Should I back out of this? What are my options for Mom's care?

A friend of mine reported her alcoholic brother to Adult Protective Services when she found out he was taking financial advantage of their mother. APS put a stop to it.
There is nothing at all drastic about reporting your drug-addicted nephew to Adult Protective Services if he is taking financial advantage of your mother. If it is your sense of family loyalty that is preventing you from turning this over to APS, realize that your nephew has no family loyalty. His loyalty is to drugs and drugs alone.

Call the police and report the theft. Detectives can interview her and you should move forward with an Order of Protection to keep him away. Do this before the cops come after you for theft. No other way. Do it now.

The AL I am familiar with allows the person who admitted the resident (you) to restrict visitors and certaily to restrict who is allowed to take the resident out of the facility. Ask about such procedures. If you have POA change banks and accounts. Have only your name on the account BUT keep it separate from your own funds. Don't put your Mom on as having the authority to withdraw funds. This may stem the flow. If you can find a place nearer to you (and then don't give out her whereabouts) that might help on several fronts. Good luck

((((((hugs))))) very difficult! It sounds like your mum is competent still, so she is free to spend her money where she wants to, yet this grandson is financially abusing her. It might be worth talking to the bank about what options they can suggest to better protect her, talking to the ALF as suggested above about visitors, talking to the cops as suggested above to see how you can protect her and even taking to an elder lawyer to see what suggestions you can get there. Financial abuse of the elderly is not a new thing, and, hopefully you will find some means to curb this. Unfortunately she is willing to go along with the grandson's games which may limit what you can do. You say she has "dementia". I am not sure what that means. Has she been diagnosed with dementia? Do you have medical and or financial POA? I think you would need an active POA to easily place restrictions on her spending.
Good luck to you - it looks like a very difficult situation.

APS too drastic? Sooner or later the nephew is going to take it all and then where will the money come from to pay for her assisted living? She will not qualify for medicaid due to her generous gifting to the nephew. What then? If you live in a state that has filial responsibility laws you could be on the hook for her care.

You clearly suspect that your nephew has diddled your mother out of her car, her diamond wedding ring and several sums of money. You clearly further suspect that he has done this in order to fund a drugs habit and presents for his girlfriend.

If this behaviour, unchecked, gets worse and therefore comes to light, and you are accused of being complicit by knowing of these facts but failing to report them, will you still think you don't deserve it?

If reporting what has happened to the authorities seems too drastic, what do you propose to do?

Reading between your lines, it sounds to me as though your mother is in fact giving these items to your grandson. She may not be aware of their value, she may not really comprehend what she's doing, but I hazard a guess that she enjoys giving him presents, he is appreciative, and neither sees the harm in what he doing.

But there is harm. He is abusing her trust, and effectively stealing from her: a lady who does not understand what she is doing cannot freely give her belongings to someone else. It is time to get heavy. You either speak to him yourself or you get the authorities involved.

Take the car keys and take the plate off her car. She won't be going anywhere in it. And what geewiz said. Talk to the facility and tell them that he's not allowed in there, not allowed to take her anywhere, period, for any reason, for her own safety. And what Emjo said, too. Talk to the cops while you're at it.

Well, you can and should certainly talk to all these people. It is good that you are trying to protect your mother. But unless she is declared to be incompetent by a court you cannot stop her from spending or giving or throwing away her money. She has given away her car, so taking the keys means nothing. I hope someone you talk to will have good practical suggestions for you. If that happens, please share! We learn from each other.

daisy - I was not sure what "dementia" in quotes meant. I see that she always has been difficult and I know from my own experience that it is hard to tell what is the old ways and what is due to relatively recent mental illness and what is a mixture of both. If you had financial POA you might be able to rearrange her bank accounts, so she only has access to a small amount of money regularly. I think I read on here that someone has done that. I know of someone who put his money in trust for her brother - she had POA - as he was being fleeced by a drinking buddy. Similar situation to yours. He had been declared incompetent and we are in Canada anyway which is a little different. Depending on the type of POA in the US you can act right away or have to wait till she is declared incompetent.
from website wills.about.com
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A Power of Attorney can be "durable," meaning that it goes into effect immediately and continues to be legally binding if you become mentally incapacitated; or a Power of Attorney can be "springing," meaning that it does not go into effect until you are declared to be mentally incapacitated.

The person or entity named to act on your behalf in a Power of Attorney is called your "Attorney in Fact" or your "Agent."
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The durable one has obvious advantages.

However that does not deal with the unpleasantness, the accusations and blaming. Have you had any success from the calls you made? The psychiatrist may be helpful - I hope!!!

(((((((((((((hugs)))))))))))) let us know how you make out.

Daisy, too drastic? I don't think so, sounds like you know'about several large items that have ended up with the male relative. It is going to get worse if he is not stopped. Then you will be asked when you knew about all of this. APS will also ask why you didn't do something about this sooner. Are there any relatives taking assets (yes a diamond ring is considered an asset, as is a car) from her other than this man? Whether she wants to make these gifts of not it is having an impact on her ability to provide the care she needs. It will be discovered at some point. BE STRONG!