Mom had an old medical directive refusing assisted living. She is still living at home alone but cannot do anything herself due to dementia. Her doctor has deemed her incompetent. She also still drives, which is horrifying. My brother has POA and is helping where he can but is exhausted. She is hostile and stubborn and doesn’t want to move. She refuses to let any strangers in the house. Memory care facility won’t admit her due to medical directive. Can we give guardianship to the state? What other options are there?
Now advance directives do not consider choices for care in future.
That is because someone may need care whether they want care or not.
So it is fine to refuse "heroic" measures such as dialysis, heart transplant, invasive surgeries, ventilators, and etc.
But one cannot make a directive that is "suicidal" if you get my meaning, because suicide is not lawful. If competent, one can refuse food or water and do a VSED exit by stopping eating and drinking, but if INcompetent, then the POA takes over.
Your POA for the mother will now have to arrange care for her so that she isn't in danger of death caused by being alone and helpless.
Hopefully that will make some sense. There need be no heroic measures to prolong her life, and in fact if the doctor agrees she can be put on hospice care.
As to a memory care that won't allow a POA to place an incompetent person due to some that silly in an advance directive (which I as a NURSE never heard of in my life, having read some 1,000s of directives)? I can only say I really can't imagine such a silly place (and in fact find it quite unbelievable; I think there must be a misunderstanding somewhere here).
So I would simply choose another nursing home.
Don't worry, no social worker will allow an old, incompetent woman to die in her home because of something silly written years prior.
Things are no longer in you dear mom's hands; when we are incompetent there are legal means of having our needs acted upon.
Just a PS here:
Now that mom has been DIAGNOSED as incompetent brother does need to remove the keys and the car. Part of his duties as her POA for her own safety and the safety of the general public. Your mom at present is somewhat of a lethal weapon brother is responsible to contain.
I would, in fact, given the level of misunderstandings of what POA is and is responsible to do, suggest a visit for an elder law attorney and getting some of these issues ironed out. It will be well worth the money whatEVER the cost.
Don't worry.
Then he needs to sit down with a good Elder Care attorney to talk about the nonsense in an advance directive about no managed care for an incompetent elder with dementia.
Good luck to you.
When he is removed as POA, your mother becomes a Ward of the State. Then her court-appointed conservator will put her in memory care.
Don't you think most seniors would make an advanced directive refusing AL, memory care, or a nursing home if it could actually force their family to care for them at home? It can't.
Your brother can easily resign as POA by signing documents at the probate court. I was a POA for a mentally ill relative for a time. I couldn't take it anymore. So I went to the court and signed documents removing myself as their POA. I did not need their permission or anything else. It was easy. Visit the probate court with your brother and in the meantime, put in a call to APS tell them what's going on. Visit the local police and ask them to do wellness checks on your mother. They will and they will call APS too.
Worth a TRY, as a much easier route.
If not, the attorney could go over the details of the process of how your brother could drop POA and then have the state appoint a guardian, if you were to go that route.
either way I think an attorney is going to help you a lot
Next, both Assisted Living and MC are not medical care, they are custodial care. If they are considered medical care then health insurance, Medicare or Medicaid would cover it, and none of them do. There's nothing medical about living in a room and having meals prepared for you. I don't see why anyone would honor this ridiculous inclusion to her paperwork. That lawyer did it to humor her, or she did a DIY document.
If all else fails your brother can resign his PoA and reports her to APS. This paves the way for the courts to assign a legal guardian for her. They will get her appropriate custodial care.
Please read the original post again. This elder is not safe at home and it cannot be made safe even if both kids move in with her. My mom lived with my husband and me and it became too dangerous because she was wondering through the house in the middle of the night and not using her walker, going into closets and pulling thinks down on top of herself. 11 months in, I had to face the fact that I was not the best caregiver for her. I think you have little to no understanding of what it takes to care for an elder who refuses any outside help, becomes combative, withdrawn, refuses to bathe, etc. You have a single experience with your mom but read the stories here and see what we've experienced and stop judging others for doing their best for their loved ones!
No one wants to dump their mother off, we arrange qualified 24 hour a day, 7 day a week care to ensure their safety and comfort when their minds no longer allow them to care for themselves!
My mom was driving when she should not be, her wreck, which totalled two cars and put her in the hospital was what alerted us to how affected with dementia she was. Her grandson moved in to help her and she was certain he was there to take advantage of her so i moved her in with me until that was unsafe. She still thinks, 3 years later that she can live alone and drive!
As one who is not a fan of a facility, sadly in this case, the OP probably has no other choice but to place her. Mom doesn't want strangers in her home, which rules out caregivers coming in, which is practically her only choice at this point to stay out of the facility.
OP and brother have done all they can to honor her wishes to not be in a facility, sadly placement in a facility is now the only solution.