My aunt became her sister's new POA and I suspect she never takes her out of the nursing home.

freqflyer; Yes, i could provide 3 shifts as i was doing that with my aunt, my parents plus having a 5 year old which i was babysitting at the time everyone was living with me in another state. She did not need much oversight at all. My aunt did not require any care except when her caregiver began to NOT follow the preventive health direction i was giving her to use for my aunt and my parents as we were doing for years which kept them in the best health. SHe then married my sibling so it became impossible to continue with ways which kept them healthy and active. Once my sibling married the caregiver, my aunt could not take walks anymore for groceries, or getting breakfast each morning at the cafe... She would not provide info on bowel habits and prevented me from speaking to my sibling regarding protocols for my parents and aunt.

You just want your aunt to enjoy the best quality of life she's capable of, yes? That is a very correct aim, one that no one could take issue with.

So. She is 60 years old. She is currently housed in a SNF and should be taking part in a day program. You hope that she is, or at least that there are plans for this, being visited and taken out by family members so that she can benefit from inclusion in family life.

Is there any particular reason why you can't just ask other family members if this is happening?

I agree with your aim of describing and treating your aunt in the same way that you would any other vulnerable person, rather than presenting her as a "case" with a label. But please do give us some credit for understanding that people with physical and mental illness and/or disabilities have the same rights as any other individual.

The reason I say this is that when we get down to it, what you would actually like is a more appropriate residential setting to be found for your aunt; and I agree: if in fact she has always needed support because she has a chronic or lifelong condition then just shoving her in the nearest facility with very much older people is far from ideal.

But there is a lot more going on than constipation, is there not. Are we talking learning difficulties? Chronic mental ill health?

There will be organisations that can offer you support with advocacy and information - I have yet to come across any condition that does not have its own network of groups and lobbyists. Write down a summary account of what's gone on with your aunt, like a CV - dates, location, main care givers, key events - so that anyone you speak to can easily get a picture of her life.

Another important question: does your aunt with disabilities have capacity? The thing about POA specifically is that it can only be created with the informed consent of the person for whom it is being created. If your aunt when to court and applied to become your disabled aunt's primary decision-maker, then she's your disabled aunt's guardian, not her POA. The (not bad, as such, but) difficult news there is that guardianship has a much broader decision-making remit; but the good news is that it is also subject to routine scrutiny and reporting, so that yours will not be the only eyes being kept on your disabled aunt.

Anyway. Bottom line: you are not satisfied that your aunt is being adequately supported, and you have every right to make enquiries and to speak up. I do urge you to look for a network of people with similar family members and loved ones so that you can benefit from their resources and experience.

And there is nothing wrong with using somebody's social security money to pay for their care and their living costs. Where you might run into difficulties is if good records weren't being kept and it looked as if the disabled person's money was being misused.

So what's the status of your former-caregiver sister-in-law in relation to your aunt? Is she playing an active role still?

jeannegibbs, what i want to have happen at this point is that she gets placed with a family in an ALF. She could chop and help cook and now she is in bed after dinner in a fetal position. I have taken up care of my own elderly parents but if i had assistance for my aunt, i can house her again if my other aunts are not able to do their part the right way. If they are and i learn that they are making up for lost time, then i will step back because i will know my aunt is getting out and the nursing home is just for sleeping and for day program. Her diagnosis is constipation and might also be selective mutism and has potential to leave which she won;t leave if she likes where she is. She would not leave when she was with me and i let her go for walks to get groceries  and she always returned. She had a cell phone and i would call her. She was functioning in society. She is in the wrong place.

GardenArtist, The only reason i wanted access to take her out of the facility was because i suspect my other aunt is not doing what we thought she would which is to include my aunt into her life. The facility released her to me three times and then stopped when my other aunt found out. My aunt befriended the former caregiver who tried to force everyone out of their home and have it sold so she and my sibling can buy another one. So it is a control thing. My disabled aunt lived with my parents for 40 years and when my other aunts found out that my parents and my sibling used my aunts disability income to pay for caregivers and charged my aunt rent, my other aunts got crazy upset. I don't know how else we were suppose to do things. I feel it worked out fine as did the Soc Sec office case manager. She had 7 years of savings from not collecting SS while she was homeless and some of that was used to do repairs on the flooded house and some was used to buy a new car which was flooded during the hurricanes. But it was monies that were suppose to be deducted from my aunt to pay for her share of groceries and financial contributions for surviving 1 year while relocating while renovations were being made. This was a family functioning in a balanced rationed out way which was working efficiently and fairly but family on the outside has no idea what it entails to care for elders and how the family caregivers put their own jobs and lives on hold or stop and start to hold the fort. THe story has too many details. I just know that i need to get assistance because my aunt is in the wrong type of facility.

POA is not a caregiver role. It does not require visiting in a care facility. That would be nice, and many POAs would want to do that. But it isn't a requirement of the role. And if this is a mental health facility, there may be constraints on outings.

It is wonderful that she responded so well to your care two years ago. But the improvements you mention did not involve her mental health. What is the reason she is now in a mental health facility? Even if she were back under your excellent care, you might not be able to improve that aspect of her health.

We are all candidates for dying. In fact, every single one of us will get elected to that role at some point. I assume you mean that she is not ready for hospice or that she should have significant time left to her. How old is she? What are her impairments? Why is she where she is? Is someone expecting/encouraging/neglecting her to die? Why do you bring that up?

Have you tried visiting and been turned away?

What do you want to have happen at this point?

Countrymouse, When my sibling got married to my aunts caregiver, they flew my aunt out of state to stay with me for a few weeks. When she arrived her legs were swollen and she was bloated and heavy like i had never seen before. I had her stay an extra month to get her moving her body and lose 20 lbs. It is like they had no concern that she had these issues. She was called back to return so she did not lose her spot at the day program. Years later i had communication with other relatives who said my aunts former caregiver said it is more important that my aunt enjoy her life and eat what she wants because she already lived her life and it is everyone else's turn now. Blatantly shamefully sick things to say in my opinion. There is more to the story which i can not put down here but i need to do something because she is NOT a candidate for dying and only 60 years old and in a home with people who are 80 and very very ill. I have since flown up to live with my parents for a while who use to live together with my aunt but their home flooded during a Super Storm and there was alot of relocating while repairs were being made on the damaged home.  We hired caregivers after moving everyone back into their home and my sibling who lived with my parents and my aunt, married the caregiver who moved in and everyone was soon out of their home. I feel she is psychotic and i don't want to run into her as she visits my aunt and fooled the facility into thinking she is an elder advocate. The nursing home has released my aunt to me three times already but it stopped once my other aunt found out and removed me from the list. My aunt became POA out of being embarrassed for never being involved and to look good with the caregiver who married my sibling. My aunt does indeed like to be with me and probably lucky she had some good years of normal purpose filled healthy active living like a regular person. 

I'm a bit confused. You wrote "My aunt also now has POA over her sister which is about time instead of me the niece who was managing my parents and my aunt all these years. " That infers that you want some help or rather don't want to be entirely responsible.

Then you indicate that you want to be significantly involved in your aunt's care and welfare. Is it that you want to be involved but want someone else to have the legal authority?

If your aunt is in a "state run mental health facility" as you indicate, the rules for leaving and visiting are quite different from those of a skilled nursing, nursing or AL facility which are more open.

What actually is the type of facility in which your aunt now lives? If it's a mental health facility, you need to contact them to find out about visitation rules first, let alone removing your aunt from their care for whatever reason, even just for a short trip.

In addition, you state that "We were manipulated into having my aunt go into a state run mental health facility." What was the basis for this? How were you "manipulated"? Is there a temporary order for mental health examination, pending subsequent court review? And in fact was a court involved in making this placement?

These are issues that have to be addressed before anyone becomes involved in Aunt's care or takes her out of a building.

And there may be diagnoses that prevent her from being removed from the facility. She's there for a reason.

Truthbetold, one has to realize that a person is in a Nursing Home for a reason.... the person needs a high level of care than can be provided at home. What are the health issues for your Aunt? If your Aunt has memory issues, sadly there is no reversal.

Do you feel you can do 3 shifts of caregiving that your Aunt now receives being in a nursing home? You would need to set up your home as a mini nursing home, unless you already have the equipment from previous caregiving.

Is your aunt's sister your Mother or another Aunt.
You certainly can ask if your aunt is being taken out. There may be very good reasons why this is not happening. You may not be loud and chatty but you certainly can aski questions especially of your aunt in a non threatening way.
As POA i am afraid your Aunt does control who visits or takes you Aunt out especially for overnight visits.

Do you go to visit your aunt in her facility? I should start with that. Then you can ask your aunt if she goes out, or wants to.

People do age and get worse, you know. Even with the best of care. When was the 'before' when you enjoyed some success in improving her condition?

It doesn't matter if you are meek or Xena Warrior Princess, it is the POA document that gives your aunt the ability to dictate what kind of care her sister receives. If you truly mean nursing home and not assisted living then your aunt is in need of a high level of care or she wouldn't have been accepted there. There are also rules about leaving a skilled care facility that relate to payments and keeping her bed that you may not be privy to. IMO If you truly want what is best for your auntie then you need to focus on adding value to her life as it is now, not one wishful thinking.