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I've a unique situation and am seeking some advice. I'm my 85 yr old Dad's POA and he does listen to my advice, most of the time. I'm afraid, however, facing what I'm going to be telling him this time might just set him against me for good.

First off, let me say that Dad is doing just fine financially. He has a good monthly income and a decent amount in savings. Due to illnesses (and some symptoms of early dementia) he's currently staying with my brother and sis in law. My sis in law is watching him nearly 24/7 due to unsteadiness on his feet and periodic confusion, especially after waking from one of his many "naps". She's afraid to leave him on his own at all and he won't hear of having a "babysitter".

My older brother and I both live out of state so can't help. We seriously believe that it's time that dad starts paying for his care. He does pay his share of the bills and food, but my brother, and especially my sis in law, are really doing above and beyond for him. SIL has put her life on hold for him. They also need someone to stay up and watch him at night so they can get decent sleep (I'm sure many of you know what I'm talking about here). My niece (age 22) has told me she would do it for 500.00 a month (she's a true night owl), a real bargain if you ask me. We think Dad should pay her to take the night shift, and pay my SIL 1,000.00/mo to care for all the other hours of care she's giving. Thing is, he can more then afford this, especially since he gambles nearly 1500.00 a month at the casino.

My sister in law is the one who takes him to the casino and she's tried not taking him but he get's like a little kid...rants, raves, cries and pouts, for days until she finally relents and takes him.nnFunny thing is, none of us want to take his gambling away. We know why he does it...it helps to ease the pain of being old, dependent, sick and without mom. We're all of the mind that he and mom earned their money, and if he wants to spend it that way, more power to him. He can afford, for a few year anyway, to pay both the 1500.00/mo for his care and gamble 1500.00/mo. He will need to sell his home up north (will never be able to go back to it anyway) to help him do it, but it is an option.

I know he's going to feel betrayed when I bring all this up. He thinks he's earned his care by having raised my brother. He already feels betrayed by my older brother (long story) and I'm afraid bring this up is going to cause him to believe my younger brother is only after his money, which is not at all the case. The paying was my idea, actually, and we all three children agreed it was what needs to happen.

I know that we are extremely fortunate that he does have the resources he does, but it doesn't change the fact that I know he's going to fight us on this, and I'm not sure what to do if he does. Does anyone have any ideas?

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Just want to say that it's really nice to read about siblings who are working together for their parent. Your SIL is so fortunate to have sibs who recognize that she's going above and beyond, and who want to support and help her.
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Dustien, do a credit check on Dad if you can. You may find massive credit debt and a lien on the home up north. If that is the case, pursue Guardianship.
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God Bless you and your family. This is a challenge, but at least you are able to look at it and try to work on it as a family.
My dad was ok financially, not super rich, but OK, including the very real possibility on my mother out living him. Weekly outings to the casino gave him something to look forward to..... So few interactive things he could still do. Maybe cut back on the gambling, not necessarily cut it out. Definately, get an agreement and get SIL paid and get her help.

Best of luck to you
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Dustien, I'm sure you know this better than I do: that as your father's POA you have first to protect his best interests, and then, as long as that's done, to assist him in living as he has always chosen to do and would choose to do if he were still competent to make his own decisions.

As long as his gambling does not cause his monthly outgoings to exceed his income, well then - however counterintuitive it seems - you are correct to let him visit the casino. Your SIL actually *taking* him there might be a bit above and beyond, but you certainly shouldn't stop him - and if she goes too then at least she can keep some sort of eye on him.

My ex-husband's grandma, bed-bound for forty years (long story, medical boo-boo, don't ask), was as happy as a sand boy with her horse racing on the tv, her Cognac, her Sobranie Cocktails (she didn't like the yellow ones) and her direct line to her bookmaker. She made a modest profit, too, until the very end. As Roald Dahl put it: "…which proves that gambling's not a sin, provided that you always win."

Hm. The only fly in the ointment for me, with your father, is that the tantrums and the upset when he can't go… well, they say "addiction." That's more of a worry. But the thing about THAT is, if he is addicted, then it isn't something a loving amateur can cope with and you will need to call in expert reinforcements. No matter how carefully you "approach" him about it, if he really is addicted you're not going to get anywhere and you'll just upset him. Don't despair - it still doesn't matter as long as it's not harming his welfare - but if I were you I'd be looking ahead at strategies for when he's no longer able to gamble simply because he doesn't have sufficient cognitive function or is losing too heavily, whichever comes sooner.

Does your brother or any of the family like card games, backgammon, mah jong, even Monopoly? How about introducing betting games at home, where he can't do any harm because it is, literally, only Monopoly money he's playing with? Maybe you could bring in friends or neighbours to give it more authenticity. It could even turn into family entertainment..!?

The point about your father feeling hurt if you raise the idea of his paying rent and care costs to your brother's family: well. Your father may have earned his right to be cared for by his family, yes, if he and they both like to see it that way. But that doesn't pay for the rent, the utilities, the groceries or the chargeable time, because those are about $ and not about love and reciprocity. He'd have to pay his living and health care expenses wherever he was, and he's probably still astute enough to acknowledge that part. What he gets free, on top of his living expenses, is the warmth and comfort of having his family around him. It's not rent, it's him paying his share of the household costs - otherwise he's freeloading, and I can't believe he'd like that idea.
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Well...talked to dad. He, as expected, was not happy. I was ready to not mention the gambling, but when I told him he needed to seriously consider paying Brother and SIL at least 1500.00/mo he insisted that he already paid them 800.00/mo for bills, so he should only need to pay them 700.00 more. I explained that the 1500.00 needed to be paid separate from his bills, since his bills only covered his keep, not all they were doing for his care. He then insisted he didn't have enough coming in monthly to pay both. I told him he had money in the bank he could draw from but he said he didn't want to have to sell any stock or get into his money market savings and he started getting angry. That's when I brought up the fact that he could have enough coming in from his monthly income if he cut way back on his gambling. He said that his gambling was his business and none of mine. I agreed with him, and told him none of us want to try to make him quit gambling...just that we all feel that he needs pay SIL and brother for all they are doing for him, and that he has plenty of assets with which to do it, and still be able to gamble. So he said one solution was that he, my older brother, and I should all split the cost of his care because Justice and Debbie were doing all the work and we didn't have to do anything. He then brought up that he and mom took care of our Grandpa for 15 years and the only thing grandpa could pay for was his share of the groceries and they had to pay for everything else. That's when I reminded him that was because Grandpa had been an alcoholic all his life and had no money. That if grandpa had thousands in the bank, he knows good and well he and mom would have expected him it to use some to pay for the care they gave him, especially since he would otherwise use a good portion of it to go barhopping (substitute gambling)! I explained that we all loved him and wanted him to have the best care he could, and that was with my brother and SIL...that he's loved there, but that, if he doesn't start paying them, the increasing care he's needing is going to begin to take it's toll on everyone. Money doesn't guarentee it's going to get any easier, but money does alleviate some of the burden...she could hire a housekeeper, a gardener (she doesn't have time to do much of either now) and maybe buy herself something nice now and then. It will go a long way to helping her feel appreciated, even though you tell her so.

He started shutting down when he saw that I was sticking to my guns about paying her since he had no good reason not to and a score of good reasons he should. I knew it was time to wrap it up for the time being and let him think on it. I told him to give it some serious thought and that I'd call him in a few days.

I'm just glad he didn't hang up on me, and I hope it sinks in and he remembers the conversation...most of it anyway. I didn't get any guarantees that he's going to start paying, but he knows how we all feel now. The ball is rolling....
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Just a word on the gambling. It can easily become addictive, especially if he's playing slots or video poker. If he's such a regular he may be signing IOUs to the casino for credit. In NV those are enforced like a bad check if not paid timely. What is the enabler doing while he gambles? Gambling herself? Does he pay for her gambling too? Anyhow, what is it about the gambling that is rewarding his brain? Is he enjoying hanging with the old guys at the sports book? Does he like the attention of a pretty dealer? Is he getting reinforced by the machines? Could you replace that with Candy Crush on the computer at home? Find out what bells are being rung for him in the gambling experience and replace it with something less costly. Again, don't overlook the influence of the one who helps feed the need.
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Dustien, he can afford the gambling and eating out -- I wouldn't worry about it. What if he went to much more expensive restaurants and spend that much each month just eating out? What if he loved opera or symphony concerts or live plays and spent that much per month on that kind of entertainment? How about a couple of guided bus excursions per month? Why shouldn't he choose the kind of entertainment he wants? Since he can afford it, I don't see why you need to confront him about it at all. Keep an eye on it, of course, so the amount doesn't escalate, but I see no reason to deprive him of what he likes and can afford.

What I think you do need to confront him about is paying for his care. He can afford it. He absolutely should not expect anyone else to treat him like a charity case. Do draw up an official agreement spelling out what he is paying and what he is getting. If there comes a point when family can no longer do this there will be a huge sticker shock of paying the actual going rates, but at least he's got a chance now to break into paying for care gently.

It sounds like the family is united about this. Wonderful! Make sure Dad knows that.

It is also wonderful that Dad will be able to pay his own way for some time to come. There is always the possibility of catastrophic expenses that no one can anticipate and therefore always the possibility of the need for Medicaid. Let's hope not. But keeping records and having things in writing is just good practice whether he ever needs to apply for financial help or not.
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Dustien I'm still not quite understanding the problem, or why you fear you may be risking your relationship with your father. He is financially sound. You feel he has enough money to support himself until he is at least 95. But the recent visit to the doctor makes it sound like he isn't going to live to anything near 95. So why is it either/or about paying for his care or his gambling? Surely he can afford both for the limited time he has left.

You are the POA. You handle paying his bills, do you? So pay your SIL and your neice. Let him continue gambling. If this does go on more than a few years, sell the house he will never return to.

So the real problem, apparently, is that he will feel betrayed if you point out to him that caregivers get paid and he should pay his. You don't want him mad at you. Is that what it boils down to?

"Dad, Brother and Brother and I have been discussing how to ensure your continued good health and happiness. What if something happened that SIL could not look after you? So just as a contingency plan we looked into what it costs to bring a caregiver into the home. Well, we all hope that will never be necessary, but the more we thought about it, the more it seems to us fair that SIL be paid something for the time and effort she puts in on your behalf. You can afford to pay her, and if it means there is a little less for us all to inherit someday, hey we all want to do what is fair."

Don't drag his gambling into it at all.

It may be that as time passes he will be less able to go on gambling outings anyway. As the dementia progresses he may not remember what his assets are and you will have to make those decisions anyway. Don't borrow trouble from the future. At this moment he can afford both paying for his care and enjoying himself. Deal with the future when it gets here.

I sincerely wish you the best of luck. Certainly don't jeopardize your own relationship with him. But I hope you can find a way to help him do the fair thing.
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Unfortunately, your SIL, understandably under pressure, is enabling him to gamble when he acts like a child, and he knows how to manipulate her. Even though you understand and accept this behavior, I'm wondering if it's more than compensation for loss of so much at his age but rather an addictive behavior. Did he gamble before your mother died?

Can you think of ways that he can use the $1500 more effectively, such as through charity work? It sounds as though he's still mobile enough to get around. Does he have any business background that he could contribute through SCORE (retired execs)? Any hobbies he could share through senior volunteer work, or with scouts, or would the dementia interfere with that? Is he active in any church work? Does he like animals? Could he volunteer at a local animal shelter?


I would also ask one of his doctors about getting home PT for the unsteadiness on his feet, and make adaptations such as clearing out throw rugs, installing grab bars, etc. to eliminate fall likelihoodo so that your brother and SIL can get more sleep.

I would also consider a medical alert device as backup and extra protection.

I think the payments to SIL and niece are reasonable and justified.

As to raising the issue of payment to him, I think you're right that he'll become angry. But realistically, it's not fair to expect your brother and SIL to provide care for him while he's spending $1500 on gambling. He couldn't go to a casino and play for free. What they're doing is worth far more than $1,000 a month - it would cost him several multiples of that at an assisted living facilty, which I'm sure he would fight tooth and nail.

I'd discuss this thoroughly with all the family before approaching him and see if you can't find a way to make him think that you're adding an extra level of care for him. Try to redirect his resentment toward your family into appreciate for your consideration and thoughtfulness.

If you have to, let him know that your brother and SIL can't do this forever, that their health will be compromised, and then they'll have to consider another option (i.e., assisted living) if they become ill.

I suspect though that that kind of projective thinking isn't realistic for him now.

Alternately, I would really try to think of ways to keep him occupied in charitable work or something that would reward him ("feel good work") so that he doesn't need to gamble to spend away the emotional pain. If you can find a substitute activity that makes him feel good and provides a sense of helping someone, it may rechannel his loneliness and emptiness.

I think so often people who've worked all their lives are just so susceptible to the disposable attitude which seems to accompany some aspects of getting old - so much attention is given to the young while the elderly are sometimes considered burdens. We as a society need to find ways their lives can be shared and still be useful as they age, despite infirmities.
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Dust,
You say Dad is unstable, yet SIL takes him gambling? Not the best of environments for someone with difficulty walking. Paying SIL and brother $1,000.00 a month is a pittance, as is $500.00 for overnights compared with the cost of home care or agency caregiving. Before anybody is paid you need a care agreement in place or Medicaid will look on these payments as gifts and require a penalty period equal to the gift amounts prior to becoming effective. Hopefully, his share of the bills are not being paid to SIL and brother, if so you need to fix this immediately.
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