Jillian,

It sounds as though there are a number of complex, emotionally laden issues at hand, each of which seems urgent and time sensitive.  It may be useful to try to break down and prioritize the steps of what needs to happen.  I would suggest addressing the issues in the following way:

1)      Alzheimer’s Evaluation

2)      Driving Issues

3)      Financial and Legal Issues

Alzheimer’s  Evaluation

Given the fact that your father is showing several signs of Alzheimer’s disease or a related dementia (poor judgment, difficulty with complex mental tasks such as paying bills or managing his business and memory problems) it would be important for him to have a proper evaluation.  Broaching the subject of Alzheimer’s disease can be a complex and challenging process. You may want to start out by providing reassurance or support.  Try saying, “I understand you have had some forgetfulness in the last few weeks. I care so much about you and want to make sure that you are well. How about we make an appointment with the doctor, just to get it checked out? Don’t worry, I will be by your side the whole time.” Alternately, if your father still has some of his reasoning capabilities intact you may want to try the following approach: Consider sharing with him that sometimes symptoms that appear to look like dementia can be attributed to other medical conditions (thyroid imbalances, vitamin deficiencies, urinary tract infections, medication interactions or side effects, etc.), which may be reversible.  If he still has some ability to think rationally, you may be able to get him on board with going to the doctor to test for the potentially treatable conditions.

Also, you may want to consult with your dad’s sister and friend about what they think the best strategy is for getting him to the doctor.  In some families, it is difficult for a parent to engage in this kind of a conversation with a child, but may be more open to discussing it with a peer (i.e. a sibling or friend).  Alternately, some individuals may be more likely to follow the advice of a person in authority (i.e. a doctor or clergy member).  If this is the case, you may want to reach out to your father’s doctor and provide information about the changes in his behavior and request that the doctor reach out to your father and request an appointment.

Driving

Driving represents a sense of independence so it is challenging to take away an older adult’s keys.  It  is important to note that in most cases it is not safe for an individual with overt symptoms of Alzheimer’s disease to drive. First, operating a vehicle safely entails dozens of smalls steps, any one of which a person with Alzheimer’s disease can forget and put himself and others in harm’s way. Second, your father is at risk for getting lost since confusion or disorientation in familiar places is a common symptom of Alzheimer’s disease.  Given your description of your father’s impaired judgment, he will most likely be unable to participate in a discussion about the risks of his driving.  Consider bypassing the need to convince your father to stop driving, and focus your energy on simply stopping the risky behavior.  This might include asking the doctor for a “prescription” that advises your father that driving must be stopped. Similarly, many police departments or motor vehicle departments offer a driving assessment program,, which will take away a license if the participant is too impaired to pass the assessment.  If these interventions do not stop your dad from driving, you may want to consider hiding or removing keys to the car, dismantling certain features of the car engine system so it is inoperable, or removing the car entirely.

Financial and Legal Issues

Given the complexity of your father’s financial and business situation, I would encourage you to consult with an elder law attorney, a lawyer that specializes in issues relating to the older adult population (i.e. guardianship, power of attorney, estate planning, benefits enrollment, etc.).  Power of attorney laws vary from state to state, and each type of legal document requires a certain level of decision making ability.  If your father has not yet signed power of attorney paperwork an elder law attorney can help pinpoint what level of legal capacity is required for signing such documents.  Additionally, if your father is deemed incapacitated and unable to sign power of attorney paperwork, an elder law attorney can advise you on guardianship issues.   Often, having an neutral outsider can help diffuse the resistance and difficult emotions that can arise during the process of handing over control of finances to a child.   An elder law attorney may also be able to assist you and your father with his divorce as it relates to an Alzheimer’s disease diagnosis.  Elder law attorneys can be found in the local phonebook, or on the Web site of the National Association of Elder Law Attorneys www.naela.org.  The American Bar Association can provide referrals to local groups in each state www.abanet.org.  In addition, can visit the web site for the National Legal Resource Center at www.nlrc.aoa.gov. 

Sincerely,

The AFA Social Services Team