walk, bathe or shower, get into or out of her chair or bed without a lift or 2 people, has meals made for her, and RX given by a nurse. She hasn't written a check or paid a bill in 18 months.


I'll add I am not a predatory relative. I am trying to do what she designated me to do. I have kept track of every check, receipt and bill since she entered full time nursing care.


Most of the time she doesn't even ask if they are paid. Any suggestions for how to find two Drs willing to write letters of incapacity would welcome.


Thank you.

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Maybe her regular doctor does not feel he is qualified to give a Dementia diagnosis. My MILs Rehab had a Pshychiatrist associated with them who saw my MIL. Like said, maybe your NH has one they can call in. Its just a matter of him saying that Mom is no longer competent to make informed decisions. Because of that, the POA which her daughter has been assigned, is now in effect. Then maybe the NH doctor will write a letter saying that he agrees with the Psyciatrists findings that from his observation he too feels Mom is incompetent to make informed decisions so this would make the POA now in effect.
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You need referral to neuro-psyc MD for formal diagnosis. I agree with AnnReid on that. You will have to contact an elder law attorney on getting that done. Without that you will have to file for conservatorship or guardianship which would still mean that you have to have a formal diagnosis. I cannot imagine WHAT in the world is wrong with her current MD, myself.
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Find a suitable form letter (maybe one is available from the financial advisors or ask your lawyer to draft one) so all they have to do is provide a signature. Around here doctors expect to be paid extra to write letters so asking the fee might move them in the right direction, especially if you are standing right there with the form.
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Have you initiated a specific attempt to get her “undiagnosed” dementia formally diagnosed? It seems impractical to attempt to take her out of her residence. Is it?

Since she is “living in a nursing home” you may be able to get a recommendation from the staff administration and/or social services department there, for someone to come to the site to administer testing.

As I recall, we worked with the resident physician and THE recommended psychiatrist in my LO’s MC, and once we were able to do that, the process to the letter of incapacity was a direct route, and that document, with my POA, was the solution to every potential issue concerning my position as POA.

Perhaps your mother’s personal physician is unwilling to supersede the opinion of the resident physician at her residence, or vice versa. Might your mother be better served as a patient of the house physician only, rather than the present arrangement?

I understand your sense of urgency. Hope you soon have a solution!
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Do no harm. Good. But are these Doctor's scared a 95yo is going to sue them for wrong diagnosis &/or taking their rights away?
Where's their CARE for their patient's situation? To HELP get the CARE Mom needs?

I think I would ask specifically what is stopping them giving their medical opinion on her ability to make decisions for her living arrangements. If they need to perform a mini-mental exam, then they do so, right? Surely they have training for that?
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So sorry for your situation. Like it's not hard enough without these doctors making your situation basically impossible. I guess the problem is undiagnosed dementia. I would ask the doctor WHY he won't provide you help to take care of your incompetent mother? Does he have a boss? In a practice with others or solo? If there's someone above him in any way, complain to them. Put your request to him in writing (hopefully they have an online portal you can use), detailing out the reasons she is incompetent and the reason you need this declaration. If he won't cooperate, I'd find SOMEONE to complain to. I wonder if she needs an MRI to diagnose? But that would be such a pain and so unnecessary. I think her lack of abilities is enough proof.

Good luck.
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