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As many of you know, my dad spent some time in the hospital last week and was released to go to assisted living, not home. He cannot be by himself anymore. We had care coming to his house for 6 hours per day, 7 days a week before the hospitalization. It was about $6000 per month. He insists he is walking out of assisted living on Friday. And I know he will although I don't know how he is getting home. The facility he is in is wonderful and he actually seems to like it but is treating it more like a vacation. Full time in-home care would be over $20,000 per month. That's just not in the plans. And even at that, there are many other things wrong with the in-home scenario and having full time care would not fix them (i.e. he refuses to allow med management, he won't eat properly, refuses bathing, no socialization, lives on a busy street with no sidewalks--going for walks is dangerous, etc - he has way too much control for making unsafe decisions in his house). I am his guardian and we have sent the paperwork to the court for the move so I guess the final decision will be with the judge (dad will contest and we will have a hearing) but I'm not sure how to keep him there between now and then. I need to give the facility 30 days notice if he is going home or he's out over $6000-$7000. I could refuse to allow any in-home care since he's already paying for assisted living but then I'll be in trouble.

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Well, my dad is still at assisted living. He's been there 2 weeks. He hasn't figured out a way for anyone to get him out yet. Still talks about it constantly. I go every Saturday and he is still angry. But it was different today. His personality was essentially zero. Confused, unable to think straight. I had a power lift chair delivered this morning. My husband and I chose one with only 4 buttons on the controller so it would be easier for him. He couldn't figure it out. I had the TV remote from his house brought over because the one at the assisted living had too many buttons. The maintenance people programmed it to their TV for us. He didn't know how it worked even though it is the same controller he had at his house. I find he is not even able to carry on much of a conversation anymore. His anxiety is off the chart. The doctor's office told me Friday that they are sending home health for PT, OT, and a mental health counselor for his anxiety. He's failing fast........... He doesn't even seem to be able to be social anymore. I think back even a year ago. So different. He was diagnosed with LBD a number of years back. Don't know if this is part of that or because of the move to assisted living. We do bring in caregivers 3 days a week for 6 hours a day to get him out and to appointments and to visits at his house.
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AlvaDeer Oct 2019
Babs, thank you so much for the update. My brother has early stages LBD and to tell you the truth anxiety is his absolute worst enemy. When it hits he can't do a thing. For myself, I would NEVER be good at anything that requires buttons, including the drivable carts in groceries, even now. They confuse and frazzle me. I am lucky to figure out my jitterbug phone which just about does it all for me. I am wondering if mild sedation would be good for the anxiety? Does the doc think that would be worth a try. Something very very mild? Sorry that this seems to be going downhill. Glad he isn't trying to go home at present. There is no upside to this all and it isn't like there is some miracle cure waiting. It is painful to be on a road that is so downhill.
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No Fear, Dear, You are Court appointed Guardian now. Dad has to Stay Put or The Facility Anyways, Who Knows his Condition and Story, Could get in Hot Water With Adult Protective Services.xx
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A geriatric case manager could be a big asset.
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Babs75 Oct 2019
We have one. She is awesome. She does a lot. Plus the geriatric psych. However, in my state (Oregon), they are VERY generous to the protected person.
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What sort of shape is ‘home’ in? Could you do trash job on it so that it isn’t very attractive? Tell Dad that it isn’t ready for him yet, but you will take him back to have a look and choose things he would like to have with him in the meantime. Then fridge and freezer empty with door open (we had to clean it out, Dad), heap of clothes on the floor and the bed from where you sorted things, no photos in view, boxes and heap of paper everywhere. You refuse to go to the shop for him – Look, it just isn’t ready yet!

Many of us would love to have the chance to look at a previous life, previous home, previous friends. Perhaps it would make him happier. Just leaving your home on a stretcher without notice can’t be easy. Perhaps a chance to say goodbye to it might help. You saying that you will take him there on Friday should take the immediate pressure off.

What he needs to see is that it isn’t really the way he is thinking about it, that he can’t be ‘independent’ unless he has you to depend on, and that ‘for now’ he is better off at AL. Perhaps tell him it’s much cheaper anyway - he can’t depend on you, he can’t cope by himself, and $6000 as against $20,000 if he wants to depend on other carers. Lots of older people are very responsive to wasted money!
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Babs75 Oct 2019
We have set up outside caregivers 3 days a week for 6 hours a day that go to the assisted living and get him out, take him to doctor appointments, bible study, and to his house. Then they come back. We are tracking with the care service just how much time he is actually spending at the house as opposed to other places.
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Can you tell him that he can't go home yet because there are things at the house that need to be taken care of before he can go back?
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Here's hoping he continues to abide by the baby steps you set up. Hope also that the courts will see through his stubbornness and charade, allowing you more control. He really needs to be in MC. He has already threatened to walk out and there won't really be any way to stop him if he is in AL only. This was my concern when YB kept insisting on AL not MC for our mother. We never did the guardianship (facility would refuse to accept her, she was refusing to move anywhere, which is how I ended up on this site!)

From a previous thread you posted, I was curious about guardianship and the issues you were having with it. I discovered that it might not always be 100% control! Others seem to believe this, but I know now and they should READ this and understand it is what the court decides and it might not be 100%. For others education: The courts try to ensure the person retains as much independence as possible. Sometimes they can still function at some level, so not all control is granted. Later this might need revision, which is where you are.

Similarly, many misunderstand the whole POA business - too many think this is the answer to everything and that is NOT what POAs are for, nor can they allow you to do everything you want! They allow financial oversight, signing for the person, contribution to medical care/decisions, and not much more. Too many on the site tell others to get POA to assist in moving someone. NO. We had DPOA and MPOA and EC atty said we cannot force mom to move. In the end we had to use some "trickery" to facilitate the move.

I am hoping the courts will revise your guardianship. I also hope your dad will stick to the 'arrangement' you have - if not, see to getting an emergency hearing to ensure he doesn't skip out of the AL.
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A geriatric care manager could be hired to advocate for Dad, allow him to choose a place (not home) that he feels may be more comfortable. In Dad's best interests, the care manager can advise you, document your heroic efforts to care for him, and be stronger on his behalf because you are also his daughter with an emotional connection. Not wanting to be forceful (often thought to be the bad guy, or mean), you can allow the care manager to be the bad guy, take the heat for what has to be, in Dad's best interests. It is understandable that you want to preserve a relationship with Dad first.

I know it seems like his finances are bleeding money. Once a guardianship has been placed, your role as his caregiver is to keep access to that much money away from him. Once you have the support you need, and temporary guidance from the care manager, you won't need the support of a care manager.

You do need support, maybe a full support team. Keep trying, you are not the bad guy.
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Babs75 Sep 2019
We have a wonderful care manager. She takes a LOT of heat off of me. She has been my main contact to the hospital people and dad still likes her so he actually let her borrow his house key to get his clothes, etc. when he moved to assisted living. He has never allowed me to have a key (although when she got it she let me make a copy but he doesn't know it). She makes arrangements for dad's appointments and keeps the caregivers scheduled properly. I work full time so she is the 'go-to' during the week.
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If you can get help or friends to keep him busy everyday until the hearing. Maybe take him shopping or out to eat, etc.
My concern is that if he starts to wander, the AL will insist he move to a higher level of care. If there is no brain damage/disease just repeat it is doctors orders and you are waiting for permission to move him home.
If you're sure he will try to leave, prepare & schedule the trip for him...Supervised by someone you & he trusts.

Change the locks, if possible move furniture out of view from the windows. Maybe even put a sold sign in the front yard.
This will make him angry, but he will see moving home is not what he thought. If he is functioning like a child, wanting the security of his home, he may need to see someone else is living there..or will be soon.
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Babs, keep in mind that the Court can ask for a report on your spending of your Fathers money anytime. And they want a detailed report, they won’t accept Gave Dad $100. I’m also not sure they will approve the cost of the extra caregivers at assisted living. You may want to check into the guidelines to see.

What do you think the best outcome would be for your Dad? Whatever it is, put that plan into place. Because it is up to you. The court decided that your Dad is incapable of making decisions, so they put you in charge. Don’t make the Court give the Guardianship to someone else.
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I don't recall the website I found before (did a little poking around based on a previous post by Babs75, wondering why her guardianship didn't seem to be 100%), but I did find that the courts can be specific about duties allowed and what the guardian can/can't do. The court wants to allow the person to have as much independence as possible. In Babs75 case, she does not yet have full control and was waiting for this required review to have it adjusted.

Another website I found lists "Guardianship, by nature, requires the elderly person to lose some of his or her rights. For example, the elderly person may lose the right to manage his or her finances, to choose his or her own caretaker, and to decide where he or she lives." Note it says lose SOME of their rights. I believe Babs75 is in the DonutHole of guardianship!

Hope is that the courts will revise enough to allow her more control as it is needed in this case (dad is worse than a mule!!!)
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Ask the doctor to pay a visit to him where he is as part of an 'evaluation'. Doctor can tell him that he is simply not ready 'yet' to go home. Maybe he will agree to stay where he is to get more rehabbing to get stronger. You can continue to reiterate same conversation - not ready yet, would not be safe, etc.
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Since it is difficult for you to get dad to realize the truth, get "authorities" to do so. Primary care doctor can tell him why he can't return home. Get a psych consult and psych doctor will tell him why he can't return home. If you must get him declared incompetent, judge will tell him he can't return home.

After having the "authority" explain why he can't return, make arrangements to sell his home. Go through his home with him to cull keepsakes from things to let go. Have him decide what to give to others and what to sell - and do it. Have a realtor come by to give advice on staging and get the place sold. Help him make the ALF as "homelike" as possible. Then, remind him that the ALF is "home".
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Babs, it will be so much easier if YOU can accept the fact that YOU are now your dad's parent, (the turning point for me). Try to see him as you would a toddler or kindergartner. You have compassion for him, love him and want to protect him and care for him. There's no expectation of a toddler or young child making wise decision for their own care. Make the necessary decisions without inner turmoil. You only want the best for him, so make those decisions and explain them to your dad in clear, understandable words without talking down to him. State what will happen. He's done nothing wrong, but cannot make wise choices anymore. Put in place all the safety plans for care necessary and do not ask permission from him. Think toddler; what do I say? Do you want to go to the bathroom? No. "It's time to go to the bathroom." No room for argument, or a "No" or "Later" from him. Just a fact. Best wishes.
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My mother with dementia is in assisted living with memory care. It is a keycode-secured building. There is a phone in the hall that residents are free to use, and my mother--who wants to leave--has used the phone to call the lawyer to "get me out of here." But she has never simply called a taxi to take her home. Her dementia makes it impossible to stick to a train of thought for long and carry out multiple steps over time. She's been in the memory residence for 4 months. They keep her occupied with music, activities, socializing with other residents. Maybe your dad can talk up a good game, like my mother, but will not actually be able to do it.
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It sounds like he needs a psychiatric evaluation for competancy as it appears he is a danger to himself, such as refusing medication, and yes home care would cost an enormous fortune. He may need nursing home placement due to elopement issues. There may be a point in time he will suddenly start wandering and not just taking walks.

That's what happened to my mom over 5 years ago--she just *suddenly* started wandering and I came home from work, and she was missing. I almost had a heart attack not knowing where she is, and lucky the Emergency Room had her and left a message on my phone. She wandered out on the street and fell face down. The CT of the head was negative, and no urinary tract infection. In fact, physically she was healthy. THAT CHANGED MY LIFE requiring 24-hour supervision around the clock. She had her moments of confusion but was able to talk to me fine, but she NEVER wandered. Strange after that fall she forever changed and had that glassy-eyed Alzheimer's look which is like a flat affect. This worsened as time went by. Oh they did the CT of the head and found no bleeds or clots, just age-related atrophy. I've been dealing with her Alzheimer's since age 78. She is still alive. Living with me. 90 years old, and kept alive with a feeding tube. Bedridden, and practically brain dead ravaged from years and years of Alzheimer's disease. Been to the Emergency Room multiple times...long story. It is although she already died..but her body is kept alive with that feeding tube.

Mom has been on hospice for over a year. It took over an hour to feed her and I gave her fluids one teaspoon at a time thickened and feeding/drinking was an all-day affair. Eventually she stopped taking in food/water and she went into dehydration with kidney issues so I did have to revoke her hospice to get the feeding tube put in (they tried to talk me out of it, but I did NOT want her to die a slow and horrible death due to dehydration which can take 2 to 3 weeks). Sign a piece of paper hospice is revoked. Feeding tube insertion only took about 10 minutes. She was discharged put back on hospice and they provide me with supplies such as diapers, feeding pump, tubing, tube feeds. She's doing good--but her brain is gone.
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Babs, you are paying for this with Dad's money, right?

What will you do when he refuses to leave his home with the caregivers? Have you been in touch with the local police who might need to assist?
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Babs75 Sep 2019
Yes, assisted living is paid for out of dad's funds. And yes, we can call the police if necessary. So far, he's been back to the house twice and it has not been a problem to get him to leave.
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We have reached a small compromise (and baby steps) since my original posting. Dad had no way to get a ride on Friday so he is still at the facility. We have had caregivers there all week (paying for that plus assisted living costs!) but today was the last day. We went to his house and got his car and being the sucker that I am, I have agreed to have a caregiver there from his outside care service 3 days a week. They can take him to appointments and take him back to his house (this is the man who, when caregivers were coming to his house, spent the entire shift out and about in the car because he hated being in his house.) Now we are hiring caregivers to take him back TO his house 3 times a week. I told him this would not be forever, that we would scale back at some point. He is insistent that he will fight to get to move home which I doubt the court will do.
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AlvaDeer Sep 2019
Babs I fear you are putting off the inevitable and it will be more difficult with your father in future. Like a 2 year old he is training you to do as he wishes and you are doing it. I think this is something you will see in good time, and meanwhile, you are likely right to handle it in the way you see fit. Wishing you all luck with Dad. Keep us posted.
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My father was a very stubborn man, even before dementia and even when it was unreasonable to be so very stubborn. I am my father's daughter and inherited his stubbornness in full measure; however, as a child I decided I did not want to be stubborn about snap emotional decisions and cut my nose off to spite my face as my father sometimes did. As an adult, I listen and consider everyone's views then make my decision and stick to it unless or until someone brings up a new view/fact/position to consider. I do not change my mind just because someone else doesn't approve or agree with my decision.

As my father's dementia worsened, I became the "only person who can deal with him", primarily because he knew I was as stubborn as he was and would do what I said.

When Dad didn't want to go to MC and told me he wasn't going, I told him yes he was. "You can go the easy way in the car and walk into MC with your dignity or you can go the hard way drugged and strapped down to a gurney by removal attendants. Either way you are going. You need the level of care the MC can provide and I think you will like it there once you get used to it. I would rather see you walk in but one way or the other you are going to MC." I showed up at an appointed time and followed the car while my estranged brother drove Dad to the MC. Dad walked in to his room where he was surprised to find it contained his favorite rocking chair and was decorated with photo collages of family and collectibles. He did adapt and even like being there.

I don't know your Dad's personality or whether his dementia allows him to remember things enough that talking to him would do any good. If you think it would work, I suggest you talk to Dad about what's going to happen if he walks out of the AL. That he has no money and no keys to his house; his picture will be on the news as an elderly dementia person the police are looking for and when the police find him he will be taken to a hospital to be evaluated and held until a locked MC facility can be found, or maybe a NH if an MC isn't available because he won't be able to return to the AL after "escaping". Emphasize that you will have little to no control over what's happening once the police are involved. Ask him to please not do this to himself. You want him safe and someone available to see to his needs and right now the AL is the best place for him. Good Luck.
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Babs75 Sep 2019
Thank you! Yes, he still has a house key and until he was in the hospital, I didn't have one. All these years and his guardian and he would not allow me a key. The care manager got his key from him to get him some clothes and she let me make a copy. He does not know I have one (he holds his keys hostage - I still can't get in the garage, however) and would be furious if he knew I did. And the cash? Yep, when he went to the hospital a week ago, it was found he had $1800 on his person. He insists on cashing his pension check and NO ONE touches his pension check. The caregivers take him to the bank (he still has his own checking account where he pays utility bills for his house - we help him write the checks but he signs them). I've had to pick and choose my battles with him. When he left the hospital, he took his money and it is now locked in a drawer at the assisted living. I have no access to it. Stubborn, stubborn old man. He doesn't know it but I have forwarded his mail to my house (this should kick in any day) and I don't have to move it back to his house since he's not supposed to be there anyway. This will drive him nuts..............
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Ann Reid seems to have the most logical solution although nothing's really a solution. It's difficult no matter how you look at it but keeping him in the facility is your best answer I went through the same or similar situation with my mom I was fortunate that the hospital had determined she needed 24-hour care so it was a decision that I did not have to make but once she was in the system she's in a great place and I couldn't be happier for her she actually calls her room her home and when she goes out to the activity room all rooms she has a blast with everyone there the mother that I've known all my life would never have tolerated which she is now but she is doing remarkable she is truly my inspiration. Good luck with everything and I hope all goes well for your dad and for you.
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You are his guardian, it is your choice where he lives not his. He has been declared incompetent, so he no longer has a say or will be able to contest.

If he walks out they will come looking for him and then require that he be placed in the memory care wing on lock down. Or they will tell you that he needs to be placed somewhere else.

You are in charge, not him.
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I think that sooner, than sooner than later, you will most likely be looking into a locked unit.
If the AL he is presently at happens to have something like that, the transition may be easier than having to remove and transfer him.
Your first reaction, if you are anything like me, is that he is functioning at a higher level than the other residents of the locked unit, and in some ways that may be true, but if he has been diagnosed with dementia, you have been granted guardianship, and he has no perception of his inability to manage his ongoing needs, you can begin to assume that his need for a secured, structured environment is somewhere on the horizon, and in some situations, it is easier to head in this direction earlier than later.
Under the terms of the guardianship, is there any language that requires you to provide a safe, secure environment for him?
If you place him now, in a locked unit, you will at the very least have a certain amount of time to figure out what to do next.
If his prior living arrangement was NOT possible as a consideration, it is not fair for to him OR YOU, to spend time figuring out ANY REASON OR PLAN for keeping him there, so start thinking forward to other scenarios that MAY work for him and don’t look back.
My LO has been in a well run MCU since last June. I visit often, and whether I leave in tears or marveling over how much she is still her old self, I am content that she’s monitored, safe, and lovingly provided for.
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AlvaDeer Sep 2019
I so agree. He either can get the rule or he cannot now absorb the info; if he cannot understand he cannot leave he will need memory care; such a concern because cost doubles right there.
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Babs, if you have guardianship, YOU and not dad determines where he lives.

Talk to the faculty about this issue. As an AL, they may not be able to keep a person who wants to leave, against his will. You may need to move him to a secure memory care unit.

Have you consulted his doc about meds?
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Based on what I read in another thread, guardianships are not always 100% - the courts want to allow the person as much "freedom", independence and choice as possible. Don't know what OPs level of oversight is. Even if it is 100%, dad is contesting, which is allowed (more time and money down the drain! The court will appoint an attorney, could order testing, etc.)

I like the idea someone suggested about getting 'an expedited hearing or a temporary restraint'. I do know that EC attys can request expedite.

One thing I will add - dad NEEDS to be in MC. AL will not babysit him or be there to stop him from walking out the door. The ramifications could be dire if he does walk out. This was my argument with YB, who insisted mom would prefer AL. Sure dude, maybe 5 years before that, but not with dementia! Staff said no to him.
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It sounds as if you feel your father is suffering from some form of dementia or is otherwise a danger to himself and have begun the process to force a guardianship. Until he's declared it may be difficult to force anything but perhaps you can talk him into staying for a longer vacation by telling him you've already paid for the month and if he leaves you will lose the money. You could tell him his home was infested with mice while he was away and the exterminators are getting them out while he's on vacation or some other small lie? If nothing else works and he does walk out of the facility with no way of getting home that would probably be enough to get the local police to pick him up for evaluation which might have the result of forcing the declaration a bit quicker than the usual route. I hope everything works out for all of you.
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Babs75 Sep 2019
Yes, my dad has dementia. He was diagnosed a number of years back. I was advised by APS 1-1/2 years ago to get guardianship which I have had for a year.
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I would make it clear to him that he is not going home now. You can tell him, if you think that he is capable of absorbing it (I would suggest their social worker with you) that if he cannot abide by the rules and stay in his facility he would have to move into memory care, which is a locked unit. I would tell him that it is a good deal different in that it is more like a hospital with more staff, locked door, and often a roommate. Those are the two choices. There is, sadly, no third choice of coming home because it is no longer affordable.
It is time to do the tough love thing.
Often the facility suggests you curtail visits during this adjustment period because the elder sees you as "a way out" as someone he or she can manipulate, knows, and knows HOW to manipulate.
Only suggestions I have, because if he insists on this then he likely IS looking at memory care. You can tell him that along with being much less nice, it is also much more expensive, and if his money runs out during his lifetime he could end himself in a quite not-nice circumstance that you would be helpless to fix for him. Remind him you know how tough it is to go through this one loss after another thing, but that you will continue to do the best for him that you can, and that you love him, and that you don't EXPECT him to be happy about it, because not everything in life is about happy.
This will not be easy. Think of a toddler that is given too much control and ends up in meltdowns constantly with the fact they can win, then don't know what to do about it. It needs to be more certain for him. More set in stone. No argument. Just the simple loving facts told as kindly as you are able, with sympathy, over and over and over when he goes "there".
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Not an area of expertise of mine, but can you request an expedited hearing or a temporary restraint to keep him there until the case is reviewed, given the circumstances? I have read enough to know all these issues of health directives, DPOA, guardianship seem to vary by state.
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totally unnecessary. She has guardianship. She doesn’t need to go to court for this kind of thing
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