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My 92 year old father fell about 5 weeks ago and was in bad shape for awhile. My sisters had him declared incompetent before he had a chance to recover saying they needed to sell the house to take care of him. It was done so quickly that he never had a chance to get better. I am the primary caregiver for him and have been for the last two years. He wants to go home now and the doctors are lying to him at my sisters' request telling him that he is going home, however the truth is they are sending him to a board and care and have already had realtors out to look at the house. Has anyone ever been successful in getting a doctor to re-evaluate their loved one? I am not the power of attorney for healthcare and have been told there is nothing I can do. Any advice would be greatly appreciated.

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So you are saying that TWO doctors are willing to jeopardize their MD license by lying to the patient and signing the papers? And Dad's brain has completely regrown the dead tissue? He can now bathe himself, dress himself, cook, clean, manage meds and finances? Are you sure? Are there any other witnesses to the recovery?
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Pbassett, the key question is how good your father's cognitive function is - it's a bit more complicated than whether he recognises people. It would be more like an independent assessor deciding whether your father can analyse his own situation and understand the consequences of his decisions. How was he, in those sorts of terms, before he fell?

The thing is, I really don't like the sound of how your sisters are behaving and I can understand your anxiety; but you've got an uphill struggle ahead. You could call APS and voice your concerns, but you will have to do so cleverly: forget about your sisters' being 'bad people' and concentrate on the ethics of having him declared incompetent while he was being treated for a specific traumatic injury.

Another idea: does your father have his own lawyer, and do you know who that person is? If a lawyer who has known your father for some time went to visit him socially and have a little general chat, that could also give you information you could work with. By the way, the lawyer isn't for you, so the fees wouldn't be paid by you. The client is your father. All you have to make sure of is that any lawyer - for goodness' sake pick one with a good reputation if there isn't one already attached to the family - understands that you do not have the authority to hire him and are asking for his advice on spec.

Now then. This is harder for me to say, but try to calm down and focus on facts. If your father were back to his completely normal self, and fully in command of his faculties, how long do you think the doctor would go along with the idea of telling bare-faced lies to his competent patient? It would be SO unethical, and what's in it for the doctor? Have you had a conversation with this doctor yourself? Does he continue to insist that your father is incompetent?

What I mean is, it's important that you allow yourself to consider the possibility that your father really can't go back to his own home, or manage his own finances, and give some thought to what alternatives might be best for him. If your sisters are planning to sell his home and squirrel away his funds while he's carted off to a sort of elders' orphanage, well, there are rules about that sort of thing, too - they can't just pinch his money and commit him to substandard care. There are rules about POA, and your father's money has to be spent wholly and exclusively on his welfare. Any deviation from that and then, yes, you most certainly do call APS.

I hope you'll be able to get good advice from professionals on what to do first. Best wishes for your father's continuing recovery.
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Some clarifications first, please...

Was your father in a rehab facility after the fall, specifically for the purpose of recovering from the fall?

HOW did your sisters "have him declared incompetent" if he wasn't at the time, or if he appeared to be but wasn't? I assume one or both of them are named as health care proxies? Was the declaration made by doctors with whom he treated or was just seen after the fall? On what basis specifically was he declared incompetent?

How did the declaration hinder his "chance to get better?" Was he emotionally upset after learning of the declaration?

What evidence do you have that "the doctors are lying to him"? This is a pretty serious accusation to make. It assumes that you not only know the doctors are lying but that you also know what the doctors are telling him. Were you present when the doctors "lied" to him? And what proof do you have that it was the sisters' request to be untruthful?

I'm not familiar with the term "board and care". Are you in the UK, and is this some type of assisted living facility?

Your sisters could not sell the house without legal authority to do so, so I'm assuming they also have a durable power of attorney?

As to reversal of the declaration, it depends on how it was obtained, and the laws of the country in which you live. Your post title states that your father is "fully recovered." Again, on what do you base this? Another doctor's evaluation?

There are just too many unknowns to provide an accurate answer. If your father was in fact incorrectly diagnosed, you'd probably have to get an overriding opinion from other doctors. But you'd also have to address the basis for the original declaration as well as the fact that the sisters apparently seem to have legal authority while you don't.

You might consider advice from an elder law attorney.
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pbassett77, from what you posted, your sister has Power of Attorney for Health Care.

Do you know if your father give your sister(s) a separate Power of Attorney to sell his house and manage his finances? Unless your sister have such signed and notarized paperwork, they are waiting the Realtors time.

The house might be worth $600,000 but what equity is in the house? Is there a mortgage on the house? Reverse mortgage? Open equity loan? And if the house can be legally sold, said proceeds will go to your father, minus the expenses from selling the home. And what about his furniture, clothing, etc.? If you sisters sell any of that, the proceeds also go to your father.
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We really need an answer to who is named in the Durable Power of Attorney. If your sisters don't have financial authority pursuant to either a DPOA or guardianship, then selling your father's house without his consent and signature on the listing agreement, any purchase agreement and/or closing agreements would be illegal.

Let's address this issue and then move on. This point is begining to take predictable twists and turns but in order to provide appropriate answers we need to address some basic information.


And I'm still not able to accept that these doctors deliberately lied to your father. While there certainly are bad physicians, I'm inferring from your post that the two who certified him are actually collaborating with your sisters. I really find this difficult to accept.


You stated:

"Since I am not the Power of Attorney, it is legally not my decision to have another Doctor come in for a second opinion now that Dad is recovered. I really don't know what to do, because if another Doctor came in, Dad would be deemed competent again."

Okay, so you don't hold a medical power of attorney, but if your statements are correct that your father is competent, why can't he ask for a re-evaluation himself? Notwithstanding that the alleged Dx was that he can't make medical decisions for himself, this is not a complex medical decision.

And as Jessie points out, you don't need a medical POA to talk to the doctor.

The other posters have also raised answers which need to be addressed, including FreqFlyer's questions on any encumbrances against title to your father's house, Pam's questions about the doctors who allegedly falsely certified incompetence, and CM's queries about your father's position on your sister's activities.

And if you really believe these doctors are lying, take Whitney's suggestion and see what happens when you accuse doctors of falsification. This issue keeps coming up, so address it and move on.

Lacking answers to these important issues, I think answering any further questions by posters who are trying to help is futile.
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hi pbassett77,

Apologies if I've missed some of the useful things people have said in the responses. Just wanted to mention that "competence" is usually determined by the courts, and that on their own doctors are just supposed to assess a person's ability to make medical decisions. We are occasionally asked to provide a letter or opinion to someone else, like a bank or a court or an assisted living facility, but as far as I know, on their own doctors cannot make someone globally "incompetent" and allow family to take over all their rights. (That said, when an older person is obviously very impaired, everyone will act as if family has the right to take over decision-making, but that can be contested.)

If you have the time and energy for a fairly technical resource, the American Bar Association and the American Psychological Association collaborated on creating "Assessment of Older Adults with Diminished Capacity" resources. One is a guide for lawyers, and the other is a guide for psychologists who are asked to weigh in re competence.
http://www.apa.org/pi/aging/programs/assessment/capacity-psychologist-handbook.pdf

Believe it or not, psychologists and doctors are often not familiar with the law, or the "best practices" on how to handle these situations.

Everything kind of varies state-by-state, but the info might help you think of how to frame the questions.

Unfortunately I haven't yet come across a similar resource that's written for family caregivers...maybe someone else can speak up if they know of one.

good luck!
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@pbassett, glad to be somewhat helpful. I've taken a closer look at the thread, since I'm a geriatrician and this kind of situation is of great interest to me. Here are a couple of thoughts that I hope will be of use.

As others have pointed out, it's very common for older adults to be confused and lose a lot of mental capacity right after an illness or injury. It often takes weeks to fully recover, and I've seen people slowly get better over a year.

Doctors are NOT supposed to make permanent assessments of mental capacity at this time, we're supposed to give people time to get better. (But many docs don't know this.) Now, there are decisions that have to be made while people are impaired, like how to manage a safe discharge, and so in the hospital if someone doesn't seem to have capacity to manage that, we have to turn to family/surrogate decision makers.

You can and should point out to your sisters, the realtor, the doctors, etc, that an assessment of your dad's mental state in the weeks after injury cannot be grounds for taking away his rights permanently, or making major changes such as selling his house.

You can also remind them that taking away rights and declaring global incompetence usually requires courts and more proof.

You can point out to the realtor that a hospital doc's opinion is not enough to give your sisters legal authority to sell his house. Even without having a lawyer, if you express concerns that the sale may not be legal, this will probably give the realtor pause and buy you some time.

You did mention a trust, and you may want to find out what are the criteria specified for letting another person take over the trust...could be a little different than your state's standard for a person losing their rights. I have occasionally submitted opinions on a person's cognitive capacities and given it to people involved in a trust.

I personally always specify in my opinions what the deficits are, what the circumstances are, and how likely it is that the problems will persist or worsen. But many doctors write very vague letters saying "so-and-so cannot manage their affairs." This is very sloppy but it's considered the historic norm so I think we can't fault docs too much for this.

However, you CAN ask docs to reassess, and you can ask them to specify in writing just what problems they are observing, what they think the cause is, and whether they think it's permanent or temporary.

I would involve APS if you haven't already done so. They are usually understaffed but it should be free for you, and they might be able to offer you some useful advice.

You also mentioned Kaiser; if your dad is a Kaiser patient then I would also see if you can get any help from their social workers or maybe an ethics consult. (altho the ethics consult often only seems to be for hospitalized patients facing end of life quandries)

good luck!
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Drkernisan, my husband's doctor agrees about the positive impact of the supportive environment I was able to create. But that is kind of my point and frustration with the gloom sayers. I'm afraid that sometimes negative predictions become self-fulfilling. Nobody expects this person to improve and they treat him as if he won't and so he doesn't.

My husband's PCP at the time of his "meltdown" said, "He appears to have dementia. Here is a prescription for a walker which might help prevent some falls. Good bye and good luck." No referral to a specialist, no suggestions for any drugs (not even aricept) no advice about support groups, nothing. She did not expect him to improve and he was off her radar even before we left the room.

Thank heavens that the Mayo Clinic doctor (Brad Boeve) had a very different attitude. He was clear about the disease having no cure, but he assured us that the various symptoms could be addressed, one by one, and set about doing that.

Yes, caregivers need to know the possibilities to be prepared for, and false hope is a painful trick. But no hope at all is worse, in my opinion, and does become self-fulfilling.
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We'll I would say you will need to get an attorney and possibly fight this if you are that insistent, but consider the trauma of all this fighting, etc. on dad. The court can order an independent evaluation of dad and his abilities and prognosis. You will have to pay for that and attorney and court costs.

Secondly, your sisters can sell the house, but those funds will have to go to dad's care --you and sisters are ill informed if you think they can just split the estate and keep the funds for yourselves. It doesn't work that way.
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@drkernisan, Thank you so much! I have been looking for just this type of resource. The telephone conference is tomorrow afternoon. I have research to do! You are most likely spot on as far as this seems to have been handled. I no longer desire to even attempt to cast blame, I just want to do my best to get Dad home, if possible. I am hoping that nothing is written in stone yet, as there has been nothing filed with the courts as of today. You have all been so supportive. Know that you are supporting a wonderful man and excellent father. I will let you know how it goes.
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