My mother (83) has been diagnosed with dementia and a number of other health issues. She is refusing in-home care. Can I insist?

Has she been diagnosed with dementia? ( that's what your profile says). Or she's only demented when noncompliant with meds?

Why doesn't she tske her meds? If she's forgetting them, or resisting taking them, then that would seem to indicate that she lacks the capacity and judgment to make medical decisions for herself. Depending upon the wording of your dpoa, that might OBLIGATE you to get her care.

I would not take her into my home and i would not get her to an ER in anything other than an ambulance. Once she's in rehab, I'd talk to the discharge staff about how to get her into care.

Talk to the lawyer who set up the poa about what your next step should be. And you pay the fee out of mom's funds.

Happy62, I would never even consider doing a reverse mortgage, as this will be needed WHEN she finally gets into some sort of Senior Living situation. As for paying a family member, who? That would be a terrible thing to put upon someone, especially a family member! Your Mom is only going to decline further from here, so strapping somebody into caring for her seems like a terrible idea, and they will eventually grow to resent you! Now if you were thinking to pay yourself, yes, this can be done in a Caregiving Contract, but then again, do you really want to be stuck caring for her 24/7?
I agree with Babalou on this one. Allow her to return to her home, and the next time she falls and goes to the ER, refuse to take Any responsibility for her, ANY! They will work with social workers to find her a better living situation, and take over the application for placement. At some point, unless she is very wealthy, her house will need to be sold to pay for her care, and believe me, it's well worth it, so that you can continue to Love and support her from a distance. Its not worth giving your life up for! Good luck!

Happy, how often a day does she take her medications? If your mother doesn't want to have anyone come into her house and wants to continue to live there, could someone go over to make sure she takes her medications? Beyond medications, is she able to manage for herself? If she is able to eat and bathe, perhaps medication management and perhaps a maid would be all that is needed right now. Does a family member live close enough to check up on her if needed? I imagine since someone probably has to shop for her that someone is close by.

What medications is she not taking? Why do her symptoms when not taking medications mimic dementia? For example, does she need insulin and doesn't take it? Does she have cognitive decline any other time? Not taking meds like insulin would be considered life threatening and I would approach it that way. Are you also her Healthcare POA?

Who told you that she would not be found incompetent in a court of law? I would have all necessary information and then consult with an attorney in your jurisdiction in order to find out what the court needs to find someone incompetent, either about their healthcare decisions or handling of their financial affairs. Sometimes, the court doesn't just look at memory, but matters where the patient is not using good judgment or not able to run their household. I'd be wary of non-attorneys telling you what might happen in court. People say a lot of things that may not be based on truth.

I'd also explore all the technical requirements regarding how to pay for her care if she goes into long term care. Getting mortgages, selling property, etc. can have serious consequences, so, I find all of that out before making those moves.

Thank you all so much for your helpful suggestions. My mother was diagnosed with mild dementia by two different neurologists six months apart. My mother has hypothyroidism. When she does not take her thyroid medication, she lapses into myxedema which mimics severe dementia. She does not take her thyroid medication because she does not believe she needs it and it is also inconvenient for her. She needs to take it on an empty stomach. When she gets up in the morning, she wants her coffee immediately due to breathing problems. She said, the coffee helps. She nibbles all day and never has an empty stomach. Her entire life, she has never believed that medications were the answer to her health problems. She literally had to have two heart attacks before she agreed to take blood pressure medication. She has short term memory due to a cardiac arrest back in 2012. She has been fighting her medications ever since. She currently takes her meds 3 times a day. I am also her Healthcare POA. A social worker told me that due to her mild dementia, a court will not find her incompetent. She is in denial of her capabilities. She is not able to manage her household on her own. The closest relatives are all 30 minutes away. I have been her wheels for groceries, errands, doctor appointments, etc... for the past 15 years. My husband and son maintain her yard and house. Since 2012, I have been taking care of her finances for her. My son loves his grandmother and only wants the very best for her. He is 19 years old and just graduated from high school. He is going to take a year off from school, work, and then study abroad. He would like to care for her in her home until he goes off to college in the fall of 2017. Mom has a defibrillator. The battery will need to be replaced next spring. As her Healthcare POA, do I need to sign off on that? She does not want to take the medications, she does not want the defibrillator, why renew it? Or is she not in the right state of mind to make those decisions? Last December, I asked a social worker at the hospital, "Is it quality of life or quantity of life?" She promptly called Adult Protective Services. Of course, Mom passed that in-home visit with flying colors.

Since she is making decisions for herself and not for a minor child she can decide not to treat her chronic conditions. It sounds like this is a long-term philosophy for her, and not simply the result of reduced cognitive functioning. That is very hard for me to comprehend, and for you, too, apparently, but it appears she is willing to risk the consequences of her philosophy.

As for the defibrillator, why renew it? When my husband had his implanted he was relatively healthy and looking forward to many years of health. When he developed dementia many years later he wanted the heart surgeon to remove it. The doctor was shocked and tried to talk him out of it. Finally he agreed but said he would not do invasive surgery just to remove it -- he would remove it when it was time to change batteries, in a few months. My husband continued to have a pacemaker, because that contributes to quality of life -- it is not pleasant to have a very irregular heart beat. But his attitude was that if he was to have a heart attack, so be it -- he did not want CPR either from a person or a machine. He had a DNR on file and this device was contrary to that decision, he felt. When the doctor came out of the surgery to tell me all was well he also said, "I've been thinking about this a lot. I think your husband made the right decision."

As for your son caring for her, bless his heart! What a wonderful attitude. I really don't think it is appropriate for him to have this responsibility at his age and stage in life. If it is just a matter of giving her the pills and she is wiling to take them from him that is one thing. But mild dementia progresses into moderate dementia and that progresses into severe dementia, and nobody knows the timeline.

Hugs to you. This is very hard!

I would write everything down that you are aware of and get an opinion from an experienced attorney who regularly handles competency litigation. At least you will have peace of mind knowing what is required. I would not take the word from a social worker. They may or may not know what they are talking about, but....that's all I'll say about that.

It certainly sounds like a terrible situation. If she is competent, she certainly as the right to treat her health as she pleases. You may have no choice, but to let her ruin her health further. If your son goes to live and care for her, I'd leave him an out to leave it she progresses. It may be much more challenging that he expects. It's such a wonderful gesture, but, I would explain that it's not required and that other arrangements can be made if he has to move out.

In your shoes, the person I wouls be worried about is YOU. You have DPOA and in most states, that implies acting in the person's best interests when they are inable to do so. So you really do need to see an attorney and discuss what YOUR responsibiliry to your mother is. If she's competent, I think I might talk to her about getting hospice involved, since she wants no further treatment.

Hospice is a good idea. The condition you describe is very serious. Also, ask if her thyroid meds can be taken with coffee. She might not get the full effects, but would they work just a little? I take those meds too, and I make sure to take them on an empty stomach, but I would imagine not everyone is always compliant. I'd get her doctor on board. For some reason she's ignoring a serious medical condition that can be easily treated. That must be so frustrating.