1. My 88 year old mother has dementia. There is a medical POA and a durable financial POA in place. Her doctor stated recently she is no longer able to manage per personal or financial affairs. One sister (of 5 siblings) has arranged an appointment with a neurologist on May 11, 2023 to have her evaluated. If she is declared incapacitated by the neurologist, do we have the legal (I assume the moral) responsibility to have her monitored at all times. She is very set against having anyone in her house, other than family, to help her. I am 8.5 hours away, and the local siblings aren’t willing to do more than just check in on her. She is very against going into assisted living with memory care or a nursing home. And she doesn’t seem to need it right now. She seems to be cognizant at times. Another question is: if we get APS involved, will they tell us what needs to be done, rather than giving us a choice, and will they help us get it done when mother is impossible to deal with and screams at those trying to help her.

    • My understanding is that a finding of incapacity relates to a specific decision – like whether to have an operation, move to a nursing home, or get married. It’s usually not possible to declare a person globally incapable, unless they have a sever cognitive impairment or are very ill, such as in a coma.

      It’s really up to you as a family, based on your knowledge of your mom’s personality, preferences, and life history, as to how much supervision she would want. Whatever her living situation, whether at home or in an assisted living setting, there will be risks and benefits. You might be interested in this video about “Living with Risk” :

      I can’t speak to what Adult Protective Services will do, as it can vary from region to region. There’s usually some leeway for choice, unless it’s an emergency or crisis.

  2. I have an 85 year old grandmother that everyone says is competent, but I have raised many concerns (including but not limited to safety concerns.) I live with her as well as my mother and we also have a roommate. Recently we found toxic black mold in the addition so I removed the paneling and treated the mold, insisting that everything that was treated and no longer had mold on it be put into the garage while the room was fully treated. It has been a steady fight to keep the doors to the room closed to prevent mold from coming into the house and making everyone sick. I tested many other rooms in the house and found mold spores in all the rooms downstairs. Should a doctor be involved or an attorney.

    • I’m not sure I have enough information to answer your question about whether to consult a doctor or lawyer.

      Black mold is also known as Stachybotrys chartarum, a fungus that can secrete a mycotoxin. Usually, molds cause issues if they trigger allergic reactions in some, but there’s controversy about mold as a cause of severe disease.

      It’s great that you’re looking out for your grandmother and making sure she has a safe environment in which to live.

  3. I am reaching out, I have a brother who has seizures constantly, and a very bad loss of memory, pretty much dementia, he goes out in the street and cant to remember where he lives or how to get back home.
    he is also an alcoholic, i don’t know where to start to get assistance for him, he doesn’t have a primary doctor, because he can’t afford the doctor bills. he does get a disability check from Social Security, The family believes he needs to be in an assistant living facility, what do you think

    • Seizures can be more likely to occur in those with alcohol use disorder, and can cause confusion, usually after the seizure occurs (called a post-ictal state). It does sound like your brother is vulnerable given his seizures and episodes of getting lost.

      Is there a social agency on your area that can assist with vulnerable adults? Some communities have a crisis mental health and addictions team that can intervene when a person is at significant risk of harm to themselves. I would start with contacting the social services in your region for advice. In your state, try:

  4. What can I do if I don’t think my father is being cared for by his spouse properly, but she is the one who has HIPAA authorization, Medical Power of Attorney and advance care directive? I am in another state and can get no information on his medical. Do I hire an attorney to ask for this to be evaluated? We just want what is best for our Dad and to know what medically is going on. At this time, he is not able to make decisions on his own due to heavy medication and thinking he is somewhere other than where he is, or thinks people are in his room taking everything out but no one is in there. Normally his mind is good, this is due to some sort of medication. Need advice

    • This sounds like such a difficult situation.

      First of all, I do recommend Dr. Kernisan’s recent book: When Your Aging Parent Needs Help: A Geriatrician’s Step-by-Step Guide to Memory Loss, Resistance, Safety Worries, & More . In the book, Dr. K offers clear advice about how to focus in on the best way to help your parent, even when there are cognitive and family issues.

      A lawyer might be able to help get access to the medical information. Are there any social agencies that your could report to about the situation? There may be an elder abuse team that could visit your dad and his spouse and determine if there’s any risk, and whether any other services could help.

      It’s so hard doing this from a distance. Another idea is to express your concern to your dad’s medical providers (if you now who they are). They may not be able to share information back, but might find your information helpful.

  5. Hi. My 88 yr old mom had stroke 5 wks ago and went to nursing home for rehab. Medicare stopped paying after 3 wks in and she lives alone in apartment and was not assessed to be able to go home. They agreed to ok her for assisted living so my brother and I got her to go. She just talks about when she goes home constantly. She has left side weakness, a fib, incontinence and short term memory confusion. She has no power of attorney. She has nobody that can live with her as she needs major assistance. Can she be released on her own to go home alone? She needs assisted living care but does not want to stay. She cannot function alone and cannot afford live in care.

    • I’m sorry to hear about your mom’s stroke. It sounds like she’s having trouble adjusting to the idea of assisted living.

      If your mom has a very unrealistic impression of her current needs, then she may not be capable of making a decision about her shelter needs. If she’s not capable, her substitute decision maker would need to decide for her (usually a POA but could also be a relative in some jurisdictions if POA hasn’t been assigned).

      I would advocate for the staff to determine capacity and and help plan for a discharge to a place with the right kind of help. A consultation with a Geriatrician or Geriatric Psychiatrist could also help.

  6. Hello my mother recently had a stroke (2 months ago! She is only 71! From the moment I found her her cognitive level has been spot on however when I moved her to the rehab center I was trying to get the doctor to do a cognitive test so that I could get a power of attorney to help with her affairs however he is one doctor of 14 facilities and he came in an afternoon after she had had a seizure and I don’t think she was even able to really be woken from her sleep so she said she was scared of the stairs he said she’s noncognitive because there’s no stairs there I said there’s three flights of stairs at the house that she lives with me in. I have yet to see the doctor in 4 1/2 weeks that she’s been there I can’t get anybody to help me and I can’t get anybody to come in to do a power of attorney she has been cognitive that doctor did not talk to any of the PT no nurses no staff or anything of anyone that has dealt with her on a regular daily basis I cannot get him to contact me and I am stuck because my mom‘s Medicare ran out on May 10 it is now the 17th and I can’t do anything about taking her home or helping to get care for home because I don’t have access to the finances my sister and brother are both in line and wanting me to have the power of attorney I’m willing to let us all be power of attorney but I’m just running into Roblox and I don’t know if there’s somebody outside source that I can request to come in there they won’t let anybody else in the facility that’s medical staff which is just seems really odd to me ! I spoke with the PA and he said only the Dr can make that call! I don’t want her to wind up with tons of bills because I can’t get anything moving ? Please help

    • I’m sorry about your mother’s stroke and glad she’s in rehab now.

      It sounds like your mother was found incompetent to name a Power of Attorney by a physician, and you’re not sure that the assessment was done fairly.

      I’m sure it varies by jurisdiction but in most cases, an independent capacity assessor, or even the lawyer who is drawing up the POA, can assess the person’s capacity. It sounds like the communication with the facility is not great.

      I wonder if a social worker could advocate for your mother to get a re-evaluation of her capacity, in order for her bills to continue to be paid while she’s in hospital. If the facility has a social worker, I would ask to speak to them and explain the situation. Hope it works out.

  7. I have lived with my elderly father for the last 5+ years once he started forgetting. He thinks that everything is going to be fine and refuses to deal with issues. Our dog just died because he thought she was fine after I had been asking him for 9 months to take her to a vet. He refuses to get his vehicles fixed and thinks that the cars don’t need to be inspected so they aren’t. He keeps saying “It’s my dog” “It’s my car”.

    What can I and should I do? All I want do is take care of things before they become an issue but I’m being stopped.

    • If this is a change in behaviour for your father, it could well be a sign of dementia or another serious medical issue. I made a YouTube video about dementia and related memory changes here: Dr. K also has a great article about dementia diagnosis:

      Getting some clarity about a diagnosis is a good longer term goal, but in the meantime it’s vital to communicate effectively with your dad to figure out the next steps in helping him. Dr. K has recently published a book called: “When Your Aging Parent Needs Help: a geriatrician’s step-by-step guide to memory loss, resistance, safety worries, and more”. This is a practical guide to how to start helping an aging parent, even when you don’t know where to start. You can learn more here. The book can help you to set small goals and make progress towards helping your parent.