How can I get my mom to understand she needs Assisted Living?

I think the first thing to do is bring her to the doctor and get a cognitive exam so that it's in her medical records (assuming she has some decline). I see you've got that scheduled, so yay! You can pass the doc a pre-written note requesting a cognitive exam so that your mom doesn't get upset. They will do this for you.

Your PoA is not active unless you can prove she has cognitive impairment or she's allowing you to make the decisions on her behalf (if she is not mentally impaired). Make sure all your mom's financial info is locked down tight asap so that the nephew can't access it and your mom can't withdraw money or write checks to him. If she's giving him anything this can delay or disqualify her from ever receiving Medicaid, and this may be a very bad thing even if you think she doesn't need it right now.

This arrangement your mom is in is a very common problem. You can consider actually hiring him formally with a written caregiving contract. But then this makes your mom/herPoA an employer so you must follow the employment laws of your state. You will of course need to be on top of your nephew to make sure he's working out to your standards. But if he's not trustworthy and you're just done with him...

Go to your mom's county govt center and file an eviction notice for the nephew. You can't just kick him out legally since this has been his only residence, especially if he is receiving mail or bills with his name and that address on it. You pay the eviction form fee to file then post the notice at the home where he can see it (or whatever the eviction process is for that county). Make sure to take pics of this so he can't deny it was posted. This gives him 30 days to get out and then he can be legally physically removed if he refuses.

If I were you I'd plan an extended visit at her home. Show up unannounced so that the nephew can't prepare. If at all possible, get both of them out of the house on some ruse so that you can search for and remove any sensitive financial info, like her checkbooks, passport, SS card, insurance, investments, titles, etc. Take pictures of the contents of her house. Spend some time with her. Depending on her cognitive condition it may not be valuable to argue with her about moving. If she can barely walk and can't see I'm not sure she will be recommended for AL...but that's up to the facility. Please consider a place for her that is both reputable and convenient to you. Anything less will just add to the caregiving challenge. Wishing you success in dealing with the nephew and advocating for your mom!

You can get the doctor to say she can not live alone.
She would have to have testing done to determine if she is cognizant. (does not have to be full blown exam the doctor can determine this in the office. If other testing has been done that also confirms, great.
But she is not living alone if he is there.
If you are POA the first thing you do is get him out of the house.
The other thing..how bad is her failing memory?
In AL she can leave with someone, or go out on her own.
In Memory Care she can not leave unless she is with someone that you have stated can take her out.

Thank you. I just spoke to her doctor's office, she has an appt. on the 8th and they will do an assessment then. He is unfit to take any responsibility, and I just now found out he does have a suspended driver's license.

Are you asking if you can have an assessment of your mother's mental capacities?Does she have a diagnosis of dementia? Do you have good reason to think that your Mom is entirely incapable of making her own decisions?
Do know that the POA, if your mother is not so demented that she is unable to know what she is doing, can be changed by your mother at any time if she doesn't have dementia. She could, in fact, appoint this nephew.
So it comes down to this questions solely as to what you can do. What you can do also comes down to what is written in the POA. The POA my bro and I created with his Lawyer, when he was diagnosed with probable early Lewy's dementia, was so strong in giving me powers that the attorney said "Be certain that you know that all of this, all of these powers, are what you wish to confer on your Sister, along with being Trustee of your trust, because signing these documents means quite literally your sister can sell the gold out of your teeth."
You speak of selling her home and property. Is your intention then to place your mother in care?
Does your mother have a will? Is he the designated beneficiary in the will? If your mother has dementia, then any will cannot now be changed.
So many questions here. First, what does your mother want? Second, is she capable of making her own decisions. You say that in your mother's eyes this man who lives with her is a "Saint". Is he cooking for her, cleaning for her, doing other things for her? Is he paid to do these things.
Just some things to think about. Hope you will update us as you move along.

That’s really sad about your poor sister, she did all the caregiving and ended up suddenly passing away,....you must be in a lot of grief about that, have you talked with anyone about the loss of your sister?

I am so sorry for the passing of your sister. The primary care doctor can put the ball in motion, however, in most states your mother will have to have certain testing done to prove her incapability. It is not as simple as it seems. We had issue in the family where the mom was giving money, the use of her car and other things to one of the other family members and this money ended up being over $200,000 and the way the law looked at it is; her money, her possessions, hers to do what she wants. While other family members disagreed, the law is the law and while what we consider to be illogical decisions unless guardianship is granted, you may find yourself at a loss with doing the things you want to do. Check with a elder care attorney in your area. It is very frustrating, but, your hands maybe tied. :-(

how awful of his sisters to treat family that way, if that’s the case have you or anyone ever spoken to them about it? it sounds as if the ones who were primarily there for your mother and in her life were your sister and nephew,

Unfortunately my most recent caregiving experience has been tainted beyond repair because I didn’t find out until too late that my trusted relative was a twin for your nephew.

If your mother’s physician is a reputable professional he may choose not to “sign something g” but to arrange for a fair assessment of her cognitive abilities, done if possible) by someone trained in the evaluation of geriatric clients.

Contact her physician without delay. There are differences between “legal” competence and the assessment done by someone who knows how to ascertain actual level of functioning, but in my experience, NOTHING is more useful than a statement by a psychiatrist, neurologist, or other degrees professional with credentials in geriatric assessment. As just one example, if you wind up needing to become her designated payee for Social Security purposes, a well written psychiatric can be accepted ; social security does NOT accept POAs.

My LO was duped by someone whose devoted claims proved to be FAR DIFFERENT from what was being practiced. Her assessment provided me with grounds to take protective actions on her behalf.

You may wind up having to go to court because of his ludicrous claims, but having Mom’s cognitive assessment in hand, combined with is dubious history, should give you a useful step up.

GOOD LUCK In insuring her safety, peace and comfort.

In my unfortunate experience, it was brother “caring” for dad. Reality was brother closely resembles your nephew.

Dad had a stroke which was the crisis that necessitated change. What I did to get brother OUT was to file an APS report for financial abuse and start the eviction process. I was lucky in that these two jolts resulted in brother leaving on his own. He also left an incredible mess for me to clean up, but that’s another story. Brother is unlikely to put forth any effort to come after me, thankfully. Lots of talk, no action. Maybe start with those two things. It won’t cost much and is pretty swift.

One very important caveat is that my father was willing to back me up in my actions. It doesn’t sound like this is the case for you. I’m so sorry as you must be incredibly frustrated watching this play out. Please keep us updated.

It certainly is an unusual arrangement- your sister did all the 24/7 caregiving yet somehow your part has to do with your moms money/ poa. It sounds as if the only main role you offered was an interest in your moms money. Typically the sibling who’s close by and actually *helps* has poa and financial oversight for obvious reasons. It sounds as if you have a problem with the fact your mom is quite okay with her nephew, please allow her and your nephew ( my goodness his mom and her daughter passed away) to enjoy their time together, honestly it sounds like your the only one unhappy they’re close. Perhaps talking with a therapist would help you to work on yourself and why it is your so focused on other people’s relationships. Your mother isn’t a child, it’s counterproductive to her overall well being to attempt to undermine the closeness she has with her own nephew. this may not be easy to hear but for the sake of your mom and her health you need to set aside whatever issues you have and stop trying to influence her family relationships she chooses to like. I suspect there’s a valid reason she really likes him, probably bc he’s not the person you try to portray to her. I hope you also don’t bad mouth your sister to your mom, especially since she did all the caregiving and most especially bc your mom is grieving her. Let it go and work on having a better life for you