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My mom is midway+ through vascular dementia. Same symptoms as Alzheimers, just a different timeline.

Mom lives by herself and she should not be. I was going for several hours 5 days - every week, but my son developed some serious health issues - my focus must be for him. I now go 2 days a week and we have outside help 3 days for 4 hours a day. Brother pops in the evening and sister for a minute on the weekend. Mom does not eat unless I make her and someone sits with her. I am the only one who sits with her. She won't drink unless she is made to.

We have had 2 family conferences with Mom's doctor about the need for placement in a home or having substantially more outside help, but my POA brother will not do it. My sister didn't come to either meeting.

He told me he has seen all of the incidences I have told him about. It makes no difference. He says she is fine for now. NO SHE IS NOT! I have worked for a year to get more help and/ or placement. On mother's day of this year, my brother finally agreed to start the process - however, he was leaving it to me. I told him I cannot start the process - he is POA - he has to do it. Immediately it was a big fat no way. He doesn't want to be the bad guy - but he was willing to let me. Okay. It needs to be done. Her doctor was ready to write the order before the first conference, but couldn't since I am not POA.

The only thing I can do is step back completely and let them take care of everything. I will call Adult Protective Services if they do not act. I will still visit with Mom and check on her, but I will not wait to get into legal trouble because of elder neglect. And that's what will happen if anything happens and Mom ends up in the hospital with injury from a fall, or whatever. It is a matter of time before another fall happens. I don't know if this about preserving what little money she has, or the emotional aspect, or just plain stubbornness. Mom's situation is not good and I am afraid for her safety. Her wellbeing must come before what she or we want.

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I would not bother with a threat. I would just call APS and tell them that your mother lives alone and is no longer safe to do so. And that you don't have POA and thus have no say in the matter. That's all.
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Second Babalou's advice. Do it now.
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Something else, if brother has POA, he really only has the ability to sign checks, not to determine where mom lives. Anyone can "start the process" if by that you mean research the best facilities available that your mom can afford and that will accept folks with her level of infirmity. The soctor is the "bad guy"; he's the one saying that she can no longer live alone. Someone has to get mom to agree to this, unless one of you gets guardianship.
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What do you expect APS to do? Do you know what to really expect if they get involved? Wht not try to work more with herdoctor? If he thinks she needs placement he should write the order. Then give it to brother and help him find the right place. I wouldn't invite APS in unless you are prepared to end up alienated from everyone else in the family, including mom.
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Have you asked your brother if he would relinquish his POA to you? That may spur him into doing something if he does not want to give up control. Since this has the potential to be a family battle, have you talked to anyone about going to court for guardianship since the POA will not nothing and you can prove that she is unsafe.

If APS shows up in the house, it is clean and she is lucid, will they really do anything?

Could you talk your mother into "voluntarily checking herself in" to AL?

All options.
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Has anybody talked to mom about what she wants?

You can challenge his POA in court, but it's going to cost.

Sometimes we actually do have to let Humpty Dumpty fall off the wall to be able to make changes. A lot of adult children simply can't handle the idea that mom/dad is old enough to need more help, or isn't safe at home. Decision making is clouded by what they want to be true versus reality.

There is nothing you can do to change your brother's perception of this & the world. He will have to experience the "load of bricks" the universe will drop on his head.
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Thanks all. This is already a family battle. Mom doesn't think there is anything wrong her except that she's old. So, there is no talking her into involuntary admittance. I have talked to her about it, tho. No, I have not talked to anybody about guardianship. Unless funds come out of her money - I cannot afford a lawyer or court costs. My brother has been their durable POA for many years. I have always had too much chaos in my life (sick kid). They chose him. I have done all the research, all the footwork and decided on a place I thought was great. He was ready to let me go ahead and start the paperwork - but he is the only one who can do it from what I was told at the facility. This is a threat - I hope by scaring him and my sister, that they will act before I have to do this.

Her doc would write the order in a heartbeat, but, whether my brother would accept it is different ballgame. If APS got involved it might scare him enough to act. I don't know what will happen, okay? I would hope they would make him see the need for placement, but if her doc couldn't do it, they probably couldn't either. Except for the threat of legal action. That is what I am trying to avoid. I gave her doctor my full diary from October until a couple of weeks ago. He has a letter from a therapist Mom had, and the letter I will give my siblings. I don't want to do this, but I have to do something. The more I bring it up, the more stubborn and nasty they both become. Neither he or my sister did anything about the big ugly skin cancer on her face - I did. I had to guilt him into taking her for the surgery. That is what I'm up against.
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For what it's worth, you have another option. Wait and see. Maybe take a break and go somewhere (even across town - just away) and have the siblings forced to take on care because you are simply not going to be there.

Perhaps your time off is a reason to put mom in a temporary respite program. This is a great way to Try Before You Buy.

It sounds like a communication breakdown between you & brother. Forget about the others for a minute. Do you actually have a list of your brother's specific objections, or is this just assumption from experiences? Maybe his objections need to be addressed one by one and then the obstacles are cleared. Take him on a tour of the place, eat lunch there with mom, let him ask as many questions as he wants.

Only you know his style, but if he is the kind of person who needs time to gather information, then more time to process, think, and will ultimately respond, but not immediately, that's how it's going to have to be. These kinds of thinkers will not be pushed or rushed. I get frustrated as heck with them, but I have to work with them in my job all the time. Sometimes just being quiet and waiting will get a decision faster than demands, threats, and strong words.

I assume you came for advice, and my advice is to have a 10 day cooling off period for everybody where this is absolutely not discussed. You take some time off.

Another option is to get a professional mediator involved. This neutral 3rd party can work wonders in situations like this. They can eliminate the competitive nature of the discussion, get everyone to talk and listen, and come to an agreement. Family Court where I am uses this *a lot* to keep people out of court. It's a far sight less expensive too.
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I think Sandwich has a point to step back and take a "wait and see" approach. But I also think you have a right to step back on your responsibilities as well and focus on your child.

You don't have to provide specific details other than that he needs your attention and you have to cut back on your hours. If brother steps in for more of the heavy outlay of work, he might see things differently.

From my perspective, his physical role is minimal, so he could benefit from an opportunity to get the full picture.
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The POA does NOT decide where a person lives. Keep that in mind.

Naturally the care center wants to be assured that they will be paid. That is probably why they want to make sure the person with the checkbook is on board.

How long will Mom's money last in the center you've selected? When would she need to apply for Medicaid? Does this center take Medicaid? POA has to deal with these kinds of things.

If her doctors think Mom needs 24-hour care and she is not getting that, I see neglect. Does POA brother think bringing in more in-home care would be better than a care center? How long would Mom's money last, doing that.

The neglect has already begun -- it does not sound like the paid help + family help equals what the doctors say she needs. If a neighbor or some other person calls APS, this could get more than a little embarrassing for family.
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jeannegibbs - I have done the homework. The facility is a medicaid facility. Good dementia program. We already have funds in escrow for the elder attorney to begin the medicaid process. Self pay until about 6 months before her money runs out. My brother has every bit of this information - I kept him well informed, plus he toured 3 of the places I had on the list. Neither of my siblings want to hear the truth about the neglect. Not only their not acting for Mom's safety, but her own self neglect. I do what I can, and keep him informed. He won't even increase the amount of time the outside help comes in - I am flabbergasted. Disgusted. I feel like if I leave it all to them, something will get done. But, I am afraid that Mom will be in even more trouble if I stop what I am doing. UGH!! His past history with making good decisions is not a good one. He won't even acknowledge that his youngest daughter is bipolar 2. She's just a behavior problem (at 19). I will give them the letters, but wait a bit to see what happens. That's basically what the letter states. If they do not act in some manner..... I keep my sister informed, but have no contact with her otherwise - she used up her three strikes a couple of years ago. Aren't families grand? NOT!
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Sandwich and Garden - I only go two days a week now. My son has to come first. I have been patient with my brother. I have waited. A year. We go two weeks or better without a word. He was all set to go until I told him I cannot do the paperwork. Because he has to be the bad guy he changed his mind. He doesn't need to gather information - he has seen everything I tell him about. All of the episodes. He is in big time denial of the situation and the level of dementia. Sure, Mom still has some days when she's here , but she is slipping quickly. She falls and doesn't get up without cues and help. She laid on the floor for 6 hours one day because she didn't know how to get up. She wasn't hurt, she just didn't know what to do. Hubby and I had gone over because she didn't answer her phone. She fell and broke her wrist one afternoon - it took her over an hour to call me. She fell and knocked herself unconscious on christmas night at my brother's house(she hit the bathtub). He did not take her to the ER - he took her home! He did not call me - I found out two days later! I have had to call my hubby at work to come and help her up - I can't do it (shoulder surgery). Mom has life alert, but she doesn't know what it's for even tho we go over it all the time. This is my fear. This is what I am dealing with!
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Wow, fedup15, you are between a rock and a hard place! I feel for ya!

Have you considered going to your elder law attorney for advice on what can be done?
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Hey jeannegibbs! I emailed them with a question, but never heard back. I will have to call him or see him in person. I truly can't afford a lawyer. I am still paying off my surgery copays (after 1 1/2 years). Between my son's doc appointments, and hers, I spend a great deal of time in offices. I have to do something -the lawyer is my next step. Hopefully he can give me some ideas with a consultation. I really don't want to get APS involved, but I fear that is going to be the only way to get my siblings to wake up. No one wants to go into a nursing home, but, sometimes needs have to come before wants. Thanks.
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Hey jeannegibbs! I emailed them with a question, but never heard back. I will have to call him or see him in person. I truly can't afford a lawyer. I am still paying off my surgery copays (after 1 1/2 years). Between my son's doc appointments, and hers, I spend a great deal of time in offices. I have to do something -the lawyer is my next step. Hopefully he can give me some ideas with a consultation. I really don't want to get APS involved, but I fear that is going to be the only way to get my siblings to wake up. No one wants to go into a nursing home, but, sometimes needs have to come before wants. Thanks.
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Fed, why are you concerned that you would be in legal trouble if mom falls,etc? Have you called APS and been told that as non poa child, you could be charged with neglect? If that is so, then I would alert APS to her situation so that you are "on record" as being concerned but legally powerless. You've tried your best. Your brother is not going to be convinced by you. He's going to have to be legally compelled, which is sad, because then mom may end up in a placement far away, not the one you've chosen. So, I'm sticking with my original answer, which is to just call them. And please take care of yourself and your son.
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I see!

Call APS. Call them every day if you have to. Do what you must to get mom placed in care. Her health and mind may very well improve once she is in the right environment and not falling.

A POA cannot withhold health care and obstruct the person they are attorney-in-fact for. It's not the same level of control as guardianship, so by doing nothing, he is actually causing her harm. HE ought to be concerned about a knock on his door about this.

Call the police to go do a welfare check on her. They will do that for the elderly. That is another way to get authorities involved. If she is hurt, have her sent by ambulance to the hospital and do not go get her at discharge. The social worker at the hospital will find a place for her.

Call them, call them, call them.
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Well! I took Mom to the surgeon yesterday for her post surgery check - it is good. Anyway, while she was eating(picking at it), I brought up the subject of moving to a home or having greatly increased care. That was an interesting conversation. How quickly she sounded like a petulant little girl. She told me that my brother was having the outside help come 5 days a week for all day!! I was floored! He hasn't set it up yet, but he said he will call them on Monday. I just wonder if the hospital said something to him, or even the surgeon. Mom had to stay overnight after outpatient surgery supposedly because her blood pressure was off the charts. Hmmmm..... He might just be getting tired of my griping about it. Anyway - I'll take this, even tho she should be in 24/7 care. He said we will try this for a while before placing her. UGH!! It's not ideal, but better. So, persistence pays off. I will definitely keep tabs on Mom and keep after him, but he's cracking! LOL!
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Oh - I also think he and my sister talked about the neglect issue - maybe researched it a little. She was going to respond to my text about that very subject and never did. Maybe his wife made him think. We'll see how this plays out. Not much will change, I don't think, but it is a step in the right direction.
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Have you told your brother how he could possibly be held criminally liable if something bad happens AND he could have to pay money damages? If his refusal to get her proper care causes injuries, damages, etc., and a guardian is appointed to her by the state, they could come after him for monetary damages. If he thinks his wallet could be in danger, maybe he will wake up. He sounds like a very dense person. Is he mentally stable? What's wrong with him? He doesn't sound like a proper person to be making decisions for her.
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Sunny, that certainly is a good point.

With regard to your mom sounding like a petulant little girl, due to the damage in her brain, that's exactly where she is, cognitively.
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My blood pressure goes up every time I read about helpless elderly being neglected like this. Like Babalou said, just do it.

Your sibs will be mad at you for a while, but they'll get over it. Or not. If they are like camels, the grudge will last forever. But at least you'll have the peace of mind of knowing you did the right thing.
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Your brother is in deep deep denial. New care hasn't started yet? AND MOM LIVES ALONE? With a working stove, etc.? And her doctor states she is not safe to live alone? I might get in touch with her doctor and report this situation.

So what happens when petulant mom fires the caregiver?
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Oh, I thought of another idea. You may not be able to afford a lawyer to file a court action, but you might see an attorney and retain them for the purpose of writing him a demand letter of sorts. They usually charge a flat fee for this and maybe for a couple of hundred dollars.

The lawyer will know what to say in the letter. Send it certified mail. Maybe, that will get his attention. If he thinks lawyers will get involved and he'll be taken to court, perhaps he'll see a lawyer himself, which is good. They will tell him what danger he and his mom are in. Maybe, he'll listen to them.
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fedup15
Sounds like you have a lot on your plate including you son's health issues. He should be your first priority. It's sad that your POA brother is being selfish in not wanting to get the best care for your mom. You sure have done your share in caring for her and wants what's best. If you don't mind my saying so, the longer the waiting game goes on, the more neglect your mom endures. Something needs to be done as soon as possible to be sure she gets the care she needs. Your brother should be ashamed of himself for causing issues. Sure he doesn't want to sign something to get her into a place where care comes first, but nobody wants to see their loved one in a nursing facility (he's not the only one). Even if he's a POA, that doesn't mean he gets to choose where she should be living. If all he has to do is sign a paper, then he should just do it, never mind worrying that he's the bad guy! Once your mom is situated, it will be better for all of you and will free up the time you need so you can focus on your son; you also won't have to worry that she's not eating, getting the medicine she needs, etc. She will be well cared for and when you go to visit, you'll be more relaxed and enjoy the time together. Hope this helps - remember take a few moments for yourself and get re-charged so you can do the things you need for your family.
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On this board we hear "I don't want to be the bad guy" as an excuse for anything & everything. That one really aggravates me because it's cowardly.

Well darling brother, you already are the bad guy by being so weak, ignorant, selfish, and uncooperative over this.

The GOOD PEOPLE step up, take responsibility, do the work, make the plans, and execute. They get off their rear end, educate themselves on the disease and options, and get it done instead of hiding from it like a scared little child. Be an adult already.
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Your brother thinks she's "fine for now" - so ask him what, exactly, he is waiting for. Ask him to visualise it, and describe the scene in detail. He thinks he'd feel bad about moving her? How clever does he think he'll feel when what he is waiting for actually happens, through his clear neglect of his responsibility. Weak as water. Give him a good slap from me.
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Sunnygirl - Heehee. Yeah, he's mentally stable, just incredibly stubborn and like someone else said - a coward. No, he really isn't the best person to be making decisions for Mom , but, that is who my mom and stepdad chose to be POA many years ago. As an adult he has not made some good choices. He's a very nice man (except to me now). Just doesn't like unpleasantness. But that's just too bad. This is an ongoing battle that I will continue fighting.
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Babalou - I know this is where Mom is at when she gets upset! Boy do I know it. We do have minimal help coming in right now - he wants to just increase the time they are there. He is trying to placate her wishes, but she doesn't think there is anything wrong with her or her living situation. Her doc is fully aware - we have had two family conferences about this. Maybe he can notify the state. If I had had POA, he would have given me the order months ago. This fight will continue, you can bet on it.
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Eddie - My bp is up just thinking about the situation! Heehee. My wonderful, caring siblings are already mad - I do not care one iota. If they never speak to me again- it would not be a loss for me. They are both selfish and not doing everything they could be. This whole situation makes me sick.
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