My dad and I have a medical and durable POA on file. His DPOA says that it needs a Dr. to certify in writing that he is mentally incapable of managing finances. This was done 7/2021.
About 3 weeks ago he had a fall and I called EMS. He had an infection that turned septic and was taken off his Clozaril (major psych med). He was put on Abilify and about a week after this fall he became nonverbal. He had been on/off the Clozaril the last 2 weeks and is in a total catatonic state. Trying to speak, in and out of awareness and following commands. Usually unresponsive. The hospital has both on file and have enacted the MPOA. They call me for major decisions like a feeding tube, etc. and I call for updates every day and they provide information. However, I am 100% getting the run around when it comes to getting a certification on his incapacitation so that I can enact the DPOA, go to the bank, and start handling his finances. In the last 3 weeks I have asked his usual psychiatrist in the same hospital network, the current psychiatrist while he is in the hospital, 2 attending physicians, and 2 social workers, as well as his PCP who should likely be getting updates. All in the same hospital system. No one gets back to me. The original psychiatrist’s office did say that because there is no release of info on file they cannot disclose information despite having the MPOA. I reiterated that they have and have been utilizing the MPOA and that my dad cannot consent to anything right now. Even the current psychiatrist seeing him daily said she is documenting incapacitation in her notes, but then never called me back after promising she would get some answers in what to do about providing documentation several days ago. I worry the longer we go, the poorer his prognosis gets and more behind he gets on his bills.
Also, at this point the attending and psychiatrist says that the next steps will be trying ECT (shock therapy) to help him come out of this state, but that requires guardianship as the MPOA will not allow consent for this type of treatment, which of course can take weeks to implement. I don’t understand the bureaucracy and it feels negligent. Any insight on where to go or what to ask for to get the necessary paperwork? Hire a lawyer and go straight for guardianship? Will the hospital even talk with the lawyer since they won’t help with the document certifying mental incapacitation?
Thank you for any thoughts.
All you need is a letter stating that his Dr. feels he is not competent.
"The original psychiatrist’s office did say that because there is no release of info on file they cannot disclose information despite having the MPOA." IMO they don't know what they are talking about. First, you are not asking for his info. Your asking that his doctor write a letter saying Dad is incompetent to make decisions on his own. And when that is done, your POA is in effect and then you can ask for his info. You are Dads representative.
I would see the SW. Tell her that no one seems to understand that all you need is a letter saying Dad is incompetent at this time.
How old is Dad?
You could also demand that a meeting be scheduled to address all the outstanding issues, prepare a list of them but also consider that providing a list too soon could allow them to close ranks and come up with other "options."
This is where your good insights could come in; think of options, raise the issues that apparently aren't being considered by the staff, and provide solutions from which they can choose. It wouldn't hurt to bring in an outside person(s) knowledgeable (or expert) on these issues involved, so the staff can't reject your questions and solutions out of hand.
Chills ran up and down my spine when I read that ECT might be considered.
Frankly, I'd think that if your medical POA has been activated, then your DPOA should have been activated for the same reasons. By what means did the hospital decide to activate the MPOA?
If this is what the DPOA lists as making it go into effect, and it has been done as per your OP (or was the DPOA created on 7/2021?? - that's not clear to me), I'd take both papers down to the county clerk office, pay to file both as one document, pay to get a certified copy and then hand it over to the bank stating I'm now in charge of my father's finances. Any financial location should accept that the requirements of the POA to be active have been met and let you do what needs to be done.
That takes care of the financial.
If the MPOA lists something different for you to take over his medical decisions on his behalf then those requirements must be met as well. What exactly does the MPOA list as requirements to be activated for decision on his behalf?
It might be faster to get an emergency temporary guardianship -- on average 24 - 72 hour turnaround and in some cases just have to show a more harm evidence and not full incapacitation-- to stop the electric shocks and then go for a full guardianship later. That is much more expensive but the most expedient in the name of time.
Edit: I just read your comment that it does say you need a declaration on the POA document, but your dad has no on line profile. Go that route while you wait for the letter. My father is the same, no online profiles for anything. He doesn’t even do email. As soon as I started seeing bills not being paid and confusion with finances I created profiles for him so I could monitor all the accounts and pay the bills until I was able to get clarification from his attorney about my DPOA.
The guardianship for shock therapy is another thing entirely. At first I was thinking how did he get from a fall to needing shock therapy? Then I reread and thought about it more and it sounds as though your dad has had some psychiatric issues so perhaps his needing to be taken off his meds created this need, either way your dad was obviously preparing for a scenario like this by setting up DPOA and MPOA so I’m not sure why they are requiring guardianship if this is something they really feel needs to be done and believe in. Guardianship is usually an expensive and somewhat lengthy process, again your dad was trying to avoid this for you and I might ask them what they would do if you weren’t around would they go get temporary guardianship of him so they could perform this procedure, just do it because in the absence of someone authorized they can or leave him somewhat catatonic and move him to a facility? Make sure you get all the facts from them before deciding to jump through extra hoops for them, they may simply be trying to pass the buck so to speak. Unless of course you don’t want this and they do or vice versa, then yo are at odds and they are covering their bases.
I have found that doctors are very reluctant to put in writing that a person is cognitively unable to make financial decisions they even dance around a diagnosis of dementia deferring to a neurologist for some reason so maybe you are running into a form of this? Though it doesn’t sound like dementia is the issue so perhaps simply go to the bank with your DPOA and tell them he is catatonic in the hospital and you need to pay his bills. If they insist on a doctors note call the attorney who drew the papers up and ask them what you need to do in this instance instead of trying to chase down doctors who don’t want to do this for some reason. Know where you stand and what you need from whom before making waves with his doctors and giving yourself extra stress and work.