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Hello, my father is the POA for my mom. I'm next in line should anything happen to him or if a miracle occurred and he decided to put me in the position instead.
She has dementia and won't cooperate with drs, dentists, lab draws or anything. Thankfully I was able to get her on to Kaiser's home health program where the doctor comes to her at home, but this doesn't extend to Dental Care, obviously. She's been this way since 2010.
Recently, she has been taking one bite of food, grimacing, and pushing the food away and holding her lower jaw as what she has left of her teeth are hurting her. (But she denies pain)Tylenol helps, which is how i KNOW she needs to see a dentist as soon as possible..This should have been taken care of years ago, but my father is not good at caretaking another person.
2 weeks ago, i sent him the name address phone number etc of a local dentist that provides sedation as my mom will not cooperate with a dentist due to her dementia. She won't know why she is there, and definitely will not sit long enough for the dentist to do any work to her mouth. I'm sure all of us can imagine the scenario😑 This is why sedation dentistry is needed.
My father has yet to take any action on this. My mom is suffering and I do not know what to do. I do not have the ability to pay for a dentist visit myself, nor do I have any of her insurance cards or Medicare cards or anything like that. Unfortunately, he made the very irresponsible decision to not get either of them any dental coverage when they totally can afford $22 a month. As it stands, she is only covered for an examine and xrays. Everything else will be $$$$$... Now I have two parents in their 80s that have absolutely no dental insurance or coverage and both of their teeth are going bad. He is the one without dementia so if he doesn't want to take care of his own teeth, that's his decision, but he holds power of attorney over my mom and I am not able to do anything for her at this point. It's extremely aggravating and worrying to me because he has other hobbies and things in his life that he is interested in doing and is so concerned about making sure those things get taken care.
I don't don't know what to do about this situation. Please dont suggest getting legal and taking him to court to forcefully remove power of attorney from him and placing it on myself as that is not an option for me and my family. The solution of getting legal and forcing people's hands is not always a viable option for everyone and every family. Her mouth should never have been allowed to get this way in the first place as her husband should have taken care of this for her YEARS ago but hasn't done it. For years I had been saying mom needs to see a dentist but it fell on deaf ears as so many other things such as maintenance of the house and other issues have. All I have tried to do throughout the years is to proactively recognize a current, near or future problem, provide solutions and then encourage those solutions to be taken to prevent future disasters from happening but I am never listened to. And now here I am again, in the middle of the situation that I tried to prevent years ago by taking the correct steps but was ignored and now it falls basically on me to try to resolve somehow. I am so sick of this crap😣Im in the end of the perimenopause transition and its kicking my butt so badly and i have so many other health problems that have been exasperated from the stress of this whole situation...sometimes i really just wish i would die in my sleep because this is all too much for me. I wont even get started on why the h3ll is it so hard to find a GOOD dr that can and will provide HRT!? Womens health is so badly overlooked I shouldnt be feeling like death is better than life when i am barely 48.

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"miracle occurred" that Dad hands the reins to you. LOL. Well not, but I get it.

"For years I had been saying.." insert WHATEVER. Yep. Get it.

"end of the perimenopause"
💩🔥😵‍💫😡👿
I get that too

Advise them.
They decide.
Consequences are theirs BUT in this case Dad decides (no dentist) & Mom suffers the consequences 😞

How would it go down if when you visit, when you SEE Mom wincing in pain trying to eat, you ask HER do you want to see a Dentist? If yes? Google a sedation Dentist, call & ask them what on Earth do I do here?? Surely a big clinic must have had this scenario before? I'm thinking inpatient treatment maybe.
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Reply to Beatty
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As POA for my late mom who did an immense amount of $$$ for dental work in her late 80’s and early 90’s, I’m concerned about this from a different perspective….. and it is that this is a way wAAAaayYy bigger issue than the seemingly 1 spot that seems to be the point source of her pain. That is is not just a straightforward root canal that an experienced general dentist can do, but that as she has gone years without regular dental care and probably does not brush her teeth fully each and every day that now gone onto gum damage that has to be dealt with and that bad tooth has pulp infection / damage which is driving her pain. Care for these = care from an endodontist.

If the dental office you spoke regarding their ability to do sedation dental has not actually done bitewings and individual tooth X-rays to provide a diagnosis as to what & where the issues are, I don’t think you can assume this dentist can do whats needed in your moms mouth.

My mom had really old dental bridges, like the ones you can take out! She got upper canine implants with work done on the surrounds on either side. All done in office with mild & moderate sedation. Took about couple of months to all be done and all settled in. My Mom was late 80’s and still very cognitive, living in her home, driving, had a boyfriend, traveled. Couple years later had gum work done on lower level with a different endo guy and this was mild sedation or just laughing gas. Pain wise the gum work was way worse and it required every day brushing & flossing & prescription mouth rinse that had to be spit out. But all things she could entirely do on her own. The aftercare stuff is really important so if your mom cannot follow through on general directions, like swish then spit out & do not swallow a rinse, the results are not going to be successful. For my mom sedation done it was a 2 part process with suppository done the night before and then whatever drugs the dental office used the day of. Procedures done in the early AM and mom had to get up to actually pee before they would let her leave. I think there was a cardiac clearance that was done too, like filled out by her internal medicine doctor.

Sedation dentistry - in my understanding - requires the patient to still be somewhat cognitive, like responsive to a tap on their cheek or a shoulder for mild sedation or can still respond to needle prick for moderate sedation. To have them be knocked out, that’s general anesthesia and is way serious stuff. Like done in a hospital setting but in the day surgery center. I cannot image a general dentist doing GA in their office as their liability insurance would be impossibly high.

As a suggestion, please clearly find out if this dentist can consider someone like your mom - who sounds like one who cannot follow through on basic asks - could be a patient and in addition to if they can do all the work needed.

If her dental health is seriously affecting other diseases she’s has, like she needs cardiac valve work done, Medicare will cover the dental work. It’s going to be a real ballet to coordinate the providers for her care but Medicare has recently revised its take on paying for dental services to cover things like this.
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Reply to igloo572
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I would make an appointment for her to be seen and treated. They will bill her and dad will have to pay the bill. Tell dad when the appointment is shortly before it comes up. I would plan on taking her yourself because you can't count on your dad to do it. I agree with another poster that he is likely having problems with making plans such as these. Those memory test don't pick up everything. My mom's test had her presenting much better that she really was. It was so annoying! When I knew she couldn't make the simplest of plans, yet the tests and diagnosis were way behind her actual decline.

Call today. It's cruel for your dad to let her suffer like this. If he's not a cruel person, then obviously he is having other issues.

Good luck.
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Igloocar Aug 6, 2024
In my experience with dentists--too much--they really don't want to bill you for an entire procedure; they want some payment upfront. You don't know if what your mother needs is a root canal--could be less or much more serious, as has been suggested--but she's probably going to need to go to a specialist--an endodontist if she needs an extraction. Many general dentists will not do extractions. The endodontist's office will not know your mother, so some upfront payment will almost certainly be required; sending the bill to your father is not going to cut it, in all likelihood. So I don't think plans that don't involve your father's active participation will work.

There is one way that perhaps your father would reconsider. Dental infections can sometimes lead to cardiovascular infections, which can be fatal. This happened to the father of someone I knew. If the dentist with whom you've communicated is willing to write a letter to your father concerning this point, perhaps your father would reconsider. He's probably just thinking your mother can live with the pain, but if he knew doing nothing might result in serious illness, perhaps this would make a difference to him.
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Your Mom probably needs a root canal. Which I would say, just pull the tooth. Your Mom could die if she becomes septic. Call APS and tell them Dad refuses to get Mom help. Maybe time for Mom to be placed if Dad cannot care for her appropriately.
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Reply to JoAnn29
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My uncle had no dementia whatsoever and refused to call an ambulance for my aunt, his wife of 55 years, when she was gasping for breath with emphysema. Instead, he made her wait till morning when he drove her to the ER himself to save the Medicare CO PAY for the ambulance ride!!!!! She died in the hospital less than a week later because her husband the dirt bag was too big a cheapskate to do the right thing by his wife and left her to suffer all night long.

If I were you, I'd get to the doctor and ask for LoEstrin 1/50 birth control pills which took me from a crazy wreck to a normal human during perimenopause in short order. Some bc pills are over the counter now even. Honestly, they saved my life.

Then, when you're in a better frame of mind, why cant you take mom YOURSELF to the sedation dentist and tell them to send dad the bill? Tell the old man you're not gonna sit by and watch mom suffer ANYMORE period. He can do the right thing or you will. You can have moms bad teeth pulled out, and if you go to a place like Comfort Dental, the bill won't be outrageous. Some of their offices DO have sedation dentistry. When my mother had advanced dementia, the only dental work I had done for her was extractions. Anything else was too involved for her condition and would require multiple follow up appointments. Devices were no good, she wouldn't wear them.

Wishing you the best of luck with a difficult situation.
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Reply to lealonnie1
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I saw your added info of dad passing a cognitive assessment. I’m not sure I think it was accurate, if it was dad is incredibly cruel, or at the least insensitive and uncaring. I’d be heavily considering calling APS and reporting the situation. And please guard your own health, you matter too
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Reply to Daughterof1930
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waytomisery Aug 4, 2024
I agree . People with vascular dementia can still pass those mini tests that are geared for memory issues from Alzheimer’s . Executive fuction is tested on the longer tests .
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You could also try calling your parent’s County Area of Aging . Look on the County website under Dept of Aging . My mother had undiagnosed dementia as she refused any cognitive testing . The Area of Aging sent a social worker to my mother’s house and deemed she was not safe living alone at home . It may be worth a try . Maybe they can talk some sense into Dad about the dentist . They seem to be more helpful than APS in some areas .

The social worker would tell my mother hypothetical situations and ask my mother what she would do if ……happened. The social worker said my mother could not “ come up with a plan “ . Nor could my mother execute a plan ( for emergencies as well as other scenarios ) . But mother’s memory was not bad at all . Her executive function was not working due to vascular dementia ( diagnosed later ).
This could be part of why Dad doesn’t address your mother’s dental issues . It would involve calling a dentist and making an appt etc . too overwhelming .
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Reply to waytomisery
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What concerns me more than your moms teeth is the fact that you wish you would die in your sleep at the young age of 48. Please call 988(the suicide hotline)if you need to.
You obviously are beyond stressed(and a bit high strung)over I'm guessing not only the issue of your moms teeth but a whole lot more as well.
You need to take several steps back for your own mental health's sake and let your dad do what he feels best for your mom. You are trying to control a situation that you'll never be able to control, and it seems to be driving you a bit crazy, and the only person that's being negatively affected is you.
You do realize that you can only bring a horse to water but you can't make it drink right?
So for now, why don't you just make sure that your mom is getting pureed foods so she doesn't have to chew, and will get the nutrition she needs.
I'm sorry that you are so overwhelmed with this situation and I hope and pray that you will be able take better care of yourself before it's you that will need to be hospitalized.
And if things get too difficult for you perhaps a call to APS may be what is needed as they will come out and do an assessment of the situation and make recommendations from there.
Like I said at the beginning of this, I am WAY more worried about you than either of your parents.
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PureExistence1 Aug 4, 2024
Hello and thanks very kindly for your reply. Most of what im experiencing is caused by being in perimenopause. Cant say i was managing things well before, but this hormonal hell has added a horrendous layer to my difficulties. I guarantee im not going to do anything drastic, i am just very miserable at this point in life and finding the medical help i need to hopefully be ok is much harder than it should be for any woman.
I unfortunately probably need to allow things to take their course with my parents as i am really not in the physical or mental condition to do much more at this point. I WANT to help my mom, but i have too much going on with myself, namely the GSM/VA caused by estrogen cessation.
I am not happy at all with the way this phase of life is manifesting.
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Please read your PoA document to see what conditions need to be in place in order for you, the "backup PoA" to have activated authority. I'm going to guess one of the criteria is sufficient cognitive impairment by the primary agent (your Father).

If this is the case, then you first will need to get the HIPAA Medical Representative form from his medical clinic. You will write in your name and date and have him sign it. This gives his doctors the legal ability to discuss his private medical information with you without his knowledge, permission or presence.

You should also present your PoA paperwork to his clinic so they can copy it and keep it on file. Do this in advance, you don't want to do it in a rush in front of your Father or in an emergency.

Then you go into his medical portal and inform the staff that you'll be bringing him in for his Medicare free "annual wellness" exam but that the real reason is to do cognitive and memory testing (and you can give them more details as to why this is necessary). What you are in need of is a letter of diagnosis on the clinic letterhead signed by his doctor stating his level of cognitive/memory impairment. You print this out and keep it with your PoA paperwork.

Then you will need to somehow get him in for this appointment. The staff will be happy to accommodate your secret mission (I just did this with my Mom, also did it with my MIL for whom I was not a PoA at all).

Once you have this you should be able to act on your Mom's behalf.

Who is your Dad's PoA? Is it your Mom? I sure hope not.

It will be tiresome and a struggle for a while but once you have the PoA authority activated, you will be able to make headway.

FYI dental insurance won't pay for much the first year you purchase it. Even though I've had Delta Dental for decades, when I switched to BCBS plan, I needed to provide proof that I had coverage the prior year.
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PureExistence1 Aug 4, 2024
Thanks kindly for taking the time and putting in the effort to write your reply. Yes, his mental health is a stipulation and he recently passed 2 cognitive assessments so im thinking i dont stand a chance going forward in this manner😞
I am looking to add delta dental to both their coverages but have to wait til oct22.
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Have you tried calling APS ?
I also read your profile , sounds like Dad has some dementia going on as well.
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PureExistence1 Aug 4, 2024
I have highly highly considered doing so. I should look onto it again and see what conclusion i arrive at. Thanks kindly for your reply.
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