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Nyskan Asked March 2017

Can a daughter take her parents out of assisted living or memory care anytime she wants?

My dad is in a memory care unit, mom is in assisted living. Both have Alzheimer's needing different levels of care. Both are/were happy, comfortable where they are although they would like to be together. Six months ago they were living in their own house with limited home care services because dad would not allow additional help. Mom was placed in Assisted living due to a fall, but no major injury. Dad couldn't care for her. Three months later, Dad was placed in a Memory care unit due to wandering and needing hygiene assistance. I have 5 siblings. All were on board for mom's placement. Unfortunately, when dad needed more care, there were no facilities available that could care for both of them. So we found a complex that has them across a driveway from each other and mom can visit dad daily, if she wants. The problem is one sibling(#3) is going rogue and taking them out of their facilities frequently (3 times a week) for hours on end. They have not asked to be taken out and are tired out from the activity. They were never that active before. #3 has been telling them both that once dad's foot clears up (it is infected, but he refuses medication), they can be moved in together in the assisted living facility. This week #3 took dad to tour another facility. Now she wants me to fill out a financial form for that facility. She thinks that dad is healthier now and will pass an evaluation for an assisted living facility rather than a memory care unit. She doesn't understand that the Alzheimer's diagnosis will not go away. I am Heath care Proxy and POA. My brother (#5) is also POA and second on the Health care Proxy. He is getting sucked into her lies. She asked him to get the tenant agreement from their current location but didn't tell him it was to fill out an application. I have been paying their bills for the last 4 years. He has had nothing to do with it and wants nothing to do with the financial piece. #3 has secretly taken dad to the bank twice to withdraw money. It was a small amount, but I do not trust her. I moved the money. Two other sisters #2 and #6 have been doing an outstanding job caring for our parents for the last two years getting them to dr appts and grocery store, doing their laundry, cleaning. They are the closest in physical proximity to the parents. I live 5 hours away, and visit monthly. #3 has cut off almost all communication with the rest of the family and is doing whatever she wants with our parents. Can I do anything to stop #3 from tearing our family apart and upsetting my parents by giving them false hope and using them as pawns? Can I prevent her from taking them to the doctor for an evaluation?

Nyskan Apr 2017
Just had a great productive conversation with brother POA. Seems he still wants nothing to do with the finances, but #3 is desperate to get dad out of MC. She still is in denial that dad has Alzheimer's. Brother is trying to be patient and get her to understand that he does have Alzheimer's and needs MC. We have agreed to have a "PRI" Patient Review Instrument, and or a separate evaluation to determine that they cannot handle their financial affairs.
I just think #3 is spiteful and struggling with acceptance with the diagnosis of our parents.
I hope to go visit and have a meeting/conversation with her at the end of this month. I am trying to be patient as we know that she struggles intellectually. Thanks for your advice.

Countrymouse Apr 2017
Call a summit meeting with the director of the current facility and get the ground rules set in stone. Notify all involved siblings of when the meeting is to take place, giving them reasonable notice. Make further unsupervised access to your parents conditional on their attending the meeting and indicating their agreement with the rules laid down. I would expect the facility to welcome this because children at odds must make life uncomfortable and difficult for the staff; plus it's convenient and appropriate neutral territory for everyone.

Remind brother with finance POA that appropriation of your parents' assets for personal use is theft. And if it is carried out by the person with POA it is also an abuse of a position of trust - I believe, from wider reading here, that in the States it's a breach of fiduciary duty? POA Bro may wish to change the locks on your parents' house and be very selective about who gets new keys. And I'm sure he plans to place the proceeds of the sales in your parents' account in due course, hem-hem.

Mentally unwell... Yes, probably. But all I mean by that is that, in these circumstances of extreme stress exacerbated by conflict I think we can all go a bit loopy, and start demonising one another, and behaving like we're the victims in Enemy of the State or something. Do you think she could have imagined herself trying to tiptoe round security cameras before now? I know I couldn't have imagined having to struggle as hard as I did not to assault my SIL violently (it really was touch and go - for two pins...).

I don't suppose you could bring yourself to go and see her, and just talk? It depends what your relationship was like before; but if it was even halfway decent and normal, do you think a proper, private conversation could reboot it?

Why did she want to muck about with the dental appointment?

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Nyskan Apr 2017
A month has passed and things have gotten worse. #2 and #6 and I went to the assisted living/memory care proposed by #3. AL was beautiful, MC was small, dark, and lacking appropriate activities for my father. The three of us discussed the possibility and remained open minded. The next day #3 went to our parent's house with a cousin, avoided security camera motion detectors, and took items out of the house. No one knew they were going there, but by coincidence #6 saw them on the camera. #3 then lied about her reason being there to #4 & #5. She (#3) has refused to answer calls, texts, or emails from #2 , #6 and me. She has arranged for cousin to take dad out of facility without mom for entire day several times. She convinced #5 (male) with POA to request financial information from me and follow through with the evaluation to the other AL/MC facility. He said he wants nothing to do with it, but I suspect otherwise. (Side note: he has sold parents vehicles and scrap metal and refuses to put the money in the bank.) So as it turns out the other facility doesn't have a bed open for MC and they have determined dad needs MC, so they will not be accepting my parents there. They attempted to contact #5, but he doesn't answer and his voicemail box is full. They asked me to contact him, but he doesn't answer my calls. #3 has poisoned so many people. I just don't understand her. I know we are doing what is best for both parents. I have offered a mediator/conflict resolution program, but it will do no good unless #3 participates. I seriously believe there is something wrong with her mentally. Two weeks ago, she rescheduled a dentist appointment for my dad saying she cleared it with me and telling them she was Healthcare Proxy and POA. I clarified it by presenting the paperwork. Last week while she was with my mother, she posed as her and posted to family facebook pages using my mother's account. I know it wasn't my mom because I was talking with my mother on the phone at the time and mom doesn't know how to use IM. I changed mom's password. Yesterday she took my parents for a joy ride for 6 hours and turned my mom's cell phone off so we couldn't reach her.
I am hesitant to take action against either #3 or #5 for fear of making it worse but this has to stop! I am so frustrated. Any suggestions?

pamstegma Mar 2017
Nyskan, I think you may have to get a lawyer and get a legal restriction on #3, based on physical abuse, mental abuse and financial abuse. Allow supervised visitation only. No trips anywhere.

Veronica91 Mar 2017
Sounds as though Mom would be totally miserable with Dad in AL. She would be totally exhausted trying to keep track of him. In Memory Care presumably he can't actually exit the premises alone.
Perhaps #3 taking the parents to the bank was a trial run to see what she could get away with. You were absolutely right to move their money. Do they have a substantial amount by the way? I always say "Follow the money" when a question like this comes up. You have financial POA so you can use that to prevent them being moved. Go with what will make Mom happiest.

Countrymouse Mar 2017
Well, you can see your mother's point of view... And it is possible to love someone very much in theory but less so in the same room...

And there's no telling quite how knackered she got at home while he was saying they didn't need any more help. She's due a nice sit down and a bit of pampering, isn't she.

I hope the penny begins to drop with your sister. It'll be easier, and she'll take to it better, if you let her quietly work out for herself that things will not be getting back to normal no matter how hard anyone tries.

This must have been a rough patch for all of you. I really hope things settle down now without too much more, um, "only trying to help" from #3.

Nyskan Mar 2017
Thank you CM and geewiz. Those were very helpful answers. As long as my parents agree to be seen or taken out by #3, the facility will allow it. I took a step back and agreed to look at the facility #3 is interested in. The facility did not have a complete picture of my parents' needs. I continue to emphasize the need for the family to be involved. #3 just continues to act on her own, but I have left the ball in her court. I explained that before an application is filled out, close by family needs to tour the facility, then I gather financial information, then we have a family meeting and discuss if it is a better arrangement for the parents. In the meantime, mom goes to visit dad for a couple of hours then asks to go back to her place because she is "sick of him". While dad continues to wander away from her every 5 minutes. Not sure they really want to be together all the time.

geewiz Mar 2017
Nyskan, to answer your question - - - when I (POA and Health care proxy) signed my Mom into memory care I had to complete forms as to any exclusions on who could visit or take her out of the facility. I did so but was also allowed to have them call me for permission should anyone else want to take her out. So you might be able to restrict such trips .
BUT it seems like a 'family council' is in order. One that allows everyone to have their say and make their suggestions in an open forum. Family dynamics differ so who knows what is going on. Perhaps #3 is disturbed at the separation, etc. But  l agree with CM, get the feelings and concerns out in the open. Long after your parents are gone, you and your sibs will still be family. Frankly, I would have been happy to have ANYONE visit and take my Mom on a field trip. When my out of state sister visited, we took her out for ice cream adventures and she loved it. But the entire adventure was about 90 minutes.

Countrymouse Mar 2017
Also, about the foot - isn't your sister attempting to motivate your father to take his medication? She's giving him the best reason she can think of to take it, no?

Countrymouse Mar 2017
Sorry, I missed that bit - could you prevent her from seeking another evaluation? Probably, but why would you want to? - unless you think she's managed to find a doctor who'll take bribes or something. By all means check the credentials and specialist expertise of the doctor in question, but since an evaluation is either going to back you up or present further and better particulars worth considering I can't see how it's a bad thing.

Countrymouse Mar 2017
Well.

Difficult.

Perhaps the first thing to do, as a blood pressure reduction exercise for yourself, would be to recognise that #3 believes that she is restoring your parents to one another. And if only all things were equal, that would be a desirable objective.

But they're not equal, as you correctly recognise. And you need to get her to understand complexities that appear to have passed her by.

Do her the courtesy of looking closely at her proposal with an open mind. Perhaps call and speak to the director of the facility she's approached, and see if the truer picture of your parents' prognoses and care plans actually could be a good fit here - as might be if it offers genuine continuing care - or not.

Let's assume not, and let's assume it is confirmed that the current facility is the best available compromise, allowing your parents to see one another regularly and spend as much time together as possible.

You then need to enlighten #3 about the facts of your parents' abilities and stamina and the likely progression of their health difficulties. Unfortunately, it's very difficult to retrieve a situation where trust has broken down. Is there a manager or a health care professional you could ask to talk to her?

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