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Mrsw93 Asked March 2018

Power of Attorney versus guardianship?

My Grandma was just told by her doctor she can no longer live at home, she’s unable to care for herself. She has Dementia. We knew this was coming but she was fighting us on moving her to an Assisted Living facility. My Mother has a general Power of Attorney and has been handling her finances (what little she has) and such. Some agencies have been demanding guardianship docs. We understood from our Attorney that the POA is sufficient. Can you please help clarify this for us? Thank you!

NomadSE Mar 2018
IMO it should be very difficult to "put" someone anyplace they don't want to be. Yes that makes it hard with LOs with dementia. Part of their disease process may be to not recognize that they need more help than they can get at home.

But I don't think that having to go the extra mile to "prove" that someone loses their right to self-determination is too much to ask.

So even if your state allows a POA to lock someone in a facility, it only makes sense for that facility to require documentation that allows the POA to take away the PWD's rights, and thus protect themselves from a charge of holding someone against their will.

The documentation could be a cognitive assessment or some other legal document that shows the POA is legally invoked.

NomadSE Mar 2018
Without guardianship do you have the authority to place your LO in a locked facility? In some states, a POA is not sufficient to allow a facility to keep someone against their will. So if you put mom in the facility and she wants to leave they would have to let her unless you were her guardian. It depends on the state and the specific wording in the POA.

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GardenArtist Mar 2018
Real, glad my suggestion helped. I spent a lot of time validating home health care companies and private duty companies and found that many of the latter have canned responses but can't answer specific questions, some frankly misrepresent the truth. Some are even comical.

I think the most amusing, and almost sad example was of one woman who claimed to be the office or business manager, something like that. All she could do was repeat, literally ver batim, the list of services.

When I asked whether she had staff who knew how to puree foods and had experience with dysphagia, she paused, and then repeated the list of what they did. Eventually I gave up and concluded her company definitely didn't meet my criteria.

One facility that's repeatedly "offered" as a possibility for rehab post hospitalization was one with a reputation for accepting patients who came out in body bags. According to what I learned the death rate was high, compared to other nursing homes.

It may be that the patients were sicker, but it may also be that the nursing home was inadequate. At any rate, I stayed away from that one.

One private duty company seemed very flexible until I raised certain changes (such as the terms for forfeiture of the deposit, things like that). Suddenly, I was treated rudely.

A private duty facility owner became offended when I told her I couldn't tolerate smokers as caregivers. Another private duty company owner was a former deputy sheriff and planned to do his own assessment of care needs. I'm sure he could have provided a good assessment of home security, but I'm not sure that expertise translates into medical assessment.

But perhaps the worst one was a company which claimed to be a superior private duty company. The conversation was with an alleged nurse with 20 some years of experience; I can't remember the other woman's claimed expertise in this conference call. They both encouraged me to visit their website, bragging that both were in photos on the site.

The photos were of 20-somethings, or perhaps 30-somethings - those bright young women with great figures and smiling faces. There wasn't anyone old enough to be in the 40's or 50's. Yet another lie from pushy recruiters.

But more specifically on the issue of guardianships, the local news a few weeks ago had a feature on a woman whose parents were the subject of egregious violations by guardians. Apparently there's a committee in our area that's been formed to combat these guardianship abuses.

I was surprised; I had no idea this kind of "parent stealing" and putting the parent in an unlicensed dump of a house was going on in my county.

Actually, I thought of that last night when an intake NP suggested I put my father in "adult foster care". I almost asked her if she had a financial stake in this so-called care house.

Isthisrealyreal Mar 2018
GardenArtist, the back ground check is perfect. All of these professional guardianship companies bilking seniors out of years of good care by unreasonable charges. Thank you for suggesting that.

GardenArtist Mar 2018
Before I even read CM's response, my first question was which agencies, and why are they involved? Are you referring to AL facilities? If so. as Real suggests, find out specifically WHY they want guardianship docs, and if it's for them to act as guardian or to prove that you have the authority.

Also, do background checks on any facility you consider. You never know what you're getting into.

Isthisrealyreal Mar 2018
I think guardianship makes you responsible in ways that a POA does not. If an agency demands that, you demand they show you the statutes for your state that require you become guardian. I have found that when I say, show me in writing, it causes the person to have to go ask a supervisor, then they are corrected on their error.

Countrymouse Mar 2018
What agencies?

Your grandmother's POA should be sufficient. That doesn't mean that everybody who ought to know that does know that; and some organisations are extra-punctilious because of the potential for nefarious goings-on and general monkey-business.

Patience, courtesy and firmness should eventually win through. But has any "agency" demanding guardianship explained why they need authority above and beyond POA?

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