Per another thread on this forum(https://tinyurl.com/ewjk5kzt), my sister and I are trying to figure out what's best for our 88-yr old dad who has early signs of dementia.
The short story is that he is living alone in a trailer with no running water in a very remote west Texas town with no reliable services/care options. He is lucid 50% of the time. He isn't aware of how terrible his living conditions are, nor that he has dropped significant weight, is incontinent, and forgets to eat. My sister and I are deciding whether it's better to 1) move him into her home in Colorado against his wishes, but where we can keep an eye on him and readily get him some long term medical care, or 2) observe his desire to stay put and call APS to conduct an investigation and let the DHHS take the wheel.
Feedback on calling APS in my earlier thread has been mixed. I also talked to an attorney in the same town where dad lives who STRONGLY recommended against calling APS. But we don't know what other options we would have.
I'd love to hear about others' experiences with using APS, both good and bad, in caring for a loved one in cognitive decline. Particularly from those who have experience with the Texas system. What are the pros and cons of getting the gov't involved? Note that dad will likely feel mad/confused/angry/betrayed about the state coming to investigate him, as he's lived his entire life flying "under the radar", so to speak.
"In general" if APS does a wellness check they will speak with the senior ALONE. Not that they won't speak with you ALL later, but they will be sure to discuss with Dad alone. And if he comes up rational they will not/cannot transport him to an ER for a 5150 admit (72 hour hold) for evaluation.
Evaluation is the ONLY way you and Sis would have any power, and that being IF he fails and IF a court will grant you temporary guardianship.
Guardianship for an uncooperative elder is, as I mention last posts, something you will none of you thrive in, I am thinking.
If this attorney does NOT want APS in what DOES he/she want? Because if he is suggesting guardianship that is a 10,000 process he will stand to GAIN by and that would be your reason to look carefully at his advice.
The other reason I advise against guardianship other than an uncooperative, thankless and furious senior on your hands is that you cannot get out of it (a court won't let you unless you can prove you, yourself, are ill). So you are STUCK and you are responsible.
There is so much involved here. I am 82. Over my career as an RN I saw much of both APS and CPS. I think if anything they intervene too seldom. I would trust them over an attorney.
Down to final outcomes here, the fact this is ongoing now about a month? If Dad isn't cooperative and is at ALL rational I think no court will take his rights from him. The government is LOATHE to strip a citizen of his rights, and in TEXAS? Double that.
I don't know if you have contacts on the ground there where your Dad is concerned. Without running water many are going to say that this is unsafe. But in Texas, I wonder?
I will say one thing here. I think that you should not put a lot of money into an attorney on this. I think none of you, Sister, you or your Dad will have a good outcome no matter the amount of cash thrown at this. I think your father would rather be DEAD than have you make his decisions for him. And I don't know but that he isn't right in that.
I can't know how badly his living conditions have deteriorated. I can readily understand your wanting to make this better, or even OK for him; I just don't know if you CAN.
My heart goes out to you, but I think were this me I would be turning this over to APS and the Department of health, and giving my Dad my phone number, and any who could or would check on him. And then I am stepping away from what is CLEARLY A TRAGEDY. In times gone by Dad would have been institutionalized against his will for certain. Was that better. Quite honestly, for an old Texan? I am not certain.
I wish you more luck than you can imagine. Know you can SPEAK with APS anonymously. They are a call away. You can give them the basics and ask for their advice. You can tell them that for now you are too fearful of what may happen to you and your father should the wheels begin turning with no one at the steering mechanisms and cannot give you name at present for that reason.
Good luck. Keep updating us. You are in the hearts and minds of many here I do believe.
Per the lawyer: he has actually been very clear about the pros/cons of guardianship and in no way is he pushing us to hire him for that. Nor do either me or my sis want that. This is actually the SECOND west TX lawyer we have hired. The first overcharged us for setting up the POAs and then didn't follow up with the tasks we paid him to complete...until I physically went down there and more or less stood on him until he did. The second attorney I've been working with in dad's county knows the first and is building a case against him. Anyway, that's not mine to chase. But I do trust the new lawyer we are working with, as he comes through a personal recommendation.
My sister called APS anonymously, thanks for the suggestion. I haven't heard from her yet about what they said.
It is, as you say, a tragedy in the making. But it's hard when this is exactly how he wanted to live, up until recently anyway. I will post the latest on our original thread.
It's about all that needs to be said, other than I am highly suspect of an attorney who advises against APS and if one said "Oh, don't call in APS here" I would say
"Be-CAUSE??????"
I would definitely want to know his/her reasoning.
Co is 8 for medical coverage for elderly. Texas is 35. But here’s the thing, much of what is factored into elderly care your dad may not appreciate. He isn’t worried about how expensive it is. He already knows he isn’t paying. He isn’t concerned how many facilities there are. He is in the only one he is interested in. There are no great medical cures that are going to make him self sufficient. He is not going to thank you for interfering in his life no matter how you dress it up. Look up ADLS, IADLS. See which ones you can help him with from a distance and which ones you can hire help for him. An interesting enough care pack coming in on the regular could keep neighbors checking in. He would be eligible for Medicaid care in his home if staffing is available. It’s probably as plentiful as it is in the NH. Aging Care would know this. They would in turn call APS if they can’t handle. You could buy him a little more freedom this way.
He isn’t afraid of being alone. He isn’t looking for a daily bath. You seem to know that your dad is more about his own space no matter how humble.
Find a home health company if he has insurance. The nurse will see him once a week unless he has a wound and then they will come more often. An aide will come a couple of times a week to bath him if he will allow it. She will wash his sheets, does he have a washer? If not send more sheets, bed pads etc. shop at the thrift store. Less trouble for him unwrapping. Therapy can come as well. Go through these services first. A camera is good if he has Wi-Fi in the area. Probably not. You might be able to pay a neighbor a few bucks to look in on him and give you a call. Decide how much you and sis can contribute and make it count. Your father will see you as a blessing if you help him in this way rather than trying to disrupt his “utopia”. I would pay extra to not ever have to walk into a nursing home or assisted living. If you feel compelled to do that, just go volunteer at one for a few months while dad is trying life on his terms with a bit of help from his wonderful daughters. And you are wonderful to want to help him. God bless you.
To your questions about insurance, home health, washing machine, etc. We are in the process of confirming his Medicare coverage. He absolutely qualifies for Medicaid and is a Veteran with VA benefits, but we are actively researching all these to see what our options are. Friends said he claims to have cancelled his health insurance due to the expense (and when asked if he's concerned about what happens if he gets sick, he responds "well, I guess I'll die"). We'll know the full truth soon, as we sent Medicare a copy of the POA so that they will release his info to us.
There is only one home health company in the area and they have a terrible reputation. I have ordered meals on wheels for him, but TBD if they are actually delivering meals to him. They offer free meals in-house at their facility in town too, and he is aware of this, but refuses to go.
His trailer has no running water therefore no washing machine, nor does he have a way to take a regular shower so even if a home health aid were to come. This is problematic b/c he is incontinent and unaware of it. Before his mind started slipping, he took "baths" by filling gallon milk jugs with water from a small sink in a building adjacent to his trailer, warming them in the sun, then pouring the water over his head. He will not allow us to change his sheets for him when we visit. The situation is multi-layered, too much to describe in full, and very complicated. His is a unique situation, and what used to be mildly annoying or comical is now deeply concerning. Dad has flown under the radar for the past 40 years and nothing is obvious nor above board with this person. My sister and I have discovered that attempting to understand everything from how he ran his business practices as a self-employed car mechanic, to who owns the mailbox where he receives all his mail, is like deconstructing a Russian doll.
No, if this is mental illness they will not intervene. In the case of mental illness, unless person a threat to self and others there will be no court intervention or requirements for evaluation. In the USA it is OK to be mentally ill, and courts will seldom do anything about it. They will with dementia that is DIAGNOSED and the person being incompetent to safely care for himself/herself. But not for the mentally ill. I am amazed that APS did as much here for you as they did do. I was thinking of Berl's situation in bed this a.m. and wondering if hauling out the old trailer and driving in a new one wouldn't be a temporary solution here. This is a really difficult case.