My dad has been diagnose with dementia and has a really week heart. A heart fraction of 15%. Doctors have said he is in the end stages of heart disease. He has been on the decline since December 2017. He kicked my mom out of the house and they have since gotten a divorce. He only has social security and as soon as he gets his check he spends it - paying no bills. He has a spending problem. He doesn't take his pills correctly and goes to the hospital once a week to get drained. He gets around 5 liters of fluid off his stomach each week. He is very stubborn and won't go into an assisted living program. He is currently living in a trailer that he bough once my parents sold the house. He doesn't have water or electric hooked up. He often asks for money and I used to give him money to help him with gas and food, but I have currently stopped that and he now refuses to talk to me. He has been really mean and it's not my dad anymore. From here I don't want to take guardianship, but I know the state will. I wonder if anyone has had this kind of experience. Thanks
A call to Adult Protective services might also work but if he does not allow them in they can not do anything.
I am very surprised the Hospital has not said or done anything. If he returns to the same hospital every time they should have noticed something. Without water I can not imagine that he is washing laundry often nor would he be bathing often. Can you contact the hospital and talk to a Social Worker? Or are you contacted when he goes to the hospital? If so ask to talk to a Social Worker at that time. Due to the privacy laws THEY can not tell YOU anything but you can certainly inform them of what you know. (Unless you are listed on the forms that you Dad signs that they can discuss findings with you.)
Unfortunately in many cases nothing can be done until a "catastrophic event" occurs. But we should do what we can to prevent one.
Your father may mentally be gone, but he's still your dad. Call his social worker, take a few days off and drive over to help manage the situation.
Hadn't you better contact your local social services and get their advice? I don't for a moment disagree with your decision to stop funding your father's precarious situation, I can't see what else you could have done: I'm sure you were correct that you were merely supporting his ability to reject help that he badly needs.
But it is just such a pity that your parents' marriage came to this and that his behavioural problems weren't flagged and addressed by his medical team long before. I feel for all of you especially because my own mother was diagnosed with CHF in the mid-'90s, and I swear nobody but nobody even mentioned vascular dementia until 2012 - even though it's medically well recognised as a very common result of long term heart disease. When I think how much better I could have coped if I'd had been given just a little heads-up much earlier on, it makes me want to spit.
But never mind the "if onlys". I hope you'll be able to get good, practical guidance from your local services - ideally from people who don't hope they can bully you into doing their work for them.
They should be able to prescribe something for your fathers agitation and stubbornness that comes with certain types of Dementia.
If he earns Social Security Income, have his doctor write a letter to Social Security about his incompetency to handle his own money decisions and say that he requires a payee to handle his affairs. That shouldn't be hard to prove/validate if he has a diagnosis of Dementia and is not adequately providing for his own needs. Then, Social Security Administration will require a payee to be appointed - family member or a payee agency in his city/state. That payee will then take over being in charge of paying for all of his necessary bills (housing, utilities, health care) and issue him limited spending checks, so he can't just blow all of his income on unnecessary things.
Hope these measures can help reduce both stressors to have his financial problems better handled and his lack of self-care addressed.
You have received some great suggestions. The only one I would add, talk to the Social Workers at the hospital. They maybe a good resource for you.
Perhaps if you explain that he does not have safe living conditions they may not be able to discharge him.
Good Luck
The only thing I can point out is that depending on the state you both live in, they could hold you "responsible" if something happens. That was MY concern about leaving mom in her condo alone. I would bang on every door you can find to let them know that he NEEDS to be cared for and that YOU cannot do it. Police. Doctor. EMTs. APS. DHS. Social Services. Senior Center might have information you can use. The Pamphlet left at his door should have contact information on it. Contact them ALL! Send certified letters to back you up if they do nothing to show that you made every effort to address this and you were ignored.
It is sad that there are cases of guardian system abuse (lookup article in New Yorker re Rudy and Rennie North), where unscrupulous people take advantage of the elderly, even those who do NOT have dementia, yet when there ARE needy elders, you are ignored! But, do cover YOUR butt and call/write everyone and anyone you can think of.
I wish you the best of luck obtaining state-directed guardianship. I'm sure the process differs by state (county/jurisdiction).
Since guardianship ultimately involves taking away a person's individual rights to make decisions, whether medical or financial, there is a huge "gray area" and the process may not be as quick as we would like.
My mother's situation is similar, but a little bit different to include dementia (memory loss), catastrophic heart failure (CHF) metastasized cancer, anemia, and diagnosed as "unable to make a medical decision" due to memory and cognitive issues, she goes to ER monthly, complains that hospitals will not fix her problems, but doesn't commit to any medical procedure and cancels all outpatient appointments. As her illness progresses, she will visit the ER more frequently.
Each time she is hospitalized, staff stabilize her and reach out to me (as the Responsible Adult) to state she has a safe discharge plan, i.e., long-term care, home health aid, stay with a family member, or safe to live at home alone. I don't have POA, but in the state of Virginia, next of kin are supposed to make "medical decisions" if the patient is documented as unable to do so. For various reasons I won't get into detail now, I hesitantly sign her discharge papers to enable the hospital to release her home.
Back to the "gray area." Hospitals and states want to avoid risk and treat state-directed guardianship very carefully to avoid lawsuits. For starters, in my case, the hospital must perform psychiatric evaluations and involve their "ethics board" prior to moving forward. I've been told, "if there are no family members involved who can help the patient" the process may move quicker and state may be more likely to initiate guardianship. However, a case manager informed me they were going to move forward with guardianship and I would be contacted within 4-6 weeks by a state attorney to be interviewed to be the guardian (or another family member). I followed up with the case manager who told me they didn't pursue guardianship and suggested I obtain it independently which is expensive. I reached out to several lawyers for information, but didn't retain their services for various reasons.
I also reached out to Adult Protective Services, county family services, doctors, social workers and case managers, elected officials … you name it, anyone who will listen. My mother insists that she retain her independence. Yes, I know my mother is quickly heading down a path of extreme medical and legal challenges, but since she has enough sense to know when a psychiatrist is questioning her to determine in her competency, she gets up and leaves the hospital and staff can't do anything about it.
A case manager told me "we all have a right to make poor decisions." I think deep down my mother understands she is approaching end of life and she requests privacy and stay in her own "cluttered" house. My mother doesn't want any help from me as she believes I'm part of the conspiracy to get her committed.
I think you and I have at least one thing in common, we want to help our parent who isn't making the right decisions and has declining health (dementia and CHF), but they don't want our help. This is hard because we want the best for our respective parents … maybe they just want to be left alone and in the U.S., don't they have the right to be left alone?
Like guardianship, they will require that you keep records on how the money is spent and report this yearly... I haven't had to do this yet, but it has not been quite a year yet. In our case it will be simple - both her pension and SS pay a portion of her "rent" at the MC facility, so that's all I will have to provide to them (pension is federal, so they require it too.)
The other thing that has to be done, once approved, is to open a special rep payee account - it lists you as payee for your LO. Only you can be on it, and LO has NO access to it. First check comes as an actual check, but once the approval is done and the account is set up, you can call and request electronic payments.
This would be one way to control his funds. He can be given some "spending money", but if you keep the bulk for necessary payments and dole it out in small amounts, this could at least keep him afloat financially... For his bills, contact each party and have the bills sent to your address (leave it all in his name!) I did not have to provide POA to most of them - they don't really care where the bills are sent, so long as they get paid!
As for his living conditions... where is this trailer located? is it private land he owns? The town could have him removed if there are no working water or electric (if this were a house, a permit to live there would require water, electric, heat, etc to be working, otherwise, they'd shut it down and lock him out. I don't see how a trailer would be any different. You could try the building department at the town hall.)