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Topic Gambling, should I be concerned? Go to previous topic Go to next topic Go to higher level

By walkinthewoods On 2009.01.17 21:35
As I research PD on the web, I read about gambling concerns with PD patients. But at what level does this become a concern?

My FIL has been playing Poker Stars online for what we refer to as play money, (no actual money is involved) for about three years now. During his routine Neurologists appt's the doctor would inquire if there was any concern for gambling. At the time, we informed him it was for play money and there was no concern because there was not.

However, within the past month my FIL has been talking about setting up an account on Poker Stars where he could play for "real" money. To my understanding to set up such an account would require him to enter his checking information onto this website, where than Poker Stars will make an immediate withdraw of any funds he wants to play with.

Due to my FIL's immediate financial distress my husband and I have both spent a lot of time telling him that he is not able to set up such an account. As well, as mentioning that the Neurologist was concerned about this sort of thing happening. Right away my FIL gets defensive, he will argue his side for a few minutes and than seems to agree and will drop the subject.

Well, that was until today when I was shocked to see that he had a withdraw out of his bank account to an online service, a withdraw I knew nothing about. When my husband asked him about it, he quickly replied "ya it's for Poker Stars."

As my FIL's POA, I have been beating my head against the wall already because I have been battling for sometime now frustration in helping him with his finances. He will authorize payments through his checking and/or debit card and not tell me which in turn overdraws the account, which has cost him hundreds of dollars in overdraft fees. Than the spiral starts, my FIL obsessively logs onto the online bank account and when it reflects a negative balance, he gets stress, when he is stressed he gets hateful, when he is hateful you can only sit back and wonder what is next.

I tried contacting his Neurologist and Attorney last month about this exact problem and unfortunately, until he is declared unable to do for himself there is nothing I legally can do to prevent it. But now, I have the gambling on top of everything else. I tried talking to my husband about what we are going to do but he lives in denial too. He says we will just tell him he can't do that, well anyone reading this post probably already knows that is not going to work with a PD patient.

My FIL is on Sinemet 6 tabs daily and Mirapex 3 tabs daily, if that is a factor in any of this.

Thank you for your time

By annwood On 2009.01.17 22:57
Yes, you should be concerned. I see that your FIL is on MIrapex and that is known to trigger gambling (and other) compulsions. Taking them off Mirapex rarely solves the problem entirely but it helps. I would call the neurologist first thing on Monday morning and tell him that you FIL has started gambling. I would also tell him about his inability to handle his finances. If need be show him the bank statements. You will need a letter from the neurologists to take over the accounts. Do you or your husband have Power of Attorney in the event this happens? If not, you will have to handle it through the courts and become his legal guardian.

My huband spent over $3000.00 in one month so I know of what I speak. Expect your FIL to be angry and to make all sorts of threats but it has to be done. You may have to take away his internet. Buy him a computer game for poker. Others on this board have horror stories about this very subject. You need to act quickly.

By walkinthewoods On 2009.01.17 23:15
Hello annwood,

I have tried telling the Neurologist about his inability to handle his finances, they referred me to my FIL's attorney. His basic response was "good luck, until he has been declared unable to do for himself there isn't anything you can do." My husband has the same Internal Medicine doctor as my FIL and he has been talking to him about our concerns. However, now my FIL refuses to go back to this doctor because he doesn't want this doctor to take away his "independence." (he has been going to this doctor for over 10 years).

My husband and I have discussed thoroughly the relief we would have if he did not have internet or phone access. Of course, this is not a relief that my FIL shares. You hit it right on the nose, he threatens ALL the time. So much so I have begun to fear, "What happens if someone believes him over us?"

By ihatepd On 2009.01.18 02:32
Please be very concerned about mirapex and internet gambling. My husband was prescribed mirapex soon after his PD diagnosis. He took the drug for 18 months and quickly developed a severe problem with internet gambling. He would wake up in the middle of the night with a strong compulsion to go to the computer and bet money on horse races in Japan! He said he truly couldn't control the drive to gamble on the internet while he was taking the drug. I had no idea that he was doing this until I finally discovered he'd lost several hundred thousand dollars. When his neurologist was informed of the problem, she immediately took him off of mirapex. Within days of dropping the drug, he'd lost any desire to gamble and thank God, it hasn't returned. His problem came to light about a month before the FDA required the drug to carry a warning label about the gambling compulsion possibility. It is such a strange, bizarre side effect, but it's a very real possibility. Access to internet gambling and a mirapex prescription can cause a lot of financial ruin! By the way, we didn't notice any significant change in his PD symptoms once mirapex was dropped. The doctors did increase the doses of some of the other PD drugs he was on to compensate for the loss of mirapex.

By annwood On 2009.01.18 09:51
I think that you need to be very straight forward with the physician who asks you about the gambling. Say:

He is gambling
He is unable to control his finances
His accounts are overdrawn
I can't reason with him
I would like a statement from you saying he is no longer able to care for his finances.

If you have children, you know how they bully you with their demands about age 2. This is what your FIL is doing. Try to ignore it. You have the documentation with the bank account statements. This behavior is not uncommon in PD. Despite his threats nobody will believe him over you and it most likely will never come to that.

As for internet and telephone access you can control that. Locks on door, viligance, etc. It will not be fun and he will throw a tantrum but it seems to me you have no other choice. Do not waste your breath explaining this to him since it sounds as if you have already done that. If he is developing dementia he won't be able to understand your explanations and you will just get angry. Be firm and simple in your actions and try to ignore his responses.

Good luck - you can do this.

By lynn On 2009.01.18 20:17
Annwood-My husband and I have designated each other as POA's. I've often wondered how these instruments are activated. From your post, you suggest a letter from his doctor saying he is no longer able to handle his own finances. Do you then take this letter to the bank or do you have to see and pay for an attorney?

By annwood On 2009.01.18 21:47
I live in Ohio so I only know about Indiana & Ohio. We also had designated each other to be POA. When the time came I just started stating that I had POA. I gave copies of the document to the bank, credit card companies and our broker. I explained (many already knew) that my husband could no longer make decisions because of his health. I did not need a letter from the MD or an attorney. If you check your wills the POA and medical consents are generally there as an appendix to the document. My point with the query on this board was mainly if there was not a POA assignment. I would think in that case you would need the doc's letter and an attorney.

By rajenriver On 2009.01.19 09:13
We have 2 POAs for my FIL. One was for his financial decisions and was affective immediately upon his and my husbands signature.

The 2nd one was for making any medical decisions. This one was dependent upon a letter of authorization from his Dr. that he could no longer make medical decisions on his own. This one did not become effective until we had a letter from the Dr. stating his medical condition and invoking the POA.

Both documents were signed by my husband and my FIL in front of my FIL's sister and brother-in-law in addition to a notary. We made sure we had plenty of witnesses.

They can all be different, it just depends on how the document is written. We had ours done by a lawyer to make sure that it was valid with our state.

My understanding also is that all POA's can be challenged. The most binding authorization is to go through a judge to get conservatorship. This takes time and of course costs more money.

For us, no one in our family nor my FIL have ever challenged the POAs so I don't think we will ever have to go that route.

The only thing I would have done differently would have been to either gain co-POA ability with my husband or to define a backup POA if my husband was not available when decisions needed to be made.

We had one situation when my FIL was in the psychiatric hospital getting all of his meds balanced. He aspirated food or water and was sent to a regular hospital for emergency care. Once he was stabilized, they were going to check him out and re-admit him into the psychiatric hospital. They needed my husbands consent for re-admission. He was several hours away, visiting with his uncle and left his cell in his car. I couldn't get ahold of him so we had to have my FIL held in the regular hospital until I did get ahold of my husband. That was a difficult hour for me because I was afraid that he would be checked out, then they wouldn't have a bed for him in the psychiatric hospital. I wished that I would have had the ability to be able to make that decision.


By bandido1 On 2009.01.19 11:19
Advice with Disclaimer: Prior to my retirement and PD diagnosis I was a Trust Administrator for a well known Trust Co. Duriing my almost 50 years in the business I handled private trusts, guardianships and consevatorships for the benefit of those legally unable to care for themselves. In all cases I worked with those in a family and/or appointed by the court in managing assets of an individual. In usual legal terminology that is known as trustee, guardian or conservator of the Estate vs. Person. A family member is generally named as the latter. My "beneficiaries" included alcoholics, compulsive gamblers, mental patients etc. A Power of Attorney (POA) can be of some use during certain stages of incompetence but can become legally and practically complex. My caregiver has one covering all financial matters. I am not an attorney and do not offer this post as any legal advice. Your FIL needs more protection than a POA. Some medical authority may be needed to document his apparent incompetence. Have the docs consider switching him to Requip XL as a substitute for Mirapex. Lastly get him a membership under and he can play Texas Holdem to his hearts content for tokens --not money. Works for me!! Bob C

By walkinthewoods On 2009.01.19 17:37
I talked with my FIL's Neuorologist's Nurse Practioner today, I explained everything that we have been going through (yet again) and the gambling. After talking with the Neuorologist they have decided to slowly decrease the Mirapex over the next week, reducing his dose every other day. She was very helpful in her description of the POSSIBLE side effect of Mirapex. This medication can result in impulsive behavior in some patients. This sort of impulsive behavior is not only limited to gambling but a wide range of things.

For example, this morning we as a family sat down to have sausage/biscuit and gravy, bacon and french toast. My FIL loves his "big" meals. Everything went fine through breakfast however, when my husband entered into my FIL's room about 45 minutes later he learned my FIL had called the attorney's office to sell his/OUR house. No rhyme or reason to it, there was no fight, no negative words exchanged, he just got up and did it.

Overall though my FIL's Neuorologist is not willing to declare him unable to care for himself, nor are they willing to address the removal of his driving and that's a little frustrating. I feel like I am talking in circles, going from one doctor to another.

P.S. I would also like to add that every patient is different and the advise I got concerning my FIL may not be the same your loved one would receive from their own doctor. So please check with your own doctor regarding any medication concerns.

By annwood On 2009.01.19 19:44
I am pleased that they are taking him off the Mirapex. It can take 2 or 3 weeks for any behavior change.

You have hit a nerve with me on the driving. I have addressed it often on this board. Ask the neurologist to give you a letter stating that your FIL is physically and mentally able to drive - I bet he won't do that! I don't care if he wants to kill himself in an accident but I don't want him taking my children and or grandchildren with him. Caregivers have responded that the pt doesn't drive far but most accidents happen within 25 miles of home. I think even the PD pts on this board agree that driving is a real issue. An individual with PD does not have the response time or the coordination to control a motor vehicle in a crisis situation. There are OT programs in several hospitals that assess a person's driving skills. That is an option. I just took away the car keys and kept them locked away. Yes, you bet there were many arguments about it but I never allowed him to drive. You and your husband have a legal responsibility if you allow him to drive and know that he is impaired. I have that straight from an attorney.

Pick up the telephone and talk to the attorney and the bank - explain this situation to them and they should understand. My husband continued to "bank" and "trade" with his broker but none of it counted. They would listen to him and then check with me. Fortunately he never thought of the transactions once he thought he had completed them so it worked for me.

By susger8 On 2009.01.20 08:14
Agree with you, annwood, about the driving. My father still insists he should be allowed to drive "with restrictions" even though he's extensively impaired. When I started to notice problems with memory and cognition I rode in the car with him a few times, and although he was managing the physical part of driving, he kept forgetting where he was going. I had also observed that he was having problems with spatial relationships, which are so vital for safe driving. (This was noticeable in the way I had to coach him to walk around the car door in order to get in, or which hand to put on the door handle.) As you point out, the fear that he would injure or kill another person was of serious concern to me.

I knew that is was pointless to agree to restrictions (like not driving at night) because he would just forget them.

I had a very hard time getting his neurologist to tell my father he shouldn't drive. I ended up just physically taking the keys away. It worked out that his license expired while he was in rehab recovering from a fall, so he just came home to a new living arrangement.

By walkinthewoods On 2009.01.20 09:50
During our "discussion" with my FIL yesterday, my husband did tell him calmly that he was taking the car keys away and he did. Of course, my FIL threatened everything in the blue moon but my husband still did it. However, my husband and I spoke with a local police officer that my husband is good friends with. We explained the situation and the advice we received is that a letter from the doctor would be helpful if they were called out by my FIL.

I just felt that the Neurologist would be a little more concerned with everything that I have been telling them about his driving privileges. They just don't seem to be. We are going to his GP today and he has already told my husband that my FIL should not be driving. My husband is going to ask for that in writing today.

Thank you all for your help in this situation

By annwood On 2009.01.20 11:17
Good for you! I hope that the GP gives you the letter. Driving is a form of independence and individuals guard it. Remember that your FIL is no longer capable of making good decisions so he would probably never willingly give up the driving.

This is one of the most difficult things about caregiving in my opinion - being the police officer.

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