What can I expect at the initial doctor appointment to activate the medical power of attorney?

Hope you get an answer! I would get him to a geriatric psychiatrist when you have the ability to get him to the doctor. It sounds like he needs meds for agitation.

Has your dad been deemed officially incompetent? Abuse is not the same as incompetent. You cannot really be in a POA position unless the person is not capable. It becomes a legal issue. That being said- perhaps confrontation is needed on the bad behavior. Good luck!

Good luck today, Franklin. Let us know how it goes.

I was a receptionist at a family practice office, and the majority of our patients were elderly. They had been with this doctor since he started his practice forty years earlier, and grew old with him. From what I remember with the patients that were agitated from dementia or Alzheimer's we did it in a way that wouldn't agitate the patient. We were familiar with them enough to know when their children needed medical power of attorney so we wouldn't ask questions about their memory in front of them. If they asked what we were having their children sign we would simply explain it was something so their children could continue to bring them to appointments, and continue to call for them if refills were needed. Something like this is always a touchy subject, and your doctor will want to make it as easy as possible. It sounds like he/she knows your father well enough already to not have to ask certain questions. Also it wouldn't be a bad idea to see a geriatric specialist to get something for the agitation like someone else mentioned. Medication works differently for elderly patients with memory loss, and what might work for you or me could make them more agitated or hallucinate. My mom's family practice doctor started her on a low dose of Ritalin in hopes it would help clear her mind a little. Unfortunately it caused her to hallucinate, and gave her extreme paranoia. She was convinced her aid stole her earrings, and started hiding things like her phone and remote in her sock and underwear. My mom was ready to call the police when her aid contacted my sister and I in a panic.

This is THE most difficult aspect of caring for a person living with dementia.

The book, "Elder Rage" is available on Amazon and explores this challenge in fairly useful detail. To summarize, there is a toolbox of non-drug techniques that exist to assist you to minimize the potential for verbal and physical abuse. Additionally, there are a wide range of prescription drugs that the various Doc's will try to reduce the abusive behavior. If he is physically abusive to you, and you fear for your health, call the police and they will get him temporarily admitted to hospital psychiatric care in any effort to determine the optimum medication. Research "Baker Act" that explains this possibility.

If you place him in a long term psychiatric facility under your POA for health care, and he legally challenges it, the judicial system will release him to live on his own if he has that capacity. Being verbally and physically abusive is a large grey area.

Rest assured that the hospital psychiatric facility will waste no time to assure the safety of him, other patients, and the staff, by the use of prescription drugs to control his behavior.

You might want to contact the Alzheimer's Association for support and information. Also, my sister and I have MPOA for my mom and all that means for now is that we can be present at her dr. appts. and can let the doctors know anytime she is having a medical issue. We can't force her to take any meds, but we can let the dr. know if she doesn't remember to take them or refuses them.

When my mom sees her neurologist, she insists she is fine and can do anything she wants to do--Ha! So my sister and I will say things like, "Mom, we have noticed that you are not remembering if you ate." so the doctor will know. She does get upset that the doctor NEVER talks to her and only talks to us (not true, but she can't remember), so we just say something off subject.

I would also call the doctor's office, ask to speak to the nurse for that doctor, and ask what to expect. I've actually never heard of a doctor activating a MPOA, so I'd like to know what happens as well, please let us know. Best wishes!

I wrote a letter to dr ahead of time listing all the strange behaviors in detail; for example, "Jan 1, Mom talking to herself and imaginiing talking with her deceased brother"; "Feb 28, Mom says she visited Dr. Sham and he says she has a tumor on her back"; etc. This way, the dr can probe more deeply with specific questions to discuss with your dad without you being present.

I did this the week before the visit, though you could probably email the dr and just explain you want to provide additional perspective on your observations for dad to get the right medical help.

Mom's dr found this very helpful. He didn't sign incompetence at that time, but as things progressed; we at least had a baseline and she was diagnosed with mild dementia at that time and referred to neurologist.

Its been a long road for me. I hope your dr is cooperative and documents your dad as incompetent. In my case, drs, psychiatrists, neurologists diagnosed everything but would not sign incompetency as they don't like to do that for fear of legal retribution or damage to their practice (particular if alot of their practice is financially dependent on medicare; medicaid). Plus they do everything to protect elder's rights.

In my experience; Primary care won't do much for you, they refer you to neurologist or geriatric psychiatrist who will do more thorough probe vs just "draw a clock, who's the president, count backwards, repeat 3 words" -- if this is all they do -- beware that is not enough to invoke POA.

I finally saw a lawyer a few weeks ago about the POA's that I have (medical and financial). The lawyer said they were active the minute my father signed them 10 years ago. I have been fighting doctors over HIPPA ever since then, and I didn't need to. I assume your medical POA says it's only active if he's declared incapable of making his own decisions? Of course, in reality, the POA's do nothing that allow me to force my father to go to the doctor or clean himself so I'm still no where.

For me it was a nonevent. I just gave one of the nurses, or perhaps one of the doctors, a conformed copy. They copied it and returned it. End of issue.

Unfortunately, I'm still asked every time I go to that hospital as well as the rehab facility where Dad has been 3 times.

When the asking party at the hospital is politely reminded that I provided the documents to them in August of 2002, there's usually a stunned look and nominal response, something to the effect of needing another copy.

Perhaps I need to explain the concept or archived documents to them.

I've never provided copies to individual doctor's practices though; never been asked for that documentation. But up until recently I was the only one who ever took Dad to doctor's offices, so I was always present for any advice or discussions. Dementia hasn't been an issue, though.


Franklin, I would contact the doctor's office beforehand and brief them on the fact that your father may become upset. I would also ask if they take a copy during the intake process, when they copy medical cards and photo ID.

If so, you just slip it to them with a note cautioning against the possibility of upsetting your father. There's no need to create unwanted and unneeded anguish on anyone's part by anyone in the doctor's office raising the issue.

As to being asked questions in the presence of your father, warn the doctor's office before about this issue. And find a way to sit behind your father so your nods and head shaking if he's not answering truthfully won't be seen by the doctor.

My Pops was mean as a Rattlesnake, very high strung and short tempered he suffered with PTSD from the Korean War, so I get what your going through! A litttle over a year ago he was put on Citalopram its the generic for Celexa. Its like the difference between night and day. Pops has a calm demeanor now, he has patience I wish he had when I was a kid, but better late than never. ask his doctor about it, we have had great success with it. but most importantly Pray, the lord will get you through the tough times!

The POA form my friends filled out to make me in charge gave me that authority immediately so there was no delay or further doctor appointments to verify it was time. They checked the boxes that gave me the decision authority even if it disagreed with their choices. They trusted me completely and I have honored that trust by being most careful and circumspect. Initially I just monitored their spending and once their drivers licenses were revoked, took them shopping and to their appointments. As the wife's frontal-temporal dementia worsened and she resisted getting cleaned up after she soiled herself, I took her to a geri-psych ward at a nearby hospital so they could figure out what anti-psychotic meds would work best for her to calm her without doping her up. It took 3 1/2 weeks there, all covered by their health insurance, but it worked and she was able to return to their memory care apartment where she and her husband were then living. After she passed from her mind shutting down, the husband is content to stay there and I continue to take care of all his affairs as I pay his bills and go through his condo getting it ready to sell. I am doing this out of friendship, not gain, so I charge nothing for my mileage driving back and forth. If I can sell anything, the money goes into my friend's wallet or bank account to help pay his expenses. BUT, the geri-psych ward was key to getting this all to work. I hope you find a good solution like that and that it works well for you, too.

that's what my friend did with her mother as well

Maybe depends on the state you live in and we're in California. I had to have two physicians submit letters stating Mom (with advanced dementia) is incompetent to make her own decisions. I got one from her neurologist and primary.

I'm in Alabama and I understand that's the way it is here; something we're dealing with with hub's aunt; they possibly have gotten involved in the same thing as Franklin with her primary but she's never seen a neurologist

Never heard of activating a medical POA. Under the impression parent has to be in her/his right mind to give anyone POA otherwise its guardianship that needs to be initiated. No doctor or institution has questioned my POAs.

I filled out the DPOA, had it notarized (yes, mother had to go along to sign off on it and she had let her ID lapse-it was invalid)...luckily the notary public accepted it because he knew and liked her...she thought it was a social event anyway!

as Health cate surrogate an durable poa dcf authorized appointed teptesenative. i endevor to keep him under the guideline of ADA 504 least restrictive envirome nt sA

Sorry I haven't read all the answers but if your dad is abusive and you are fearful, I would say that he is "a danger to himself or others" and what that gets you in many states is a hospital that will hold him for observation or until they are assured he is not dangerous to himself or others. We did that, and while in the hospital I am sorry to say my Dad deteriorated to the point where he could not capably argue himself out. On occasion he can pass for ok, but any staff who has spent any time with him knows that is fleeting, and would know to wait to see if that mood held. He is in secured section of the VA, and I regret that he can't have more independence, on most days he can handle it.

I think the term incompetent is misunderstood and misleading. I think that most people that are incompetent due to dementia are obviously so, and no court is needed. If it were, I believe it would so expensive, that doctors will do everything possible to help you. It worries me that someone might get railroaded that way, so we all have to be really careful of elder's rights. Our experience was in NJ.

without court deemed by judge. activation of dpoa proxy especially if protesting unnecessary surogacy. dpoa proxy without a general poa usually activated when 2 doctors and proxy agree in best interest and patient unable cognitively to oversee own healthcare or healthcare defecit to extent pt irrational unable to comprehend own health care or unconscuous.. I think this is what dr was referring to.. The acknowledgement of you overseeing his healthcare and bringing you tinto the innerli innerlloop

Franklin99: Why are you obtaining DPOA?

Franklin99: Scratch that. I meant to ask "why AREN'T you obtaining DPOA?"

Everyone, thanks for your support. I took Pops to the doctor and they had both his family practice doc and his neurologist there. They asked him a few questions about how many animals can you name what's the date who paid your bills, etc. then while the nurse was talking to him about his medication the two doctors pulled out a form they both signed it and they gave a copy of it to me saying that he's incapacitated. I have been durable power of attorney for years but the problem arose because pops was giving money out of the family trust to other people. The people at Ameriprise where the trust is said durable power of attorney is not good enough for them. They said we had to get him declared incompetent. We called my dad's attorney and $800 later, they said yes we need the medical power of attorney activated which declares him incompetent so that I can take over the trust. Now my question is, can he vote in the upcoming November election?

Franklin, I'm so glad the doctors' appoint went well.

The voting question is a tough one. I'd call the Board of Elections in dad's area for an answer.

Glad everything went smoothly!

I should also mention that they put him on Depakote for aggressive behavior

My Board of Elections said that as long as my elder understood enough to know that she was voting and could indicate yes or no for questions or candidates, that was good enough for them. They also set her up on auto absentee ballots as long as we request one for each new election season. Thus, when she moved to the memory care, we had a tax referendum she voted in, and that was it for the year. The next spring, I sent in her request for the primary, and then she also got the next 2 run off ballots in the mail and the general election. Her nursing home is in a different district, so I print off the info about her candidates and read it to her when we have the ballots so we can have it done all at once. I knew her party and that helped.

Yes, DPOA was what I told you I thought you should have.

Franklin: For the voting question, look up the information on the Athens, Wisconsin site/page.

Franklin99: I just spoke to a woman at the Board of Elections in Athens, WI. I asked the question "can a person with dementia vote in the upcoming Presidential election?" Her response was "I imagine they could."