Can Our Grown Children Become Our Worst Enemies? (relative, accidents, adult)
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We have recently had my MIL tested for dementia and it is a test that is part written and part oral, about 15-20 questions that test various mental functions, takes about 5-10 minutes.
A lot of old people are hard of hearing. They might flunk the oral test by not understanding the questions. A lot of old people who are hard of hearing are very reluctant to admit they have problems understanding what people say. So they guess what the question is. If they guess wrong, it can make them seem incompetent.
Likewise, a lot of old people might have trouble reading the written questions. Hearing problems and vision problems are signs of old age. Old people want to seem younger, and often guess what they're hearing or reading, instead of admitting they're having problems hearing it or reading it.
And old people also often get dehydrated which can make them temporarily incoherent.
For those reasons, it's very easy for an old person to be falsely convicted of having a brain beyond its freshness expiration date. And by the time their assets are seized, it's too late for them to appeal to a higher court, because they can't afford it.
In some states the situation is much worse than others. Some states leave it entirely up to the judge, who often doesn't care much, and only needs a small amount of inconclusive evidence, to quickly get the case over with, and move on to more interesting cases.
Is it possible for a doctor to "test" a patient for competency, without telling the patient?
Quote:
Originally Posted by armory
^^^And risk the possibility of being sued? You have heard of HIPPA, correct? A patient's doctor cannot run a battery of tests on them for no reason and to do so will draw questions from an insurance company as well as Medicare.
I doubt many seniors will submit to such testing for reasons told them; I won't.
Come on now, the doctor does not say to the patient "Now I will test your competency". He or she just says, "I have a few questions for you to answer" and then asks them.
How do I know this? Because my husband has brain damage & short term memory problems and I go with him to all of his doctor's appointments and hospital visits. I have been with my husband on dozens of occasions when doctors have asked him those basic questions. Sometimes they will just intersperse them among other general questions. "How are you feeling? How long have you had this pain? What is the date today? Does it hurt when you stand? Does it hurt when you lay down? Where are you right now?" Although, it is hard to sneak in the "Who is the president?" question without it sounding odd but I have seen doctors do it.
Now, I have to admit that it would be difficult to do a lot of testing without the patient realizing it, but I have seen doctors ask 5 or 6 questions that I knew were competency based questions that most people would never, ever realize were actually "test questions" where the doctor was recording your response. Doctors sometimes make the questions part of their welcoming conversation or chit-chat during the visit.
A lot of old people are hard of hearing. They might flunk the oral test by not understanding the questions. A lot of old people who are hard of hearing are very reluctant to admit they have problems understanding what people say. So they guess what the question is. If they guess wrong, it can make them seem incompetent.
Likewise, a lot of old people might have trouble reading the written questions. Hearing problems and vision problems are signs of old age. Old people want to seem younger, and often guess what they're hearing or reading, instead of admitting they're having problems hearing it or reading it.
And old people also often get dehydrated which can make them temporarily incoherent.
For those reasons, it's very easy for an old person to be falsely convicted of having a brain beyond its freshness expiration date. And by the time their assets are seized, it's too late for them to appeal to a higher court, because they can't afford it.
In some states the situation is much worse than others. Some states leave it entirely up to the judge, who often doesn't care much, and only needs a small amount of inconclusive evidence, to quickly get the case over with, and move on to more interesting cases.
In a sense, having severe hearing or vision problems and doing nothing about it is prima facie evidence of lack of competency. Yes, sometimes these deficits are not correctable, but those are not the cases I am talking about.
In the event something can be done, it is up to the old person to get it done. At age 70, after realizing for several years that my hearing was slowly going to hell (although I could still function - I just had to ask people to repeat more often than I liked - I got my ass to a doctor and followed up with the recommended audiology testing, then followed up with the specialist ENT who recommended hearing aids, then followed up with the purchase of the hearing aids, which have helped a great deal. It was my responsibility to take action, and I took action because I am not incompetent.
Ditto with sight. I get an eye exam either every year or every other year. What two things are more important than sight and hearing to one's functioning? Well, mental acuity is probably as much or more important, and my point rests on that - if one is not mentally limited, one will follow through with appropriate measures to safeguard and maintain one's sight and hearing.
Think of it this way, if you don't make a PLAN in advance, one may have to be made for you and you'll have fewer choices.
I started begging my parents 15 years ago to plan for their future, they were 65. My dad retired about that time. They KNEW they wouldn't be able to live in their home forever, and whenever I brought the subject up, however gently, they bolted like scared bunny rabbits. Two years later, my dad started getting evaluated for cognitive impairment. By 2005, he was clearly headed for dementia. I BEGGED mom repeatedly to explore various options for downsizing to something more practical. They have a 4 bedroom suburban split level that is not easy to maintain or convenient to much of anything but strip malls. They live in suburban washngton DC which IMHO is not senior friendly.
As my father declined, my mom furiously fought any conversations about planning for the future. She became less competent to care for him. by 2010 she was locked into a daily struggle to maintain the home and monitor him, and her own mental illness was getting worse as a result. We tried everything we could think of to get her to put him into a day program, she fought that for a year. The she fought putting him in a facility. Her psychiatrist seems to be unaware of her deficiencies because she tells him what she thinks he wants to hear. She hurt her back very badly and her MD sent her, an alcoholic, home with a bottle of percoset to take care of my dad, who is also his patient. Dad has three different doctors prescribing contrary meds and we have to struggle with mom just to find out the details of his care plan. The MD seems completely clueless.
If you met my mom in a social setting, you would have thought everything was fine. I'd say about 6 months ago that changed and you would now wonder about her almost immediately upon meeting her. She currently cannot walk upright due to her hip being out of alignment, and she refuses to go to physical therapy. (which has worked in the past)
Now she has begun her own cognitive decline, forgetting where she is driving to for what reason, missing appointments, unable to complete the most basic of conversations about what a next step could be. We have our own homes, jobs and families to tend to and limited time to assist. Dad's facility is mediocre at best, but she gets angry if we communicate our concerns to the facility 'behind her back'.
She wants control, wants to be in charge, and does everything the most difficult way possible. If we suggest things such as Mail-order pharmacy, she complains about the extra cost, regardless of evidence to the contrary. Any idea she doesn't like,instead of giving a measured answer, she makes up reasons why it won't work or help, with great imagination and belief in her own fantasies. She lies to us repeatedly, and we don't know if she is always aware she is doing it.
If you could see her when we try to discuss ANY aspect of her life at this point and how to help, you would see the absolute FURY she reaches. My brothers and I are smart, competent, of good character. We don't care about the money. We don't have ulterior motives. We are holding our breath waiting for some accident to make her house of cards come crumbling down. I personally think it will be a car accident, my brothers bet on a pot left on the stove.
So if you would criticize me for someday having to sue for guardianship of my father, or place my mother into a facility of some kind, you go right ahead. I am very confident that we are doing the very best we can in a very difficult situation. Blame for this situation falls COMPLETELY on my mom, who has lived in denial for the past 15 years.
Situations like this are a quiet crisis in our country. What happens to people like my mom who don't have decent insurance or financial resources or children who can help? Why can't the medical community help more?
So please don't indulge in paranoid ramblings and urban legends about children forcing their elders to move to a home. Go see an attorney and get your stuff together. Look realistically at your current living arrangements and then look realistically at what that should look like in 2020, 2025,2030, 2050. And MAKE a viable plan for change that you can implement in small steps, rather than wait for that big bang that sends you from rehab to a home with your children left to clean up the mess you left behind because you refused to take responsibility.
I agree with everything you say. But if you think your mom is likely to be involved in an accident, or might burn the house down, you need to be seeking guardianship now. I certainly don't want to be mowed down by an incompetent driver. I also don't want to suddenly find my neighbor's house on fire, and have to go banging on the door of residents who (probably) can't hear. I think most of us do wait for a crisis before acting, but please do stop your mom from driving. If you don't do anything else, please do that.
Once I was run off the road by a frantic old woman who, apparently, needed to get her dog to an emergency vet. I literally was off the road as she drove past, ninety to nothing. I could have been injured, because she was not competent to drive under those circumstances. Please, don't allow your mom to injure herself, your father, or someone else with her driving.
The questions, "what is today's date", "where are you right now", and "who is the president", are those questions part of a well-known test for senility? What's the name of that test?
The questions, "what is today's date", "where are you right now", and "who is the president", are those questions part of a well-known test for senility? What's the name of that test?
I'm not sure if it is a real "test" or just a quick way for doctors to see if a person is aware of their environment. I know that if/when my husband misses one of those questions the doctors ask him more questions of a similar nature.
I would certainly hope that a doctor would need a more substantial test to judge if a person is competent or not. For example, many/some retired people don't keep track of the date and could easily miss that question.
But, it is possible that a person who is not competent could be given a 25 or 30 question test, over the course of a routine doctor's visit and not realize why the doctor is asking those "funny" questions (say the alphabet backwards, count backwards from fifty by seven, what would you do if...). I have no idea if that is enough for a doctor to say that someone is not competent or not.
In a sense, having severe hearing or vision problems and doing nothing about it is prima facie evidence of lack of competency. Yes, sometimes these deficits are not correctable, but those are not the cases I am talking about.
In the event something can be done, it is up to the old person to get it done. At age 70, after realizing for several years that my hearing was slowly going to hell (although I could still function - I just had to ask people to repeat more often than I liked - I got my ass to a doctor and followed up with the recommended audiology testing, then followed up with the specialist ENT who recommended hearing aids, then followed up with the purchase of the hearing aids, which have helped a great deal. It was my responsibility to take action, and I took action because I am not incompetent.
Ditto with sight. I get an eye exam either every year or every other year. What two things are more important than sight and hearing to one's functioning? Well, mental acuity is probably as much or more important, and my point rests on that - if one is not mentally limited, one will follow through with appropriate measures to safeguard and maintain one's sight and hearing.
I was thinking the same thing. If you think it is a good idea to try to fool people that you can still hear or see without any problems, that sounds like you are not thinking straight.
Come on now, the doctor does not say to the patient "Now I will test your competency". He or she just says, "I have a few questions for you to answer" and then asks them.
How do I know this? Because my husband has brain damage & short term memory problems and I go with him to all of his doctor's appointments and hospital visits. I have been with my husband on dozens of occasions when doctors have asked him those basic questions. Sometimes they will just intersperse them among other general questions. "How are you feeling? How long have you had this pain? What is the date today? Does it hurt when you stand? Does it hurt when you lay down? Where are you right now?" Although, it is hard to sneak in the "Who is the president?" question without it sounding odd but I have seen doctors do it.
Now, I have to admit that it would be difficult to do a lot of testing without the patient realizing it, but I have seen doctors ask 5 or 6 questions that I knew were competency based questions that most people would never, ever realize were actually "test questions" where the doctor was recording your response. Doctors sometimes make the questions part of their welcoming conversation or chit-chat during the visit.
It's worse now that Obamacare is law. Everything those doctors write down goes into permanent records and follows the patient around. If you show up in an ER and a doctor asks about something out of the blue you can bet he got it from your permanent records. One of the goals of ACA was to make your health records available to all. Health records is a big umbrella. They will ask if you ever have thoughts of injuring yourself and if you have access to firearms. What the hell does that have to do with my arm needing stitches? Nothing, they just found out you have firearms and it is going on record.
Big Brother is watching you.
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What the hell does that have to do with my arm needing stitches? Nothing, they just found out you have firearms and it is going on record.
