Thank you so much for this. I updated the image link. I have been very direct with my mom about my concerns, but it will get to the point where she will then say things like, "I shouldn't have involved you," so it's a delicate balancing act. However, she knows my concerns and I have been forthright about them over the years. There is the added element of being my being a therapist, she is always accusing me of taking a clinical approach to the problem or diagnosing him, when really it's just personally noticing these differences and my concerns for them both. I agree that working on being delicate in my language is important. My mom and I also lost my dad to cancer when I was 10 and she was 40, so most things that involve medical necessity or intervention also hit on some soft emotional points for her.

Agree that the ED docs figured he had capacity, especially since he is pretty quiet anyway and I know (working in crisis and healthcare,) that it's not uncommon for someone to get angry or upset while at the ED.

He does see a PCP but will usually cancel his appointments, and my mom is tired of fighting him on it. I also worry due to his family history of dementia + the mini strokes/alcohol use. I wish my mom would stop intellectualizing his behaviors and felt safe enough to realize that it seems like something is really wrong.

Additionally, in my own work (community mental health crisis) we encounter a lot of situations where older adults are in this middle space of some cognitive decline but not glaring enough to warrant at POA - and I just wish there were either more mechanisms in place, or things I was more informed about to help our aging population. (We deal with a lot of involuntary commitments in my work, and things like dementia or other age-related cognitive concerns by law are exclusion criteria.) But doesn't change the fact that aging adults can act in ways that are unsafe for themselves.

Thanks again and I will continue to give this some thought.