We often discuss what adult kids need to have on hand for aging parents–wills, trusts, healthcare directives and a power of attorney document. Check. But could the tables ever be turned and the parents would need something like that for addressing a matter involving their adult children? Emergencies can happen to anyone.
What An Older Couple Never Thought Of Doing
Concerned Dad (CD) and Mom (CM) found out the hard way that they should have at least gotten one legal document for their adult child earlier in her life. CD and CM have a 40 year old daughter (AD) with a history of being an anxious kid. She had anxiety attacks all during her high school and college years and after that, did support herself. But after a life-changing trauma, the anxiety escalated. She could no longer work and was diagnosed with a mental illness. They had to go to AD’s state and bring her home for her own safety. AD rapidly deteriorated, and eventually had to be hospitalized after a disturbance brought the police. Her parents could not ask any questions of her doctors and could not access any medical records, as all health information is protected by Federal privacy rules. AD was so paranoid, she would not allow her parents to get the information they desperately needed to plan for what to do next. Extreme paranoia was a characteristic of her kind of mental illness.
Psychiatric hospital
Corbis/VCG via Getty Images
What Would Have Helped The Parents
If CD and CM had thought of it, though few rarely do, they would have asked AD to sign an Advanced Healthcare Directive (aka “power of attorney for healthcare”) when she became an adult. They could also have had her sign a Durable Power of Attorney for finances, with a clause in it that would specify when it could be used. At AgingParents.com, where we consult with families of elders, we have found older parents in need of legal documents for their adult children on only a few occasions. Most often, it’s the other way around. But AD’s case is not so rare that we can just skip the legal considerations. Accidents, health crises, and other emergencies can happen when a person of any age suffers something that leaves them unable to speak or make appropriate decisions. That was what happened with AD. She could not make any good decisions, as her mental illness caused her to be extremely paranoid and have many persistent false beliefs. She was no longer able to work and keep herself safe.
Healthcare Directive (Power of Attorney document)
Had CD and CM gotten at least an Advance Healthcare Directive for their daughter to sign long before she fell ill and had to be hospitalized, their journey through the crisis would have been much easier. These documents are free on the internet and can be downloaded at home as soon as a child turns 18 years of age. We recommend getting a form from your doctor or a reliable healthcare or government source rather that from an entity that sells any services to the public. Laws about what constitutes a valid signature with witnesses vary, but you can be sure that getting the signature notarized will make it valid. Note that this document about healthcare is distinct from the document that gives power of attorney for finances.
The Frustration
CD and CM could not ask the doctor any questions while their daughter was hospitalized. They did not have legal authority to even find out when she was going to be discharged from the behavioral health hospital nor to plan with the staff there about what would happen after her release. It was frustrating and deeply upsetting to them, as they just wanted AD to be safe and get follow up care after she was released. They hired a licensed psychologist who was able to provide information about possible alternatives for after care to the psychiatrist in the hospital, but their privately retained doctor could only provide information, not get information. The psychiatrist at the hospital was bound by privacy laws not to give any information to anyone without AD’s permission. AD continued to refuse to sign anything, given her mental illness.
The Uncertain Outcome
AD would be released from the hospital according to their legal limits on keeping AD confined there. What would happen after that was not clear. Go back to her parents’ house and repeat the ordeal of paranoia, refusing treatment, outbursts, police action and rehospitalization? Go to a shelter? They did the best they could without direct contact with anyone for formal discharge planning. They will eventually make some difficult decisions about what to do next. They were advised by the private psychologist to establish conditions for her to be allowed to come back to the parents’ home. Those included agreeing to get follow up treatment after hospitalization, take prescribed medication and sign the release of information the parents will need going forward.
Takeaways
The facts in this description are somewhat changed to protect all identities, but the dilemma of mental illness in an adult child, the lack of a legal document to help coordinate care, and the frustration it created are based on an actual case. This really did happen. We understand that such a thing could happen to anyone. We urge the following.
1. You can have more peace of mind about protecting any adult children of any age by having them sign a healthcare power of attorney, or Advance Healthcare Directive as it is also called. They may ask why now. Share this story with them if you wish.
2. The document is free and can be gotten from your doctor, or on the internet. Get the signature(s) before a notary, for the most secure way to ensure that the signature is validated. If that is not possible, read the document carefully to see what witnesses you need for the signature as an alternative to a notary.
3. Keep the original document in a secure place and make copies for your adult children to keep with their own estate planning and other legal documents.
