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My aunt has no children and has been diagnosed with mild dementia. During the day she seems ok, but I've noticed she getting worse by the weeks. She lives by herself in a different burough and refuses home care. How can I gain the authority to assist her in managing her medical care, finances and housing ?

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It cannot be assigned. Only aunt can request who it is. Have you a talked to her about it?
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It must be given to you by your aunt, and the signature witnessed by a notary public. It would give you authority to act when she wants you to act. You still will not be able to force her to accept in-home help or to see a doctor, etc.
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You get an appointment with an elder attorney while she still has the capacity to make a decision about who she wants making decisions for her when she can no longer care for herself. If she has passed that point then you would have to file for guardianship. You need an elder attorney to advise you. Don't put this off. Also be sure to have your aunt checked for a UTI as the symptoms can mimic dementia.
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Letty, if your Aunt doesn't a Power of Attorney, chances are she doesn't have a Will or a Medical Directive. While at the Elder Law Attorney's office might as well have those done, if it is within your Aunt's budget.... and while her mind is fairly clear during the day.

I agree with the posting above, about having your Aunt tested for an Urinary Tract Infection.
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