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I've been POA for my father for almost 4 years and care manage his entire life. This includes taking care of his old house, paying all bills, managing his health care, dealing with issues with his tenants and caregivers (and finding these people/hiring/firing etc) I live in a different state. I have full time work that I can't effectively do. I have developed intense debilitating anxiety and depression dealing with all of this. I've kept him in his house all this time (he's 91 with dementia) but at great cost to myself. He is currently in a temp rehab place and absolutely miserable saying he wants to go home. I need to step down but don't see what other options I have. He has children in another country but they don't help, only tell me what to do. I am going nuts. What do I do...

Sun,

I completely understand!!
I care for my Aunt long distance.

I had to place her in MC and sold her home "as is" to pay for her facility. Her home was in shambles ! I have all her bills on auto pay.

I know your Dad desperately wants to go home, however, at 91 he is only going to decline.
Most likely he's going to need ALF soon.

IMHO, find him a wonderful ALF now. Since he's already out of his home, now would be ideal.
He may actually be happy there. There are lots of activities to keep him busy and lots of folks to talk with.
This would relieve some of the pressure on you!

God bless and (((hugs)))
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Reply to xrayjodib
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As a Power of Attorney (I assume for finances and health) you are uniquely responsible for your father's health, safety, security, and overall well-being.

That does not mean you must do these things to your own physical, financial or emotional detriment.

That does mean being objective and decisive.

In this case, I encourage you not to turn over those decisions, but rather to make them. You know what your father needs for his health, safety, security, and well-being. It is time to take a deep breath, pull together your resources, perhaps take some time off from work, and get those decisions made.

Trust that you were picked for exactly this purpose, and do not look for someone else. It is a hardship, yes, and one you agreed to doing years ago. It is just time to move to a different level of care now.

As someone who has battled thru anxiety, I understand all too well how overwhelming this feels. Making these decisions will be part of your process as well as his. Have a good therapist to keep you on track. You will see the strength build in yourself and you do the work.
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Reply to MAP2013
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James is right. Downsize the problem. Call a realtor. Call a retirement center. Get the ball rolling.

Sell his stuff, property and all. Get him placed.

Visit occasionally.

We ALL have to come to this point, pull up our big girl or boy underwear, and do what needs to be done. It feels impossible but people do it every day because it is time!

Good luck!
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Reply to Salisbury
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Listen to James J. That is the BEST way to get your parent support and it will give you tremendous relief too.
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Reply to Silverbella10
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I have some of your problems. I went to counseling. Got Mom on Medical, trying to find her a place. She does not want to leave my home (moved out of husband and her house 4 months ago). She says she is happy. I am not. My father who is a drunk still lives in it. They have lived their 53 years and still owe money on it. My father might have more dementia than Mom. Not going to help the man who yells and me every time I see him.(while growing up also). Counselor told me still can be a good daughter by putting Mom in a assisted memory place. If I can find one that will only bill Medical. You are not responsible for their bad choices. I have no siblings, so I cannot relate to that problem. But, I will say. You are either part of the solution or part of the problem. If you are part of the problem GET OUT. Do what you think is best. Good luck. Remember to breath.
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Reply to Phyllis2020
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Have a talk with his dr about not being able to manage him from a distance any longer. Hopefully doctor will understand your situation and assist you with moving him to a facility closer to your home and telling him he needs to be closer to family to manage his care. If he hears it from someone other than you, perhaps he would consider a move and sell the house to use towards his care. I would hesitate giving up the POA and managing his financial affairs all together.

It would be much easier to manage his caregivers, if you needed to hire some and arranging for medical visits for him. You could notify tenants the house is going to be sold and they need to vacate. Or continue to use the rent they generate as income for him as income to pay for a memory care or assisted living facility near you. Personally, I'd sell the house so you don't have to deal with tenant complaints and repairs.

The siblings who are out of the country can assist even though they aren't here - they can pay any of his bills online for you. Or, you can have the bills auto drafted and only have to follow up with a bank statement or credit card statement for accuracy. Other than that, I wouldn't discuss any decisions with them. They aren't here and don't do anything now, so you have to make the decisions that are best for you.
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Reply to my2cents
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"He has children in another country but they don't help, only tell me what to do."
Don't have contact with them, at least for now. They're no help, only hindrance. There's no need to take ANY input from them. If you have to, block them on phone, social media, etc., at least until you get this all sorted out. If they're pestering you, this will take one load off while you work out the rest.

I'd hesitate to recommend giving up the POA unless there's absolutely no other alternative. Once you give it up, you can't get it back, since he has dementia.

Start by finding out how long he can stay in the rehab. Sure, he doesn't like it, but who does? He may be limited by Medicare for time or if he's not making progress, they can cut him loose, so he'd have to self-pay. This may cost more than you'd be "saving" from not having the care people at his home, but it's to give you time to get this resolved.

For the house, can you contact the mortgage company and find out how much equity there is? You say it's an older house - would it need a lot of work to fix up for sale? If there's not a lot of equity, why not let them repo? You'd have to warn the tenants that they'll have to find another place to live. IF only his name is on the deed, it won't matter if it hurts his credit rating. Or consider a sell "as is." There is potential, depending on how much he owes, that there might be residual to be paid to close out the account. A little number crunching, but in the long run, what he pays for mtg, re tax and utils, plus the care givers would go a long way to paying for a facility.

Keeping him in rehab or temp in a LTC place that might do monthly will buy you some time to get the tenants to move, the house gone and eliminate all those extra "duties." Would you consider moving him to MC near where you live? It would reduce time managing everything else AND you can watch over him easier if he is local. As for all the warnings about the virus, most elder care facilities were FIRST on the list to get vaccinated. There should be LESS worry having him in a facility now than having random care-givers you have no control over coming and going in his house!

"...but at great cost to myself." I hope you mean physically and emotionally, not that it's good, but hopefully you're not paying to cover his shortfalls too.

You need to consult with EC atty, to get advice about selling or ditching the house, getting the tenants out and whether your father would qualify for Medicaid or perhaps VA benefits. Many offer a limited free consult. Make a list of all these issues to make the most of that free consult. Have the atty give an estimate for taking care of all that you need help with (should be dad's dime.) If possible, find other EC attys who offer the free consult and take notes at each one. Go with the one who gives the best advice and plans.

If you can get him into MC, either where he is now or near you and get rid of all the rest, managing as POA isn't nearly as difficult. It would be easier if he moved to your area. I know how you feel. I managed all mom's finances, medical and dental care, and had to go often to replenish food/supplies for several years. No real help from brothers, even though one is local (the other is several states away.) I made sure the move was to a place near where I live, as I knew this would all fall on me. Even after the move, all her needs were mine to oversee, but it was so much better after the condo was done and sold! The only differences were I was laid off about the time she needed me to step in, so that wasn't a concern for me, and there were no tenants. We considered renting her place, but being overwhelmed with everything else, I decided I was NOT going to become a landlord! The cost of hiring rental manager would likely take any income and I'd have to worry about damages, repairs, etc. So, once it was ready, SELL IT!!! I retired early. Though it was a financial hardship for me, it was better than juggle all and work.
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Reply to disgustedtoo
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Imho, seek out the assistance of an elder law attorney. This dynamic must be amended now.
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Reply to Llamalover47
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My parents could not physically care for one of my grandparents.

They hired 3 CNAs to cover 24-hour care. One was appointed manager and was responsible for managing schedules, groceries, doctors appts., and any problems. The 3 generally worked their same 8 hour shift each day. When they needed to switch, they switched with each other and maintained the same number of hours. There were a few personnel changes, but this worked fairly harmoniously for 8 years. It wasn’t perfect, but it was really great.

The one who served as a manager used this to build her resume and earned a slightly higher wage. She loved the added responsibility.

Grandma was happy, clean and in her home. They loved her and she loved them. The three CNAs became close friends and appreciated this arrangement.

You can set up auto bill pay or hire your bank to pay bills. Hire a payroll company to pay any workers.

Everything will be okay.

I am one of those people who believes in at-home care, which has worked in my family for multiple generations. It doesn’t work for every family. You need to manage what works for you and your dad.

Dont take orders from anyone who is not there helping… And tell them just that.
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Reply to ACaringDaughter
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Executor of Estate our lawyer just recently did that for me as mom passed from covid19 last year really suddenly. But Dad was her POA and I'm Dad's POA. It's a lot of money for these attorneys. They will charge you to walk their happy fat butts over to the Fax machine and pick it up and read it. If you call them and play phone tag with them they will charge you for it. If you speak with them on the phone they will keep you on the phone for at least 15 minutes so that they get their hourly rate. If you see them in the grocery store and you say hello nice day isn't it they'll tell you to call the office. I've spent over $15,000 and I've yet to handle my father's property. He's still alive. FYI pres Biden has FEMA program where funeral costs for covid19 will be reimbursed probably need receipts and death certificate that specifically covid19 was one of the causes. Good luck
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Reply to Deborahlyn
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First and foremost DO NOT feel guilty, you are in a hard place with to much to do. You say he still owes on his home and he doesn't own the rentals - was he the manager of the rentals? If he doesn't own the rentals and manages them - advise the owners he no longer is capable of doing the job and they will need to find another manager within 60 days or whatever the contract provides. I realize this will kill his income but he is no longer managing it, you are. You may need legal advise on this step.

You do need an attorney, whether it is an elder law or medicaid attorney they can help you get him ready for medicaid, but I hate to add to your load, but you will have a lot of paperwork to gather. I worked many hours a week getting the documentation of my parents to get my father on medicaid as his life was winding down. In Missouri, they did not require 5 years of bank records, but they can go back that far.

If you remain as POA the next few months won't be easy, losing the rental properties, getting him on medicaid, finding him a new place that takes medicaid, selling his house and other assets. If there is no way for you to do this, then unless other family members take on the burden, the state will have to take over for you. Before you do give up, check with the social worker where he currently is and see what resources are available to you. Find an attorney in the area familiar with applicable laws to give you solid direction.

If you can hang on for 2 or 3 months disposing of his business, home, get him on medicaid, and get him placed in an appropriate facility, being a POA will be simplified for you. Please realize few elders wish to leave their home, but there comes a time for a lot of them, where there is no choice.

As for his other children in another country or not - if they are not helping, they get no say UNLESS they plan to take over for you. DO NOT let them guilt you. There is NOTHING to feel guilty about, you can only do your best and when your best is not enough then it's time to find new solutions. I know when my father was in his final months of life I made decisions that I hoped to God were the right ones. Mom, dad and I were presented with the information and did make a group decision, but I was the person in charge of Dad's finances and medical decisions. Decisions can be heart wrenching, but you go with what you believe is in the best interest of your LO. In your case, you must also make the decision that is best for your father and yourself. Taking on this much will take a toll on anyone.

May you find peace in whatever decision you make.
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Reply to cweissp
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You are having a very difficult time handling your duties for a man with dementia. You obviously have responsibilities of your own. The worries and anxiety are harming you and your way of life and this is just wrong. No one wants to be away from their familiar homes but sometimes physical and mental issues make that extremely difficult or impossible. Leave him where he is cared in a facility - and if not this one, consider finding a different one. It is a fact that no one is going to step in and help you so having him in a facility makes the most sense. If you don't want to be a POA, speak with a social worker or an eldercare attorney. Perhaps someone can be appointed as a guardianship. I don't believe there is any law that says you MUST continue this job if i is causing you serious problems. You are not in jail. I just don't know all the ways this can be done so please seek out professional help and get away from that which is harming you.
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Reply to Riley2166
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Is there a secondary agent listed on his POA? If so, they could take over. If not, is he able to appoint a new POA? If so, have him do that; if not, you are looking at hiring an attorney (elder law) and getting a guardian/conservator appointed by the court.
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Reply to cjwilson
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disgustedtoo Apr 7, 2021
"...you are looking at hiring an attorney (elder law) and getting a guardian/conservator appointed by the court."

Question - why? OP has POA. I do know that POA doesn't allow you to force someone to move or give up their homes, but with dementia, we can work around some of these issues.

We had POAs, wills, etc all done. When it wasn't safe for mom to remain in her place and she refused to move elsewhere, the EC atty told me we couldn't force her to move and suggested guardianship. I highly doubt she would have been approved at that time. She was still able to do ADLs and could seem very normal, but it wasn't safe for her to remain in her place alone (she refused to let aides in.) We managed to make the move happen without taking her kicking and screaming to the facility AND without guardianship. The facility staff had told me 1) they don't accept committals and 2) just get her here, we'll take it from there. So, we were able to move mom WITHOUT guardianship. That is expensive and time consuming, even after it is approved.

I don't understand why you say OP needs to do this. If at all possible, I'd see about keeping him in the rehab, even if it means self-pay, until a place in a MC facility can be secured and then move him directly into that. POA WILL allow one to sell the home too - no need to involve the courts.
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No advice. Sharing tears and hugs.
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Reply to Jean1808
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I want to echo what TouchMatters said: TAKE CARE OF THIS NOW. He gave you power of attorney for a reason: so that you can make decisions, tough decisions, that have to be made (which is why IT IS SO IMPORTANT TO HAVE P OF A IN PLACE BEFORE IT IS NEEDED!)

Tell him he must go to assisted living and sell his assets to pay for it. and do not feel guilty; everyone facing this must make these hard decisions; it is part of life.

That said, if you just feel you can't anymore, go to court and get a court appointed guardian; they will make the tough decisions for you; they deal with this all the time. Caveat: once you have done this, stay out of it and let them do their jobs! `
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Reply to mshog44
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Did you contact an attorney? If he has tenants, he may be able to have a legal guardian take over if his children won't. You may need an attorney to contact his children if you do not. I certainly understand. Taking on these responsibilities is huge. Often we do not know what we are getting into until we are smack in it and then wait and wait and wait until our own health is seriously affected.

YOU NEED TO MAKE OTHER ARRANGEMENTS NOW.
For your own well-being and health.

Yes, he will continue to say he wants to go / come home. Expect this. Do not allow yourself to feel guilty - you'd want to go home too. However, there comes a time when changes need to be made. And that time is NOW. He will adjust to 'what is' as best he can. As you have adjusted. We do what we do for as long as we can do it.

And if his children and he do not thank you, I am thanking you for the four years you've been doing this. It is a huge service. I know, I'm in a similar situation. gg
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Reply to TouchMatters
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Take a vacation!!!! If I was you I would leave him in the nursing home . All dementia patients want to go home. They don't know where they are but do know things are not familiar. I have been in rehab, nursing home and assisted living. And most of the patients want to go home and many that isn't realistic. He wi get used to the place and be will complain and still want to go home. This kid all part of his illness.
Bow you do all you do from another state and still work full-time is beyond me since your siblings are not helping you have the POA SO SE THE OLD HOUSE AS IS. Sell all you can and use the money to take care of your father you can take his favorite chair,his tv, pictures or art work . Make his room as much like his home this will help his anxiety and feel he is at home. Good luck to you. Take care of yourself. Keep the POA .
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Reply to Sharon45caregiv
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If he will not accept placement you likely need to resign or hire a financial fiduciary or allow state guardianship. Time to discuss with family. This may be able to be done from outside the country, or he may need to be moved or have placement. Start with discussing with his children out of the country. Tell them you cannot go on and that State guardianship with appointment of Fiduciary to manage and place will be next if they don't wish to participate.
All of this assuming he will not move near you and be placed in assisted living with the sale of assets there where he is now.
So you will start with speaking with Dad and other relatives that you will be resigning you POA, or hiring a Fiduciary if assets allow. As POA you can do this.
The cost in California for a Fiduciary runs about 90.00 an hour more or less two years ago. Costs more while setting up the system, less once set up dependent on the amount of personal care the person requires.
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Reply to AlvaDeer
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The rehab place has a social worker. That is the person you need to be talking to. Laws vary in each state. DO IT NOW!

It sounds like he's got money, so there is no reason why you cannot use his money to pay for an eldercare attorney to sort things out, including a court appointed legal guardian.

If he has dementia you are not doing him any favors letting him live by himself. One day he will wander off and get injured or killed. My sister-in-law let her mom live by herself, and I have been warning her for years to not allow that. She refused to listen. Her excuse is that her mom did not want to go to assisted living, and totally with it. She was in her 90's. She fell, broke her hip, and was on the ground for DAYS before someone found out. She ended up dying from the complications of being in the hospital from a hospital-acquired infection.
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Reply to cetude
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My heart goes out to you, you have been amazing managing your Dad from afar for so long. Of course he wants to come home, who wouldn't? However, with dementia it's obvious he should have 24 hour supervision. It's time to make a change.
Talk to the Social worker. Do not have him released home, the hospital cannot release him if he doesn't have someone to care for him - but if you do - it will just be a matter of time before he has another hospital event. If you can hire a Geriatric Care Mgr this will take some of the load off of you in regard to coordinating his health care.
Another option would be to take him in with you until you can find a nice facility near you that can give him the care and safety he needs. You say he is running out of money and still owes on his house. Please contact a well regarded elder care lawyer who can help you navigate real options for your specific situation, rather than just getting family opinions. This is probably the most important thing for you to do without further delay. Keep us posted on your decision and progress, we really do care!
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Reply to NYCmama
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Dear sunbrooke- you have some excellent answers here. Mepowers really sound like like they know and have researched this issue. Prayers and virtual hugs
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Reply to JoyfulOne
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If your health or your livehood is affected you must step down -- Contact Elder Services - tell them you are no longer capable of taking care of your father. Give them the names and telephone number of your sibling. Tell them by expressed signed notification that you are stepping down effective "x" date and that one of them need to step forward otherwise, The state will appoint a legal guardian.
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Reply to MsRandall
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I was tested and wound up being autistic +dd a few yrs ago which answered a few questions.My wife who is several yrs younger is like a care giver not poa have also became incontinent which adds something else.
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Reply to sport1317
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Whi ok e your health is important and taking care of someone with dementia is a very daunting experience. The one thing I do know is if you step down and no other family member is willing to take charge, he will become the ward of someone that has no vested interest and possibly a ward of the state. While the decision of putting him in a care facility that deals with people who are diagnosed with dementia may be a decision that is hard to make and you probably will get backlash from your dad and other family members it will drastically reduce your tasks for his care. He will be fed, bathed. clothes washed and a whole lot more. There are doctors right there and while I do suggest you take a FMLA to check places out near where he lives. The home will call you if there is a problem. Many will allow auto withdrawal for the rent, reducing much stress. I had to make that choice for my dad, as he had dementia and to be honest it was the best thing I ever did. It is about providing the best possible care for your father meanwhile preserving your own health. The perception of what a home for the aged is now to what the elder preceive is quite different. Your dad will most likely continue to want to go home, but the staff is trained how to deal with this situation.
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Reply to thingsarecrazy8
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Most people with dementia do not like change. They tend to thrive on a consistent routine. So living at home has been the one thing consistent in his life. However, it appears that trying to provide this consistency at home is coming at great personal cost to yourself. So, it is time for a change - and he will not like this change until it becomes his new routine.

Talk to the social worker at the rehab facility. Let them know that you care not able to continue managing your father's care as you are currently doing. You have choices

1 - It may be time for your father to enter a memory care unit. Then, you could sell his place (you'll have to do it after he passes) and put the money into an account to cover his expenses.

2 - Ask for the courts to appoint a legal guardian. This person will do the job you did as POA. This person may or may not be able to keep your father in his home. Most likely he will be placed into a memory care unit, his home will be sold along with all assets, and his assets will be placed into an account for his care. Not sure what will happen to any assets after he passes. You might wish to talk to a lawyer before going this route.
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Reply to Taarna
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KaleyBug Apr 6, 2021
If she has a POA she can sell the house if he is in memory care.
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What do you mean they "tell you what to do"?
Do they instruct you on each of the aspects then you carry out the wishes of his other children?
Tell them that you are no longer going to be POA. Is the Attorney that drew up the papers still a family lawyer? If so send them a certified letter that effective (and give a date) you will no longer act as POA. Make sure the date is enough in advance so that the others can be informed and another POA chosen.
You can tell them that this is your plan so that they can begin the process of choosing another.
You do know you will be "roped" into doing all the same stuff you are doing now just because you are here and they are not in the country.

Your other option would be to discuss with the Social Worker where he is now the fact that you can not effectively care for him, manage caregivers and care for his house so it would be best to find permanent placement in Memory Care.
Then you can begin the process of selling property that will pay for his care.

I do hope you have been getting paid to do all that you have done. Geriatric Care Managers get paid quite well. (range is $50.00 to 200.00 per hour.)
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Reply to Grandma1954
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Taking care of someone with dementia is overwhelming and depressing at times.  The key is while making good decisions for him, you have to make it manageable for you.  The fact that he is not currently in his home is the perfect time for you to find a facility for him to go to permanently.  If you let him go back home, it will be twice as hard to get him back out.  If you get him into a memory care facility and sell his house, you will have much less to manage.  At my mothers place, the doctor comes to her, the podiatrist comes to her, the meds are administered there, ect….everything is streamlined so that I am not managing the logistics of all of that.  Sell his things and move him to a great facility where they can provide the care he needs 24/7.  Then you are paying one or two bills and filing his taxes for him.  Much less stress.
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Reply to Jamesj
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You have 5 choices.

Keep doing it.

Step down and not do it any more.

Hire someone to handle it for you.

Let someone take his home over to use as a Care place that includes him living there.

Bring him to live with you.
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Reply to bevthegreat
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Jean1808 Apr 6, 2021
Question . how can someone take over a seniors residence to use as a care place with them in it? I am wanting to find my mom a new roommate (I move out) who would pay rent and watch over mom.
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If it were me, I would be telling the social worker at the rehab that discharge to home is no longer an option. It has been my experience that the job of the social worker at rehabs (depending upon the state) is to effectively discharge the patient. And if you are POA they will lean on you, so you need to be firm about it being unsafe for him to go home and that you live out of state, and that you can’t care for him at home because you work. I would be consolidating all his assets for a spend down. Your goal might be getting him into a facility where you pay one bill a month, the facility coordinates all the care, until he runs out of money, and then apply for Medicaid. If you can find a decent elder care attorney for advice I would consult with one about your various options, including selling his home. I don’t know what resigning a POA, entails but believe me I have wanted to resign my POA many many times. If you do resign and no one steps up, he will be assigned a state guardian that will manage his affairs. But if you had things under control, you wouldn’t feel this great of a burden, And use your fathers money for the attorney. Do not make the mistake of using your own money to supplement his care or bills. The lawyer can advise you on what expenses for which you can reimburse yourself.

You cannot go on trying to figure out how to make what he wants happen. It will kill you! Your health and personal life will suffer, if it’s not already. You need a different plan and you need to tell your father his plan is not feasible. At 91 and with dementia, your father has no business owing a ton of money on a home that he cannot manage or seem to pay for, on his own. It is not easy. He will be angry with you. But his situation is not going to get better. Having POA means YOU make the decisions- you are in charge - you are not following your fathers impractical plan. I would also advise counseling. I had to go to counseling (via Zoom) and start medication for the anxiety and depression brought on by stepping in to care for my mother. It really helped. Good luck!
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Reply to Mepowers
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I urge you to see a Medicaid Attorney (not and Elder Law Attorney) right away. The Medicaid Attorney will help you understand how to navigate the upcoming decisions you will have to make. But you need to make these decisions and not feel guilty about them because they won't be easy. But once you see the situation for what it is legally and financially, you can start to breathe again. Also, please see a counselor to help you with anxiety and depression. Elder care is too much for one person, and it's a long, sometimes rocky, road. But knowing options and having a plan is the best solution for you. My best to you.
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Reply to ArtMom58
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Caregiver1955 Apr 6, 2021
Agree with talking to Attorney. Try to get one with a good rating. There is a lot of paperwork including 5 years of banking records. If he was a veteran there are also benefits to help pay for care. I had the same situation with my mother over a year ago. Ended up moving her to a AL with memory care near us, after being in the hospital for dehydration. Moved her directly to AL from rehab, rather than 4 hours away. The AL has skilled nursing if need and has some Medicaid beds with about a 4 month wait. The attorney commended 3 facilities. I knew he was good when we visited the places, they knew the attorney and had no issues that mom would be accepted in Medicaid when needed. We sold house since it was out of state using POA, all went fine. That will give us a couple of years in the AL. She still thinks she is going home when doctors say she is OK. We tell her the house is fine and everything is being maintained. When I looked at the cost of caregivers and maintaining the house it was more than the cost of the AL. Lot of stress off me and we can see her every week. Some AL take a Medicaid waiver, it may very by state and can have a longer waiting list than regular Medicaid. Found a useful book "How to protect your family's assets from devastating nursing home costs by K. Gabriel Heiser with an Indiana verson. I liked the case studies near the end of the book and the VA benefit requirements. Found an attorney from my financial advisor who gave me a good list of items needed for Medicaid application.
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