Have uncle who is in assisted living, but has several aging issues (sight, hearing, etc.) who will not accept help with paying bills, opening mail, etc. Concerned that problems will arise. He will not assign a family member to be a guardian for legal power of attorney and medical directives. He does get along with the family, but is being stubborn. Thanks

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This is a very common problem. Could you have the police do a well being check?
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My MIL was extremely opposed to having ANYONE help her, she wouldn't assign POA, she wouldn't make a will---and I finally used this tactic: "Well, Mom, it's up to you. BUT, although you 'want' your 3 kids to just step in when you're gone and quietly split everything 3 ways, no fuss, no bother, that's not what will happen. When you die "intestate" (and I explained to her what that was) somebody you don't know will come and go through your house, your belongings, even your underwear drawer and decide who gets what. And guess who will get the "most". Uncle Sam. And this is the law." I stated it very calmly, she didn't believe me, but after checking with few friends, she found that I was essentially right and got a lawyer and got her affairs in order.
I don't necessarily suggest using such manipulative wording, but with mom, she doesn't "get" much of what's going on, so we had to be kind of threatening. The thought of strangers in her house is her number 1 fear.
You are sweet to be concerned for your uncle.
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The problem with some seniors who resist help, even when it's obvious that they need it, is that their reasoning is damaged. I would consider that he may not be capable of truly understanding and processing the explanations of why others need to help with his finances, bills, etc. It sounds logical to us, but, we are not thinking with their brain and what may have caused them to think differently. Logic may not make sense to them.

Sometimes seniors just aren't able and refuse to accept help, regardless of how bad it gets. This could result in them losing insurance coverage, being charged late fees, interests, penalties, legal action against them, etc. At some point, someone may need to seek legal authority to act on his behalf. If you're interested, I'd consult with an attorney to figure out how to do this, the evidence needed, costs involved, etc.
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Problems probably will arise for your uncle if he continues to resist assistance in his daily affairs. And having even the most basic Power of Attorney is always a sound decision for our elderly loved ones. But the question is, how to get your uncle to recognize these issues and accept help?

Some families have to experience an emergency with their loved one before changes can be made. An emergency can be a fall or a sudden illness or anything of that nature. My mom was sick and refused to go to the hospital. I begged and begged. I yelled at her. She would fall everyday because she was so weak and I'd go over there to pick her up off the floor as she continued to refuse medical help. One day she fell and I pretended that I couldn't get her off the floor. I told her we had no choice but to call 911 (I knew they'd take her to the hospital). So this was how I got my mom medical attention.

My dad was just as stubborn. Actually, it wasn't really stubbornness, he just wanted to hang onto his independence. But with my dad I had to get his Dr.'s on my side and it was his Dr.'s who would tell him that he needed assistance and my dad listened to the Dr.'s and finally let me help him.

Some elderly people willingly accept the help they need, others don't. Is there someone at your uncle's facility whom he trusts? Someone he'd listen to? Maybe someone in the family he's particularly fond of who could convince him to accept help?

Try starting off with baby steps. One small change. Maybe with the mail. Offer to go through his mail with him, or offer to go through the mail and remove all the junk. If your uncle is open to this do this for a while and then take another baby step. "Oh, Uncle Mike, I have to stop off at the grocery store on my way home and I can pay that electric bill while I'm there."

I know it's so stressful when we have elderly loved ones who won't accept the help they need but they just want to hang onto their independence with both hands. Many times people don't want to bother their loved ones, they don't want their loved ones to go out of their way but this just creates more stress for the family which is exactly what our elderly loved ones don't want. Oftentimes it's a mess.

Good luck with your uncle. He's lucky to have a niece who's looking out for him.
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If he has the capacity to manage his affairs then yes, he has the right to do so.

But all experts recommend that older adults set up a durable medical power of attorney and a durable general/financial power of attorney, so that a trusted person can step in and assist if it ever becomes necessary. So I think you are right to bring this up to your uncle.

Some things you can do to help him move forward with this:

- Be sure to start by helping him feel that his concerns and goals are heard. Once he has articulated some goals, try to frame your suggestions as ways to help him achieve his goals.

- Point out that POA documents can be written such that they only become activated if the older person becomes incapacitated. This may reassure him if a concern is that you will take over too soon.

- Ask his doctor or another trusted professional to bring this up with him.

- Try to provide some gentle education, pointing out that any older person can suddenly take ill, have an accident, or otherwise become impaired. In these cases, a POA is important to help the older person get the care and assistance they need. Sometimes sharing newspaper stories of how things went awry when an older person didn't have a POA ahead of time helps. It really depends on the person. There are also brochures for older adults, spelling out which legal documents they should complete and why.

- Frame your concern about this as you wanting to be in a position to help him. Use lots of "I messages": "I worry that if something were to happen to you, we wouldn't be able to help pay your bills and you might be slapped with big fines. We want to be able to help you if it's ever necessary."

- Try to correct any sight or hearing problems before having these conversations.

In short, you need to find ways to be supportive and persuasive. Recruit the help of others (e.g. his doctor) whenever possible.

It is not easy but with persistence and the right touch, it's often possible to make headway. Good luck!
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Do you have information that your uncle is not paying his bills? If he is mentally competent he is within his rights to handle his own business. How long has he been in AL? Did he move in on his own? Perhaps someone else is helping him out?
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