Help Needed to get elderly NPD w/dementia declared incompetent

[SCDaughter]

Background: My NPD father lives in WA state, I live in another state and have been NC for over 20 years. My brother lives in the same town and has tried to retain a relationship with him.  Father is now 82 years old, our mother died of cancer in 1996, he is divorced from his second wife and lives alone.  He has alienated himself from all other family and has no one close to him.  He is suffering from severe health issues: 1) Heart disease, for which he needs surgery to replace a valve but he's not healthy enough for it.  2) He is insulin-dependent diabetic 3) He has been diagnosed with dementia with a probably Alzheimer's diagnosis.  He is also an undiagnosed NPD.

Over the past year he has been in and out of the ER at least 10 times, several times for mild heart attacks and retaining fluid, and most recently he's been calling the ambulance and gone to the ER twice - physically ok, but telling the doctors that my brother is stealing from him or trying to kill him.  My father does not trust ANYONE and would not ever consider giving a medical or financial POA to his children or anyone else.  He has control of a trust in our name and money is how he tries to control us.  We've long since tired of this game and it's not about money for us, but he also won't accept any help.

As a result this has gone on and on for months now, and his primary care doctor is trying to get his cognitive and psychological health evaluated.  However, our father is still aware and his main fear is losing control of his money and his agency, so he is refusing testing.  He's had some cognitive and memory tests which do you show decline and a tentative diagnosis of Alzheimers (and has been prescribed Alzheimers meds).  APS went out several months ago and did an investigation but found him ok at that time.

We've tried talking to a lawyer about getting him declared incompetent but were advised against it by the lawyer, knowing our dad can and will fight this and it can go all the way to a jury trial.  Today a social worker once again advised we go this route, after he ended up in the ER this morning physically ok but ranting that my brother was trying to kill him (!), but that involves hiring a lawyer on our own dime to fight him, and he has much more financial resources than we do.  We were told if we wait for the state to get involved, it will take a much bigger incident.  I'm not sure what that could be, considering he's now calling 911 and ending up in the ER daily (during a pandemic!).  At this point however, there are countless incidents documented in his medical records of his delusional and paranoid state as well as not being able to care for himself, manage his diabetes and medications, etc.  He's also refused any in-home care.  Our hands are literally tied, we cannot help him. 

On top of all his medical issues, there are significant financial concerns as well.  His tax bill for 2020 was $200k which is alarmingly high considering he owns his home and has few expenses, and his CPA just notified us that she is firing him, after trying for months to get him to provide documents for his tax return.  He recently told my brother that he sent his computer out to a guy to "help him with his passwords".  There is significant reason to believe he may have been a victim of elder fraud, but again, nothing he says makes sense and he won't allow my brother to help him.

Does anyone have any advice for how to get our father declared incompetent so we can get him in a residential care facility?   It seems we have to initiate it, and that means getting a lawyer on our own dime.  Everything I find online seems to assume a willing patient or one who is sufficiently incapacitated that they have no idea how to fight a competency evaluation.  How do you help someone who will fight to the death to retain control of their finances and automony?  My dad has spent a lifetime suing those he thinks have wronged him, so he can be a formidable force even with his dementia.

[Andeza]

I really, really wish that WomanInterrupted was here, as she would have the answers to all your questions and then some. But I would recommend digging into her profile, the topics she started, and there's a wealth of information there if you go back a couple of years.

My suspicion, but I don't know this for sure, is that he's going to have to fail an evaluation one of these times he goes to the ER before the state will declare him incompetent. Which means... he may have to get much, much worse before that can happen. In the meantime, maybe have a little list of places you would send him that have memory care units, etc. A gameplan for when the day comes. Did you speak specifically to an elder care attorney? I would want to know that I spoke to the most informed individual.

[DaisyGirl77]

I was in a somewhat similar boat to you.  What I was told by Massachusetts' APS was what you've been told by Washington APS.  They have to get severely, incredibly worse for the state to step in.  I'm really sorry that there's nothing you can do to stop the train from flying off the tracks, but that's what it's gonna take for your uNPD father to be declared incompetent.

You might want to consult a lawyer specializing in elder affairs to protect yourself from anything your uNF might pull.  Keep your hands inside the shark cage.  Let the chips fall.  At some point, the ER doctors will get tired of him showing up daily & something will be triggered.  But until then, you simply have to wait & watch him fall into ruin. :/

[SCDaughter]

Thank you both for your replies.

I found WI's posts and read through them, she seems to have been in a very similar situation with her father, but it sounds like eventually there was a crisis situation (fell and broke a hip), he was declared incompetent and her father eventually willingly signed a POA.  That will never happen in this case.

We can continue to wait for a more significant crisis and let the state step in.  We are aware that there is a trust that our mother set up for us before her death that our NDad has been complaining for decades that he cannot get access to (he controls it, but he can't remove the funds), and that it may have significant funds for us and his 8 grandchildren (he has no relationship with any of them).  It would be a tragedy if the state ended up confiscating that money, my brother cannot afford to send any of his kids to college.  Dad has his own funds too, but it's unknown his financial status because he is extremely paranoid and secretive about money.   He's obsessed with the trust and ensuring that his children don't get it, because of course we are just awful, abusive, terrible children in his rewritten narrative.

As sad as it would be to have the state take over the money our mother wanted us to have, it's not worth fighting our dad over it.  That's what he wants, that's what he expects, because he's projected his own obsession with money onto us.  I just really wish there was another option here to get him declared incompetent besides hiring a lawyer which my brother and I are not in a position to pay.  APS will be able to get tons of documentation from his doctors including his delusional and paranoid behavior, diagnoses of dementia and Alzheimer's but apparently that is still not enough. 

[Heartchakra1]

He sounds like my father, in fact all the stories here sound like my parents. 

My father has,  apparently,  a couple of weeks left, and he too use to end up in ER with nothing wrong with him.   In the end the family let the hospital place him in a resthome since my mother (his ex wife) had had enough of him, but later removed him from the resthome to look after him.

Essentially, what I'm getting at, is it possible to let the Healthcare system look after him?  Or do you have someone at home to care for him?

My father,  at the time, had no one to physically care for him hence declaring him unfit to live in his own, and since he wouldn't stay with me, and my mother at the time didn't want to have to look after him, they took care of his care.

[Heartchakra1]

It sounds awful, but essentially abandoning him to the system? 

I'm not sure what it's like there, here we don't put anyone out on the street. 

In short, we let him phone the ambulance all he wanted.  It only p...d off the Healthcare system who didn't want him doing that. Of course we didn't want him using the resources like that, but it also meant it wasn't our issue.  We couldn't force him to not phone.  Another thing we did was make sure a neighbor could look out for him and phone us if he was in trouble (as in laying on the floor and not closing his curtains or opening them).

It's such a tricky time!  I feel for you. My father acts the same way about money too.

He's now not able to speak more than one or two words and I'm tossing up whether I tell his POA (who intends to move him closer so I can be with him in his final days) about my mother and her potential desire for him to remain where he is.

I say 'potential' because she's got an evil side to her that I can't explain.  I suspect she doesn't want me with him in his last days.

[Fiasco]

I found WI's posts and read through them, she seems to have been in a very similar situation with her father, but it sounds like eventually there was a crisis situation (fell and broke a hip), he was declared incompetent and her father eventually willingly signed a POA.  That will never happen in this case.

If someone is declared incompetent they can't sign legal documents anyway. That doesn't mean you can't pursue guardianship, if you want to, at that time.

We can continue to wait for a more significant crisis and let the state step in.  We are aware that there is a trust that our mother set up for us before her death that our NDad has been complaining for decades that he cannot get access to (he controls it, but he can't remove the funds), and that it may have significant funds for us and his 8 grandchildren (he has no relationship with any of them).  It would be a tragedy if the state ended up confiscating that money, my brother cannot afford to send any of his kids to college.  Dad has his own funds too, but it's unknown his financial status because he is extremely paranoid and secretive about money.   He's obsessed with the trust and ensuring that his children don't get it, because of course we are just awful, abusive, terrible children in his rewritten narrative.

I'm not an attorney, and maybe you would feel better if you at least consulted with and retained one for the future, but if he doesn't have ability to remove the funds then the trust doesn't belong to him and he can't do anything much to mess it up. Having "the state" assume guardianship of you does not mean they also own your assets, do do whatever they want with, and certainly not a trust set up by, and for totally other people.

I also use a forum on Aging Care and there's tons of questions similar to yours on there all the time. But the general consensus is always "if you need to know for sure you have to ask an attorney". You will probably need one to probate the estate some day, may as well find one you like now.

[1footouttadefog]

This past spring I took guardianship of my spouse.

There was also a trust involved.  Our trusts were set up by us and we are each other's co trustees. I now need to change that.  Part of our reason for a trust were to keep any money from being eaten up by taxes as we are later in life parents.  Also it was clear pdh had mental health issues and we knew things could be sketchy down the line, and we are there now. 

It might be possible to give the lawyer who made up the docs a call and ask if you or another sibling or relative is given any assignments by the docs that would help.

There were specifications in the trusts about what to do regarding incompetency.   However I ended up going the guardianship route.  I paid to ha e an estate planning package for if and when pdh became incompetent but was then sent to a gaudianship lawyer instead if executing the docs in the estate planning package. 

In the end it is likely for the best.

The trusts may have docs that regard Incompetency.  There may be power of attorney docs or medical power of attorney docs.


You will need a lawyer that specializes in guardianship.

Once I got the ball rolling it went easy for me.  My spouse was assigned a guardian ad item lawyer by the court.  He then had to pay for this iht if his money, I hired a lawyer thst knows gaudianship law.

The guardian ad litem interviewed my spouse in our home and read out estate planning docs and could see it was clear that his intention was for me to take care of him etc.

My pdh did not deny the issues and even helped out by asking "isn't this what we paid alot of money for those big folders of  legal papers for".

I had medical records, etc.

Your situation will be tougher if he denies and fights, but it might not be as bad as you think if there is enough proof.  Medical records, evidence of being abused financially/evidence he has been scammed.  Evidence of instability etc.

All states are different.  I as guardian have to give an annual report about his money and how it was spent.  I had to take out a bond to cover that.

Often trusts are set up to save inheritance taxes.  If so there are often three or more trusts involved.

Each spouse has a trust that is a living trust with each other as trustee.  Then if one dies their trust goes into a family trust.

This keeps the tax exemption from being wasted giving the money to the remaining spouse.  Instead it goes to the family trust.  Once there it's inheritance tax has been paid once or was exempted in whole or in part.

If it goes from spouse to spouse then to the heirs it gets taxed twice and depending on what the rates are this could leave very little.

This is referred to as generation skipping.

Sometimes there is a step in between called spillover or something.

It's possible that one of you siblings are mentioned as substitute trustees or as medical power if attorney once your mother passed.

It would be benificial to determine if there was an entire package made up as its pretty typical to do so when reati g a trust. 

[Sneezy]

We are aware that there is a trust that our mother set up for us before her death that our NDad has been complaining for decades that he cannot get access to (he controls it, but he can't remove the funds), and that it may have significant funds for us and his 8 grandchildren (he has no relationship with any of them). 

If your dad controls the trust but can't access the money, then it is likely that he is the trustee and you and your siblings are the beneficiaries.  You need to talk to an attorney who specializes in estate planning, tax planning, and trusts. Please don't go to a family law attorney or general practitioner - find a specialist who works regularly with trusts.  You may have rights as the beneficiary to examine the trust documents.  At that point, your attorney can advise you as to what your next steps should be regarding the trust.  It may be possible to pay the attorney using funds from the trust (it all depends on what kind of trust it is, what state you are in, etc. - only an attorney who is well-versed in this area can give you those answers).  If no one has examined the trust documents since your mother passed away, it's high time to do that.  For all you know, the funds in the trust may be designated to go to the beneficiaries when they reach a certain age.  Maybe you or one of your siblings is designated to be the trustee when you reach a certain age, or when your dad reaches a certain age.  You won't know until you investigate further.  And (one more time at the risk of repeating myself) the best way to do all this is with an experienced attorney who does this kind of work every day.