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strugglinson Asked April 18, 2024

Can I assume this write up from my father's Geriatrician means he is not competent?

Hi all.


For those who have read my posts, my dad is unhappily in AL, and keeps coming up with repeated and often crazy, reckless ideas for going back to live in his house. He has never had an offiicial or legal determination of competency, but me and my brother have DPOA and medical proxy etc.


I finally got him back in with his geriatrician, after 6 months. Not suprisingly, he asked her "can you get me out of this assisted living place?" The doctor answered, "no that would be unsafe, we need you in the monitoring and safety of an assisted living". I just read her note on the patient portal, she wrote : "Memory poor, needs 24 hr support and care. Needs cont assist living. Discussed needs 24 hr help , high fall risk and pt poor insignt into memory changes or risk. Will cont 24 hr assist living. Son supportive."


Can I assume this means she is saying he is not competent? Should I ask her on the patient messaging portal to clarify it further? Or is he going to need a full neuropsychiatric test or something? He may well refuse that.

waytomisery May 23, 2024
You have DPOA and the doctor has documented that he has to stay in a facility for 24 hour supervision etc .

Stop worrying . Your Dad is stuck there , he’s not going back to his house .
strugglinson May 23, 2024
yup. no more fears of that.
Beatty May 23, 2024
To me that summary reads as *non competent*.

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strugglinson May 23, 2024
This post was from April, over a month ago, not sure why it popped up again, I guess someone found it from way back and commented.
I did not do anything further with the PCP, except for request referral to geriatric psychiatry, which will be scheduled soon. ongoing anxiety and depression likely is part of the issue and I hope can be addressed

Everyone is on board now with continuing to stay in AL and he has been told that all close family members, friends as well as PCP say NO to going home....firmly.
thats it. I've realized there is literally nothing else I can do that will materially change things.
AL it is. For his new requests, complaints etc, I'll keep deflecting , and ignoring the ridiculous ones
so there has been good progress...
Isthisrealyreal May 23, 2024
Progress is always good. Well done!
MeDolly May 23, 2024
Don't start overthinking this again. It is clear he is not able to live on his own, what more do you need to know?

Nothing to clarify further, what exactly are you trying to accomplish? There are no further tests needed, he has a broken brain, it is as simple as that.

Your musings will not stop him from coming up with all his ideas, accept that. Tell him the truth and leave it at that.

It is almost like you are trying to come up with a magical cure and acceptance pill for him, it is NOT going to happen.

Sell the house, keep the proceeds for his ongoing care, stop trying to justify something that needs no further justification.

Go about the business of living your life.

DianaFS May 23, 2024
Many folks in AL have the same type of notes in their files. Many in AL are living with dementia. Many want to "Go home". Perhaps a white lie, such as, your home is being renovated and we'll go home when it's fixed. Look at old photo albums with him. Find activities to redirect him. Unless he has dementia that requires more care he can stay in AL. The AL facility should have a social worker and head of nursing who do checks on his mental capabilities. Stay strong, you can handle this!

lealonnie1 Apr 18, 2024
What you can assume from the doctors notes is, "dad needs 24 hour care in Assisted Living." Which is precisely what you tell HIM the doctor said every time he brings up another cockamamie reason to go back home. It's not YOU saying no, it's HER. And the subject is closed for further discussion dad.

He would, in reality, call you within 10 minutes of arriving home because he has no ability whatsoever to live independently and no memory to make promises. As his dementia progresses, the only "home" he's looking at going to is memory care.

BarbBrooklyn Apr 18, 2024
SS, part of this whole process (being the adult "child" suddenly in charge) involves the ability to say, with conviction "no mom/dad, I can't/won't do that".

And meaning it.

And being willing to walk away if/when you see that your parent's unreasonableness is going to cost you your life, health or livelihood.
strugglinson Apr 18, 2024
Thanks. Interestingly, my Dad's latest proposition/ proposal involved him leaving and that I "could" walk away and he would not call or bother me at all and I would not be involved, (which is what I had stated in the past if he tried to go home).
However thats him with dementia saying that now. I dont believe him or that it would happen that way. I think within 2 days he would want to call me and be begging for help.....
So I need to really do the former. "No you just cannot do that. I wont even drive you home. And if you try on your own and end up at home, I'll call APS that very day".
Fawnby Apr 18, 2024
Don’t ask for clarification. Her portal notes give you everything you need to keep him where he is. Neuropsychiatric testing would take you somewhere neither you nor dad needs to go. He might object or refuse, and it could be hours of - what? Questions he finds stupid and uncomfortable and that will tell you what you already know: That he needs 24/7 supervision.

strugglinson Apr 18, 2024
Looks like an admin changed the title of the post to be more appropriate.

To Alva's point, I was thinking along these lines this AM while driving to work. Maybe its best to NOT do anything for now. I have the doctors note and what is written. There may be no benefit, and possibly downsides, to trying to ask for a more definitive statement. My dad really cannot pull off going home on his own. He "says" he will hire all sorts of home help, but I dont see him being able to do that himself and if he calls agencies they will question his competence just speaking on the phone!. Most friends and relatives listen to his story and wishes, but dont take him seriously. There are one or two aunts who sympathize with him and have said they wish he could be home - but they are are not local and would have to come here for a few weeks if they were to help him pull anything off, - right now no actual mention of anyone doing that. so no direct challenge

As for status at the AL, he is not permitted to leave without an adult accompaniment, and if he called a taxi or something, they would question that. He has tried once to go for a walk to the local store, but they did not allow him to go. So eloping is not really a possibility for him. (hes not actually in locked MC, but they are pretty good with monitoring the doors for the most part.

As for the POA, its a DPOA and he signed it before going into the AL. I reviewed it with my attorney and the POA is fully in effect. My dad would have to go back to his own attorney to revoke it if he were to try that....

So Barb is right, at this time there is no benefit to getting him declared, except perhaps to answer him that "stop these ideas, you are incompetent to make decisions so that is that". However, maybe there is no need for me to have that to say right now. I can just stop his ideas and fantasies without needing a legal answer per se.

To Geaton's questions, I signed him in to the AL as POA. The only person who might try to get him out is this one aunt, but no evidence of her actually intervening or coming to town at this time.
AlvaDeer Apr 18, 2024
I think his constant chatter about this is needlessly worrying you, S. Just let him talk and let it go. He is recognized as being not competent to be on his own. Should you ever need to prove that it would be a simple 1-2-3 process.
Don't worry it. It's fine.
Geaton777 Apr 18, 2024
There's medical diagnosis of incompetence and there's the legal bar of incompetence/incapacity. Why don't you send it to the lawyer who wrote up the PoA docs and ask him/her? In my personal experience, the lawyer needed to interview my Aunt privately to assess this (and also to ensure she wasn't being coerced to make changes to her Will or PoA).

Is your Dad capable of moving himself out of AL without help from anyone? If no, then what is the concern? Does he still have friends he can call up to break him out? Who signed the intake paperwork, him or you/his PoA?

I think you can also share those medical notes and have a conversation with the facility admins, if you're worried.

JoAnn29 Apr 18, 2024
Memory poor does not mean incompetent. But it does say he needs 24 hr suppervision so cannot go home.

Is your POA immediate or needs Dad declared incompetent for the POA to be in effect? If immediate, read what the POA says. If it says you can sell his home, do it. The proceeds then go into an acct for Dads care and needs. Can't go home if there is no home. If you need a Dr or Drs to declare him incompetent, then see a Neurologist who will do the propper testing.

BarbBrooklyn Apr 18, 2024
Why do you need him assessed as "incompetent"?What difference would it make?
AlvaDeer Apr 18, 2024
I am thinking Strugglin thinks Dad might convince the facility just to let him go.
Or is questioning his own right to make decisions under the POA.
Most POAs that are part of will, or Springing POA as they are called, require the assessment of two MDs saying a patient is no longer able or competent in his or her own decisions.
Because Dad keeps trying to "get out", Strugglin is awake at night wondering is someone will challenge the placement.
Just my guess, tho. Strugglin will have to weigh in here.
AlvaDeer Apr 18, 2024
You needn't do a thing, here Strugglin.
Yes, the doctor has said that he has these deficits and needs 24/7 care.
And this is enough for current purposes and will be enough for his facility to care for him with your POA.

NOW, IF IF IF
Some well meaning person brings an attorney to your Dad's suite and tells him he will go to court to prove him competent (free of charge of course)
THEN THEN THEN
Someone may tell you that Dad is challenging his placement and going to court.
The court could provide an attorney.
You could need court ordered examination.
Dad would fail.
Dad would remain in care after the legally required neuro-psyc evaluation was done.

So what I am saying here is that there is no challenge here. You are his POA and he is in care. YOU will be contacted. He will not be allowed to leave.

Don't go walking into the woods of woe when you don't need to. I don't know when your witching hour is, but mine is always 4:30 a.m. to 6:30 a.m. when I can get up. That's the hours I think up every single dire thing that might happen to me or one I love.
Don't go there.
Don't look for trouble.
Simply respond to Dad that doctors agree it isn't safe for him to be on his own now.
That you've placed him so he can get care and you understand this loss and despair for him, but that there's really no answer but to continue to love and support one another.
Beatty May 23, 2024
"Don't go walking into the woods of woe when you don't need to."

GREAT advice!

I once read our brains can dwell on'problems' overnight yet the 'problem solving' part is in downtime mode. I read this out to my daughter & she had the biggest wide-eyed look of Wow! She then said she will now make a conscious decision to always self-talk *think about that in the morning - when ALL of the brain is awake & online*.

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