Hypothetical Question: Someone you love, who suffers from a serious illness that can adversely

[Mike 03]

affect judgment, begins to make decisions that are against his or her best interest.

And perhaps in some instances, these decisions may affect your interests too.

What would you do?

I do NOT want to embarrass or hurt this person, but he is making choices that are hurting him, his family and those around him. It's crucial to me to preserve my relationship with this person. So far I've done nothing but voice a few sentences of logic as to why some of his decisions lately have been dangerous. Most likely, it is a result of the amount of medication he is taking, but it could be other things too, like the disease moving into his brain. I don't want to think that, but it is possible.

I'm so torn. The last thing in the world I want to do right now is get into any kind of disagreement with this person. I know he's ill. I love him. But he's making dumb decisions now and they are affecting a lot of people.

I am not sure what to do.

Sorry for the venting.

Usually, I can figure out how to handle these issues that come up, but this one is very tricky.

[ayeshahaqqiqa]

1. What is his primary diagnosis?

Alzheimers? Senile dementia? What medication is he using that might cause the behavior?

Are you the primary caregiver? If not, have you spoken to the primary caregiver?

[Mike 03]

6. This is difficult to answer, because it is a type of cancer, but a type is spreading to

the head. Also, the amount of painkillers being administered is very high, and rose rapidly. I'm in constant touch with him as well his primary caregiver.

[ayeshahaqqiqa]

10. Talk with the caregiver, then

and see if there have been any arrangements for giving power of attorney over decisions that the patient is not making. If not, see who could get that process started--it can be done if the patient is showing signs of dementia. This, of course, is assuming that the caregiver agrees with you about the patient's behavior.

[Lyric]

2. It would depend entirely upon what "interests" are involved.

For example, if I shared a bank account with my Mom and she started buying junk that we don't need, I'd totally confront her about that, because that money is legitimately mine too. However, if my Mom had her *own* money and wanted to buy something I disapproved of, well that's not really any of my business. Other adults are entitled to make their own decisions, even if we disagree with them.

I only use that example because a friend of mine and I recently had this conversation. Her 75-year-old Dad owns a little convenience store that my friend was expecting to inherit someday, but apparently Dad has a new, younger girlfriend, and he's decided to sell the store and take a long vacation with said girlfriend. My friend feels like her Dad is frivolously spending *her* inheritance on some floozy-come-lately gold-digger, and wants to try and get her Dad declared legally unfit to manage his own affairs, because he has a medical condition that *can* cause a form of dementia, even though he sure doesn't *seem* to be demented. Her motive is ostensibly to keep him from making "unsound" financial decisions, but really she just wants to keep him from spending what she sees as "her" inheritance on this new girlfriend. I flat-out told her that I disagree, and heartily. Nobody is entitled to the money that their parents have earned. If he wants to blow it all on his new Anna-Nicole-Smith clone, well that's his decision to make.

I'm not suggesting that this is what *you* are doing, of course. For all I know, you aren't even talking about money. But I would caution that you be absolutely *sure* that dementia (or something like it) is the root cause of these decisions against his/her "best interests" before making any kind of legal intervention. It's important not to strip away someone else's freedom to make choices (even ones we disapprove of) unless there is 100% sound evidence to back it up. I've seen too many elderly and disabled people whose lives were ruined by well-meaning family members who used illness as an excuse to strip away all freedom, leaving behind nothing but a life in a gilded cage. Caged things don't tend to live long, ya know? Be very, very sure that he or she is not of sound mind, because if you act too soon, you risk driving said sick person into a depression that might hasten death.

On the other hand, if you ARE absolutely sure that this is dementia and not just a form of illness- or elderly-related "midlife crisis," then by all means act. I'd suggest a personal intervention in which you express your love and concern in a way that lets this person know that you are only concerned for *their* well-being and happiness. Be willing to listen, though; sometimes the things that make sick and old people "happy" are not the things that are necessarily "responsible." If it's someone with a terminal illness who wants to, I don't know, go skydiving, well maybe you should consider that this person's "bucket list" means a lot to them, and make accommodations?

It's complicated, but I know you're a good person. I just hope my friend turns out to be as good a person in the end, because what *she* is doing is really, really wrong. I was just thinking about posting something about the situation in the Lounge and asking for advice myself--do I tell her Dad what she's planning to do, or do I stay the hell out of it?

[Mike 03]

7. Wow, I appreciate your post very much. It helps a lot. This is NOT a case of dementia. And I

promise I'm just trying to do my best in a complicated situation. In fact, that is why I have said nothing at all. I guess I am willing to just let him do whatever he wants, but it's so painful to watch this. He could potentially wipe out my mother's future funds.

[Lyric]

9. So your problem *is* money? Hmmm.

With your Mom still around, that's entirely different. She has every right to take at least half of what's available and sock it away for her own well-being, because marriage is a partnership--that money is meant for *both* of them. My story was about someone who's dealing with only *one* parent's best interests...it's not the same thing when there are still two parents to be considered.

What is it that he's spending money on? Perhaps you could distract him with something he wants even more--a little side-trip somewhere that he wants to go, for example, especially if his time is limited. People do sad, desperate things when they know the end is close, because they're panicked about not getting to do all the things they wanted to do. Maybe a little trip somewhere he's always wanted to go, if he's movable, would make him feel less panicked?

Either way, I feel for you deeply.

:hug:

[sandnsea]

3. sil's brother has ms brain lesions

If you're talking about something like that, all I can say is that it's heartbreaking. The person you knew is gone and they'll never come back, unless there's a cure. There isn't any choice but to be proactive because the ill person can end up in some very serious trouble otherwise. If he's sick, somebody else should be monitoring the disease so that's the person I would go to.

:hug:

[Warpy]

4. First, get him to a doctor and talk to that doctor

about what you see happening. If his drugs need adjusting, that's where to start.

If it's an issue of substance abuse, Al Anon can help you learn how to protect yourself from his bad judgment.

If it's illness, the doc can be a great resource on clipping his wings just enough that he's not a danger to himself or you, including telling him not to drive and getting his license lifted if that's an issue.

And last, consider how much independence you want to remove. My dad wasn't making the best decisions in his final few years, but they were his decisions and I knew him well enough to know he'd want to make his own decisions rather than live a few months or years longer with me making them for him.

[rug]

5. Adult Protective Services or Guardianship.

[kickysnana]

11. Careful Guardianship can be a scam.

Any disagreement with a court appointed guardian comes out in legal fees, both sides paid for by the client.

Minneapolis Tribune story about Wells Fargo Elder Care.

[MiniMe]

8. Are you a relative or do you just care about the family?

If you aren't a relative or a legal guardian, you have no legal standing, so the only thing you can offer is advice to the family. If you are a business partner, it depends on what the business relationship is.

[blogslut]

12. My mother's diagnosis was far more clear

Brain Cancer - terminal and concentrated in the part of it that controls cognition. Right after the diagnosis, she chose to refuse treatment because the doctors would only be able to extend her life for six months at the most, Those months would be filled with agonizing treatments, probably worsened by the fact that she would still lose her faculties. She (and we, her children) did not want to see her suffer in her remaining days. After she made that final decision she granted my sister guardianship and made my brother executor of her estate. She faded fast. Her mind was 3/4 gone after the first month and she passed a month after that.

I don't know the details of your situation. Is this someone you love being treated for depression as well as the other thing? It's pretty standard for doctors to prescribe for, or at least address, the depression that often accompanies a life-threatening diagnosis. Clinical depression really screws around with rational decision-making.

[hay rick]

13. Sometimes.

Sometimes you have to embarrass, hurt, or upset somebody you love- because you love them. It is not uncommon for the elderly to start making erratic and destructive decisions. Dealing with such things can be a thankless task.

My wife ended up taking care of her Uncle John several years ago. Uncle John was diagnosed with dementia. He started doing impulsive things and became vulnerable to manipulation. Early on it was a gold-digging younger woman. I think he figured that one out on his own. He was still able to make occasional rational decisions.

His condition was marked by progressive deterioration. My wife started helping him out with his shopping and finances. The next crisis was his inability to safely drive a car. He clung to his "right" to drive longer than he should have. It represented independence and the ability to still function normally. After a few episodes of getting lost, the trauma of trying to drive at night (he had macular degeneration), and a few fender benders- he started leaving the car in the garage. A year or so later he had come to terms with the fact that he would not be driving anymore and he gave the car to one of his sons. In retrospect, we probably put him and others at risk by not pushing harder on the issue. It was difficult because it was such an obvious and decisive marker of his loss of independence.

Uncle John had a stroke and the dementia worsened rapidly. The next crisis was family greed. One of his sons started visiting several days a week. They would go out to lunch- and they always stopped at an ATM. The son handled the transactions and kept most of the money. My wife was getting the bank statements. She tried explaining the situation to him. He claimed not to remember and seemed not to care. We intervened anyway. We started getting nasty, threatening phone calls. Ultimately we ended up in court and my wife became her uncle's guardian.

My wife took six years off work to take care of Uncle John. He died last August at the age of 88 and my wife is his executrix. We are not beneficiaries- by our own request.