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My 88-yr old dad moved to a very remote Texas town about 20 years ago. He is 3 hours from the nearest city/airport. My sister and I live in Colorado, a 2-day drive away.
He has been independent, mobile, and in good health until recently. His phone stopped working several months ago and my sister and I could not reach him (he rarely if ever calls us, even when his phone is working).
One of his friends got in touch to let us know our dad has lost 20lbs in the past 2 months (weight he couldn't afford to lose), seems disoriented, and claims he has no appetite. So last week I took time off work to drive down to see what's up.
He is confused, living in a trailer in absolute filth with no running water, mouse droppings everywhere (including inside his fridge), and he's an absolute skeleton. Also incontinent and unaware/uncaring. Thank goodness I got his signature giving me medical and durable POA while I was there. I kind of forced him to go to the local clinic, first time for a checkup in over 30 years. Although he is wasting away, his bloodwork suggests no major physical issues except dehydration. But he scored 0/5 on the cognitive assessment. His memory is shot, e.g., he can't remember my mother's name (his ex-wife) nor conversations that happened earlier in the day, and obviously he's forgetting to eat too. And he still drives (!!). Doc said he should not drive and shouldn't be living alone. He has VA benefits but we're not sure if he has Medicare. I paid out of pocket for his clinic visit and labs. There is no VA where he lives and he has said that if he ever needs medical care to take him anywhere but to the local hospital. There are also no assisted living facilities and no home health care services, outside of meals on wheels which he refused.
My sister has invited him to move in with her for a while, at least through the winter, but he refuses. All his friends suggest we just put him in the car, tell him we are going on a short trip, get him a milkshake, and then drive him to Colorado. Basically, kidnap him. He likely wouldn't notice given his current state of mind, but he is actually lucid about 50% of the time and will of course notice at some point. They also suggested we tell him that it's only temporary, that he should come hang out with his kids for a few months and once it warms up again in spring we'll take him back to Texas. Once in CO, we will take him to the VA for a more formal cognitive assessment and likely plan to find a local memory care place for him near to us, since it seems his body may outlive his brain.
My sister is making arrangements now to move him in. She has a one-way flight and a rental car lined up to get herself there, pack up dad and some of his stuff, and drive him back to CO. We sent Medicare his info and proof of POA and we should have access to his benefits soon. We are kind of in a state of shock and not sure how to navigate getting dad here, but he absolutely can't stay where he is. He is very docile, so we don't expect him to physically protest, but we're not sure how best to navigate this. It's happening so quickly. Any ideas/suggestions would be appreciated! Thanks for reading if you made it this far.

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I advise against all you are doing and think it is a plan for utter disaster.
You have an uncooperative gentleman and you have an ILLEGAL POA signed by someone who is in no state to sign it. Whether it was witnessed by a notary or not (worthless junk if it wasn't) it is, without an attorney, not worth the paper it is written about. You have no right to move your father anywhere, and I doubt that your sister doubts the level of care she is currently agreeing to take on.

You are an adult. You and Sister will do what you wish to do. But this is starting out badly.
Were it me, I would now turn your father over to the state through a call to APS and their assessment of his competency to remain safely alone. The state will take on guardianship and management, will have your father properly assessed by a neurologist, will have guardianship of a Fiduciary assigned, will manage his SS and whatever assets he has, will apply for Medicaid and will place your Dad.

My best to you, whatever decision you and your sister come to together; I wish you all the luck in the world.
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Berls501 Oct 11, 2024
Um, thanks total stranger on the internet for your judgement, despite not knowing all the details.. It is in fact a LEGAL POA, drawn up by an attorney and notarized in a law office while I was there, signed by my father in a moment of lucidity. I'm sure you mean well, but your tone is dismissive and condescending. I suppose your paragraph about calling APS is useful, but the rest of your response isn't helpful. We are doing our best to sort this out.
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Berls, why would you ask a total stranger on the internet a question if you didn’t want a total stranger-like answer?
People on here, many of which have been down this road for a long time, can only go by the information given, and even then, only give their opinions based on their experiences. If you would give it a minute or two you may get several different opinions, some of which may line up better with your expectations…..if that’s what you really want. It’s up to you to take what you can use and discard the rest. No need to be offended. Like you, people on this forum are doing their best to sort out your question, with less personal info but perhaps more experience, to rely on.

I know you’re freaked out, you have every reason to be, but please give people a chance.
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This is going to be really hard on sister, so you should be quick to get him into a memory care facility if you can find one. What part of CO are you in? There are some MC facilities that take medicaid, but not many. Do a search. When you find one you and sister can still visit him there, but it seems he is going to need 24/7 care. Good luck. Let us know what happens.
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Oh, and I thought also of your sister driving Dad for 2 days. Is there any way you or someone else can go with her?
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fluffy1966 Oct 20, 2024
Agree, one sister alone should not make this drive with Dad. An adult with driver's license needs to accompany Dad and sister. Sister's Husband? A grown Grandchild? A hired helper? SOMEONE who can assist the driving sister.
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Berls501, welcome to the forum. Glad to read that your Dad will be re-tested probably using the Montreal Cognitive Assessment which is used by the doctors here in the United States. This test has 30 quiz questions.


I am also questioning your Dad signing the Power of Attorney as you had wrote "His memory is shot,". The Attorneys usually interviews the person alone, and from that interview decide if the person can understand the wording in a POA.


Glad to read that you and your sister will be looking into Memory Care facility for your Dad. Huge question, can your Dad afford the monthly rent at Memory Care? Such facilities cost between $5k-$10k per month depending on location. If your Dad is unable to budget for that cost, then you would need to look into Medicaid. Also check with a VA facility. Whatever you do, neither you or your sister pay for Dad's care, as you need those funds for when you get older.


Hope everything works out smoothly. Keep us up-to-date. Please fill out your Profile page, that way if you have other new questions, you won't need to keep re-typing the back story.
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Igloocar Oct 17, 2024
Having been down the memory care assessment lane, I'd like to add a little. The Montreal test is a good basic screening test for memory issues. However, it's just basic. Once someone shows problems on the Montreal or the Mini-Mental Status exam, the person being examined will normally have a number of additional more specific tests to pinpoint specific weaknesses and strengths. These may last 3 or more hours. For a weakened elder, the tests might not all be done on the same day. Medicare pays for this diagnostic testing once/year.
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I would not take him into either of your homes . Once you do that and your sister makes her home Dad’s residence , it’s difficult to get a parent out against their will even with POA .

I did ALOT for my parents but I drew the line at having them move in with me for fear my mother would never leave .

I would get APS involved , or Dad’s local County Area Agency of Aging to help navigate this .
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You want to “basically, kidnap him”. That's pretty blunt. Is that what he wants? Would he prefer to live and die in the mess he is used to? Have you asked him? Many people really do prefer it. Why do you think “your judgement” is better than his – or that of anyone else given the facts you put before us? Yes, it's very confronting, but how long do you really want "his body to outlive his brain"?

You “paid out of pocket for his clinic visit and labs”, and think that's worth mentioning. That’s a very different matter from paying anything for his care, at several thousand dollars a month - even for a few months before 'help' comes along. Think twice or three times before you and your sister pick up the tab, financially or emotionally or care-wise.
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AlvaDeer Oct 12, 2024
I so love all you wrote, Margaret. I have so radically changed my attitude with aging and with more approaching this time of choices, need, etc. At 82 I think so differently from what I did at 62.
What does it mean to rip this gentleman from where he lives against his will, attempt the impossible in terms of change and care. Why? For what reason? A year or so more befuddled in a nursing home? Because surely that is where all this will lead given human limitations in taking over the life of another.
They may all rue the day that they chose to decide "what's best" here. IMHO.
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Berls, I agree with what everyone has said. APS is the best alternative here.

I know you don't want to hear that but your sister is going to go through h*** and back again , with having your dad living with her. If his physical health is good, your sister will be completely stuck with a demented person for years

We get so many questions weekly of people in complete burnout because they brought there loved one in and can't do it anymore. This people are suicidal, even so desperate they commit them selves to 3 days in a ward to get a break. It happens, more times than you will ever know.

Yes you should be concerned for your dad but you need to be just as if not more concerned for your sisters physically and mental health.

Caregiver burnout out causes PTSD, causes all sorts of physical issues from irritable bowel -cancer. Not to mention how it will destroy her family.

So please get together with sis, have a meeting on the best way to help dad with limited effects on both of your , financial, mental, and physical health.
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Berls, my heart goes out to you. Seeing your father living in that condition is a shock and will cause a person to make panic decisions that is based on emotions and not logic. The first step is save and rescue based on a panic reaction.

Do what you feel is best. No one can make a decision for you. Some parents do live with their adult children, and it works out. Others, not so well. I don't think I could live with myself knowing that I left my parent in a state like that either.

If dad has regular Medicare and not Medicare Advantage, you can use regular Medicare in any state in the US. Call APS in his county and tell them your situation with dad and his state of living and what they would recommend. If need be, maybe sister can take him for about a month to get him to a doctor and checked out while APS is involved with the intention of returning him back home. Or, checking in with Medicaid and signing him up for it. That way, drug costs would be covered, hospital costs will be covered. Medicare only covers cost the first 100 days so make sure you get Medicaid coverage. I wouldn't advise you to pick of the tabs of any medical or placement costs since this can bankrupt you. You have to consider your own financial well being. Let his state handle the costs. If it gets too much for your sister and she feels she can't handle him, you can have dad Baker Act. Take him to the emergency room and tell them that sister can no longer handle dad.

Or, like Alva said, contact APS and let them take over. This of course is done in his own county where he is and you don't remove him from his home.

Also, contact the Department of Aging that can give you information on how to proceed with dad.

Things will work out.
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Sorry, but Alva is correct. You really cannot do much without Dad being declared incompetent. The Medical you had him sign is no good. He is not capable of signing a contract. Your best bet is to call APS in and allow them to evaluate. Maybe even take over Dads care. For now I think having him placed in LTC with Medicaid paying is your best option. LTC cannot be any worse with how he is living now. At least he will be carried for, fed and warm. This will give you time to get your ducks in a row.

I am afraid at this point, you will need to get guardianship which is very expensive. Maybe better allowing the State to become guardian. Things will go quicker than if you try to.
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Berls, good for you and your sister stepping in and doing the hard things for your dad and his situation.

I would discourage you from contacting APS, no running water will get an emergency guardianship and take everything out of your family's hands. You DO NOT want the state of texas involved when you already have a good plan. I would encourage you to help your sister transport him though, 2 days can be a very challenging time for your dad and he could be too much for 1 person driving to handle, it comes with dementia.

Just gather dad up and move him to CO. As long as the people that care are all in agreement, your POAs will be fine. Problems come when somebody contests the validity of said documents, and you know that is not a problem.
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AlvaDeer Oct 12, 2024
APS in my long history as an RN is thrilled when family will take this on. This daughter already went to the trouble of trying to get legal papers and she and sister wish to give care. APS will be overwhelmingly happy to have them do so in my long history as an RN. They only take on care when family doesn't wish to be involved. In this particular case I would myself not wish to be involved. As I told Berl, if she and Sis wish to do this, I trust they will handle things just fine.

I know many do not like APS and don't have good experiences with them. I myself as an RN had stellar experiences with both APS and CPS, and can't imagine what we would have done without them. As Burnt likes to remind folks, my experience was ALSO two decades ago. Things may have changed.
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Berls, you have a good plan and I'd do the exact same thing if I were you. If you call APS, you take the matter out of your hands and put dad in THEIR hands. I'm sure you don't want to do that. Dad is fortunate to have you 2 to help him out.

Best of luck and keep us updated.
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AlvaDeer Oct 12, 2024
APS will investigate. If family wishes to handle the elder they will be THRILLED. They hate to go the route of the courts. They are only there to assess and take action if family CHOOSE not to. My experience as an RN with both APS and CPS was stellar. As Burnt likes to remind folks, it was ALSO about two decades ago.
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Where is Cover when we need him?
This is his big chance to say “filth rather than a care facility" or “kidnap rather than filth”.
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cover9339 Oct 25, 2024
Thanks MargaretMcKen, I'm still here :}

I'd have to say the former, "filth rather than a care facility", though he may agree to cleaning up his place some so it is not as filthy? Anything to keep him out of a facility.
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Thanks Everyone for taking time to respond. I appreciate your varied perspectives.
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Peasuep Oct 15, 2024
Thank you Berls, for your grace.
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Were you taking him to a VA facility since he's a veteran? Working with the Social Work office could give more options for paying for care wherever he lands.
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AlvaDeer Oct 16, 2024
I think that the family plans to give care themselves, Raven. The two sisters appear to be working together to get Dad transported to one of the daughter's home state, Colorado. That so far as I know is the initial plan.
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Berls501, I absolutely agree with you and sister. My sister and I did the same thing for my Mom many years ago. We told her she was taking a vacation to visit for a few weeks. She had cognitive decline like your Dad so two weeks turned into 10 years later and Mom is still living with me. I have no regrets. I do agree with others that this might be hard on your sister driving with Dad for 2 days. We shipped some of my Moms things to my home and we all took a flight back. Not sure if that is possible in your case. I wish you, your sister and your Dad all the best.
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Igloocar Oct 17, 2024
This is not for lmh1973, but rather for the forum. I accidentally hit "reply" while I was correcting what I had accidentally written in all caps, which sometimes happens because I have a deformed finger. I apologize. I haven't really finished, but I'm going to stop for now and not further interrupt the flow of replies.
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How is your sister going to take care of Dad? Does she not work? He is used to living alone and not under anyone's rules or wishes. If he is cognitively compromised he probably shouldn't be left alone so this is a life changing decision for your sister to take him in. Hopefully you can get his care established quickly in Colorado.
This is going to be rough, so hold on tight girls. He is lucky to have you even if he does't tell you.
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Igloocar Oct 17, 2024
James, she's indicated that they will try to find a memory care home for him. If the OP's sister works full-time, she can probably take Family & Medical Leave for a month when she first gets their father to Colorado. While that may not be long enough for testing and placement, if necessary, her sister can probably get some in-home care for him while she works and waits for placement. It sound slke they are not being naive about what they've doingIT SOUNDS LIKE THEY ARE NOT BEING NAIVE ABOUT THIS AND W
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Do exactly that - take some of his familiar items and set him up. He will not notice the difference from you description and its great you and sister are working together.
Not gonna be easy but taking the bull by the horns you can get this done! Blessings
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You / your sister need to call Adult Protective Services (APS) immediately.
- They will hopefully do an initial assessment.
- Likely he needs to be in a nursing home.

You will have lots of issues as you outline above until you / your sister get professional / legal / advice.

You do what you need to do for your dad's welfare. You do not listen to what he wants as he cannot make these decisions.

gena / touch matters
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I would like to first say how fortunate your Dad is to have loving daughters such as you and your sister who are trying to help him. 

Yes, if you can get your Dad into the car for a small trip to a restaurant and then onward, I think you may be able to get him to your sister’s home. Give it a shot. 
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Berls501: I applaud you and your sister for this plan for your father.
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You ladies are wonderful for caring so much about your Dad!
While your sister is planning his move to her home, you can contact the Veterans Administration in Colorado or the VA rep in your local county to inquire about any and all VA resources for him, since he gets VA benefits. I know in North Carolina there are Veterans homes and beds at the VA hospital, but I have no idea what is in Colorado. His move to your sister's home may be temporary if he gets belligerent about staying there, so contact the VA for back up plans.
Good luck.
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Thanks again to all who are responding! The big question coming up now is, to call APS or not. There are contrasting suggestions here, and I spoke to a lawyer in the Texas county where dad currently lives who suggested strongly *against* getting APS involved. I get the impression that the experiences people have had with APS differ from state to state. Might be worth posting this question on a new thread.
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AlvaDeer Oct 18, 2024
Berls:
It surely would be worth posting on a new thread. I would say "Berls wants to know: Should I involve APS" and put a copy/paste of THIS thread in the elaboration you write to us.

So as to whether or not to get them involved:
Where you do stand now?
Is Dad refusing to move? Is that why you think you may need to call APS to evaluate the living conditions and tell him he MUST move?

I think I would not involve APS, myself, unless I didn't want to take this on at all and I felt that Dad was in danger living alone. A danger to himself.
I would use APS only if I had to get Dad an evaluation, and a designation by the courts that he could no longer care for himself and you have to be his guardian.

And here' the problem with guardianship. Going to try to say this "nicely" or "right" because you got a little miffed with me first time. Guardianship 1. costs money 2. is almost impossible to do for someone who is uncooperative (you can't phsyically strongarm him into the car and transport him cross country) and 3. If you ever decide you no longer can/no longer WANT to be guardian, a judge won't let you resign. Resigning a POA is easy. But guardianship almost cannot be got out of.

Berls, what does this attorney suggest you do?

Hope you will let us know where things stand NOW with Dad.
Best to you.
Many are invested in your story and hoping you can get Dad protected and out of his current living conditions.
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Bumping question up because the original OP has asked another question of us in responses below, and I think it is being missed.
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Berls501 Oct 19, 2024
AlvaDeer, thanks for hanging on for the long haul! I like your suggestion of starting a new, separate thread regarding APS in Texas. Also going to post an update at the bottom of this one since so many folks have requested it.
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I have to say it sounds like you have it pretty well planned out. You're a planner, I can tell! Like me, you want to be prepared in advance for every detail!
I think the "kidnapping" scenario is probably the best suggestion, though I would avoid making too big a lie, maybe just misleading, or omitting information.
In his lucid moments, you don't want him to have reason to distrust you. That would make for a much more awkward and unpleasant relationship.

As for spending the winter with your sister, here are some tips:
Even though he seems out of it, remember to respect him and respect his
wishes. Everyone wants to remain as independent as possible.

In his current condition, I strongly urge you to resist trying to care for him yourselves. Hire a caregiver through a home health care agency.
Contact the local Department of Health for advice on what programs he may qualify for. I am not familiar with VA. I don't know if he should also be on Medicare. If he already has medicare, look for the card in his wallet. Old guys keep that stuff in their wallet.

Good luck! I hope you and your sister get him the help he needs, and get to spend this important time with him!
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AlvaDeer Oct 19, 2024
Caring,
Berls has updated this thread since she created it.
She has a new question for us regarding whether or not to involve APS.
That question is a bit further down in the thread if you scroll a bit, and in case you have any input.
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Hi All, thanks again for taking time to read and respond.

UPDATE: After seeing dad a few weeks ago, I urged my sister to take a quick trip to TX to meet the "new" version of the person that she may be moving into her home at the end of this month. Needless to say, she is a bit traumatized by the condition he's in, just as I was. The upside is that she now has a MUCH better understanding of the level of care it will take to have him live with her. He's fallen since she's been there, still losing bowel control, and is still ~50% lucid: my sister regularly asks if he remembers me and my husband visiting 2 weeks ago; half the time he says no. She is still working to get him to agree to come up to CO with her and her husband in a few weeks, with the intent that dad stay with them until we can figure out the best long term move. Note, her husband will fly down with her and help to drive dad back, so she won't be alone, as some have asked about.

Dad doesn't seem interested in moving up full-time, and we're learning all we can about how best to ensure he is safe and taken care of if he stays in West TX. We aren't sure if getting APS involved is the right move, based on the mixed feedback here (will post a separate question/thread about APS soon), but there don't seem to be many other options in the county where he lives. Will keep y'all posted!
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AlvaDeer Oct 19, 2024
Thanks a lot for this update, Berls.
It was my worst fear that Sis didn't fully understand what she might be letting herself and her family in for here; I am so relieved to know that she has visited and is aware of all the particulars.
Look forward to your updates.
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UPDATE #2: My sister and her husband have decided to wait until Christmas to bring dad to Colorado, with an interim visit in November around Thanksgiving. She talked to dad in a moment of lucidity a few days ago, and he is amenable to this idea compared to her coming to get him next week (which was Plan A, and that he was thoroughly pushing back against while both in and out of lucid states). This makes it easier all around, since it's less likely we'll have to contend with the "milkshake and kidnap" plan. Unless he completely forgets that he agreed to it, which is also entirely feasible.

My sister is framing it as a "temporary visit during the coldest months". Dad's trailer is in the high desert...he refuses to turn on the heat to save $$. Dad's landlord suspects this year's exceptionally hot TX summer fried dad's brain, as he would not turn on the A/C. Either way, dad seems more amenable to coming to CO in December. He hates the cold more than the heat, and with his recent weight loss, I'm sure it would be even harder on him. We are planning to take him to the VA for a full assessment while he's here, which he will likely push back on. But so it goes.

TBD if he will stay longer than winter, or if we'll take him back to TX when it warms up again in spring. We will likely go down there while he's in CO and thoroughly clean his trailer and do what we can to set up the best possible conditions in case we do bring him back to TX to live out his days. Bringing him back in spring would also return us to square one, albeit with less mouse turds And maybe we can figure out how to get the trailer's water system connected and working so that he can take showers, if he remembers/cares.

In the mean time, we have asked his friends and neighbors to check in on him and meals on wheels will (supposedly) continue to deliver lunch to his trailer the next few months. My sister stocked him up with easy-to-open soups and replenished his stash of protein shakes that I started when I was there a few months ago, and will stock him up again when she visits in November.
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Peasuep Oct 25, 2024
Thank you for sticking it out with the forum Berls; this thread is helping a lot of people in similar situations. You and sis are pretty awesome - if dad was in his right mind he would be proud!
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Dear Berls, thank you for updating us. You’ve moved a long way from your first ‘immediate kidnap’ post, and your anger with a “total stranger on the internet for your judgement, despite not knowing all the details”. It would be genuinely helpful to us if you could write about your ‘journey’ with us as regular posters, as well.

Most of us try to help, and know that ‘support and agreement’ can be less helpful than warnings. However people rarely move their ideas as quickly as you and your sister have done, and that has been a ‘journey’ with us as well as with your father and each other. Could you spare a minute or two to tell us about it? Yours, Margaret
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Berls501 Oct 25, 2024
Hi Margaret, I'm happy to share though not entirely sure which part of the journey you would like me to expand upon. If you can elaborate, I'll do my best to unpack more of the details.
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Good for you and dad and Good Luck!!

Try to keep him out of a facility as long as possible, hopefully never being put into one.
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Berls, thank you for your offer to explain how things changed. I found it hard to ‘elaborate’, but here goes. You started in crisis mode (understandably) : F ‘is very docile, so we don't expect him to physically protest, but we're not sure how best to navigate this. It's happening so quickly’. It seemed back then that you only wanted advice on how to implement your ‘kidnap’ plan, and found anything else distinctly unhelpful.

Clearly your ideas changed dramatically in about 2 weeks. Did the comments you got here play a part in this (and if so, how), or was it thinking more about the practicalities, or was it just calming down over a few days? Sometimes the change in approach takes years!

I suppose my reason for asking is to find out whether it is any help to come up with ‘objections’ that are unacceptable, or if we should just shut up, or if there is a better way to do it.
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Berls501 Oct 28, 2024
Dear Margaret, I’m still trying to clarify the specific information you’re seeking. It appears you may be asking for more details about the feedback my sister and I have received regarding our approach to Dad's situation, as well as whether this feedback has come from this forum or our own reflections. At the same time, it seems you want me to address whether I feel this forum's contributions have been 'unacceptable' and that y'all should just stop talking. 

Regarding the recent changes with Dad, they felt quite sudden, prompting a quick response from my sister and me. Given our history—our father physically and emotionally distanced himself almost 50 years ago—understanding the gradual nature of these changes is challenging. Our contact has been infrequent, and the most noticeable alert to a sudden condition was the significant delay in his response times to our calls. This is just one of many complexities I've left out of my posts, which makes it difficult to determine what details might be most useful for feedback.

I acknowledge that my initial response to AlvaDeer on my original post was defensive. I was in a heightened emotional state at the time. In retrospect, I recognize I should have addressed my reaction more openly. This forum is a space where we are all navigating deeply personal challenges, and it’s easy to forget that we are all striving to cope in our own ways.

I appreciate that everyone offers advice based on the information available, and I try to discern what is helpful and what may not resonate. With the exception of my initial response to Alva, I hope my responses have been graceful.

In truth, I have found the insights shared in this forum to be quite helpful. My sister and I are actively seeking diverse perspectives to navigate our options, considering input from friends, professionals, and yes, even strangers online. While it remains a crisis, we have settled somewhat since the initial shock a few weeks ago.

I do not view the responses here as unacceptable objections, nor do I think the forum participants should "just shut up". I’ve expressed my gratitude for the feedback numerous times. I also now recognize the importance of being mindful with my words in this space.
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