My client has very advanced dementia and periodic manic behaviors. Once, the other companion care provider found her having kicked a hole in her bedroom wall and was stabbing the wall around it with scissors. She found that the lady had gone through the house and cut the cords to all chargers and clocks with scissors when they were still plugged in! She has violent tendencies, and we replace the remote controls for her TV sometimes 3 times a week because she destroys them. She has literally busted 3 computer screens (she used it to play solitaire) because she lost at solitaire and threw a stapler or whatever else was nearby into the screen and shattered it. She did the same thing to a brand new 60 inch TV by throwing a remote at it.

She has resources and assets, but refuses to even visit care facilities. She also threatens to kill others and herself frequently when she's having one of her manic meltdowns. I do nothing but pay her bills and handle her legal affairs but she always makes up in her head that I'm stealing from her. I have been doing this for free, but frankly, the time consumed away from my work in my businesses is making that impossible, so I will have to start paying myself for the hours lost in my work. I'm thinking of a figure something like $36,000 per year, simply because I spend so many hours at her house or on the phone with her solving problems she's made up in her head. She routinely tries to close her bank accounts, and until I got the bank folks on board, they would let her, destroying the hours and hours of work it took to set up her bill pay accounts online. She hates everything on the computer, so if she finds out I have online access to anything (which is basically the only way I can find out how much she owes on the accounts I pay the bills for), she will figure out how to call and restrict this access. Even though my POA is on record with all her vendors, they will usually respect her wishes leaving me dead in the water. Most recently she opened a new bank account at a different bank than she banks with, just to take advantage of a higher interest rate but as soon as she got the welcome letter in the mail, went to a strange branch and filed a fraud claim accusing me of having set up an account without her knowledge or authorization (which I technically COULD do, but have never). Once the branch where she set up the account and funded it told the fraud department that she had set up the account herself, they resolved, it, but some idiot in the fraud department called her to tell her the issue was resolved, and she again told them she hadn't set up an account at their bank and reopened it. I've spent some 40 hours so far trying to work with them to recover her funds from a suspense account!'

So, my question is this: How much would be a fair amount to charge her for the hours I spend dealing with problems she causes due to her illness (and a mean streak she had well before dementia set in), and how can I effect getting paid when she won't remember she allowed me to do this?

Thanks for any ideas. I'm about at the end of my rope. She's threatened to kill me over "stealing her money" which I clearly haven't done and can document, and threatened to kill her attorney because he won't let her cancel her POA. But my business, my income and my family is suffering as a result of the time I spend, and I can no longer afford to help for free. She has no living family members, and has run all the rest of her friends off by accusing them of various issues they also haven't done. She has alienated herself from her neighbors by calling the police and sherriff on them for things that aren't a problem, such that I believe if she fell in her yard and was dying, none of them would even bother to pick up the phone to call an ambulance. Any time we bring up looking into facilities, she has a meltdown and does even crazier things. How do I get help to put her someplace to protect her from herself?

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You cannot pay yourself unless the POA document specifies that you can. A person with very advanced dementia cannot enter into a legal contract so if the POA document doesn’t specify a salary, you cannot pay yourself. What you need to do is get her in to a facility. She’s not mentally competent so how is that she got out of a facility? Did you take her out? Get her back in and then walk away & let her become a ward of the state. She needs More help than you can provide and no one should be doing this for free.
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Being her HC POA requires you to get her help, it places the responsibility of getting her the care she obviously desperately needs right on your shoulders. You can contact the sheriff and tell them that she is a danger to herself and others. Have her committed but don't say anything to her. Put everything you know and have every caregiver put everything they know in writing and provide that to the psychiatric hospital.

You may be out the hours you have already worked, she is obviously not able to enter into a contract with you and you can't just decide to pay yourself, that is illegal.

Do what is right for this poor woman and get her the medical help she needs. Put it in writing that she is alone and has no one to help her at home.

By the way talking to her about it before hand would be very wrong, she can't process information properly and doesn't realize she needs help. Contact the authorities and let them do their jobs.

I think you should resign as her health care POA, you obviously don't have the ability to cope with it. No offense intended, it requires abilities that not all of us have.
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If she has family they should be contacted and someone made her Guardian.
If she has no family the court will appoint one.
I think a call to an Elder Care Attorney is in order. It is possible that if there is no family you could obtain Guardianship you would have to ask the attorney what you could charge for that. The court has maximum fees that can be charged by lawyers and I am sure there are fees set for Guardians as well. This is not a job to take on lightly.
And personal opinion she should not be left alone and you would not be able to do this yourself 24/7/365 so other caregivers will have to be hired. You might want to look into the expense of that VS a Memory Care facility.
Yes she says she does not want to go but she is past making competent, informed decisions for herself.
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Isthisrealyreal May 2019
I am sorry, but this person should not be her guardian, to allow this situation to continue when someone is obviously in need of medical care shows that she is not qualified to be in charge.
You need to get this woman help. Call APS. You aren't being fair to her to let this continue. She needs a guardian. You need to revolk ur POA. The court will put someone in charge of her money. You are playing with fire here. She cannot be on her own. She is a threat to herself and you.
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NeedHelpWithMom May 2019

I read this post again and this woman needs immediate help. As far as OP is concerned, this could be considered elder abuse. I don’t care if POA was granted to them or not. Who allows someone to stay in a house when they know live wires are trying to be cut? That’s just crazy!
She has to set up a written payment plan. You can consult an elder attorney and pay under her funds. I hope you are already on her checking otherwise you have to go through legal channels but once completed you can get reimbursed for a couple thou.
IF you can get her doctor to sign competence paperwork then you can get her in memory care. Some people posted that they bring the person in for a luncheon at the place then just leave. You can be proactive there by doing the groundwork and asking the marketing director creative means. Bring your paperwork with you.
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My God, how did you get to be her POA?

I wouldn’t want to do it. Why in God’s name is she alone when she is trying to cut live wires. She cannot be alone. Surely you must realize that in order for her to be safe she needs 24/7 365 protection in a facility that is geared for a person in her condition.

Why are you doing this for free? Why are you interested in money for a salary when you have stated that she shouldn’t be alone and won’t go to a facility?

Report this matter to the proper state authorities so she can get help.

I am not a doctor so I don’t know if meds could help her or not but she needs to be evaluated to see what can be done to help her.

I don’t care what her personality is like if you have POA then you should take that seriously by protecting her welfare. Best of luck to you and your client. Clearly, she is delusional and needs help.
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