How can I hire care for my father with dementia against his siblings' wishes?

His siblings are dedicated. Shame you are not all on the same page - yet. I think keep gently suggesting a paid 'housekeeper' for him & when it gets too much for them, they can agree to a 'trial'. That's how it's often snuck in..

If these siblings are that close, I'm thinking at some stage they will all move in together. Unusual, but could work? Sort of Golden Girls/Guys.

What sort of things are making you question if the care is enough now? Are there safety issues?

Interesting. Makes a good argument that the same person should have both financial and medical POA. You may want to consult with a lawyer to see how to handle this. Maybe a letter from him/her saying that a diagnosis is needed for the POA to be valid.

Have a lawyer to write the sibling with the medical POA that they are not fulfilling their duties in the care of someone with Alzheimer's. Someone's trying to protect their inheritance but not really care for dad it sounds like to me. I might be wrong though when you consider how old they are.

Also, someone younger not older than the person being cared for needs to be the medical POA and they much are older. How can you be sure they have not started having some Alzheimer's and thus not reasoning properly?

It's not really up to his siblings to decide. Medical POA does not give that sibling the right to deny your father in-home help. The other sibling is handling his finances "informally" while siding with the other sibling whose denying him services you feel he needs. Plus medical POA sibling "has told his Drs not to release any information to me". Those are big red flags!!

Can you make an appointment with an attorney, preferably the one who drew up the springing POA? You need to express your concerns to an attorney. Perhaps the attorney will write a letter to the doctor expressing concern about the medical POA making decisions beyond the scope of that sibling's authority. In my experience, doctors rarely ever like getting a letter from an attorney about a patient.

Go over to see your dad when neither sibling is around and take pictures of his living conditions that support his need for in-home help. Take that day's newspaper with you and put it in the pictures, which verifies the date. Pictures are worth a thousand words, and would help you with both the attorney and doctor.

This may get contentious but that will not be your fault. Shame on the siblings for controlling your father and for treating you like an outsider.

I shouldn't be ageist as many older folk are extremely sharp... but I agree with Yoda. someone younger should really be Medical POA. But only Dad could change that - capacity to do so now would need to be assessed.

Dad is only 73 (from profile) & sibs late 80s? Big family maybe... are you sure elder one is not his birth Mother?? (if female 🙃).

"They argue they are protecting his assets so that I inherit one day, which is not at all what I want. I want his money to go to his care".

The elder sibs don't have any authority over Dad's funds though, right?

I'm thinking a meeting with you, the sibs & a Social Worker would get all the issues out to discuss.

It sounds like they are trying to protect him but are misguided. As the Alz progresses he needs more supervision, by refusing outside help they are actually leaving him more unsafe.

They may need someone with authority to explain this to them.

Badger37, What you shared about your dad going to "accidentally overdosed on Tylenol and ended up in the ICU a few years ago. More recently he walked to the drugstore on his own and got lost on the way back. Strangers helped him get home." brings up red flags. The next time he goes to the doctor or hospital tell them this and that his medical POA is not providing him appropriate care or call adult protective services and tell them this information and how your siblings are not responding correctly. I'd even go so far as today before doing so, tell your dad's siblings that adult protective services will not be happy to hear what you have to tell them and they better straighten up. Better still, take all of this info to a lawyer for guidance. The sibling with the medical POA is in trouble in my opinion.

The reluctance to allow strangers into your father's life is what I'd guess is the main problem. When you've discussed hiring care services with the medical POA sibling, how far have you got? Have you identified any specific agencies, with their credentials?

You say this sibling has told his doctors not to release information to you - have you discussed that particular point with the sibling, and explained all the reasons why you do need to be included? It isn't just about springing your DPOA and managing his finances: your aunt/uncle(s) are in their late eighties and sooner or later you are likely to have to take over.

It's also possible that in the nicest, politest of ways they're afraid you might be tempted to run off with the money. Such a suspicion wouldn't have to be anything personal at all: if these relatives are capable and responsible, they're probably also keen to keep themselves up to date on current affairs and will have heard all sorts of nasty stories about elder abuse. It's best to be open about such issues, because then you can set their minds at rest.

I'd keep on the angle of becoming a good team of support for your Dad with the two Gatekeepers. You want to build trust here, not be onopposing sides - as you all care for Dad.

As Countrymouse flagged, looking into what is their reluctance to outside care? It's NOT saying they aren't good enough... (may be how they hear it?) but it ADDS more help.

Imho calling APS now is going to seriously ruffle their feathers & lose trust. I don't have personal experience with APS but my Doctor asked me these questions when I was researching for a not dissimilar family issue;
What will APS find? A reasonably neat/clean home? A person with reasonable clean clothes on, edible food in house, rubbish in bins?

Or unkempt squalor, rubbish everywhere, hoarder type situation, unclean person, rotten food & offensive odours?

My relative was ok if Aide present or recent. But frequent falls & lack of hygiene when not.

When caring for people losing skills, mistakes will happen. You don't know they can't manage their own meds until they can't & skip or overdose. You don't know they will get lost until they get lost. I don't mean to dismiss these concerns - they are serious, but have the Gatekeepers changed things to increase safety at each problem? If so, I commend them. They may well add a 'housekeeper' if you keep trying.

If not, you are kind of in the *waiting for a crises* club to make bigger changes.

Welcome to the club.

Badger37: Your dad's one brother "has him over briefly in the evening" begs the question - How does dad get there? Is dad still driving, is his brother picking him up or is dad walking?

Oh - oh - just saw your post that your dad has had issues in the past with Tylenol over ingestion and walking to the drug store, only to get lost (fortunately someone helped him get home?) So you may have a bigger issue at hand with dad. You need to speak with dad's physician and also a lawyer.

Also, since your dad has Alzheimer's, he needs help.

I would suggest hiring a lawyer with experience in Family Law. They have far too much responsibility for siblings in their late 80s. The most they should be doing now is offering companionship when and if needed. You, as his daughter, should have full control. Good luck.