I'm the HC and Durable POA for a friend with no living relatives. Her dementia (diagnosed at least 3 years ago) has progressed to the point that her violent outbursts make it unsafe for her to live alone in her home. Attempts at getting her live-in help have failed (she's mean, belligerent and doesn't admit she has problems), and she still has access to a car! It's just a matter of time before she harms herself or others. Just last week, we had to call the Sheriff to get EMS to pick her up because she was having one of her tantrums against the caregiver and no one could calm her down. She spent 5 days at the behavioral unit at our local hospital, with everyone in agreement (social workers at the hospital, the head of our county DMH who knows the history, DSS, etc.) that this would be the perfect opportunity to finally place her somewhere. But the young doctor assigned for the final assessment, didn't agree, because she has an uncanny ability to become "perfect" for those she knows will benefit her most. So he released her! Was about to send her home in a cab last Friday, to no one to even check on her, because I was out of town and so was her other caregiver (unexpected funeral). I had to beg them to keep her until I got back and could make sure she was safe.
I picked her up on Monday, and she's had a series of violent, destructive outbursts since, and even though I have a HC POA that gives me the right to choose where she lives, I'm being told that I can't exercise it (because she won't go willingly for sure), without a doctor's letter stating her incompetence to make such decisions. Her doctor wrote us a note years ago indicating she did not possess the capacity to deal with her financial and legal affairs, but now even with pages and pages of photographs and written documentation of the various meltdowns and their aftermath, including an accidentally obtained video when she attacked her security monitor and set it to record on baby monitor mode, showing her as literally a wild animal, beating on the TV with her fists and head, stomping on the cable box, shattering a TV remote, and just in general going wild, the doctor is telling me she won't write the letter that's required for me to have a facility do an evaluation and take her in involuntarily if they agree. I've honestly never experienced such CYA in my life, and am so disgusted with the medical industry! It's no wonder so many people are killed by the mentally ill. My friend's problems may be exacerbated by her dementia, but it's my opinion, she's been mentally ill (and an alcoholic) for years prior, and now we have a triple whammy.
So the advice of "if you have a valid HC POA" is BS. Even that can't get you the help you need to protect them from themselves.
Any ideas? I'm in SC, by the way.
I have guardianship of my father, the law is clear had he had a valid durable POA correctly done he did not need a guardian.
U can move her money, decide where she lives a of that without going to court. U can also research durable POA and guardianship in SC
We spent the better part of the day together, where I went and got a new TV to replace the last one she shattered (it didn't last a week), and tried to coax one of her cable boxes back to life (unsuccessfully). She was, of course, her usually self, waffling between, "I'm so lucky to have you," and "Why won't God take me and end my suffering?" (Did I mention she's a drama queen too?)
So, this morning, I got a phone call from her and she was literally wailing and crying into the phone that "Everything in the house is messed up, and I don't want to live!" or some version of that. When I tried to find out what had gotten her so upset, she couldn't tell me. I asked her if she agreed she needed to see a doctor, and she said "Maybe," so I let her get about 11 minutes of the wailing off her chest and called 911 and sent the EMS folks to get her again. This time, having been educated a bit more by my friend who used to work for the Dept. of Mental Health, I had them take her to a different hospital, where they still have a psychiatrist on staff.
About an hour after she arrived, I received a call that they were discharging her. She had turned into "Perfect Barbara" and demonstrated none of the craziness I witnessed on the phone. I went over to her house and documented what she had destroyed, and found several notes reminding her to call her lawyer and remove me as her POA -- no doubt triggered by the dentist asking me the questions "she's perfectly capable of handling herself." I did tell the counselor at the hospital that I would not come to pick her up, and did not support their sending her home again, and that I wanted it documented that I felt this was an "unsafe discharge." (thanks to Alvadeer for that advice) Those words seemed to set them back a bit, but they still argued that the only deficiency they were witnessing was dementia, not a mental illness. I later learned she was quite combative, and would not allow a blood test (which tells me she had been drinking this morning too). They kept her all afternoon, and the social worker called and we talked for an hour, but still the only thing they would do was arrange medical transport to take her home because I still would not agree to go get her. So, barring any ability to get someone else to witness her "in the act" of her mental breakdowns and violent tantrums, we seem to still be at an impasse.
calling a lawyer does wonders.
Start with the car! Disconnect the battery cables so she can't start the car. You're right, she is not only a danger to herself, but she is a danger to anyone she may encounter on the road.
If the state of her home is less than satisfactory, maybe try calling Adult Protective services.
You can only eat an elephant one bite at a time.
Do what you can on your own first. Seek help from others for the tough stuff.
Senior Legal Services was a great help to me.
God bless you for caring for your friend!!
You're an angel!
This time ask for social services, say you have POA.. ask social services with doctor there is she a fall risk? Do you think it is safe for her to live alone? can you evaluate her the 30 day trial in the nursing care, until we can figure out the next step... Bring all her medications so they can see them, and see if she is taking the correct amount at the right time. This was huge for my neighbor, His mom took too much at one time. Got confused so she took more. Probably should have paid the board n care the extra $300.00 a month to regulate the meds...
If you want local SC information, I would contact the Clerk of the Circuit Court’s office. Another option would be to contact a local geriatric care manager - search geriatric care manager on the web. When I was a geriatric care manager I was a member of the National Assoc of Geriatric Care Manager. Since my retirement they have changed the name of the organization, but a search of the assoc above will get you the info.
Hope this is helpful
My LO with Dementia, and underlying mental issues was somewhat like your friend, and I jumped through so many hoops to find out what paperwork was required to deem them incompetent and have lack of capacity to make their own healthcare decisions. Prescriptions etc. My LO’s neurologist wouldn’t complete the paperwork, and he informed me that it’s done by the psychiatrist.
The law is written to protect the individuals rights, and for good reason but sometimes it’s just crazy the steps that need to be taken to protect the person from themselves.
Does your friend see a psychiatrist ?
In the end it was a mental health court counselor who led me to the correct process. Even the psychiatrist never mentioned it to me but when I asked him to complete paperwork he looked at me and said yes this is what needs to be done!! Go figure 🤔
Call dss and make a report about her being a vulnerable adult who is unable to care for herself, if they do not get her the help she needs call the state dss number to report them for failing to do their duties.
The hospital by law have to have a safe discharge plan before releasing someone. I will come back after I get my dad up for the day and post the numbers to call to report both places.
I am in SC also, retired social worker from the dss system in NC and from personal knowledge and experience, sometimes dss will not act if they are not forced
Sorry you are in this position.
If she is placed under a guardian ship, she virtually will have no rights, As much as you may care, for your friend, a court appointed guardian should protect you from accusations of elder abuse, and you would be essential relieved. I'm assuming there are no family members involved?
It isn't that you don't want to help your friend, or don't care what becomes of her. It is that you are powerless to intervene. So give the task to people who aren't.
You are her Durable POA & have a physician's letter that she is financially incompetent - - use her funds to see a lawyer to file an emergency ex-parte motion for "conservatorship of finances AND person". Generally, a hearing is rapidly set, and the patient is advised to appear. If they don't, that's already an indication of a problem.
Once you get to court with the documentation you have, the judge may make a temporary order or, if there is "competent" disagreement (that is, the behavior in court doesn't speak for itself) they will likely appoint their own trusted doctors or other individuals to do an assessment evaluation.
Even if her funds are limited and she would be on Medicaid now or later, her intentions, when she was "of sound mind", were for you to act as her advocate. You won't be able to do that if you turn her care over to the State.
I have seen folks do that to family and friends and it wouldn't be my personal choice unless it's a last resort.
Unlike a POA, the conservatorship gives you to complete authority over decision making. Once you'd probably obtain that and install her in a facility, the institution doctors will likely find cause to medicate her which, in the long run, will help with her anxiety and make her more comfortable.
Has your friend displayed these behaviors before showing signs of dementia? I'm not a medical person, but I think her past mental illness as well as the alcoholism may be either contributing or the foundation for her violence. And from your description, she clearly can become out of control.
Do the doctors make any suggestions as to alcoholic withdrawal, in an appropriately monitored setting? Has she been forced into a detox situation? I'm wondering if that triggers the violent episodes? What about medication? Has that helped?
I'm wondering if at some point the local county might need to take over her control. Decades ago I was a court reporter and primarily covered juvenile cases but we also substituted in Probate court for mental incompetency hearings.
I recall that judges would when warranted issue 30 (+/-) day mandatory commitments in a psych hospital for evaluation. That might be a consideration; the local police or Sheriff's office could probably offer more insight into how the local courts might handle this, if it's an appropriate alternative, and how to implement it.
I feel badly for you; it's so sad when a friend's path leads him or her down an even worse road to violence and addiction.
I really don't have any insightful observations to offer, but perhaps after others do my mind will be stimulated to think of something.
I just wanted to extend support for your concern and the dilemmas and challenges both of you are facing. This must be so frustrating.
ETA: LoopyLoo's reference to relinquishing control (or ceding it to the local governmental or other appropriate agency) might be an option through the Court's involvement as I mentioned above.
One concern I do have is not only for your physical safety but your responsibility as well to step in. I'm not knowledgeable in the area of whether or not proxies do have obligations or responsibility for someone who's out of control; this is a legal issue on which I'm not qualified to opine. Local police or the Sheriff's office might provide insight on this.
But, sadly, it looks like there isn't much you can do for her. Like you said, she is mentally ill and longtime alcoholic. I'd be worried about her attacking you, if she is this much out of control.
I don't know the steps to take with relinquishing POA or what the state does afterward, but many on here do. I'd think once state had custody, she could be placed somewhere for good. Likely won't be an ideal place, but at least she'd be somewhere.