Hi all,
Your forum has been a wonderful resource for me in helping take care of my grandpa. My issue in short is this:
Granddad (83) has dementia, and a giant cutaneous melanoma tumor on his thigh the size of the palm of my hand. He hid this from us until we noticed a terrible smell and finally caught him with his pants down, it's a large, actively bleeding, crusty growth, about an inch tall and circular with a horrendous rotting smell that permeates the entire house. I cannot enter his bedroom without gagging.
He refuses to go to the doctor, has no health insurance, no doctor, and no money. I have engaged with multiple elder law attorneys, but it has been months of getting the run-around to begin the process of guardianship, I haven't even been given a consult despite waiting multiple months. I asked the fire department, and they said they can't take him to the ER if he refuses, which he will. He no longer has the ability to understand how serious this tumor is.
We are not just worried for his health, but also for what may happen to us were he to pass away with this tumor while not being under the care of a doctor. There is a risk that we may face charges for neglect despite his steadfast refusal to get this treated. When my grandma passed last year, because she was not under the care of a doctor, law enforcement responded to the house including a homicide detective. I cannot imagine what the cops would think if they smelled his bedroom. I am so tired of holding my nose in the house and asking him if he'll go to the doctor. Every time it's a "I just got up" or "Maybe tomorrow", then tomorrow comes and he doesn't remember saying it. I have asked him over 200 times.
We are in desperate need of help. My original plan was to obtain guardianship, have the paramedics come and take him to the ER, then file bankruptcy on his behalf after the treatment, if he survives that long. Since the attorneys are dragging their feet for months now, I don't know what to do. I feel trapped in a house that stinks of death with no way out.
What are our options? How can we force him to get treatment? What do you guys recommend?
He owns a property and if he pulled the equity out of it through a reverse mortgage yet never gave getting health care coverage for himself a thought, then too bad for him. The taxpayer (aka the 'state') will pay for him and he'll get Medicaid if he needs to be in residential care. The state (Medicaid) is not going to pay for him so you and the other family can remain living in his house. That's not going to happen.
If he goes into care the facility takes whatever equity the house still has then it will have to be sold at market value, not what's owed on the reverse mortgage.
You also posted that in FL Medicaid won't put a lien or attempt recovery on a primary home when the recipient is still alive or passes on. There might be an exception if he is permanently in LTC ("institutionalized").
You wish to inherit the home but you are attempting to pay off his reverse mortgage. He has no Will and may not be in a cognitive state where he can legally create one, and he may not wish to do it, either, and you can't coerce him to do it.
So, not sure you can have it both ways if you are unwilling to get him properly and immediately treated because you might lose your housing.
Pick one and live with it.
You could also report to the Elder Abuse hotline. Self neglect is a reportable occurrence. Since you are not POA nor his Guardian you are not responsible so I would think that would fall under self neglect. (I might be wrong and I know I will be corrected)
I do hope that you have all the documentation that you have about trying to get Guardianship and the lack of response from the attorney.
This will get state guardianship started. I caution you NOT to take guardianship for an elder who is non cooperative because at the point you get it you have a Fiduciary duty not to abandon and no court and judge will allow you to resign your guardianship. I am RELIEVED the attorney hasn't got you guardianship at this point and hope you stop asking for it. You cannot help someone who is undiagnosed and refusing help.
Truth here is that you may need to LEAVE and report granddad as a senior at risk. IF this is a cancer it is almost certainly metastasized at this point, and granddad is dying. You are not qualified to take this on alone without medical care and he is not your responsibility.
Where this man's own children are in all this I can't know, but if they exist you should leave the premises and report you have done so, allow THEM to call APS and proceed with care.
My suggestion would be to get APS in to go through those questions with him, and give you advice about what to do. If they say ‘let him do it’, and you can cope with it and that decision, get it documented to protect yourselves.
The lesion on his thigh needs to be surgically removed, obviously. I'd take
Geaton's advice in this situation.
As far as reverse mortgages go, the loan becomes payable to the lender upon grandpa's death, when he sells the home or when he moves out permanently.
The loan and interest are repaid when the home is sold, and the lender recovers the money advanced plus interest. If the home sells for more than the loan balance, the remaining equity goes to grandpa's estate or heirs.
Good luck to you.
The LEAST of your problems is that gpa's house is reverse mortgaged.
He will not accept any kind of medical help for something that sounds is going to take his life. Once a tumor begins to look like what you've described--my guess (and it's just an educated guess) is that he hasn't long to live.
You are going to have to decide if you want to leave him be and suffer whatever fallout comes.
Or--you notify APS and whatever other agencies might get involved. He has dementia, so he really can no longer make his own decisions. It's sad, but it's often what happens in life.
Your plan is a sound one and at least it's something. Plan that it will be awful, and you won't be shocked when it is.
But he deserves a clean bed and care for this tumor & other health issues.
Sadly, we often cannot give our LO's what we want to give them. We have to make do, and if this angers them--well--it was done out of love.
(And, BTW, I know that 'smell'. Just thinking about it is gagging me as I type.) He is literally rotting from the inside out--poor man. I hope you can get him help.
As far as health insurance--minimally, he should have Medicaid--why hasn't anyone checked that out? Is he not a citizen? Something you need to find out.
And it might just be best now to allow the state to take over your grandfathers care since he won't listen to any family members.
He desperately needs help and APS can get him the help he needs. So call them first thing in the morning.
I would call 911 and tell them he has an infected wound and that he may be septic and having cognitive impact and not making decisions to get it treated. You don't tell them anything about dementia because this is not considered a medical emergency. But he actually may have sepsis, so make this call and go with him to the hospital. Once there, tell them he is an unsafe discharge. Then ask to talk to a social worker about options for transitioning him directly into a facility.
If for some reason 911 won't come or won't try to make him to to the ER then I'd find some therapeutic fib to tell him to take him to the ER yourself.
If none of that works you should report him to APS as a vulnerable adult. If they determine he is not able to make decisions in his own best interests, they will recommend his case to a judge who will assign him a 3rd party guardian and will make all his medical decisions going forward and manage all his affairs.
I would not get your hopes up for cancer treatment, yet. And if he does have sepsis and his cognition improves once it's treated, then consider asking him to assign a PoA, THEN take him in for a cognitive/memory test.
Pursuing guardianship can be very expensive and time-consuming and you may find it's no easier to get a demented LO to cooperate with a very rigorous and challenging cancer treatment than before having that authority.
Another outcome could be that the county decides he needs a court-assign guardian. Then you won't have to worry about making decisions for him or getting him to do anything against his will. His guardian will take care of that.
I wish you wisdom and peace in your heart on this journey with him.