Nephews want their uncle to go into assisted living or nursing home. My wife is durable POA. What say do they have w/o it?

If as you said his family was never close why would you expect the nephews to visit more often or even have him move in with them.

My wife spoke with one of the nephews who recently visited. She said the conversation was good and lasted about 45min. He asked relevant questions regarding his health and long-term plan. My wife was clear with him, that his uncle approached us for help and we did what we would have done with our own family member. We have no hidden agendas. He never felt there was any ill intent. No discussion of the POA was necessary.
In fact, he told us that he mentioned to his uncle he should sell his house 20yrs ago and move into something smaller or an apartment. He recommended we purchase it. This tells me this person has no personal interest in his house or property. It gives me a piece of mind that we can work together.
I can't say the same for the other nephew until I speak to him.

Thank you for all the recommendations.

Kunkledude, if I may be so bold, might I suggest that your wife not share your plans until she's gotten responses from the nephews on what they will do?   If they know you'll take care of their father, it may allow them to feel he's being cared for now and will be in the future and they have no need to step up.

"Feel them out" first and find out what they'll do or not do before being frank about your own efforts.

So to answer some questions and clarify.
There are 3 nephews and a niece. We have only ever heard from 2 nephews. The other two relatives are in jail or druggies. The two that do contact him are out of state and do not ask about daily regiment or his daily status. No questions about medication health issues, etc.

I agree with most of the replies here that they care about his overall health. But, if they really did they would be in more, or perhaps even have him live with them or visit or one of their children contact their great uncle. In fact, our neighbor has never even met his great nephews and nieces, does not know their names. In my family we know each other’s lives intimately jobs, spouses and such. He himself said, his family was never close.

For the last 20yrs I can count on one hand the times his 2 nephews have been in. And they have not come in when we needed them. Examples: cataracts surgery, pacemaker surgery, a fall 10 yrs ago where he broke his shoulder and was hospitalized and sent to a rehab facility. We called them with updates. None of them came in. We were there to put his drops in his eyes twice a day, visit him in the hospital and rehab.

Tomorrow my wife has a scheduled phone call with the nephew who was recently in. She will be open and honest and hopefully discuss the long-term plan for our neighbor with input from all.

Have you spoken to the nephews directly, or are you getting the whole story from the uncle? I think you need to have a conversation with them face to face and without confrontation. Then you can determine their motivations for yourself.

Just because he says his nephews are after his money does not make it true. My grandmother told my boyfriend that I just wanted her money after she died. Seriously....my 'inheritance' was a set of butt-ugly dishes from her. There was no money. I was not expecting any money. What little that was left went to her two sons. She was of sound mind yet that is what she thought.

Worriedincali is right. This is only going to get worse. This man has relied on you for 30 years. Are you prepared to do hands on care giving when the time comes?

You have covered all the bases with medical and legal. You and your wife have been wonderful human beings to make your neighbors life as fulfilling as you have.

If the nephew makes his uncle anxious he may have to keep his distance. Regardless of what the uncle believes, the nephew may be trying to reach out to connect to family and sees his uncle as vulnerable not knowing the relationship you and your wife have with him.

Try an oximeter to see if it will help neighbor calm down. Sometimes the right numbers appearing on his fingertip can be calming.

If you haven’t already, check our “Being Mortal: Medicine and What Matters in the End” by Atul Gawande. Someone had recommend his TED talk which is also good but it is not about aging like “Being Mortal” is.

Is your wife prepared to become his full time caregiver? Can he afford full time help? What your wife thinks and what she wants for him is irrelevant. The only thing that matters is what’s best for him. Unfortunately a lot of elders want to insist on staying in their own homes but very few have the financial resources to pay for that. Instead they enslave their family members. They don’t understand that the only reason they are still in their own home is because everyone else is sacrificing their own lives & physical/mental wellbeing. What is your wife’s plan then? Is she going to become a hands on caregiver? Because clearly he needs help. His dementia is going to progress. I guess I question whether or not your wife knows what she’s gotten herself in to here.

Elders are often convinced that they will go downhill in a facility. My mother thought so. She was wrong. We KNEW she was wrong.

She thrived. She made new friends, ate better, got better, more consistent medical and psychiatric care.

In short, I think your wife is wrong

Yes, the nephews should be made aware of the POA. Your wife's responsibility is to carry out ur friends wishes. The only way the nephews could override the POA is to get guardianship. They have no legal right to put this man anywhere. Your wife has it.

I would not tell them about the Will. At this point, its really none of their business. Wills are a private thing.

Perhaps you can still be involved but work toward an acceptable solution, by locating care for him at home, but also researching acceptable facilities for long term consideration.  You're already providing good camaraderie and social interaction.

My father and I went through this, and I'm now surprised to learn that one of my younger relatives thinks I should consider moving to a(n expensive, well beyond my budget) retirement community.   It's clear to me that although the intent is good, the total lack of understanding of my level of independence, and more importantly, financial situation, is lacking from this suggestion.

And I'm a firm believer in staying in one's home as long as possible, utilizing services and making modifications as necessary.

I definitely wouldn't raise with the nephews the issue of your wife's proxy authority.   Anyone who only visits every few years doesn't need to know this.   I am assuming though that other than recommend facility placement they've shown no effort to become more involved?  They don't ask about transportation, meals, etc.?

Since your wife has experience  in caregiving, she could create a plan for as many aspects of his care as possible - camaraderie, meals (such as Meals on Wheels), life alert pendant, lock box with key for first responders, etc.).  

These are preventive and emergency practices, but not ones that would measurably change his life through aggressive intervention.

Emergencies are going to happen; it's almost a fact of life as aging occurs, but you can plan for them to ease the anxiety and confusion when they do happen.

It wouldn't hurt to discuss your plans with your attorney, or his, if he has one, just to keep things above board and avoid the appearance or allegations of interference and self interest, although the nephews may raise that anyway.

Something doesn't sound right here. If uncle went into assisted living or NH, which is what you state nephews want, Nephews certainly wouldn't be after his house or property. People who are after someone's house and property would try to keep them home while inadequately caring for them in the cheapest way possible while working to get access to their money. Nursing homes are very expensive but are often necessary for survival of adults with dementia.

If that’s how infrequently his nephews visit - no idea if they contact him between visits - they wouldn’t know how day to day varies for him.

Yes there is the issue of increasing dementia - but first priority remains his welfare and happiness. Whilst he’s able to enjoy being at home with caring neighbours watching over it would seem that is best.

Think UK POA’s are slightly different - they have to be registered to be valid and from that point the POA takes control. I used to still chat to dad about his wishes anyway.

If he has has dementia then legally he cannot sign another POA due to this.

We had to write to all relatives about the POA in case there were objections. However, you will need to work with his nephews at some point should his dementia worsen or falls become more frequent.

Difficult when you are trying to enable him and feel they are not really interested in his welfare. I would certainly check that he would legally be unable to sign any new document and then mention it to them if it’s in force

Best of luck, hope it works out

I think you are confusing what he wants with what is in his best interest, despite your empathy for his desire to remain in his home in my opinion it is his nephews who can see the forest rather than the trees and are proposing something that is in his best interest. The man is in his late 80's and has dementia, although he is managing now with your support he will soon need more than neighbourly oversight - most dementias are progressive, terminal diseases that have physical as well as cognitive consequences. If your family wish to remain his advocates then you might be wiser to work with the nephews rather than against them.