What is the next step?

joannes, thank you. Lots of good advice there.
How do you get them to sign the POA? I don't think he will sign it. Same re: evaluation by an MD. I am making an appt. with an elder law atty and his primary care physician, and none of us are entirely sure he will go to his dr., but we're going to try. How do they get diagnosis of mental status? If Poppy is told that's what the dr. is doing, I'm certain he'll just refuse to cooperate. And, no, we don't want the ED to cart him off to the first available bed. Wow. Thank you for sharing your knowledge and experience, all of you. I'm really glad I found this site.

I am not understanding the statement that with a POA you still cannot force a person to do anything? I have the POA on both of my parents. My Dad was refusing to make decisions that would keep him safe, and we had to have 2 of his MDs declare that he was incompetent to make his own decisions re: money and health. With Mom, she cannot handle paying bills and spending money, and is currently still home alone but with a diagnosis of early Altzheimer's . Once these brain diseases are diagnosed, it IS a matter of safety re: making their own choices so one does need MDs to make that statement about competency. If you must call EMTs too many times because Dad gets out of bed and falls, they will insist on taking him to ED. From ED, he may get admitted for a work up or sent somewhere else for a mental status eval, and then either MDs there or a judge will deem that he cannot return home. If you do not have a placement place for him, then it will be ordered. The main problem with them making the decision is that your dad would go to where ever had a bed, which is generally not the top of the line place in town, but a place on the other end of the spectrum. In my Dad's case, when he was taken out of the home for a mental status eval, we were in the process of looking for a memory care unit and fortunately, one of the places we had toured, had a bed so we got to choose. Unless there is unlimited money, you should plan on finding a place that takes Medicaid residents, because once he is eligible, if they do not, he will have to move again. Right now, I am working on trying to get my Mom to see that it's about time for her to consider AL, with Dad in the same place, but in MemoryCare....so they could be under the same roof and she could visit him whenever without having to drive. And if they were here, in my town, I could see them more often. I am only child left and my parents live 5 hours away. I am 70 yrs old and driving back and forth on a five hour trip a couple times a month for 4-5 days each time to take care of needs for both is really starting to become difficult for me and my own health and safety! You have to always be planning way past your nose....and making decisions based on what keeps both parents SAFE....no necessarily what they both want it to be if what they want is NOT safe for them. So POA first, then assess for competency...then assume control of their safety...whatever that entails. Elder care attorney, doctor, elder case manager can all help. Otherwise, you will have to have authorities take Dad to an ED and get hospital to help with placement. It's a difficult time but you have to be focused on the issue of safety for both of them.

thanks JessiBelle, We can certainly try that for the ER. Re: The Dept of Human Services, I looked it up on the website and I don't think they would qualify for it. They are pretty well off. Not rich, but certainly not poor. Thanks for suggesting that, though. And thanks for the words of encouragement. This too shall pass. I will tell that to mommy, who is bearing the brunt of all this :(

Something you can consider is the next time he falls, have your brother call 911 instead of helping him back to bed. Your father will probably tell the EMTs that he wants to get back in bed, but have him try to encourage them to take him to the ER to make sure everything is okay. Then have your mother refuse to take him back home because there is no one there who can care for him. There are several points that this can fail to work, but it is the only possibility I can think of unless someone has legal guardianship.

Something else you can do is contact your local state agency for elder affairs at the Dept of Human Services. Tell them the situation and ask if they can do a needs assessment. If you get a good social worker, he/she may be able to help a lot.

Good luck. Situations like this do work out, but we always hope it is in a good way.

Thank you so much for your responses. Well, they both are showing mild signs of dementia but still have capacity. Mom is overwhelmed by all the stress and worry, and just wants her stressor to go away, which is my dad. I feel so bad for her but I told her we can't just send him away.

Poppy is much better now that the stress and pain are wearing off. Biggest problem at the moment is toileting. He's too weak and frail to support his weight.. He can crawl. He keeps getting out of bed (mainly I think wanting to go pee) but falls and my brother is the only one with enough strength (and lives closest) to come over to get him back in bed. He has a diaper and a urinal but still keeps wanting to get out of bed.
jeanniegibbs, you brought up a point I hadn't considered, that if we had a signed POA, it wouldn't help because we still can't do anything against his will. We were thinking if we could just get that signed, that would open the door to get what he needs. Now I feel really powerless. He is proud and stubborn and refuses any aid. We were thinking of consulting either a geriatric care manager or elder law attorney to get a game plan on how to deal with a situation like this. Obviously this arrangement can't go on too much longer. Any suggestions for dealing with this? I feel like we are entering the First Circle of Hell and it's going to get worse before it gets better.

In-home care can work, at least through moderate dementia. But under the circumstances, namely that Mom wants Dad in a care center, I'm not sure that would be the best option here.

I am not sure that Dad would be suitable for assisted living. If he can't walk, needs a hospital bed, often is not coherent, I wonder if he would be best served in a nursing home? Visit some of each and discuss his needs and their services with each. Since he cannot wander and assuming his behavior is not problematic, he probably will not need Memory Care.

Perhaps with Dad cared for elsewhere and Mom with mild dementia she might get by on her own with some in-home care for a while. Realize, though, that dementia gets worse, and that generally persons with dementia cannot live alone past the very early stage. If she is physically well she might qualify for assisted living at that point.

Having one parent in a care center -- let alone two in the future -- is going to be expensive. What is your parents' financial situation? How long would they be able to pay for this kind of care? Most people in this situation would eventually need to apply for Medicaid.

Getting each parent to name a POA for finances and for medical decisions will be a huge help along the way. It still does not give you the authority to place them in a care center against their will (for example) but it does facilitate acting on their behalf.

Consulting an attorney specializing in Elder Law would be very helpful at this point. This will help you avoid mistakes that would cause trouble with a Medicaid application and also expose you to options for handling their care.

Who has POA for finances and Healthcare? Have you toured local assisted living facilities? If your parents both have dementia, you want to make sure that it's the sort of place that is set up for the continuing care of dementia patients.

Your father really needs to see his doctor to get the ball rolling on this, so if he won't go, that's a problem. One of the best ways to make the transition to a care facility is from a hospitalization. If your doctor certifies that you need rehab, the hospital assists in finding a bed and Medicare generally pays for the first 20 days entirely.

What are your dad's physical limitations? Does he sleep in a hospital bed where you can put up the rails so he doesn't fall out?

Can you describe some of the decisions you are facing right now?