Case Study 1

Caring for a Mother with Dementia Who Lives Alone

By Mark Pancrazio

Imagine that you are at a place in your life where your mom lives all alone and she is in cognitive decline. Unfortunately, you can’t really help her much because she lives far away and you can’t visit her except on weekends here and there. You’re an only child and your dad died many years ago. Your mom has almost no one around to check up on her.

Then the unthinkable happens. You get a call from the police, telling you that they’ve picked up your mom and taken her to the psychiatric unit of the local hospital. A neighbor reported that she was wandering the neighborhood in her nightgown. Unfortunately, her situation is grave. The hospital discharged her to a nursing home where she is now institutionalized due to her condition. The psychiatric unit has examined her and concluded that she suffers from severe dementia. You take her to a geriatric psychiatrist who confirms that your mom is no longer capable of taking care of herself. Your mother refuses to admit that she can no longer live at home alone. You also now know that her doctor prescribed psychiatric medications due to her confusion, agitation and anxiety.

This all-too-familiar story repeats itself with greater frequency as our population ages. What can you do to protect your mom?

The first thing you can do is obtain conservatorship of your mom by filing an application for involuntary conservatorship with the local probate court. The probate court will appoint an attorney to represent your mom. You must get a written evaluation from a physician who has examined your mom within 45 days of the court hearing stating that your mom is not capable of managing her finances or taking care of herself. It is then up to the Court to decide – based on a standard known as clear and convincing evidence – that your mom is incapable of managing her affairs or incapable of taking care of herself. In making its decision the Court must find three things:
(1) That your mom is incapable;
(2) That her finances, health care and personal affairs cannot be adequately managed without the appointment of a Conservator; and
(3) That the appointment of a Conservator is the least restrictive means of intervention.

If the court appoints you as conservator and you want your mother to remain in the nursing home, you would then file a petition for placement in an institution for long-term care and a second petition for authority to consent to the administration of your mom’s psychiatric medications. Connecticut law provides that in order to grant the petition for administration of psychiatric medications, the head of the hospital at your mom’s institution must make a written determination that she is incapable of giving informed consent to the medication for the treatment of her psychiatric disability. That person must also state that the medication is necessary for her treatment. In addition, the law states that two qualified physicians must also make a similar written determination. So in order to succeed in having the Court give you this authority, three people – the head of the hospital and two doctors – must each say in writing, that your mom is incapable of giving informed consent to her medication for the treatment of her dementia and that the medication is necessary for her treatment.

Once you’ve obtained these letters, you can submit them to the Probate Court along with your petition. Thereafter, the Court will hold a hearing to determine whether to grant you the authority to consent to the administration of psychiatric medications. If the Court is satisfied that your mom is in an institution for the purpose of treating her for a psychiatric disability and that the head of the hospital and two doctors have provided written determinations as required by law, it will grant your petition. Once your petition is granted, you will now have the legal authority to consent to the administration of psychiatric medication for your mom.

This story is just one of many factual scenarios under which someone can seek to care for their mom with severe dementia who lives alone. You should know that the bar is high and courts are especially careful about granting these kinds of petitions because they want to preserve people’s independence as much as possible and they won’t “rubber stamp” any petition. If you find yourself in a situation similar to the one that I’ve described in this blog, you should contact the probate attorneys at Cipparone & Zaccaro, PC to help guide you through this legal process.

About the Author  (click image for contact information)

We are pleased to announce that Mark Pancrazio has joined Cipparone & Zaccaro, P.C. Mark brings a wealth of experience in various areas of the law, including estate and trust administration, estate and trust litigation, estate planning, conservatorships and probate law. Mark is currently a member of the Elder Law Section of the Connecticut Bar Association and a former member of the Western Connecticut Senior Alliance. Mark practiced law in Danbury, CT before joining the firm.

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