Hoping he will get the care he needs. Any advice?
My BIL had a sharp mental decline back in June. He lives alone two hours from any relatives so no one can check on him easily. He refuses to see any issue. He does not have a GP only a few specialists he goes to. My husband tried to talk to one of those doctors about the issues his brother as having but was basically told not is specialty and we should take him to the ER and get him checked out. And of course BIL is not willing to do that.
I told my husband we would have to wait for an event that required him to go to the ER and that happened on Friday. He had fallen and injured his hand last week but told everyone it wasn't bad. My husband went to pick him up for the holiday and discovered it was really bad and took him to the ER. He was able to speak with a nurse and told her what else was going on with his brother and she said she'd get the ball rolling to evaluate him. BIL is angry that he is still there, but we are hoping he will get the help he needs or at least we get a direction on what to do. No one knows BIL's financial situation and we have yet to find the POA he said he did last year. So this could really get messy. The added distance does not help as well as the relatives trying to help are all in their 70s.
The sad part is another relative spoke with the attending doctor and he basically told her his mental issues were not his problem and that should be dealt with on as out patient service. I am appalled that when a relative does reach out to the medical community they get blown off rather than given resources to contact to find help.
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wanderingaster..we did ask for cognitive testing and apparently he passed. Not sure how that is possible. He thinks an imaginary person is living with him, he often confuses day and nighttime, has messed up his check book and pays bills wrong, he imagines events that did not happen. The latest was he insisted he was at a restaurant 3 hours away singing the night before and he is mad at his niece for bringing friends to that restaurant that he did not like. He was sitting in a hospital bed at the time he was telling my husband this. He got mad when my husband insisted he was still in the hospital the night before. Telling him he needs help has gotten nowhere. No one lives nearby so it isn't as if anyone can visit and work on him to convince him to do anything. He doesn't know his neighbors and even if he did this is not something they should be responsible for. At 87 all his friends are dead or moved away. That is our biggest concern that he is so far away all by himself. He is resistive to moving closer so we can keep an eye on him. At his age, there is just no telling him anything.
The next step will be for niece and husband to go down and have a serious talk with him about the next step. Can't force him to do anything. He is free to make his own decisions even bad one.
Things will likely be chaotic, I'm sorry, and you and your family can't deal with everything at once if your BIL is not cooperative. And until there is a POA in hand (for someone who is willing to be POA!) and until he is ruled incompetent to manage his own affairs, no one can make him do anything, you're right.
Perhaps take a step back and reassess: who does your BIL trust? Who will he allow to help him/whose questions will he answer? Maybe have that person approach him as a friend/confidante, and have him show them where the POA is. Have them put it somewhere safe or have them take pictures of it with their phone if he won't let them take it. If he can't find it, it might not exist, but then have that Trusted Person suggest signing another one. Facilitate this as much as possible: whatever your state asks to sign a POA, help him do it: take him to a lawyer, find the form and print it out, gather witnesses for a notary, etc. Get that paperwork squared away. Make sure it is a medical POA, too, not just a financial one!
At the same time (or first), Trusted Person can keep suggesting getting evaluated (again, helping by driving there, making appointment, going with him, etc.) If this is a no-go, then there's not much they can do except try to get him to call them when something happens. Talk to neighbors/friends who see BIL regularly, and ask THEM to call when something happens.
Then, the next time he needs to go to the ER, again engage with the ER staff about cognitive testing. Explain the decline, the bad decisions. I'm sorry that they blew you all off before, that was wrong, but the next time it might be someone else and they might NOT blow you off. This was the case with my own dad, it took a few ER visits and a few different dementia tests to establish that the problems he was coming in for were related to cognitive decline. Once they have a failed cognitive test and is ruled unable to live unsupervised, then that opens the option of the POA giving permission for the ER to place him in a care home. That'll be a whole new question and set of advice, I'm sure.
Good luck. Remember to breathe.
poa if one was done the person given poa would have been sent info and would have had to sign firms-if no one did it may be sensible to suggest one wasn’t done
he needs at least home help and to come clear about his finances otherwise you can’t help him
Legal advice might be the best option ?
Call APS, explain you cannot take long distance responsibility and he is a "senior at great risk due to refusal to see MD and appoint POA". Request guardianship of the state. They will visit him and discuss and will take action if required.
Otherwise any non responsiveness to call check ins will likely go to "wellness check" by local authorities, police or sheriff.
At some point in life, whether we die in our home or in a nursing home a few months added to our lives that we never wished for, is of little import over all.
pretty much what I was thinking. You have already said it, so I won't bother.
Unless you can prove you are his PoA or legal guardian, you do not have power to make decisions for him or manage his affairs. This is not being "blown off", this is how the law works.
Also, dementia is not diagnosed in the ER. Yes, it can be very frustrating.
"...we have yet to find the POA he said he did last year." Do you mean the paperwork? Or an actual person?
If your BIL doesn't actually have a PoA and he seems cognitive enough to send back home, this is probably what will happen. No one should take him home because he seems to be an "unsafe discharge".
Hopefully the social worker may be able to get him transitioned directly into a facility, but this would be under court-assigned legal guardianship - in which case they will take over all of his management, including financial.
When mom had another episode of vertigo one time and I took her to the ER, I took the doctor aside and literally begged him to admit her for further testing, that I was certain she had dementia. He agreed, she was tested, failed the MoCA with an 18 and we were finally making progress as far as a diagnosis went.
I wish you good luck and Godspeed with a difficult situation.
And I suppose the real question is did he really have POA papers drawn up or did he just say he did?
I suspect that if you can't find paperwork the hospital will have to have a court appoint a Guardian until they can be located. Your husband may chose to be or not to be the Guardian, it is up to him how much time he wants to invest in this.