What are first steps to take with father's MCI progressing and mobility decreasing? Spouse left him and nothing is in order.

I'm sorry your mother left your father, and YOU, holding the bag for your dad's care at this difficult time of life. The first step would be to finish getting him evaluated and see what the doctor recommends moving forward: ie: Assisted Living, Memory Care, etc. Then set up financial & medical POAs so you can manage his health care and financial decisions as well. Get a joint bank account set up, with both of your names on the checking account, so you can write checks on his behalf. You don't need his medical records in hand; just a consult with his current doctor to get an idea of where he's at mentally & physically.

Then contact his Long Term Care Insurance Company to see what sort of coverage he has, where he can go, and exactly what they will pay for and for how long. Then you can check out some local Assisted Living communities, preferably with a continuum of care; ie: Assisted Living, Memory Care, Skilled Nursing, so that he can enter at one level and move within the same community as/if required. It always blows my mind to hear of the 'stubborn elder' who's been paying thru the ying-yang for long term care insurance for a zillion years but won't hear of actually USING the policy! Ugh. In any event, if/when he reaches the point where he can no longer care for himself or stay safe in his own home, you as his POA, will have the ability to help him acclimate into a safer place. You can always remind him of how much he's already PAID towards his long term care ANYWAY, right? LOL

I know how overwhelming all of this is.........I had 2 parents (as the only child) to deal with and now that Dad has passed, my mother has been moved into Memory Care this past June (from the Assisted Living section of the community). So I know how much is involved, even when they DON'T live with you!! It's a lot. You may also want to consult with an Elder Care attorney to ask a whole bunch of questions........I did that back in 2014 and am VERY glad I did. He's the one who let me know about the VA Aid & Attendance benefits Dad was entitled to receive as a WWII veteran, which has been extremely helpful (Mom still gets survivor benefits to this day). He also advised me about asset liquidation and lots of other useful information on the subject of elder care.

Best of luck!

Thank you both for your input! Lealonnie, your step by step answer is just what I need.
Like you both said, the logistics of this (even when you won't be the caregiver) are A LOT. There is a wonderful assisted living/memory care facility quite close to me, which is where I hope he will eventually end up. We shall see, as he is very stubborn. Very. Actually, lealonnie your advice on reminding him of all the premiums he has paid through the years just might help a tad!
Exhausted, my relationship with my mother is strained. She sees no wrong in how she handled things. But, my young children love her so we see her occasionally.
I think I will take both of your advice and see out an elder care attorney. Thank you again!

Lealonnie, has given great advice. But you may want to get the POA etc in place, before you have him fully accessed by the doctors. If the doctors deem him incompetent, it my be a bit more difficult to get the paperwork put in place. Although I do know that my step dad was able to update all his paperwork after being diagnosed with dementia.

One thing that you should be very clear about is your level of responsibility if you share a bank account. You can not just be a signer and being a joint account holder could have negative repercussions if he has any debts or does something that causes a financial crisis. You could be held responsible for overdrafts and such. I was advised that I should just set up everything electronically and not share an account, even though it was only his money it put me and my husband at risk. Something to ask the elder law attorney.

You can find a certified elder law attorney at www.nelf.org. I used one and they were actually cheaper because they specialize in elder law.

Best of luck.

Assume that your mother did nothing. Make an appointment w Elder Law Atty ASAP...& they’ll help you figure it out. . If he had LTC insurance, would you know where to even look for the paperwork? Maybe when he worked, a former employer could’ve offered it as a benefit? Or a banking institution he did business with may have info? You have to first have poa so you can talk to these people. You are very brave to take all this on since you have your own life...w small children, husband & work. You have a good head on your shoulders. Get him into decent ALF if he qualifies. Tour a couple of them...maybe closer to where you live. If he has memory or wandering issues, maybe memory care facility.
Hugs 🤗

In general--underestimate his abilities in every area, and you will probably be closer to accurate. He can probably converse, joke, and argue same as ever, and will be able to do so for a long time, even as all other cognitive, mental, sensory, and physical abilities deteriorate.
Try to get him into assisted living as soon as possible. There's a good chance he will adapt and enjoy the social stimulation and conversation. Isolation will make him deteriorate more quickly.

So sorry to hear how full your plate is. You have a job and small children and you are an hour away. You say you have a POA. Call his doctors and his pharmacist. Ask can you fax them your POA. This way they are open to talking with you. See if pharmacy is on line and make an account so you can view his meds on line. Talk with his doctors as to his current state. look into what is near you. If he owns a home, talk to a realtor to sell it. You will need assisted living or move him in with you or near you. There is no negotiating WITH him. Contact local community action services which usually you can reach by dialing 211 from your cell. The quicker you have things set up the easier you will make life on yourself. Good Luck.

One question: You said your mother left your father five years ago - are they now divorced, or just legally separated? If they're only separated, you might not be able to do much at all. If they're divorced, make sure you have access to the divorce documents so you'll know any pertinent financial details.

I agree with getting the POA first. That'll make everything else easier. Before my mother went on pain management, I took care of all that (durable POA, advance directive, health care POA, etc.) as I wanted it to be completely clear that she executed all documents before she went on mind-muddling medication.

Best wishes. With all you have on your plate right now, this may be a daunting task, but you're to be commended for taking it on.

You might want to have an initial consultation with a few Elder Care Attorneys for Guidance. The 1st visit should be complimentary. They know all the options.
Also, study online about how to have "the talk" with your aging parent. Try finding a Geriatric Care Manager in your area. I wish you the very best!
Frank Arena, SRES

He can sign papers at the bank to allow your name to be added to his accounts. Then, you can set up electronic payment of his bills. You and your dad should meet with an attorney to take care of Power of Attorney and Health Care Proxy forms. Dad should make or update his will. If he owns a home, there should be a discussion about that asset as well. All of the decisions concerning assets should be made with the idea that your dad may need long-term care.

You have received great suggestions here, so I will not add to that, but suggest/ask you sincerely, NOT to move your dad into your home, even temporarily. He will become worse and need more care. It's best to move him directly into a good care facility close to your home. You already have a full plate and you and your dad will get along better if he is not in your home. Don't try to reason with him. You are now his parent and you know what is best for him. He'll be angry for a while, but he will enjoy seeing you, your family and his grandchildren because you'll be able to visit more often with him in a closer location.

Great advice here, I just want to add approach to the things you should consider it could make a big difference especially with a stubborn parent going down the dementia road. We have noticed with my mom that she digs her heals in and gets angry with us when she is feeling most out of control, not understanding things and not given time to process big decisions/changes. While ultimately you may need to make the big decisions giving him the feeling of control and participation can be really important for both of you. Mom as she relaxed about us not doing things behind her back started releasing all kinds of things to us and enjoyed not having to worry about it any more. Now it depends on the individual of course and personalities but you know your dad best and if you think about it my guess is you know how to "handle" him (I didn't want to say manipulate). For me even if their brains have them regressing to child like behavior and thinking there is still a part of them conditioned to being the adult and everyone who has reached the time in life where they have been adults 2,3, 4x longer than they were children deserves to be respected like an adult. I hope I'm making some sense here because you will have to simplify things the way you might for a child but they aren't learning like a child it's a whole new world for us their children.

Anyway I would start with getting the legalities in order too, you are thinking ahead, good for you. If your mom can't be of any help and you are simply starting from scratch maybe sit down with dad and say something about another family you heard about or that some professional suggested you and dad get his care wishes formalized and streamline his financials as well as appoint someone to take care of them for him in case of emergency. Either fain ignorance or simply join him in learning what to do and how to do it, you can ask if he knows an attorney who does this you could go to for guidance or if he's really against that ease your way through with suggestions or "should we's". "You know dad I do most of my bill paying on-line now it's so much easier and most of my reoccurring bills just get paid automatically if I want. Maybe it would help you to set that up too. As you do these things together he may find it's easier to let you handle some of it as my mom did and be quick to give you the access and later legal power. Again he still has a sense of control when he wants it, make sure you report to him things that have been accomplished. Same goes for health stuff, you start going to all doctors appointments with him and maybe order medications, take care of insurance, set up a communication portal is his doctors have one and it may be natural that he gives all the appropriate legal ok to make that easier. Then it's just a matter of streamlining with POA/DPOA and MPOA or proxy. If he isn't willing to do it all at once with an attorney take opportunities to ask him what he would want "if" and then put it in writing so you don't get it wrong in a time of stress & the appropriate people follow those wishes. It may be a bit underhanded but my mom fears the state or her doctors taking over the decisions and that keeps her doing things we want her to that she either doesn't see the need for or doesn't really want to do. In fairness that has been helped by periodic medical crises when she hasn't been listening and her primary being very clear that if we weren't so involved things would be different as well as my mom's general disposition but still you not just "laying down the law" but chipping away slowly but surely may be much more fruitful and pleasant. I know I would rather turn responsibilities over to my child than have them tell me what to do. No harm in telling him something makes things easier on you too when appropriate whether it be from a practical function (on-line management from an hour away) or emotional (I stress so much about this, take care of me). Planning together for future.

Contact an Elder Law attorney in your area.

Start at the very beginning
Is your state probate/community property or common property? This makes major difference when it all comes to the following:
1) absolutely take dad to bank and find out if their bank accts were/are joint. if they are, then mom may have cleaned everything out which is her right if community property. If the money is still there, place the account on hold (this is called a 9 hold. many people think they have way over a million dollars when they see this on atm receipts $9.999.999). All this does is require the bank to call you to make sure what checks should be paid or have been used by siblings or anybody else trying to take advantage. Mom can still take the money though. The "9" hold should require the bank to call to let you know mom is there to wipe the account out. If your state is probate, then she would only be allowed 50% of the balance. This should be stated on the hold so the teller will see a code to call the branch that the account(s) are held.I can't stress this enough. I worked on retail side of banking and had to go through this on a daily basis as there was an assisted living facility near the branch I worked as both a teller/operations assistant supervisor. I could not do this with my mother's primary account of which she placed my step-father as "authorized" signer. He had 100% access because their money was co-mingled. Ugly step-sister had attorney do an emergency poa signed off by daddy (he has dementia/alzheimer's) of which the attorney knew. The attorney could be disbarred (I'll look into filing a complaint after I get more important things done). Ugly step-sister had daddy sign a legal binding bank negotiable instrument to take 65% of the acct balance and more afterward via on-line. this type of account she had to use mom's personal info to open the on-line portal as daddy was only authorized signer.(2) Did mom have poa etc? If this was done with attorney, take dad to attorney so you are able to see any documents done. was a beneficiary deed filed showing who receives the house after both parents are deceased.(3) have attorney file for emergency guardian/conservator. is the house free and clear? Is it joint with right of survivorship? Has mom quit claimed it over to herself? Any liens? The county recorder's office will have this information. If the office has a website, you should be able to find all of this information without going to the office and paying for a certified copy at this time. you should be able to print these records from the site. get certified copies after you visit the attorney. the attorney can request via special dispensation so you don't need to do so.(4) Do you have siblings? Any step-siblings? They are going to be a real pain once they find out what you are doing. They will eventually need to be told what is happening. I have been fighting my #1 ugly step-sister in court now for over a year. she is pissed because daddy is not on the deed to the house, Therefore step-dad's children will not receive the house if my mother should predecease which would cut we 4 children created by mom's 1st marriage. Daddy doesn't have any money saved prior to marriage as mom has as sole separate, state is community. Mom's sole separate is hers. Ugly is trying to get to it. As what I am using now, it is mom's inheritance which is not allowed to be used to pay for spouse debt. Community debt is all of the bills 50%-50% until the judge dissolves the marriage (asset divorce here). Ugly owes 50% income tax paid, all community debt going back to april 2018. Total monies spent from poa/liquiable asset trust $100.000+. Ugly owes 50% and then some.(5)Your dad will not be legally able to sign any legal/binding documents due to his mental issue(s).(6) If you're able to get all the necessary poas, get the one for finances filed with the bank branch his accts are held immediately.Very important: have any funds moved to a poa acct, titled poa you're only signer.good luck

If your dad is still able to make decision on his own change the powers of attorney to yourself or someone close that the two of you trust to make decisions.

If he is resistant to Assisted Living Facility (ALF) suggest that he go to an ALF for respite care, maybe a week or two. Many times seniors hear bad things about long-term care and as a result refuse to go. However, many of my clients once I have placed them in an ALF for respite find out that they love it so much they don't want to leave.

Finally, since your live so far away you may want to hire a Geriatric Case Manager. That person can do everything for your dad that you would if you lived closer. Go to the Life Care Association website, you can find case managers that are close to where he lives.

Good luck on your journey, know that you are not alone.

Keep us updated on your progress.

Yes, DO definitely get dad to switch over POA to you now while he's still of lucid mind. How horrible that his spouse left him. Poor man and prayers sent. You may benefit from an elder law attorney on the rest.💞

yatzeedog: You're right. Sorry. I'll attempt to be more cautious upon posting. And yes, I do know about the disease of memory impairment since it exists in my family.