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A 90-yr. old Uncle, no kids, refuses home care. He refuses medical care, (obvious dementia) with a very unsafe home, drives after losing glasses, unsanitary home because he won't let the dog out for potty...it's a mess. A fantastic home health care provider suggested I get an attorney expert in Elder Care to act as a third party to challenge my Uncle's attorney who may/may not have POA or POM...so when I find an attorney, who pays? I work, but the cost of an attorney is prohibitive. My Uncle is not poor, and the Area Office on Aging/Legal Aid will not step in because he has assets. I contacted the Ohio Attorney General Elder Rep who said he has every legal right to deny home care... I am so frustrated with my Uncle; I worry he will kill someone on the road..and the poor dog is suffering because he neglects her needs.
One suggestion was to go with "tough love" (not clean up dog doo, no grocery trips, no backtracking to get his cable turned on because he forgets to pay bills, etc.)
So, who pays for the consultation with the third party attorney? My Uncle is a bachelor, always difficult. If I am the only family member with any compassion for this WW II/Korea vet...how expensive can it get?

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Alas, adults who have not been declared incompetent do have the right to reject home care, live in filth, and make their own decisions -- even bad decisions, even self-destructive decisions. It is one of the principles we hold most dear in the US -- each person's independence. In the past it was often possible to place someone in an institution mainly on a relative's word but in general we are more supportive of the individual's civil rights now.

I don't mean to lecture you -- I'm just trying to give some background to what you are trying to do. Uncle has an attorney. Uncle's civil rights are definitely going to be protected. A judge could decide that Uncle needs a guardian and you should be it. He or she might decide that Uncle needs a guardian and appoint a professional guardian to the role. Or the judge might determine that while Uncle is making very bad lifestyle decisions he is not incompetent and has a right to make them, with no guardian. Maybe someone here can guess which is more likely. I can't.

I truly do commend you for trying to take care of this family member. I'm sure you are under a lot of stress and this is emotionally difficult for you. You are doing a very loving thing. Feel proud of your efforts.

The first thing I suggest, regardless of other decisions you make, is contact the DMV and report this 90 year-old man for driving without glasses. He may have to take a drivers' test and could lose his license. If he does lose his license and continues to drive anyway report him again. He may have the right to live with dog poop if he wants to. He does not have a right to endanger other drivers and pedestrians.

I don't approve of tough love for people with dementia. With a short memory span and a disregard of cause-and-effect it seldom works. BUT you have civil rights, too. There is nothing to require you to clean his house or take him for groceries or rescue him from missing a cable bill (or several -- they don't shut it off for just one missed bill).

What you are doing right now is enabling him to continue in the ways you think are very bad for him. So it would be reasonable to try something else, right? "Uncle, after the end of this month I won't be able to clean for you any more. This should be enough time for you to find someone else to do the cleaning. Do you want me to help find places you can call to arrange that?" He will protest, of course. You "just can't do it any more." You don't need to explain why. You just can't do it. He will either get housekeeping or not. Either way you are out of the loop. Oh, I know, you will not be completely out of the loop as long as you love him. But at least you are not supporting his bad decisions.

I don't think I could go so far as to refuse the grocery shopping, that just seems too basic. But you could give him alternatives for getting his food. "Uncle, I'm not going to be able to take you to the store this week. Here are phone numbers for two different taxi companies that could take you."

You could certainly not take care of his bill-paying mix-ups. "They shut off cable? Oh that is too bad. The letter that announced that should have instructions for how to get it turned on. If you can't find the letter, call the cable company and ask for another copy. I'm sure you can work this out."

If things go downhill quickly, as you assume they will, perhaps that would be a good time to call APS to report a vulnerable adult living in unhealthy conditions.

It is so hard to watch someone you love doing self-destructive things. I am sorry for the stress this is causing you. Keep firmly in mind that this is Not Your Fault. You are sincerely trying to do the best things for Uncle. Do NOT let guilt sneak in!
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An attorney will want you to pay at least $3000 up front. If you win the case, you ask the judge to repay you from the ward's funds. If you intend to be Guardian, you have to pass a background check and credit check. If you are in debt and low income, the judge will avoid you.
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