My gut tells me that my Aunt is afraid to go to a doctor because the doctor may find her not competent. What can I do as her POA?


Caregiver advice needed please. My Aunt is 86 yrs old. With signs of dementia. As of now she is competent to make her own decisions. But, her memory is fading and forgetting alot these days. As good days & bad days. She can be very hateful at times on her bad days. My Aunt decided she wanted to get her Living Will done a few weeks back.
So, I took her to her attorney to get this done as she wished to do. She made me her executor of her will. Her attorney told me he felt since my Aunt's memory isn't very good anymore that it's best she has a POA. So, I was appointed her executor and Durable POA as financial & healthcare.

(Keep in mind she is in her sound mind as competent to make her own decisions)
I ask my Aunt many questions as when was the last time you been to a doctor?
When is your next appointment to the doctor?
Who is your doctor?
Do you have a visiting nurce? If so,when does she visit you?
She tells me she was just at the doctor last month. She tells me her visiting nurse comes once a month. I visit my Aunt 3 times a week. I never ran into a visiting nurse at her home. Or signs that one was ever there. Throughout my life I always followed my gut. My gut never done me wrong. My gut tells me that my Aunt is affraid to go to a doctor. Reason, the doctor may find her not competent .
What do I do?
I can't force her to see a doctor. She was never told by a doctor yet she wasn't competent to make her own decisions. But, she has dementia but, not taking pills for dementia yet. Seems I'm stuck anywhere I turn. Her dementia is getting bad. She has a runny nose and cough for over a month now. I keep telling her to go to her doctor. She tells me she has a Dr. appointment next month but, yet to see that happen. I was told I need to take these POA papers into her doctor. Well, I don't know who her doctor is? I asked my Aunt who's her Doctor? She tells me a name I looked the name up and it's a dentist not a health doctor.
My Aunt's lieing to me about things. Now it seems I need to go behind her back to get this information? She appointed me her Durable POA for her financial & healthcare. It's my job as POA to know this information.
By rights she needs a visiting nurse to see her at least twice a week if not more. I need to hire a part time caregiver to help me out. As of now I'm her caregiver. I do everything she needs. She dosn't want to spend any money for a visiting nurse or for a caregiver. She is very tight with her money. I don't get paid to be her caregiver. But, I am her caregiver. In ways it's saving her tons of money for me being her caregiver but, it's hurting me in return. Costing me gas cost and my time from my family. I asked my aunt at the start what does she want?
She replied to me, she wants to live in her home alone on her own. I told her ok. I will do all I can to not place you in a nursing home as agreed.
Now this is causing problems. I'm losing money out of my pocket and my time away from my family and she isn't welling to see a doctor. I feel she is affraid to go to a doctor. If she does they may find her not competent. All I want to do is get her checkedout and her cold.
What can I do as her POA?

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I think the best thing that you can do as POA is to hire other people for some of these things. Home health aide is who I would look for. 4 hours a day 2 or 3 days a week. Then keep track of your expenses and make out a check for them monthly from your aunt's bank account. You probably should also charge for a few hours a week just to go over there and be sure the smell of urine is gone, and that she is bathing regularly. Remind her who she is while you are there because you will be her lifeline to the real world.

I believe that being declared incompetence is the action of a court based on the findings of two doctors.

POA gives you the right to sign for her based on the assumption that she wants you to and you are doing her a favor by doing so. The other type of POA kicks in when she is incompetent and I think that requires a court finding, this would only be challenged however if you wanted to change her residence or do something permanent that would change her financial situation, like if you wanted to close or change a bank account. That is why you have to be careful. It is actually so easy to take advantage of her in this situation that your actions will be scrutinized if there is any reason for anyone to check them. To protect yourself, you have to write things down, keep good records. Gas purchases are the hardest to prove, keep track of the number of trips you take weekly and come up with a dollar value for driving there.

If your Aunt has a lot of money, who is her heir? What does her will say? Will it be you? If so, I would do all this knowing that you may one day receive quite a bit of money, on the other hand, track your expenses and charge an hourly fee for your time, because you may find that all the money she seems to have evaporates by liens or close relatives who can claim everything regardless of whether or not they ignored her in her old age.

You should not have to do anything for free, you should however keep careful records, and you should not try to do everything yourself. Charge for the time it take to oversee her care. Cleanliness is important. An infection caused by improper bathing is very common in elderly ladies and will cause an altered mental state that mimics dementia.

Also, my experience with dementia is that there are times when the person is totally 100% mentally compentent and times when she can't remember how old she is. That's why a doctor can't just determine it by a visit or an interview. Dementia is a physical state that can be documented, but not all people with dementia are incompentent.

Take your time to document all you do and be careful who you talk to and what you say. She needs you to care for her needs. It sounds like she should be able to stay in her home, and it should cost less than a Nursing Home. The kind of place that would take her might well be hell on earth. Help her stay home. Please. Someone will do the same for you one day.
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I'm quite surprised that the attorney didn't conclude that your aunt was not competent to give you POA. Strictly speaking, if she failed to recognise her own lawyer of many years' standing… Never mind, it's done now.

POA is not simple (who are these people who are saying it is???). I hope it was explained properly to you that you were under no obligation to take it on, apart from anything else? But your caring and long friendship with your aunt are good to hear about, and the best reason for you to want to look after her. Just don't always expect to be popular with her!

This may sound rough on your aunt, but if she's legally incompetent and you have Durable POA, she can't disown you. That's kind of the point - that she will have given you permanently the power to act on her behalf and always in her best interests. It's a really serious responsibility, and it's a good idea to keep a complete diary of everything to do with her: not just the money management, but appointments, notes of what advice she's given, possible care and home support options, everything.

Caring for someone with dementia is tiring, hard work and takes skill - especially if she's not co-operative. In your position I'd ask her doctor to explain her needs to you in detail, and get advice from your local social services about how you can best look after your aunt and what help might be available to support you and your wife in doing that. It sounds like it's going to be a challenge! Best of luck with it.
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Good for you in finding out who her Dr is. It is NOT your place to decide if she is incompetent. You need to contact her Dr, give him a copy of the POA & let him know she needs to see him ASAP for her cough and an overall evaluation. You tell her you are there to take her to the Dr, it sounds like she wouldn't remember she hadn't made the appt. You can tell her she needs to see the Dr to get her RXs refilled and to check her cough. He can then make the determination of competence.
I think the reason the attorney said to take the POA to the Dr & bank before it is too late was to make sure you are recognized as the POA ASAP before she deteriorates to the point of being in a really bad way medically & mentally. Evidently he feels she is less competent to handle things than you think she is. If she is not always remembering your name or that you were just there yesterday, she is already further gone than you realize. If it gives her peace of mind, let her keep her bills and checkbook at her house. You have authority to review things and make sure it is correct and nothing is overlooked. The POA lets you be a signer on her checking account to buy groceries, etc. The bank will have you sign the checking account signature card.
It sounds like she does have many symptoms of dementia & may need someone to help her bathe & do heavier housework like laundry, etc.
I would ask the Atty about paying yourself or your wife as caretaker and follow that advice. I wouldn't go by what someone else is doing as you have no way of knowing if what they are doing is the correct legal way. Keep accurate records & document everything to avoid any legal or tax problems.

1. Get her to her Dr ASAP with the POA and 2. Talk to her atty about paying yourself/wife for her care and your expenses involved.
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Thanks everyone,
Legally wise,my Aunt is competent to make her own decisions.As she was never told by a Doctor she's incompetent .For me as her now POA ,This all started when my Aunt decided to have her Will changed.Day after day she kept bringing up "she needs to fix her Will".I kept putting the Will arangments off because,I thought to give her plenty of time to think about her Will and more time to think who she wants on her Will.A month went by my Aunt never forgot about changing her Will.As a everyday talk from her.So,I decided to have her call her attorney to set a appointment.The day of the attorney appointment the attorney felt my Aunt wasn't competent .He stated to me that he was her attorney for many yrs.And she didn't know who he was.He went on to asked her a few simple to know questions as example,What year is it today?She replied 1988.I explained to the attorney that My Aunt hasn't watched TV in yrs.Could be why she didn't recall what yr it is.
The attorney stated that my Aunt's dementia/memory is bad.Because,of that She will need a POA for sure.The attorney agreed to fill my Aunt's wishes about fixing her Will.And I was appointed her POA & executor .And that is how I became her POA.Keep in mind there is no other family member that is welling to care for this 88 yr old lady .If I didn't agree to help her the state would of stepped in I'm sure.

I took the POA paper work to her bank.That is done.I haven't done nothing else but,that.I was told by the attorney and others to act fast with this POA.Before it's too late.To late for what is my question?The banker told me that I now have full access to her bank accounts.When/if she becomes incompetent I am ready.
I did find who her doctor is from looking at her pill bottles.I'm yet to talk to her doctor and show the POA.I guess I'm waiting for the right time to do so.Because,my Aunt 's dementia as good days and bad days sometimes brings bad days to the table.As of now my Aunt is legally competent.She can do what she wants.As of now she does pay her bills and cooks for her self and lives alone.I can't just step in and take her check book away from her she's legally competent.Doing that she'll call the cops on me from taking her check book lol.
Truth be told my Aunt I feel she isn't competent.Many signs shows she isn't competent as Urene smells in her home & bed,lack of bathing and low weight signs of not eating proper.She forgets when I go to visit her.I can visit her today and she won't remember tomarrow.She forget's my name half the time and I was her nephew over 40 yrs.She's my God Mother at that as she don't remember that.

So,what your explaining to me is,It's my job as her POA to tell the doctor my Aunt's not competent?You would think that the doctor would see she isn't competent by talking with her.Why is it me "The one" who has to tell her doctor she isn't competent?That makes me the bad person in my Aunt's eyes towards me if she finds out I'm the person that told the doctor she isn't competent.My Aunt would disown me if she would find out I'm the one that made her incompetent by a doctor.I care for my Aunt and our freindship together & history.I'd rather see the doctor take the blame then me lol.Let the doctor tell her as keep my name out of it lol.I apologize for the long thread here but,this POA and caregiving isn't as simple as they all say it is.

As POAs legally your not allowed to charge a fee for your services as a POA.
With that said,I understand I can't charge a fee for acting as her POA.
But,I'm not only her POA.I'm also,her caregiver.As her caregiver I should be able to charge a fee for my services as her caregiver.I have a friend that is caregiver over her own mother that charges $800 a month for her services.And she is also,her mother's POA.So,if that friend can charge her mother $800 a month for her caregiver services and she is also, her POA.Why can't I?
I was told since,I am my Aunt's POA that it's my job to hire a caregiver,nurce,funds ect.
With that said,I should be able to hire my self as her caregiver or hire someone else as her caregiver.Can I hire my wife as my Aunt's caregiver?I can hire a friend not my wife?If my Aunt demands my wife as her caregiver then can this be done?
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Countrymouse, is correct and the POA, I'm sure provides for reimbursement, with a statement along the lines of
"nobody shall incur expense on my behalf and should be reimbursed for any and all expenses."
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There is a difference between charging a fee for your services, and claiming back out-of-pocket expenses incurred solely and exclusively on your aunt's behalf. If you're visiting her, doing her shopping, taking her to appointments, etc. you have every right to claim back the cost of fuel, parking, etc. Similarly if you're making phone calls on her behalf, writing letters or anything else. Keep careful records, don't blur the lines, and you're in the clear - get your money back.
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My two cents worth would be that aunt probably can't make the appointments and isn't lying per se, just wishful thinking and remembering something from way back. For major things, sometimes they will want incapacity letters from the doctor, and those letters could help if anyone ever tries to get your loved one to change POA.

If you can come up with any way to get her to a geriatric specialist without it seeming threatening it would be a very good thing - i.e. going to the doctor to make sure your sniffles don't turn into pneumonia, or going to a specialist who will help you stay in your own home safely (they really will do this - some will get an OT and/or PT out to the home and help make it safer with usually minimal modifications).
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You said she is on several prescriptions. The Drs name should be on the pill bottle. Contact them, let them know you are her POA, want to make an appt. to check out her cough & give them a copy of the POA at the time. Tell her you are concerned about her cough & you want to either take her to the ER to be checked out right now or she can go to her Dr with the appt you have made. Keep track of your mileage to Dr, store, any errands you do for her, including going to her house. The IRS has a figure they use (.58 mile?) and you should be ok at least charging her for that amount. Let the bills, etc continue to come to her house and let her know her attorney advised you review them with her to make sure things are ok. It sounds like her attorney did well by her & you and it's clear you are trying to do all the right things. Just keep good records, maybe a daily journal or log of visits, how she seemed, what you did to help her when you were there, etc. Keep it in the car so you don't forget to jot some brief notes down. Good to help document everything. When her time comes, if there are any other relatives that come out of the woodwork to claim you took advantage, you have all your records to back up the care you & your wife provided, notes from Dr visits, etc to document you did everything in a caring, honest, above board way. She is very fortunate to have you!
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Your friend may be doing this with out legal paperwork, but should a family member challenge or she has to move mom somewhere and they are trying to figure out where money went it could be challenged if friend isn't keeping good records. Further there are likely tax implications so hopefully your friend is keeping good records and paying taxes on this income.

You will have to pay taxes on this income as well.
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Go to the attorney and ask him to draw up an addendum or caregiver salary agreement that is legal outlining services, responsibilities, respite care, etc so it's up and up. Establish that care will be either you and or your wife. Going rate should be $15-20/hr or you can agree on a monthly salary. Then you should transfer that money out of aunts acct monthly or weekly and pay yourself. Make sure you keep good records including a written invoice for your caregiving hrs and expenses for her care.

Aunt may balk but you just need to explain. Tell her it is this, or expenses will be higher if you hire help from the outside or have to move her to care facility. Encourage her to try it for 60-90 days and then you will open up the discussion again. She'll forget about it I'm sure but this will let her still feel in control.

Good luck but prepare yourself for the hardship and responsibility that comes with caregiving as her condition worsens.
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