Although we aren’t blood related, I grew up calling my mom’s best friend of over 70 years and her husband “aunt” and “uncle”. They have no kids and have no family in the US. My uncle was the primary caregiver for aunt, and always refused help since he was still independent even at 91. A few months ago, he became very ill and while he was in the hospital he asked me to be their POA and help look after my aunt. I felt uncomfortable so I reached out to her nephew who lives overseas in the hopes he would come over to help them as next of kin. Uncle died before his POA was in place but aunt named her nephew and I as her POAs allowed to act independent of each other. Turns out while her nephew wants to oversee the money, he hasn’t seen her in 30 years, and has no intention of flying here during a pandemic. While uncle was in the hospital it became clear aunt was way more fragile than I realized; she was calling me constantly for help but resisted in home caregivers. After uncle passed she finally agreed to in-home caregivers but I still had to do the bills, shopping and medication management, and finding good caregivers was difficult - she was already malnourished at 72 lbs and lost even more weight down to 65 lbs. because some aides couldn’t be bothered trying to get her to eat and others let her just eat cupcakes. She also began getting more anxious, agitated, and confused. She would yell for help out the bedroom window causing neighbors to call 911, and wandered around the house at night leaving all the doors wide open. She went to the hospital for anxiety 4 times in 3 months, and called the ambulance 2 more times (they didn’t transport her bc she was fine by the time they got there). Even with the aides in the house, she fell while wandering in the dark (luckily she was only bruised but it could’ve easily been a fall down the stairs). My life has been a constant stream of phone calls and text messages every day from aunt and her aides. I discussed assisted living with her and at times she agreed but changed her mind afterwards. Nephew agreed she should move to assisted living, so during one of those periods when she was on board with it I signed a lease at a beautiful assisted living facility. Because of COVID, it took a month to get the required medical tests and movers scheduled, and by that time she’d changed her mind again. I convinced her to just give it a try but as soon as we got there she flipped out. Since the in-home caregivers were gone, I couldn’t let her go back home. She was so agitated the staff had her hospitalized and the hospital psychiatrist and gerontologist agreed it is not appropriate for her to live at home in her mental and physical condition. She’s back at the assisted living facility but she still wants to move back into her house. I keep putting her off saying the doctors say she needs to gain weight (which is true) but she’s delusional, paranoid, and accuses me of stealing her furniture (most of which is in her assisted living apartment)! Even though I am her POA, legally I can’t make her stay in assisted living unless she’s declared incompetent (I do have conservatorship papers if that happens), but I also can’t continue to be attacked or manage her care if she moves back home. I already spent 5 years caring for my own parents until they both passed away. My stress levels are off the chart and this has affected my family and my job. I’m trying to do the right thing for a poor old woman who is all alone but I feel trapped making decisions for someone who isn’t even my family and doesn’t appreciate it. What else can/should I do?

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You did do the right thing, because at the very least you have bought her time. She does need to gain weight and recover strength before anyone can even think about possible options going forward. How long since she got back to the facility from hospital? It sounds as if it's still early days and she may yet settle in there comfortably.

Nephew continues to keep a low profile, does he? Oh well. At least he didn't try to obstruct her move to the facility. I don't think it would be unreasonable of you to expect at least moral support and encouragement from him. Did he ever know her personally?

Remind yourself that you're not doing this for the appreciation, you're doing it for auld lang syne and to protect a lady who can't make decisions for herself at least for the time being. Well done to you.
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Empica Oct 2020
It is still very early in her move but her hostility towards me has increased which makes it hard to visit her. Nephew does support the decision for her to move to assisted living but other than a weekly phone call to her there’s not much he can do without being here. If I rescind my POA maybe her lawyer would act instead - there’s literally no one else left in this country to look after her best interests - but then I’d feel like I failed my uncle who put his trust in me and was such a wonderful man.

I guess I just needed some reassurance. I was much more comfortable making these types of decisions for my own parents.
Ask the management staff at her AL if they have a psychiatrist on staff. If they do, have her assessed through that person. If not, ask if they can recommend someone whom they know to come in and perform the same service. If you felt confidence in the psychiatrist who saw her in the hospital, contact that person. Once you have a document defining her level of competence, you’ll

You absolutely, definitely, totally made the right decision on her behalf.

She has dementia. She can’t be expected to “appreciate” what you are doing IN HER BEST INTERESTS. The vast majority of recently placed AL residents want to “go home”. In this situation she has not had enough time to adjust to new
surroundings and accept the safety and peace of her new lifestyle.

I think you will be able to balance this responsibility with your own life if you decide that out of kindness, you want to do so, but you need to be a careful caregiver to yourself, as well. If you decide to resign the POA, you really have nothing to apologize for. She’s lucky to have you.
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Sounds awful. I hear the stress and anxiety in your words. I am so sorry that you are struggling with this.

Is it too much? Do you regret being her POA? It’s a responsibility. Do you want to stop being her POA?

You did the best thing by placing her in a facility. She is safer there. The aides at her home sound awful! Not all of them are good. It’s a shame that she was neglected.

Talk to the social worker about options. Speak to an attorney if you want out. You can’t live in this stressful situation if you aren’t at peace.

You haven’t abandoned her. Best wishes to you and your aunt.
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If you don’t want to be the POA, you don’t have to be. I’d contact an attorney to get advice on withdrawing and what steps you should take. It sounds like she may not be competent right now to appoint someone else. The attorney can advise you on how she may need a guardian, appointed by the court.

Empathy is one of the first things a person with dementia loses.

Have you read a lot about how people with dementia are often not able to appreciate their condition, understand their needs or use reason about their care. They often are not happy. They may beg to return home, even if they ARE in their home.

Many dementia patients take medications to help them with depression, anxiety and obsessions. The professionals say your aunt is not competent to live alone. And her behavior sounds like it may require teams of people to manage. I’d find peace with the decisions you made.

Finding a great safe place for my LO who has dementia was an excellent decision and if my LO could think clearly, she would be grateful and proud of me. As she progresses, she may change and stop asking to leave. After a few months, my LO thought she had lived in the MC for years.
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What you can do is to accept the fact that you made the right decision. The evidence is overwhelming that she needs assisted living and probably MC at this point. Many caregivers aren't ready for the reaction of their LO to placement. I was scared to death when my wife's facility said she needed psychiatric care to address her anger. If she (your aunt) lived with you could you see yourself trying to pick her up after she fell down the stairs? Would you be OK with getting out of bed at 2 AM, finding the front door open and your "aunt" gone? Few LOs transisiton calmly and voluntarily to care facilites. Please don't feel badly. You've put in your time as a caregiver to both parents, and your "aunt" and "uncle". You made the right decision for both you and her. Now do something enjoyable for yourself.
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Isthisrealyreal Oct 2020
Exactly. No one is ever happy to move in to a facility.

Eensuring her safety and wellbeing is the most important thing and you have fulfilled your duty.

Well done on a difficult job.
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