My MIL is still in the family home. 89, with MCI. Not bathing, diabetic, not taking her blood sugar, just injecting insulin. Not eating her Meals on Wheels. Leaving them on the counter for days. Ordering Hershey bars by the box, and shortcake with whipped cream. Having severe bowel episodes. Not cleaning up after them, refuses to dress or even wear underwear. Answers the door to strangers in really nasty nightgown. We have set up a nurse to come in 3 times a week to bathe her and set up her meds. She has locked them out, not answered the door, been very uncooperative, and abusive. Husband finally hid a key so said nurse could come in and help her. She then started putting a chair under the doorknob.
MIL is constantly undermining everything the he has done to help her stay in home. Recently she has had a set back and SIL (finally) has taken MIL to her PCP. Asked repeatedly to please sign the POA to activate it so we can keep her safe. Her PCP who has been her Dr. for 1 1/2 years told SIL that she can't go into AL, but would actually need a NH. Still, very oddly enough, the Dr. would not activate the POA. Since then, we have tried another Dr. in the region we are hoping to move her to...Where we all live, 180 miles away. That Dr. was much more intuitive and diagnosed MCI. (It was a good day for her.) He would not activate the POA either. Claiming my Husband was a "Rock Star" and to keep doing what he was doing and just up the nurse visits to 3 times a week. My husband just turned 60 and has not been in the best of health and would like to have more assistance from his sister. He took his mom to her PCP after she suffered complete hearing loss suddenly a few weeks ago. Her PCP tried to clean out her ear wax, only to send them to a specialist. (I have no idea how this "Dr" missed it on all of the visits she had had previously) Again, my husband walked out into the lobby and begged for some help because the PCP stated that it was "Out of her ability" to deem that my MIL was not okay to stay home alone. HELP!!!!!!!!!
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Here in NJ no one ever questioned my POA. They could see Mom was not quite with it. Does your state have a law saying that the POA needs a doctor's letter saying Mom is incompetent. If you do need a lawyers letter, the cost can come out of Moms money. Medicaid allows it. I agree too, that Mom needs a NH she is passed what an AL can do for her.
If you can't get the doctor to help, see if one of the NHs in the area can evaluate her. The only other thing is that if she is ever hospitalized then goes to rehab, you can have her evaluated then and she can go from rehab into a NH if they find her incompetent to care for herself.