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Mom wrote a financial POA years ago naming my Dad, followed by me, as the Agent. Dad died in 2021. I am working to activate the POA (I got legal advice on how to do it).


Mom’s PCP told her she had dementia and needed to be in nursing care, then administered the MMSE (she scored 26) and referred mom to a psychiatrist for further evaluation. I made an appointment with the psychiatrist (without mom’s knowledge) and asked them to send me the paperwork, which requires her signature in several places. I am sure she would not agree to this evaluation if she knew what it was for (the MMSE was administered at my request as part of her Medicare wellness appointment).


She has resisted help with her finances even though she complains about not understanding them and being frustrated by them (she no longer knows how to pay them online and has gone back to writing checks, double-pays and misses payments, can’t balance the checkbook, etc.). I am co-owner of her checking account, but I don’t receive her bills and don’t have a checkbook. I only track her expenditures at this point. She’s now in the process of selling her house (after moving to an independent living community in May); she doesn’t understand the terms of the contract document (asked who allowed the buyer to get inspections), can’t remember details from moment to moment (asked the realtor the list price over and over in one conversation), and frequently states she wants to take the house off the market and move back home (but is unable to make the decision to sign the cancelation document).


She also has other difficulties, but these are the ones pertinent to her financial situation. To me, and to many others in her environment (the retirement facility director, all 5 of my siblings, the realtor, her doctor), she clearly has dementia and cannot care for herself adequately. She insists she is independent. So is there a way to get her to the doctor who will make that determination for legal purposes without her signatures? It is a catch-22 to require that, although I do understand the reasoning for it in general.

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Oh oh.
Quite honestly you have problems here.
You need more than a Forum. You need elder law attorney on speed dial.

PROBLEM ONE
You have here a mother you wish declared incompetent so you can act as her POA
BUT
Your mother is currently selling a home (the contractural details of which you say she cannot understand.0
You, as POA, allowing an incompetent mom to sell a home? If anything goes wrong with that home sale deal during a time you are going for incompetency? What a mess that would be. Either Mom is competent or not, and if not she CANNOT do a home sale.

PROBLEM TWO
You seem to indicate that testing has shown that your mother is competent in her own affairs (?is that correct?) or TOO competent for the MD to write a letter of "incompetency for executive function" to the court.

PROBLEM THREE
In fact your mother may not be suffering DEMENTIA but may be MENTALLY ILL?
If I am not mistaken and from what you have written to us.

PROBLEM FOUR
You have melded yours and your mothers money in one account. People always think this is a good idea. It almost never is. And in some cases can be disastrous in any lawsuit or action, before the IRS, in Social Security management and etc.

Usually to be appoint POA for financial the person must be competent to appoint you.
Otherwise it has to go to conservatorship or guardianship.

What I see here is an absolute stew. You mention you are working with an attorney. Which is good because all of this is further complicated with you being a co-owner on an account. You cannot sign as POA then, but as co-owner and THAT CAN BE A TERRIBLE MESS. If home sells and mom puts that money in her account it is co-mingled with your money.
I really wish you good luck in this but I really think you need an attorney, and a good one, on speed dial through this, because it is complicated on many levels.
Sure hope you will update us.
And wish you a whole TON of good luck.

All I can say here is that I would have an attorney walking me through this step by step by step. The court well may not give a guardianship for someone mentally ill (they have a nasty way of parroting "it isn't illegal to be mentally ill") It leaves those with mental illness and their families helpless in this country.
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Thank you, AlvaDeer. I have always appreciated your thoughtful perspective in this forum. I agree that it’s a mess, which is why I am curious about others’ experiences in similar situations (minus the complication of the home sale, which really isn’t relevant to my question).
Some clarifications:
Your problem 4: I may have mis-spoke when I said we were co-owners of the checking account. My money is NOT blended with Mom’s. I am only a signer on her account.
Problem 1: I am not yet POA, as I need a letter from a doctor stating she is incapacitated. Mom’s POA document was written when she was more than competent but it’s not in effect yet so I believe she must be treated as though she is competent. On the home sale, I have been involved in most discussions with the realtor, and am reviewing and helping explain all of the documents she signs, but letting final decisions be hers. The lawyer I have consulted said that in the absence of a medical professional’s opinion on her competency, that was acceptable.
Problem 2: As I understand it, the MMSE is not always 100% accurate, and highly educated people may ‘pass’ it and still have dementia. Mom fits this description. I’ve seen psychiatric evaluation recommended in this forum for determining competency, and that is the next step.
Problem 3: what did I write that makes you say she might be mentally ill?

Looking for advice on getting a resistant person to sign papers agreeing to an evaluation…
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AlvaDeer Jun 14, 2024
I still think that if you are having mom evaluated in all these ways, but still involving her in the sale of her home, or she is selling it, that any problems later (all the non-disclosure problems that can come up) could lead them to say "This woman sold us a house and was in no way competent to do so, and her daughter was having her evaluated by psychiatrists and MDs for suspected dementia at the time". They would have a good case.

I am relieved about the account. Great news. No melded funds and finances.

The reason I thought there was perhaps a chance of mental illness and not dementia is that Mom seems to be passing evaluations by MD. That's rare. You can either draw the clock face and set it, spell Forum backwards, identify the rhino and the hippo and the tiger, or you can't. Confabulation can happen, but not so much with testing. Then you added you are having her evaluated by a psychiatrist. That usually means YOU are thinking there are some signs? Am I wrong there?

As to getting a resistant person to sign anything? I don't think there's a way. You will either get a neuro-psyc eval that says she is no longer competent in her own decisions or not.
I often say here on Forum that being a POA or Trustee or Guardian for someone who is not cooperative is a nightmare. A constant nightmare every single day. I did it for the kindest, most organized, most kind and cooperative man in the world and it was STILL almightily tough stuff.

I sure do wish you the best and hope you'll update us on this journey.
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Can you ask the PCP to write a letter of incapacity that will meet the needs of the POA document to get it activated? (and review the letter with attorney to make sure it fits the need?)
If PCP says she will not/ cannot, then you may well be a bit stuck as you and Alva allude to. Then consult the attorney again about what you can do.

Unless, you can get Mom to agree and sign the papers voluntarily to see the psychiatrist? As you mention, she likely will refuse, but is there a slim chance she might say yes? Never know until you try?
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Summersca Jun 15, 2024
The PCP was unwilling to write said letter, though she did make the psychiatric referral. There are definite signs of dementia: speech problems, short-term memory loss, decision-making skills very impaired, emotional outbursts; she’s very unlike the woman she was 3 years ago. She recognizes the speech and memory problems, and they bother her a lot.
I think the best option is to express it to her as an opportunity to learn if treatments are available for her memory and speech issues, and to cross my fingers!
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My LO's POA, which I held, needed certification by letter before it could become active. Diagnosis of dementia was by PCP a year and a half before it was necessary for the POA to be activated. All that was necessary was to inform the PCP that LO was no longer able to act on own behalf, so please write the letter certifying that the POA was activated. PCP had previously for two years seen LO every six months for care and observation, and he knew LO's cognitive state. Letter of certification was done by doctor that same day. LO had to sign nothing at the time of activation but of course had previously signed the document naming me POA and had it notarized and witnessed years before in a lawyer's office.
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How did she score 26 on the MMSE and a PCP diagnoses dementia??
She needs a neurologist to check her out. A CT Scan to verify brain changes.

She's frazzled and possibly depressed. Widows usually are, trust me. I couldn't tie my own shoe for 2 years. It's alot of pressure after loosing half her life. So she is struggling with bills. Selling a house is overwhelming with pressure and details, especially one you shared with your spouse many years.

What about other dementia symptoms? Such as neglecting her appearance? Poor hygiene? Wandering? An MMSE is like a pop quiz, it's only part of a diagnosis, not the accuracy of a CT Scan.
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I think the title of this post changed since I initially answered ?

I think that legally, consent to treatment rules can vary state by state . In my state , I found out that the patient must consent, except in certain narrow circumstances . You may want to find out for your state .
you mentioned “I think the best option is to express it to her as an opportunity to learn if treatments are available for her memory and speech issues, and to cross my fingers!”. Yes , this may be a good angle to go with to get her to agree to do it voluntarily . Why not give that approach a try?
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