This is the first of four articles discussing lessons Bill McIntyre learned while assisting his father, who was diagnosed with dementia in October 2016. These are lessons that no one prepared him for.
Lesson 1: A hospital emergency room won’t give you a dementia diagnosis.
This is what a friendly nurse told me while my dad was in the ER for the fourth time in two years. The ER’s main role is to save a patient from immediate danger; once the ER has stabilized the patient, they either admit the patient to the hospital for further treatment or discharge the patient.
My dad, a snowbird who spends winters in Florida, insisted he could drive the long trek on his own. He would stop in rest areas to catch a few winks in his truck, then get back on the road to continue his journey. He would eventually get dehydrated, delirious and make bad decisions.
On one occasion, he was stopped by a trucker when trying to exit a rest area going the wrong way onto I-75. On another occasion, police in the Atlanta area were called because the fender of the cargo trailer my dad was towing had hit the back of a store while turning around. My dad was found wandering around about a mile away. On yet another occasion, he pulled into a firehouse, drove up one driveway, across the lawn, down another driveway and back across the lawn, before parking in the middle of it. The firemen scrambled out, assessed my dad’s condition and called an ambulance for him.
To get my dad to accept any kind of help, we needed to activate the power of attorney (POA) he had prepared. To activate the POA, though, we needed a written diagnosis of dementia. On three occasions, my brother and I traveled to Kentucky, Georgia and Tennessee to pick our dad up from an ER. The result was always the same: Dad got discharged, we would take him home, he refused further treatment or help.
With no written diagnosis, we had no legal authority to require him to go to the doctor.
Finally, my brother and I took a different approach: When we were told that Dad was ready for discharge and to come pick him up, we refused.
The hospital staff was stunned. At first, they simply called back every hour. We told them that if Dad was good enough to be discharged, they should give him his truck keys. If they felt he had cognitive issues, they should give him a written diagnosis.
Our tactic worked. By forcing the ER to think outside the box, the hospital transferred our dad to a geriatric psychiatric hospital. Within two days, we had a written diagnosis of dementia.
With the written diagnosis, my dad’s POA was activated. This gave my brother Mike authority to act on his behalf.
If you or someone you know needs help caring for an elderly relative, contact ComForCare Senior Services at 616.285.7000, or visit www.comforcare.com/kent-county for more information.
Written by Bill McIntyre. Watch for the second article in this series, where Bill discusses the differences between Power of Attorney, Guardianship and Conservatorships in the State of Michigan.