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I am durable POA for finances and legal Medical Representative for my 88 year old mother who lives 450 miles from me. She lives in a small town where she grew up, but I have never lived there. (She moved there after retirement). She has cognitive impairments for most of her adult life from a TBI and now has lost short term memory almost completely. I travel there regularly and it is very stressful now that she has no short term memory. It has taken it's toll on my family and my mental health. I hired part time home health, but it is challenging to monitor from a distance as well as managing her finances and medical care while she fights me on almost everything. I did get her car removed (thank God) and she is very angry and sad about that. She adamantly refuses to discuss moving to a senior community/assisted living. We have tried to convince her for years...both gently and strongly. Her social worker says that I do not have to do anything to activate the Medical POA and that I am within my rights to make her move to assisted living or at least near me because her medical records show that she is not capable of making sound decisions and not safe living alone. If I am within my rights, I don't know how to physically force her to move. She is in good physical health for her age and she will fight. I would appreciate advise from others that have experienced this.

You can't make a parent move, period. Sometimes they need to be left to their own devices, or they will suck the ever-living life out of you, and you will be the one suffering. Let them deal
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Reply to amsm1964
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Is it more important to you that your Mom has people "taking care of her" or that she feels emotional contentment and peace? My 99 year old mom says, "So what if I fall and lay there for a week before dying? Wouldn't I rather do that in my own home? I could fall in a nursing home, too. Then I've got strangers taking away my life in the name of saving it. Better to die at home!"
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Reply to Grownuptoold
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Take her to visit and meet people after you select keep visiting. Clue those in it's a setup and screen them how to do it get a professional to train you and them. She's important. Can't accept tips $$ my facility will get 95% next cycle. America.
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Reply to AdVinn
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Make sure her doctor declares her "mentally incompetent" in her health records. Get copy of that. You can make the doctor the "bad guy". Make appointment for her when you are there, have doctor explain that she can not live alone or in her home safely anymore. Have doctor explain that you are now going to make decisions for her care since she can not. Then, do what is sensible - while being as sensitive as possible to her viewpoints.
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Reply to Taarna
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I so understand your situation. I'm going through it now. The NH where she was sent from the hospital for rehab kept pushing for AL. I was just perplexed on how they could figure this could work financially. One unit that was available only had room for a twin bed pushed up against the wall and a recliner. So, depressing. However, they were actually a gift. Since my stepfather was a WWII veteran they recommended Aid and Attendance as a possible option. I'm only offering this information since it was all new to me.

By the time we went through all the numbers, I was able to get mom into an AL studio apartment of 550 sq. ft. It's not as close to me as I would like but the travel time is manageable. We moved her in before her discharge from the NH and were able to get a great deal of her furniture into the apartment.

With her SS benefit of $2000, minus all the insurance required, and the possibility of another $1400 from the VA A&A (still pending) I felt I could manage it. This facility will never take Medicare. So, when the money is gone, I'll face the task of getting her into a Medicaid NHF.

Best wishes to you. And to all that may have veteran service please research Aid and Assistance for surviving spouses.
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Reply to Only100
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"She has cognitive impairments for most of her adult life from a TBI and now has lost short term memory almost completely."

* You never argue and never 'force' her to move.

* If you are the POA / handle all her life needs legally, you do what is in her best interest (not what she says she wants).

* You move her closer to you.

* Do you not 'listen' (in terms of what you actually do) to what she says although
YOU DO RESPOND with compassion and attention so she knows she is being heard. You respond with sensitivity and boundaries. In this vein:
- leaving open ended is best: "I am doing what I can to meet your needs." ... "Yes, I hear your desires. Thank you for telling me."

* You do what is necessary to keep her as calm as possible.
- Do not tell her what is coming. Stay in the moment.

* Do know that her cognitive abilities will continue to decline.
- Do not 'wait' until this happens. Handle it now.

* You must learn to take your power back while understanding that you can be compassionate, sensitive, and caring, too. This doesn't mean a huge change / move is easy on either of you. It is not. However, you need to keep your focus on what is best for her, regardless of the initial emotional responses / feelings.

Gena / Touch Matters
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Reply to TouchMatters
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We had to take my mom to a psycho-neurologist. This was on the heels of her breaking her back a couple of times and her six of her ribs. It took over a year for a vascular dementia diagnosis. It wasn't until she broke her hip that rehab refused to let her live alone and we found a nice assisted living place for her. FYI... she's settled in nicely and likes it, but she blames me for everything.
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Reply to darts1975
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KatTorrecillas Apr 30, 2024
Please don’t take the blame personally. I have two siblings and each of us gets blamed, depending on who our moms talking to.
I live 3 1/2 days in one city and then drive 2 1/2 hours to care for my mom for the other 3 1/2 days and I still get blamed for not being there full-time. I work and my husband works and it is just not feasible for us to move right now. When we do, we will be right across the street from her, Lord help us. !!
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My concern about forcing your mom into assisted living is that AL is not locked down and if your mom is in good physical condition, she could walk right out the door. Someone from your moms generation might listen to a doctor if they were to tell her she can no longer live alone. Look for other options near you other than AL.
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Reply to Jamesj
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Do you know who her doctor is? Find a place that you think she would benefit from with the doctor's assistance on her needs. Then have the doctor talk to her. Once her doctor says that she needs to move (and he should have a private conversation with her, then with all 3 of you), you might find that she is more "willing" (but not) to move to different facilities. To help the short term memory loss, perhaps he could put it in writing in large font with his signature so that she can see it and be assurred that you are not acting alone.
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Reply to ChoppedLiver
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We took my mom out to lunch then ended the day at the new place. While we were away the moving company packed up and transported to her new place. She was not happy and refused to even look at her bedroom for two days (she slept on the couch). We were advised to have minimal to no contact for 2 weeks to help her accept the placement.

it was heartbreaking but the right move and she eventually came around to it.
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Reply to CyndeeF
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Yes, my heart breaks for you. I have no answers. But, I’m dealing with similar circumstances. I have been going through pretty much the same with my mother. She will be 85 and for years we have tried . Now it’s too late.
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Reply to Di1961
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KatTorrecillas Apr 30, 2024
Why is it too late?
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I feel for you. My Mom was just diagnosed with dementia in February. I had to remove my Mom from her 2 story 2 BR apartment in Maine 12 hours from me. I'm an RN, but have zero experience with dementia. Her dementia is mild so I tried placing her in IL near me. It was great for a short period, but she relied on me for everything. This eventually put me in the hospital twice due to stress of it. It sounds like your Mom is not in a safe living environment. I am also POA, and was advised to tell my Mom that it is not me, but her MD that is telling me to move her. In the long and short of it I decided to tell my Mom the truth ...that it was just about killing me. I was fortunate enough to have gotten connected with an advocate who places the elderly. I made the decision to move my Mom into an Adult Foster Home certified by the state of MI. It's $3800/month, includes EVERYTHING except her depends, toothpaste, etc. She has 2 to 3 aides during the day and 1 to 2 at night.
There are only 5 other women in this house. She and I were both sad about moving her, but I had to be done for the both of us. My Mom is nicer with the dementia, and when I was honest with her she accepted the idea. The advocate said it takes about a month or two for the patient to adjust. I focused on safety, immediate community, support, meals, medications all right there.
I had to do it. I could not handle the stress. When her money runs out she will have to go to a Medicaid SNF unless my circumstances change.
You have to make the move of your Mom for yourself and your family. You are worth it, and not a bad daughter if you do. Your Mom will be safe. You can also tell a social worker or a " friend " who knows your Mom to call Adult Protective Services as she is not living safely....to be the " push" your Mom needs. I seriously thought about getting another person to be a guardian, but found out there are some terrible ones out there...so I had to pull my big girl pants up with God's help and make the move for my Mom. She cried, I allowed her to, gave her comfort, reassured her I loved her, and now could just focus on being her daughter who is alive and not dead. Our advocate told me she has seen so many adult children get heart attacks, strokes or die before their parent bc they can't make the tough decision for their own health.
You're not a bad daughter if you move her...you are a good and wise daughter. I suggest looking into an Adult Foster Home in your area.
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Reply to Klh39v
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Di1961 Apr 28, 2024
Oh my, I’m dealing with this NOW.
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cms4070: The decision rests in your hands as your mother's brain lacks the capacity for logical thought processes due to dementia.
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Reply to Llamalover47
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My mother was the same way, only she was 96 when she passed. It is a hard decision to make. The problem is once they have dementia, if they are in a different place, they become very disoriented in the new place. I had this experience as I tried to have my mom stay with me (about 90 miles away) and take her home on a weekly basis. Once she became disoriented, her moods changed and she was not happy at all. So, strategy changed to me going to her house on the weekends to monitor. Her sister, still living has the same issue, but my cousins were able to find a private caretaker who lives 24/7 at my aunt's house. It is $1400/week plus she receives free room and food. This is in the NJ/PA area where assisted living can cost $8,000-10,000 per month. So $5,600 a month is a deal. There is no easy solution, but forcing them into a home where they do not want to go may worsen their health conditions as well. Ask some of the Retiree organizations, churches and her friends, sometimes there are individuals that are open to a 24/7 arrangement.
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Reply to KT32145
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What I would like to know is where is everyone getting money for AL? Here in MASS. decent AL is 5-$7,000 per month No equity left in home or income enough to afford it. How is everyone talking so nonchalantly about something this expensive? Because of cost it isn't even an option for us.
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Reply to boss123
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MACinCT Apr 27, 2024
In my family, the modest home gets sold. In combination with SS, there could be at least 2 years of care. Dementia is progressive so transfer to SNF in the last tear is a good transition time for Medicaid
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Ya I have a similar issue with my 95 ur old dad.
I’ll be waiting for an answer too.
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Reply to HereIamitsme
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Mom has a Dementia. She can no longer make informed decisions concerning her care. Its no longer whatvshe wants its what she needs. More importantly what you need. Placing Mom in a AL was the best thing I did for both of us.
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Reply to JoAnn29
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Try your mother’s local County Area of Aging . They interviewed my mother and deemed her unsafe to live alone and were willing to return and physically remove my mother from her home and bring her to an AL that I had chosen .

Or ask the social worker you are already dealing with.
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Reply to waytomisery
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This is now the time to sit down with your mother and explain that she is no longer safe on her own in the best opinions of her medical team and that THEREFORE she MUST now be moved to care.
This is not an option. Don't explain it as though it were. Tell her that you will now begin the search for the best facility to care for in YOUR opinion (not in hers). As long as you make this an option, she will of course say no.

If your mother says she isn't going, then you can tell her that it is not a choice, and that you as her POA will arrange this. If she, however, is well enough to go to an attorney you may be looking at a guardianship fight in which you will need the WRITTEN documents of TWO doctors (one should be neuro-psyc MD.

I would simply go ahead as POA. MPOA is overridden by a general POA which is what you are. That means you essentially ARE the medical POA and POA for ALL THINGS when your mother is no longer competent. However, competency or lack of it, if the elder pushes back and has an attorney is a court action.

As to how you do it?
You call EMS and pay to have it done if that is necessary, but do tell mom that such behavior would likely mean she would not go to ALF but to memory care, which is a locked unit in which she would not have her own room, but would have a roommate.

It's time for a visit and for absolute honesty.
I would go WITH A SOCIAL WORKER if at all possible to do this onerous task.
Your Mom may not intend to go gently into this good night. Would you?
You may want also to contact APS for their advice on this matter.
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Reply to AlvaDeer
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Work with the Memory Care Assisted Living administrator about how to facilitate the move. Get her some calming meds from her doctor and dole them out before the medical transportation comes to take her to the facilty.

Arrange to have lunch with mom in the dining room when you arrive. If you haven't been able to remove her things from home into her suite, now is the time to have the movers or delivery people do it. While she's eating. And meeting new people, being kept distracted. That's how we did it with my mother.

Hopefully you'll have her suite all set up for her like home, and she'll feel comfortable in it once she sees it. That's the goal....to have her see her new suite set up like home for her. If she freaks out, stay away for a while abdcsllow her to adjust.

Best of luck to you.
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Reply to lealonnie1
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I would move her local to you. But, you cannot force an adult to do something they aren't willing to do, PoA or not.

Therefore you may have to create a therapeutic fib to get her into the facility. Facilities have done this for others, so pick a place and then talk to the admins about helping get her there. You may need to tell her something like: the city is shutting off utilities to work on the "lines" (water, gas, electric), or that she has a mold in her attic that needs to be cleared and it will take a while to get it fixed so you'll have to stay with us for a few days. Or, that there's an event in your town that she must attend, etc. Whatever you think she'll accept.

I suggest you discuss meds for anxiety for her with her doctor before you attempt to move her. Does she have any friends in that town who would be willing to help? A church or club? You should plan to stay there at least a week in advance for sure... I wish you success in getting her transitioned.
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Reply to Geaton777
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If you are POA and mom is not safe living alone you are within your rights to move her to AL.
But I am a firm believer that a person with dementia should not be in AL they should be in Memory Care. (the concern is that a person with dementia can walk out of AL and become "lost")
Then the question is..
Do you have her in a facility near you where you can help get her to dr appointments and visit (if you wish) OR do you place her in a facility near where she currently lives.
If she has good doctors where she is. If she needs the care they provide. If she has a good support system of friends it might be best to leave her where she currently lives.
BUT
If she can not manage dr visits, if her doctors are not specialized or she does not need specialized care and she has no friends or support system it might be easier for you to move her closer to you,.

I can tell you no matter what decision you make she will not be happy.
There are Care Managers that can help with some things from a distance so you do not have to be there for each appointment.
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Reply to Grandma1954
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