<p>It’s a terrible time when you have to step in and take away things from one’s parents. There is no true map of when, how, what to do. Just guidelines. We are going through this now with my MIL and is tearing up my DH and my relationship.</p>
<p>^^</p>
<p>cpt, I’m sorry to hear that. It is so hard, and there’s really nothing in life that prepares either us or our parents for this process. There are resources, and professionals, and others just like you who’ve been through it. But in the end, it really comes down to a set of very, very difficult conversations.</p>
<p>If I may offer some advice – If there are siblings, do whatever you can do to make sure you’re all on the same page BEFORE the conversations with the parents begin. My brothers and I had a number of conference calls, and alot of emails before we talked to the parents about major issues. That way we could present a united front, and one child could be the designated spokesperson. It prevented a lot of misunderstandings, mixed messages, jealousies, and hurt feelings.</p>
<p>And one more – Go with your gut. Even if you can’t put your finger on it, if something just doesn’t feel right about Mom’s driving, living situation, health, finances – it’s time to act. You don’t want to wait until there’s incontrovertible proof.</p>
<p>“If it’s getting worse, then it won’t get better, and if there are issues with money, that’s a huge red flag that there are other problems as well, potential or actual.”</p>
<p>No dementia on either side of our families … but the oldsters do tend to develop some batty behaviors. My Mom and Dad “team-driving” the car was scary … him with no peripheral vision and her not wanting to drive at all, but willing to act as a second pair of eyes. Or FIL who couldn’t move three feet without assistance, but insisting the whole time he didn’t need any help. Or MIL who has some very odd views on what constituted ethical behavior. “I know that old fridge doesn’t work, but I’ll get more money for it if I tell the buyer that it does!” And of course I can’t leave out Grandpa, who never paid taxes his whole life … he was caught when he applied for Social Security (despite repeated family entreaties not to!).</p>
<p>In none of these cases was family counsel effective. The best I can offer is my sincere wishes you have better luck than we did.</p>
<p>NewHope, did Grandpa end up in jail?</p>
<p>^ No, but back taxes and interest and penalties FAR exceeded all Social Security and Medicare he collected. The IRS people were pretty good about it actually. Grandpa only had a fifth-grade education, and had spent thirty-five years working his farm.</p>
<p>This topic is so poignant, as most of us will be supporting elders even as we anticipate our own retirement. Having helped several through a variety of dilemmas, I benefitted greatly from the way my parents were pro-active, having me meet relevant players in their lives-attorney, Drs., etc. before they were unable to manage. They also showed me where vital papers were and put my name on a check book account-at the time “just in case”. I had PoA early, used it when it was helpful to them with their permission (navigating endless financial institution phone trees, setting up internet access to accounts,etc.). It is also important for them to name health care proxies and sign releases of information at all medical offices so you can help them keep track of health issues. At some point, with or without dementia, even the most capable of elders will need/benefit from help. Anticipate that with them, normalize it, put it in the background for as long as appropriate. The worst is when things fall apart and you not only have the elder health crisis, but no ability to manage what should be routine, like paying their bills and sorting through treatment options. The very best gift is when their end of life wishes are clear to the family. It holds your hand through the toughest of times.</p>
<p>My dad has been diagnosed with dementia. He adamantly refuses any and all suggestions of help. He has refused assisted living and in home care. I have POA but it only kicks in if my dad is declared incompetent which in our state requires 2 doctorss to certify. His neurologist is willing to do so however his primary care refuses to sign off.</p>
<p>Dad will not consider seeing another Dr. In addition, he’s still driving with the aforementioned scrapes and scratches clearly in evidence on his car. Neurologist has revoked his license but either MVA has been slow to notify or Dad has ignored it. </p>
<p>Charities prey on him, he’s given away upwards of 250 dollars in the past 10 days. We called Adult Protective Services and they investigated. They agreed that Dad should not be living alone but say w/o 2 Drs. certifying there is nothing they can do.</p>
<p>The last piece of advice we got from them is to have a good plan in place for when the inevitable crisis comes.</p>
<p>^ terrific post … </p>
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<li><p>my in-laws had everything set-up and while emotionally tough the transitions have gone fairly well</p></li>
<li><p>my parents set up some major legal stuff (wills, health-care proxy, etc) but have resisted either giving up control or even proactively adding my sister and I to accounts/access and it is making things a lot more difficult than it needs to be.</p></li>
<li><p>That said things can be done even with grumpy resisting parents … my parents are not on-line … so I made copies of lots of their statements and set-up on-line accounts in their names (without them knowing) … while I do not make any transactions I can monitor what is going on and make sure bills are paid and just happen to ask questions when I know something is up</p></li>
</ul>
<p>My mother-in-law gave tens of thousands of dollars to contests. They got her number and a lot of it happened over the phone. She was also convinced that Publisher’s Clearinghouse needed her to buy stuff. She filled up an entire room with junk. We finally had to change her phone number to an unlisted number, get a joint checking account and then have the mail go to a post office box so it could get pre-screened. Don’t even get me started on driving. She actually had to be retested and flunked. (She was indignant, because after all no one actually comes to a full stop at stop signs. Well yes we do when we take the test!) She still insisted on driving and we had to hide the car. We really wish we had been more pro-active, but it took us an amazingly long time to realize that she wasn’t just being obstinate and that it was an illness we were dealing with.</p>
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<p>Does the primary doctor have this piece of information? Maybe that would convince him/her. For that matter, it might be a good idea if you could pin the doctor down and ask him/her exactly what criteria he/she uses for determining compentency. If a dementia diagnosis doesn’t meet the test, I’m not quite sure what would. </p>
<p>If the primary is adamant, maybe you could talk with an attorney, or perhaps the neurologist will have some ideas. Be sure to mention that you suspect he’s a hazard to public safety, with his driving issues. There’s got to be a way to get your dad under the care of another doctor long enough to get that declaration.</p>
<p>BTW, it doesn’t apply to charities, but I put my parents’ phone number on the federal Do Not Call Registry, and it has cut way back on the telemarketing calls. I also made sure they have a really good filter on their email. Seniors, especially seniors who are getting a bit fuzzy, are a phisher’s dream come true. This is one of the things that keeps me awake at night; they could inadvertently give away their entire estate in one phone call or email reply.</p>
<p>^Primary care says he believes care should be the responsibility of the family and that he is hesitant, if that word is strong enough, to force the issue of assisted living, etc. I suspect it may be cultual (he is from India). He says he thinks patients give up on life if you force them in to care they don’t want.</p>
<p>I did speak w/an attorney who said that at this point the family has done all that we can. We’re kind of between a rock and a hard place.</p>
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<p>I also have ‘privacy director’ on my phone, so if the number doesn’t show up on caller id, they have to announce themselves and then I can choose whether to pick up or not. Most hang up rather than leave a message (mainly because most telemarketers use automated dialing programs). I still get some solicitations but not nearly as many as before.</p>
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<p>My parents actually had an opposite experience. I don’t know about driving because I think my dad pretty much told his father he was done driving due to vision and other things. But my grandpa lived with my parents for 18 months. He was in the hospital a couple of times for dehydration because he would not eat and drink enough. My parents had to take him to the hospital again for the dehydration and finally my dad talked to the doctor and told him they couldn’t handle having grandpa at home anymore. With my parents still working in very busy jobs and other activities as well as my siblings and I all either going to school or working fulltime we just couldn’t do it anymore. The doctor told my dad he’d be the “bad guy” and put grandpa into a nursing home briefly and then into assisted living. He’s been there for almost a year now.</p>
<p>Some of it could be that this doctor was not my grandpa’s PCP, but was our family doctor that my parents started taking him to when he moved down here.</p>
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<p>We have practically begged my dad’s pcp to do this, but he refuses.</p>
<p>My parents have always been very fit/spry, but just last night at the opera, both were suddenly walking much more slowly than usual. Dad has water in his knee that seems to be taking a long time resolving and mom is just slowing down some. She’s concerned because he saw the doc & canceled his golf game for the first time in memory due to the knee. Both are having increasing dings & worse to their cars (both were always iffy drivers but the dings are occurring more frequently these days & worse). No one in our extended family of 7 kids wants to be the tough one and the doc admires that they’re both still active. I guess we will continue watchful waiting? Already, one or more of us will offer to drive them to many of the evening activities and they have voluntarily reduced their driving, tho both continue to drive short distances (for mom rarely more than 50 miles/week). Fortunately, both are otherwise in good health.</p>
<p>^That really makes me mad. If the family has that level of concern and presumably they know your dad better than his PCP, then he should be supportive. No one wants to have their parent declared incompetent and people generally only put parents in nursing homes as a last resort. Could you have his neurologist call his PCP? Sometimes physicians respond better to their peers than to patients’ families.</p>
<p>^That’s a thought</p>
<p>“If giving away money is her only real ‘incompetency’… it might not be a sign of dementia as much as a personal philosophy.”</p>
<p>I don’t know about that. An appropriate giving strategy at that age is <em>in the will</em>, not distributed to telemarketers at random. At most, the existing lawyer might help portion off some money to recognized philanthropic funds. If the parent cannot be convinced to answer calls with, “I’ve made my last wishes known, and you’ll find out then,” (or better yet, not answer any call that is not identified by caller ID) then yes this is a sign of poor judgment and I hope you get a good lawyer.</p>
<p>Best wishes to your parents.</p>
<p>WR2- This is a rock and a hard place. Wondering if the neurologist could follow up with the state DMV/RMV as to the status of your father’s license. Also, if there is anyone who your father might be more trustful of/responsive to with regards to any tiny steps to solidify even a small area of his life. Sometimes a family friend, a clergy person, another relative can dilute the struggle. I do recognize that the illness may preclude this. If he were stopped driving without a license, what would happen? Any chance it would set in motion an alternate living plan where a car would not be required (knowing that this would be a process). It is good that you have contact with his Drs. Maybe you could send his primary email updates of misjudgments or dangerous things, but I also think the idea to have neuro contact PCP is a good one. This is a terrible bind you are in; any gain is a giant victory. I will never believe that giving an ill elderly person enough rope to hang himself makes any more sense than leaving a young child unattended. Therefore, I take issue with the PCP expecting the impaired patient to totally own the decision. There can be room for finessing and retaining dignity. Best to you.</p>
<p>^A good friend at work is married to a police officer so I’ve been checking on his license status fairly regularly. His neurologist is willing to write a second letter of revocation. I plan to follow up on that this week. We kept PCP pretty up to date for awhile until we finally got so frustrated with him that we kind of gave up.</p>