To those that believe the elderly should always make their own decisions

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I was one of those social workers who investigate people for elder abuse. What I did in reality wasn’t anything like that sounds. Someone would call us worried about an elder, and I’d go figure out what was going on, and do everything I could to help. I did lots of listening, hand holding, phone calling insurance plans, finding Medicaid beds in assisted living, lining up care givers, and finding mental health providers. Oh, and lots of cleaning for people with hoarding disorders. My clients were almost always mentally ill or had some level of dementia. It was truly, truly rare to have a situation where some one was abusing an elder for malicious reasons. It was almost always a situation where physical health and mental health decline simply made the family system collapse. Unless there was violence or outright theft of assets no one was ever “brought up on charges” or “charged with elder abuse.” We were just social workers, not police, and the only tools we had were help.

OP, I know this is hard. I hope you find some peace and some enjoyment this holiday season.

Haven't you encountered the elder who is able to present as absolutely logical, or who at least is able to present as legally competent but exercises rights to his/her own decision making? And perhaps a spouse who is totally on board, or presents as being totally onboard? I'm thinking of 2 situations. One where an elder relative wanted help from adult services but due to problems with decision making let others make the call, and when investigated still wanted the help but was deemed too capable (his physician, nurse, and the social worker they worked with knew better, but adult services gave a thumbs down). And one involving hoarding, some long standing MH diagnosis where treatment is refused but where the mental situation is not dire enough to warrant hospitalization, even though the hoarding has long reached the point where it is life and health threatening.

Yes, for sure I’ve encountered those situations. Unless a person has significant dementia or is truly psychotic they generally retain the right to make terrible decisions. It’s a tricky balance and I don’t envy the doctors and judges who together make these calls. In the few times in my work where an elder did have a guardian appointed and that guardian forced something like a nursing home or a move the elder often did not thrive in the new setting. It makes kids feel like they have done the right thing to have a parent miserable, angry, and depressed (but safe) in a nursing home rather than somewhat content (and at high risk of death) while home alone. I don’t entirely understand. I’ve spent plenty of time in nursing homes, and personally I’d rather take my chances with a fall and lingering death on the floor alone. So I give my own parents (and gave my clients, where they were legally competent) the same respect for their preferences.

I can't with this. So the parent has the 'sads' but is safe, warm and fed. EVIL KIDS, clearly. I guess I should let my parents live in a home they can't afford, have it sold out from under them to pay for debt they incur. Maybe they can lose their last asset that can pay for their care, but hey, they are happy so why not, right?

This is why I can't stand social workers. You are all about 'the feels' and not the practicality of the situation. Did you NOT read the earlier post about the poster who said her grandfather starved her grandmother to death? Do you let toddlers wander outside in snowstorms in a diaper because they might tantrum in warm clothing?

I’m the psychologist PP above: you’re either not understanding or choosing not to consider adults’ agency in these scenarios. Once someone turns 18 and is a legal adult, the standards for obtaining legal guardianship are very, very high. You can debate whether they should be so stringent, but hating on social workers is unfair and misplaced anger. They don’t make the laws.

The grandfather starving the grandmother is similar to intimate partner violence scenarios, in which the abused partner chooses to stay. There’s almost nothing another adult can do, legally, to force that person to leave. Someone upthread suggested the grandchild in that case should have reported her grandfather to adult protective services, only to be told by someone else (you?) that would have meant more problems. These situations are rarely as straightforward as they may seem to be from the outside.

NP. You are diverting. You weren't talking about how difficult it is to get a guardianship; you described a situation where kids *did* get guardianship, moved the parent into a facility, and the parent was unhappy with it.
(I bolded it for you above.) You then said you didn't understand the decision, and would rather take your chances with a fall and lingering death on the floor. (Lovely, by the way.) As the PP said, you're advocating that kids who have guardianship should still respect their parents' preferences even if it puts them at risk.

So this talk of "agency" is nonsense. This is a situation where courts have decided that the parent can't be trusted to exercise their own agency.

You're also got a lot of nerve accusing the PP not not understanding, when you are mischaracterizing your statements.

[Anonymous]

Anonymous wrote:

In many ways the "classic" forms of dementia like Alzheimer's or Parkinson's are easier because there's a clear trajectory and a list of defined options. Moderate dementia without a diagnosis or mental illness are so so hard, especially if the person presents as normal long enough to get through a short interview. There aren't legal mechanisms to intervene. There often isn't universal family support to intervene. Yet the person can do a lot of harm to themselves and others. It's really hard.

For examples, recall all the examples of elderly people driving through farmer's markets or the wrong way down streets, killing and injuring people. In those cases I bet all should have had their license taken away sooner, but there wasn't the family will or a legal means to do so.

This is exactly what our family is dealing with with my Dad right now. My mom has more severe dementia, and he is the one responsible for her too (he hires help for her, but ultimately he is responsible and makes all decisions.)
I am terrified he will hurt or kill someone with his driving.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I watched my inlaws literally die from being allowed to make their own decisions. "They deserve to live and die how they want."

No, they were in denial that they would die, period, refused treatment, got thrown out of rehab for not cooperating, went home with poor and absent care and died in a horrible nursing home due to systemwide septic shock and stroke. Horrible to watch. The other died at home, refusing help. They actually would have not only lived, but thrived for several more years, even possibly a decade. One sibling did her best to let them do what they wanted. There's always one sibling who does this because they don't want to help.

Exactly right. Do people let toddlers make their own decisions because ‘it’s easier’ or ‘it’s what they want to do’? Because that’s essentially the age-range you deal with as elderly fail

In many ways the "classic" forms of dementia like Alzheimer's or Parkinson's are easier because there's a clear trajectory and a list of defined options. Moderate dementia without a diagnosis or mental illness are so so hard, especially if the person presents as normal long enough to get through a short interview. There aren't legal mechanisms to intervene. There often isn't universal family support to intervene. Yet the person can do a lot of harm to themselves and others. It's really hard.

For examples, recall all the examples of elderly people driving through farmer's markets or the wrong way down streets, killing and injuring people. In those cases I bet all should have had their license taken away sooner, but there wasn't the family will or a legal means to do so.

Until they reach a certain level they are considered sound to make their own decisions. It really is shocking what a doctor will consider mentally sound. With regard to driving that is another landmine and it varies by area. Some DMVs will suspend a license pending testing based on report of a concerned person, most won't. Some elderly family members are with it enough NOT to let you in the house to take the car keys. Occasionally the police can help. It's a nightmare and they have many, many rights.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I was one of those social workers who investigate people for elder abuse. What I did in reality wasn’t anything like that sounds. Someone would call us worried about an elder, and I’d go figure out what was going on, and do everything I could to help. I did lots of listening, hand holding, phone calling insurance plans, finding Medicaid beds in assisted living, lining up care givers, and finding mental health providers. Oh, and lots of cleaning for people with hoarding disorders. My clients were almost always mentally ill or had some level of dementia. It was truly, truly rare to have a situation where some one was abusing an elder for malicious reasons. It was almost always a situation where physical health and mental health decline simply made the family system collapse. Unless there was violence or outright theft of assets no one was ever “brought up on charges” or “charged with elder abuse.” We were just social workers, not police, and the only tools we had were help.

OP, I know this is hard. I hope you find some peace and some enjoyment this holiday season.

Haven't you encountered the elder who is able to present as absolutely logical, or who at least is able to present as legally competent but exercises rights to his/her own decision making? And perhaps a spouse who is totally on board, or presents as being totally onboard? I'm thinking of 2 situations. One where an elder relative wanted help from adult services but due to problems with decision making let others make the call, and when investigated still wanted the help but was deemed too capable (his physician, nurse, and the social worker they worked with knew better, but adult services gave a thumbs down). And one involving hoarding, some long standing MH diagnosis where treatment is refused but where the mental situation is not dire enough to warrant hospitalization, even though the hoarding has long reached the point where it is life and health threatening.

Yes, for sure I’ve encountered those situations. Unless a person has significant dementia or is truly psychotic they generally retain the right to make terrible decisions. It’s a tricky balance and I don’t envy the doctors and judges who together make these calls. In the few times in my work where an elder did have a guardian appointed and that guardian forced something like a nursing home or a move the elder often did not thrive in the new setting. It makes kids feel like they have done the right thing to have a parent miserable, angry, and depressed (but safe) in a nursing home rather than somewhat content (and at high risk of death) while home alone. I don’t entirely understand. I’ve spent plenty of time in nursing homes, and personally I’d rather take my chances with a fall and lingering death on the floor alone. So I give my own parents (and gave my clients, where they were legally competent) the same respect for their preferences.

I can't with this. So the parent has the 'sads' but is safe, warm and fed. EVIL KIDS, clearly. I guess I should let my parents live in a home they can't afford, have it sold out from under them to pay for debt they incur. Maybe they can lose their last asset that can pay for their care, but hey, they are happy so why not, right?

This is why I can't stand social workers. You are all about 'the feels' and not the practicality of the situation. Did you NOT read the earlier post about the poster who said her grandfather starved her grandmother to death? Do you let toddlers wander outside in snowstorms in a diaper because they might tantrum in warm clothing?

I’m the psychologist PP above: you’re either not understanding or choosing not to consider adults’ agency in these scenarios. Once someone turns 18 and is a legal adult, the standards for obtaining legal guardianship are very, very high. You can debate whether they should be so stringent, but hating on social workers is unfair and misplaced anger. They don’t make the laws.

The grandfather starving the grandmother is similar to intimate partner violence scenarios, in which the abused partner chooses to stay. There’s almost nothing another adult can do, legally, to force that person to leave. Someone upthread suggested the grandchild in that case should have reported her grandfather to adult protective services, only to be told by someone else (you?) that would have meant more problems. These situations are rarely as straightforward as they may seem to be from the outside.

NP. You are diverting. You weren't talking about how difficult it is to get a guardianship; you described a situation where kids *did* get guardianship, moved the parent into a facility, and the parent was unhappy with it.
(I bolded it for you above.) You then said you didn't understand the decision, and would rather take your chances with a fall and lingering death on the floor. (Lovely, by the way.) As the PP said, you're advocating that kids who have guardianship should still respect their parents' preferences even if it puts them at risk.

So this talk of "agency" is nonsense. This is a situation where courts have decided that the parent can't be trusted to exercise their own agency.

You're also got a lot of nerve accusing the PP not not understanding, when you are mischaracterizing your statements.

Try again. The bolded post is from a different PP, a social worker with actual expertise in this subject. So, your words (which I underlined) are factually incorrect.

I'm a psychologist, with less experience directly with the elderly, but plenty of experience working with adults with psychosis. The latter can be so severe as to require involuntary hospitalization, but it can also just mean people make really poor decisions but can otherwise care for themselves in basic ways. And if they can, there is very, very little another adult can legally do. That's the point. I've never said this situation was easy, rather that options for involuntary commitment/guardianship are incredibly limited. Also limited: filial responsibility laws, which someone was using to justify paranoia that "the state" was "coming after" her, which meant she had to martyr herself into oblivion to care for elderly parents. By all means, care for your elderly parents. But the inability to set boundaries is not precluded by "the state," but an individual's struggles with doing so. Setting boundaries is hard, but one of the best life skills adults can have.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I was one of those social workers who investigate people for elder abuse. What I did in reality wasn’t anything like that sounds. Someone would call us worried about an elder, and I’d go figure out what was going on, and do everything I could to help. I did lots of listening, hand holding, phone calling insurance plans, finding Medicaid beds in assisted living, lining up care givers, and finding mental health providers. Oh, and lots of cleaning for people with hoarding disorders. My clients were almost always mentally ill or had some level of dementia. It was truly, truly rare to have a situation where some one was abusing an elder for malicious reasons. It was almost always a situation where physical health and mental health decline simply made the family system collapse. Unless there was violence or outright theft of assets no one was ever “brought up on charges” or “charged with elder abuse.” We were just social workers, not police, and the only tools we had were help.

OP, I know this is hard. I hope you find some peace and some enjoyment this holiday season.

Haven't you encountered the elder who is able to present as absolutely logical, or who at least is able to present as legally competent but exercises rights to his/her own decision making? And perhaps a spouse who is totally on board, or presents as being totally onboard? I'm thinking of 2 situations. One where an elder relative wanted help from adult services but due to problems with decision making let others make the call, and when investigated still wanted the help but was deemed too capable (his physician, nurse, and the social worker they worked with knew better, but adult services gave a thumbs down). And one involving hoarding, some long standing MH diagnosis where treatment is refused but where the mental situation is not dire enough to warrant hospitalization, even though the hoarding has long reached the point where it is life and health threatening.

Yes, for sure I’ve encountered those situations. Unless a person has significant dementia or is truly psychotic they generally retain the right to make terrible decisions. It’s a tricky balance and I don’t envy the doctors and judges who together make these calls. In the few times in my work where an elder did have a guardian appointed and that guardian forced something like a nursing home or a move the elder often did not thrive in the new setting. It makes kids feel like they have done the right thing to have a parent miserable, angry, and depressed (but safe) in a nursing home rather than somewhat content (and at high risk of death) while home alone. I don’t entirely understand. I’ve spent plenty of time in nursing homes, and personally I’d rather take my chances with a fall and lingering death on the floor alone. So I give my own parents (and gave my clients, where they were legally competent) the same respect for their preferences.

I can't with this. So the parent has the 'sads' but is safe, warm and fed. EVIL KIDS, clearly. I guess I should let my parents live in a home they can't afford, have it sold out from under them to pay for debt they incur. Maybe they can lose their last asset that can pay for their care, but hey, they are happy so why not, right?

This is why I can't stand social workers. You are all about 'the feels' and not the practicality of the situation. Did you NOT read the earlier post about the poster who said her grandfather starved her grandmother to death? Do you let toddlers wander outside in snowstorms in a diaper because they might tantrum in warm clothing?

I’m the psychologist PP above: you’re either not understanding or choosing not to consider adults’ agency in these scenarios. Once someone turns 18 and is a legal adult, the standards for obtaining legal guardianship are very, very high. You can debate whether they should be so stringent, but hating on social workers is unfair and misplaced anger. They don’t make the laws.

The grandfather starving the grandmother is similar to intimate partner violence scenarios, in which the abused partner chooses to stay. There’s almost nothing another adult can do, legally, to force that person to leave. Someone upthread suggested the grandchild in that case should have reported her grandfather to adult protective services, only to be told by someone else (you?) that would have meant more problems. These situations are rarely as straightforward as they may seem to be from the outside.

NP. You are diverting. You weren't talking about how difficult it is to get a guardianship; you described a situation where kids *did* get guardianship, moved the parent into a facility, and the parent was unhappy with it.
(I bolded it for you above.) You then said you didn't understand the decision, and would rather take your chances with a fall and lingering death on the floor. (Lovely, by the way.) As the PP said, you're advocating that kids who have guardianship should still respect their parents' preferences even if it puts them at risk.

So this talk of "agency" is nonsense. This is a situation where courts have decided that the parent can't be trusted to exercise their own agency.

You're also got a lot of nerve accusing the PP not not understanding, when you are mischaracterizing your statements.

Try again. The bolded post is from a different PP, a social worker with actual expertise in this subject. So, your words (which I underlined) are factually incorrect.

I'm a psychologist, with less experience directly with the elderly, but plenty of experience working with adults with psychosis. The latter can be so severe as to require involuntary hospitalization, but it can also just mean people make really poor decisions but can otherwise care for themselves in basic ways. And if they can, there is very, very little another adult can legally do. That's the point. I've never said this situation was easy, rather that options for involuntary commitment/guardianship are incredibly limited. Also limited: filial responsibility laws, which someone was using to justify paranoia that "the state" was "coming after" her, which meant she had to martyr herself into oblivion to care for elderly parents. By all means, care for your elderly parents. But the inability to set boundaries is not precluded by "the state," but an individual's struggles with doing so. Setting boundaries is hard, but one of the best life skills adults can have.

So sick of pablum. Stop blaming this all on those that know what's really going on with your 'boundaries' crap and your 'it's not easy' crap. When do I receive your financial support to keep this situation going?