My mother seems to be slipping into severe dementia, but has not been diagnosed. She is currently refusing to eat, drink or take any medications. One brother has a DPOA and the other a medical POA. She has caregivers that come to her house for 14 hours a day, but they will now not get her out of bed due to an incident when she was being moved and did not hold her self up with a walker during the transition and has a huge gash on her leg. My brother was worried about the wound since it did not look like it was healing well and took her to the hospital. She then started accusing him of being in a conspiracy with my other brother against her. She started to refuse food, water, meds and care. My brother is also under the impression that if we do not do something within 60 days, she will become a ward of the state. He has been researching assisted living facilities, and found one that he was going to try to move her into this week before all of this happened, but now she is refusing. Her behavior seems suicidal, but we cannot seem to force her to do anything that will benefit her. Is this true? Do we have any resources to force her care?

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Ne1amom, go up to Money and Legal and click on POA and Guardianship.
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I thought guardianship was for when you did not have a POA. So you are saying we can pursue guardianship even with a POA. Do we start the petition first, or do we need to have her evaluated first to determine she is unable to make sound decisions?
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Let's back up a bit before addressing a decision...

You wrote she "seems to be slipping into severe dementia, but has not been diagnosed." I do know that caregivers see the signs well before the professionals, and there clearly are some unsettling signs in her behavior.

But I've also learned from other knowledgeable people here that UTIs are a common cause of confusion and drastically changeable behavior in elders.

And she apparently has an open wound on her leg. Was it determined at the ER that the wound was infected? If so, it could have spread, and complications from it are causing her to be aggressive and uncooperative, especially if she's in pain.

I am a bit surprised that the caregivers refuse to get her out of bed b/c of the near fall, lack of support from her walker, and the gash on her leg. But I would think the caregivers would have offered other means of transitioning, such as using a slideboard to go from bed to wheelchair to walker.

However, it does seem that she needs a supportive physical environment because of decreased mobility.

Trying to put myself in your mother's position, I could also feel threatened, as if my children weren't tuned in to what was going on (losing control of my life), etc.

Who told your brother your mother would become a ward of the state if nothing was done w/i 60 days? Was it someone at the hospital? I'd trace this back to the source - someone (such as a discharger planner at a hospital) might have used this as a threat to force your brothers into action.

Before I move into any kind of forcing for care though, I'd consult with a doctor - others here can better recommend that kind to diagnose dementia than I can.

I think you're all wise and concerned to be pre-emptive, but I'm also wondering if this resistance and resentment is part of your mother's personality, being taken out more aggressively now as she ages and becomes less able to care for herself. In other words, is her behavior an exacerbation of past traits or is it new?

However, if she does have dementia (and again this question could better be addressed by others with more experience on this issue), I'm not sure if AL would be the appropriate choice. This might be a reason to get medical clarification on what's going on, as well as to ensure she doesn't have a UTI.

You might also contact an elder attorney, just for a phone consultation, if necessary, to verify the 60 day threat issue.

Good luck with all of this - I'm sure it's very unsettling and traumatic, but it does sound as if your brothers and you are together on getting the best care for your mother.
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You cannot force them with just a POA. Assisted Living will not take her if she is accusing, uncooperative and unable to walk to the dining hall.
She is in need of skilled nursing for the leg, and psychiatric evaluation for refusal to eat or drink (suicidal).
Either you start the Guardian petition, which costs a few thousand, or you let the state do it. If the state initiates the petition, they will ask for protective custody. This is a practical option when the family cannot afford to pursue Guardian status. There's only so much you can do.
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