If Dad needs residential care can we make this decision for him?

Gillymack, how are things going? We have not heard back from you in 12 days. We hope things have improved. Let us know what is going on?

My mom was totally incapable of making a rational decision on her living arrangement when her dementia progressed her doctors said she was incapable of living alone. We could not care for her at home, nor could she afford a 24 hour nurse. She is fiercely independent and became nasty towards us. She fought hard when we used my sister's POA and placed her on a memory care floor. This fight when on daily for the first few weeks. Just a few short weeks later and she rarely asks to go home any more. She is doing much better and accepting our decision, even saying that "you made a good decision." Hang in there. Use your decision power. We were told that, at least in our state, medical POA was enough to make this decision. There is hope.

Im confused by some saying they were able to sign aomeone in to a facility with the POA and others saying you have to go to courts for guardianship in order to force a move to a facility. Im wondering if the rules/laws are different by state...i have POA for my mom who is 86 and has moderate dementia. She lives alone now and i help with shopping, appts, or whatever else she needs me for. I know this wont last forever though and would like clarification on what will be required when the time comes that i have to force her to move to a facility. Is the POA enough ... i have health and financial POA....or is going through courts/doctors for guardianship required to force a move???

Thank you, Rovana. I have considered the things you mentioned - APS or the Health Dept. Actually there was an issue yesterday with Dad taking too much of one of his meds (which has been a concern of mine for some time) and it really scared him and I'm hoping this might be the thing that will push his doctor to push him to allow someone to help him. Something has to be done one way or the other.

Rovana has some good ideas. I am in the same situation right now and the anxiety may just make me have a nervous breakdown.

Didnotsignupfor, it seems to me that many of these issues of aging are not addressed in any realistic, wholistic way from a legal perspective - we are just struggling with a lot of ad hoc legal rules that do not work realistically and are not coordinated. Same with mentally ill people being able to refuse medication that would control their illness. Civil right are first so people have the right to make horrible decisions, and it would seem that the only way to deal with this is to fight back. For example, forget about Dad here and think about Mom. Is she being abused? How about calling Adult Protective Services and demand that she be protected from Dad? How about calling the Health Department and reporting a public health danger in the house? Now this sounds mean, but sometimes you HAVE to be mean to get anything accomplished. Dad wants everything to go on as it always has? Well, TOUGH LUCK - it isn't going to.

I apologize for hijacking your post, Gillymack, with my own issues; this was your question. :-) I do hope you find the answers you need and I wish you well.

Perhaps it varies by state, but if you have Durable POA, it should continue after he is incompetent. His doctor may say he is no longer able to make decisions for himself. The doctor, along with the family's input, should be able to complete required forms as to what types of things your dad needs assistance with and what medical conditions he has that may need assistance or daily care.

What if you explored that and also tried to entice him to go for some kind of therapy, rehab, etc. at an Assisted Living facility? I used creative ways myself to entice my cousin to enter one. She was against it at first, but as I explained the things she would be doing and how it would help her, she became more open. After she got there, she took a downward turn, so it's a good thing she was there. I signed her in under her POA. You can read some of the ways family members encourage and support those who are in dire need of assistance due to dementia on these boards. Good luck.

Arlene, I understand what you're saying. However, I do think that it is quite unfortunate that when my father was in his right mind he chose to have an attorney prepare a document which he signed that said he trusted me to be responsible for his healthcare when he was no longer to make those decisions for himself. I cannot begin to comprehend how a person in his stage of dementia is considered to be able to make the proper decisions for his health and well-being and why I should not be able to now to do *what my father put his trust in me to do when he was well*. It might be against his will now in his present state of mind to move out of his home, but his present mental state does not allow him to know that his will is detrimental to his own safety and well-being, as well as my mother's who is physically unhealthy, unable to care for Dad, and slowly losing the will to live herself because of the stress caused to her due to being forced to continue in the same household with him in his current state. She begs me to move him to a facility where he can be properly cared for, but of course Dad refuses. My father's doctors don't seem to care one bit that he is killing my mother and causing her to live out her old age in misery (he is very mean to her - nothing physical...yet, but his cruel words and actions cause her to cry almost daily and she lives with constant depression). In my experience throughout my father's struggle with dementia none of his doctors have shown any care for the stress and pain caused to my mother and myself; we are apparently unfortunate "casualties" of my father's illness and that is our burden to bear, which is pretty much all I've heard from my father's doctors on the subject, even though they all know that their home is unsafe - dangerous stairs neither of them can manage, horrible filth and some hoarding - none of which Dad will allow me to correct. Not that it would matter what the doctors say - Dad is determined - but so far they won't even bring up the subject even though I have pleaded. (One doctor did mention it very briefly once but my dad shut him down right away and the doctor did not even try to proceed any further with the conversation). I am on the brink of losing my job due to all of this (and I have no savings or other means of support), not to mention my mind and my own physical health due to stress. Apparently a healthcare POA is only good for anything if my father is near death(?) Makes no sense... in that case a family member would have to make the decisions, anyway. I will find the document when I get home; I feel sure it must be good for something other than making decisions when my dad is on his actual death bed....

My answer may have seemed harsh, but I'll give you the back story. Two of my Aunts predeceased their husbands who had dementia. In one case, Aunt insisted that she COULD care for him at home. She had a massive heart attack shortly after her children realized he was beating her black and blue daily for the key so he could wander the town. In the second case, Aunt, who was physically frail endured years of physical, mental and emotional abuse from her mentally ill WWII vet husband. She broke her hip; he wouldn't call 911 or anyone else. He dragged her around on a throw rug for three days until a family member stopped by and called an ambulance . She had surgery, did rehab and went back, with aides, into this untenable and abusive situation. My brothers and I were not going down that road. We saw first hand how both Uncle's thrived in Assisted Living/memory care and we weren't prepared to go down the "I have to stay in my home" route, seeing as how, in addition to all of the above, chained a vulnerable cousin to his parents' home, as his siblings complained about how he lived there for free.

In my mind, the same way that a child's place is in school, when an elder needs supervision, one of the best options is out of home care.

I'm sorry to tell you that although you have POA over your Dads health and welfare, you do not have the right to tell him that he needs to move to residential care. You need to get his doctors to tell your father that he needs res care for his own safety. Unfortunately, POA doesn't give you the right to tell your Dad what to do, no matter how sick he is. You need to convince your Dad that he needs to be cared for, food, laundry, where he sleeps, and being safe. All the best.

I don't understand why people with advanced dementia retain the right to make their own decisions about where they live unless someone spends what could possibly be that person's or their own life savings trying to obtain guardianship. Is this still true if I have healthcare POA... Can I make the decision where my parent should live if I have healthcare POA, or would I still need to obtain guardianship?

Discuss this with your father's physician. He can make a determination if your father is capable to making such decision. He may be able to tell you he wants peas for lunch but not capable about obtaining specialized care. Here, if two physicians complete lacks capacity statements then you can sign him into a long term care facility. What does the POA say, when does it become effective? Contact your local Area Agency on Aging or Bureau of Senior Services, they will be able to give you info in this topic and can make referrals if necessary. I know this isn't easy for family members, but if dad's dementia is worsening he would be safer in a facility than at home. It is very demanding and a 24/7 job caring for someone with dementia. I always worry that those with dementia will go outside in bad weather and get hurt or even die. Do you have other family that can support you in your caregiving duties?

Are dad's doctors saying he needs full time care? And there is no one at home to provide it? So the conversation is not "dad, you have every right to refuse care". The conversation is Dad, this is what your doctors say is the right level of care for you. This is one way of accomplishing it. Let's go take a look and make a smart decision". If dad says no he's not going anywhere then you say, well sorry dad, we're trying to help you out here. You trusted us to give us POA because you knew we'd make good choices. If you won't go look and help us make choices, then we're going to have to give up POA and let the government take over. And mean it.

Dad just needs care, maybe there are other options vs. going to assisted living.

Your father has the right, at this point, to make his own decisions, even bad ones. Power of Attorney is the power to make decisions on his behalf but your dad retains the ultimate decision making power. Guardianship is the route to being able to make this decision for him against his wishes. Because you have POA, you can use his money to pursue guardianship becuase it is a process for his benefit.

You are in a better position to know whether or not several months of process, thousands of $$$, and the internal familiy strife would be worth it. If there are other alternatives to being able to help, like the link Panapal posted, you might want to try that route first.

https://www.agingcare.com/articles/research-assisted-living-before-talking-resistant-elders-112081.htm?utm_source=Care2&utm_medium=Partner