Last week I talked to a woman about her aging parents. They are living in an apartment in the independent-living section of a Continuing Care Retirement Community (CCRC). Her 89-year-old dad is blind, and her 87-year-old mom has dementia. According to the daughter, they are just getting by with the on-site meals and regular housekeeping; but mom’s recent falls and dad’s increasing difficulty with managing their medications has her very worried. The Continuing Care Retirement Community has a personal care home on-site, and they just had an apartment in the personal care home come open. This community usually has an 18-month waitlist for the personal care home, so the daughter felt an urgency to get her parents to move to the on-site personal care home at their CCRC. The daughter called us because talking to her parents about moving to the personal care home did not go very well. The woman told me that her dad responded with indignation and anger, and her mom denied having any need to move out of their current apartment. The daughter said she felt stuck, scared, and unsure of what she should do next. Could she force her parents to move? Could she get guardianship over them?
This woman, like so many of the concerned family members we talk to, is in an awful situation. She can see that her parents need help and need to make a move, but she is powerless to make them move. She can see the awful consequences of doing nothing, but she is not the one who can authorize any changes. So, what can she do? She has a few options:
- Create a plan and wait for the crisis. Sometimes there is little to nothing we can do to stop a crisis from occurring. Competent adults are allowed to make bad decisions, and so sometimes we have to hope, pray and then be ready to help pick up the pieces after something bad happens. In this situation, the daughter knows that her parents would be better served in a personal care home or assisted living community. She can have a plan of 2-3 communities (including the personal care home at her parents’ CCRC) that her parents can move to after the next fall, hospitalization, or medical emergency that occurs. This route is dangerous as the next crisis could be fatal, but if her parents know that they have options, understand that their current situation is not perfect, and voluntarily choose to do nothing, there may be little chance of getting them to move before a crisis.
- Ask for professional intervention. There are a variety of non-family members that can offer input and consultation. Referrals and recommendations from a non-family member are sometimes easier to accept. For this family, maybe the CCRC team is also concerned about this couple’s safety and can discuss moving to the personal care home. Their primary care physician can also discuss safety and care options, urging them to accept a higher level of care. Geriatric social workers, mediators or Aging Life Care Specialists are available to provide assessments, recommendations, and family meetings to discuss plans.
- Seek guardianship and force them to move. The most severe intervention involves seeking guardianship. This would require that the daughter petition the probate court to deem her parents incompetent and to have herself named as their guardian. This would allow the daughter to authorize her parents’ move to a personal care home or assisted living community. In this case, though, it is unlikely that her parents would meet the criteria of being incompetent. So this option is unlikely to be effective at this time. The daughter can keep a contemporaneous log of events that might build a case for her parents’ incompetency and then seek guardianship after she has enough evidence. However, even after she is granted guardianship, she still has to deal with her angry parents and might be forsaking her relationship with them for this move.
As stated above, this daughter and family are in an awful situation. The tension that exists between autonomy and safety is real and very stressful for everyone involved. It is difficult to know what are the right next steps, but seeking guidance from a Certified Elder Law Attorney is a great place to start. We will stay in contact with this family as they make this journey. There will inevitably be changes that occur, and each change in their situation will give us an opportunity to intervene and help guide this family to a safer situation while maintaining as much dignity and autonomy as possible. This daughter is in a tough situation, and her parents are lucky to have her in their corner (even if her care and concern sometime seen intrusive). We are honored to be on this journey with this family as well as hundreds more in similar situations. If this reminds you of your situation, please give us a call at (404) 843-0121 for a complimentary phone consultation.