He arrived alone, a thin man in a white shirt with light blue checks, the top buttons undone. He matched the shirt with shorts and slippers and his hair was uncombed.
Had he fasted? the radiation therapist asked. Yes, since 6 am. That’s more than 3 hours, she said, so we can see you next.
When he finished, he told the therapist he had a fever every afternoon. He declined her suggestion to see the doctor on duty.
You can call for an appointment with your doctor anytime, she said. You don’t have an appointment now but you can call and make one if you need. The number is on your card, let me show you.
I have so many questions. The shirt was too loose, was it someone’s discard or was it his own shirt and he’d lost weight? Does he have family? Does he know how ill he is? How does he cope? Who made the appointment for radiation therapy? Why doesn’t he have another appointment?
On another day at the clinic, there was another old chap. I slowly realised he was actually chaperoned by two nursing home staff who sat far apart from him.
He looked like any other patient waiting his turn except he echoed what he heard in a soft, high-pitched voice. When the nurse called a patient’s name, he would repeat the name in his falsetto. When the appointment board chimed, he would echo that too, “Bing Bong!”
There’s a gentleman in my neighbourhood who I see walking some mornings. I first noticed him about a month ago. At that time, his appearance was very worrying.
He was large and breathless and lumbered along. Unsteady on his feet, he leaned forward as he walked and I was afraid he would trip over and fall flat on his face. So I watched him until he was out of sight. Every now and then he’d wipe his face with the towel draped around his neck. He had no mask on. A tiny lady, probably his domestic helper, walked two paces behind, so he wasn’t alone. One third his size, she would be of no physical help if he fell. But she probably had a handphone or she could run home for help.
I saw him again this week, and to me he seemed much improved. His gait was steadier, though still wide as he is slightly bow-legged. He didn’t look as breathless. His helper followed ten feet behind and was swinging her arms as she walked. She looked more relaxed too.
I wondered about his story. Was he a sedentary businessman, staying at home for months during these covid times and deconditioned from lack of movement? Which doctor told him he must walk no matter what or die? Was it a wife who sent him out walking with the helper, or a daughter or a son who nagged at him? Maybe all of them, together.
Maybe he is self-motivated after a health scare. Maybe it’s all himself.
In my last post, I wrote about the process of putting an LPA (lasting power of attorney) in place, so when there’s a need because of a loss of mental capacity, someone has been assigned to have the power of attorney to make decisions and have access to finances.
What happens when there isn’t an LPA?
The joint bank account solution has been used by some. In the event of an emergency or loss of mental competence, the joint holder can operate the account. Unfortunately this also means the ‘trusted’ loved one can empty the account for their own purposes instead, and ahead of time.
If there isn’t a joint bank account, I’m sure other methods such as the ATM card (and shared pin) or forged cheque signature have been used in a pinch. Again these methods can surreptitiously be used ahead of time! Still, we do need to trust someone in our time of need and we hope that someone will not betray our trust.
Sometimes the elderly person is brought to the bank by a relative to transfer all their funds to that relative. Singapore banks have been on the lookout for scams and will stop bank transfers from someone they suspect has diminished mental capacity.
There was a huge cheating case here in recent years where a chap used the LPA process to cheat a generous old lady of millions of dollars. He made himself the recipient of the LPA, had her declared to have dementia and then helped himself to her money, her art and her house.
Fortunately for the lady who was childless, her niece stepped in and had the resources and smarts to fight the case. It must be said though, the old lady is still very fond of the scoundrel who cheated her whom she considered an ‘adopted son’. She does have dementia and I suspect it was a tough court decision to determine which decisions were made with a sound mind and which were not. Some info on the case here.
I’ll share about medical decision-making without LPA in another post.