I'm looking for some advice by people who have faced similar challenges. My father who is in his mid-70s has cognitive impairment.
He recently had a serious accident resulting in a third degree burn. He was burning trash outside and accidentally lit his clothes on fire. For a brief period the fire was burning out of control. He was within 50 feet or so of a very large propane tank. Fortunately, he was able to control the fire before any huge disaster occurred. He had to have a skin graft and has been in recovery at a skilled nursing facility following a couple of weeks in the hospital.
Three years ago, he had a major stroke which left him with minor memory problems and some speech difficulties. After his surgery about 3 or so weeks ago, I noticed his memory and speech difficulties worsened significantly. He also had a few instances of paranoia, extreme anxiety, and recently, talking to himself.
The skilled nursing facility conducted some tests and based on the results, he has moderate cognitive impairment. Based on their assessment, he should not return to living on his own. He needs nearby 24-hour care, like the level of care available at an assisted living facility. I think some of his memory and problem solving issues may have been caused by pain medicines. I've seen some improvement, but his memory, speech and problem solving abilities are still quite impaired. He has multiple health issues, including diabetes for which he requires insulin.
He is expected to be released from the skilled nursing facility in about 2 weeks. He claims he can take care of himself at home and he is fine to drive. The skilled nursing facility says, and I agree, that he cannot. And, he lives about 2 hours away from me, his closest relative, and his home is filthy and he is living in the house without a certificate of occupancy. It is unfinished with no railings inside. The house is loaded with paper and garbage. There are numerous safety issues for a person with no cognitive impairment. His car isn't much better.
I know that I can take the path to have him declared legally incompetent, but am concerned that even if I do, I can't force him to go to an assisted living facility. I'm stuck and I have a family of my own with a very busy family and work schedule.
I don't have lots of time to run him around to various physicians who are going to confirm what the skilled nursing facility has already confirmed through testing and observation. And, I'm pretty sure he's just stonewalling. Other physicians in the past have said he shouldn't be living on his own. If the fire, which could have killed him or caused him to have to have his leg amputated, isn't enough of a warning, I don't know what is.
He can afford to live in an assisted living facility for about 10 years. Given his health conditions, it's unlikely he'll live that long and if he does, we can worry about it in 5 years or so.
Where do I go from here?
Filing for guardianship is another route but involves filing in court, it is expensive, and I have a family member who has to go that route and it took her eight months to get a determination from the courts. This way is easier and faster.
That should be done ASAP.
A visiting home health nurse had reported them to an elder abuse hotline on a Fri which really got the ball rolling. On Mon, a social worker from the state called me so I filled her in on everything that has been happening. Note: I called the social worker from home health many times previously and nothing was done. My advise is to call the elder abuse hotline ASAP.
I consulted with an elder law attorney and she said that the medical POA's that my parents have states that I needed a letter from two Dr's stating that due to their impaired capacity they are unable to make healthcare decisions and that they are a danger to themselves and that the Dr invoked POA to me.
Within 1 week of the social worker being notified, my dad was back in the hospital. 3 days later, my mom fell and cut her head open resulting in her being in the same hospital at the same time.
My mom finally realized that they can not live independantly. Her Dr that was treating her in the hospital told her she needed rehab and needed to live in a NH afterwards. She was transferred there 2 days ago from the hospital. Meanwhile, dad is still in the hospital now with an infection due to loose hardware with a previous knee replacement. My dad will go to the NH to be with my mom when he is released here.
What I have learned from this experience is that if a parent doesn't want to go to a facility you can't make them unless you have a DPOA and have the required number of Dr's stating they are incompetent. Per my attorney's advise, check with the facility to see if they will take the DPOA as some of them may require guardianship however I did not find that to be the case with 3 that I called.
If they don't have a DPOA then you will need to file for guardianship. Luckly, I did not have to go this route. The state SW told me that the court will assign an attorney to my parents if they can't get one themselves. If they can not physically go to court the attorney will represent them. They judge will hear the evidence then assign gardianship. If you don't want to be their guardian, the court will assign one from the state however, they will place the parent any where they choose.
Best of luck to you. I understand what you are going thru.
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If I had not done this, my dad would have gone home, drove and spent all his money on whatever as he was thinking he was on top of the world!!! Very hard!
Can you work with Adult Protective Services? The nursing home can say they cannot release him to his home because it is unsafe.
I have no experience with guardianship. But, it sounds like it might be necessary. Talk to a lawyer, I do know it is hard to get someone declared incompetent.
Try to be matter of fact and as unemotional as possible. There is no point in trying to appeal to him emotionally. My father didn't even care when I asked him if he would feel bad if he hurt someone's child (or his own grandchildren) because of his bad driving. He basically said it was his God given right to drive. That's when I knew I would stop at nothing to stop him from driving ever again!
Best wishes. It's not easy but you will get through it.