Of the changes we face in life, assuming complete legal responsibility for an elderly parent is one of the most dramatic. coming to terms with the fact that an older parent is no longer able to care for him/herself can be extremely difficult.
Adult children are often unprepared when a parent is more forgetful, makes serious mistakes, or begins to behave abnormally. The children must face these unforeseen challenges, struggling to find reasons for their parent’s behavior.
Some common experiences are:
- Dad becomes “disoriented” frequently and can’t remember events that took place relatively recently (although he clearly remembers things that happened years ago).
- Mom misses appointments and can’t account for periods of time.
- Dad can’t describe the order in which his medications should be taken.
- Mom’s bills don’t get paid—collection notices are arriving at her home.
Adult children often don’t witness these situations directly, as the parent works hard to hide their failures. Their failures might also be obscured by a scarcity of direct contact with the declining parent.
While it is possible that any of these symptoms are temporary, repeated problems (or one serious episode) may mark the beginning of serious neurological changes, such as dementia.
as an attorney, I’m often contacted by adult children who are facing these changes in their parents, and want to “sign papers” to assume responsibility for Mom or dad. They’ve usually reached a point where the stress of working full–time, supporting a family, and trying to keep an eye on an older parent is almost unbearable.
I also frequently encounter conflicts between the adult children, who have differing views about the extent of their parent’s disabilities, and begin accusing one another of neglect.
Concerns about an older parent’s new spouse or “companion” can also create a tremendous amount of anxiety for the adult children.
The most important legal issue during a parent’s decline is determining the extent of a parent’s incompetence. This is so because, while unusual behavior and “mistakes” certainly indicate changes in the parent’s mental state, they may not be significant enough to warrant a diagnosis of incompetence. and, until a parent has been determined incompetent, he or she will continue to make his or her own decisions.
The issue facing the children, then, is whether or not they will force the parent to relinquish control, so they “seize the reins.”
Depending on the complexity of the situation, one of my first recommendations in this situation is that the family hires a Geriatric care Manager to evaluate the parent(s). Geriatric care Managers, usually social workers or nurses, are trained to address problems the family has not considered, and offer a myriad of suggestions. Most importantly, they “centralize” all of the dynamics involved. a qualified care Manager will review the parent’s medical status (whether or not he or she has a regular physician, for instance), gather information about the medications being taken (and the manner by which they are being dispensed), determine whether anything in the parent’s living environment is problematic (from poor transportation to the doctor to an unclean or unsafe home) and question the parent about any additional concerns (such as a desire to not burden their children or an unwillingness to spend money on a caregiver). They will also point out unhealthy patterns that the children have come to accept as “normal.”
In San antonio, there are a number of qualified Geriatric care Managers. I frequently refer families to Russel Gainer with SeniorBridge. Russell describes the process in this way:
“The process is like a dance, in that so many factors involved continually change. The adult children want, and need, to be involved in their parents’ lives, but have to understand the parent’s concerns. The objective is to strengthen and support, not control, Mom or Dad."
The family should, therefore:
- When possible, contact all immediate family members and notify them of the situation. This is especially true if the parent will need an appointed guardian, as all the adult children must be notified.
- Hire a Geriatric care Manager to review the situation. A qualified care Manager will also call a family meeting, if necessary, and lead the meeting if the circumstances necessitate.
- Have Mom or dad seen by a Geriatrician as soon as possible.
Finally, with more information and better support, the children (and hopefully Mom or dad) are in a better position to discuss the legal options associated with decreased competency. and often, the parent can remain “in the saddle” for a little while longer.
