I have POA for my aunt who has Alzheimer's. Do I need guardianship to place her in Long Term Care?


We think she may fight being placed.

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This issue is what brought me onto this site - mom was convinced that she was "independent, can cook, can take care of herself" and was adamant that she was NOT moving anywhere - not to AL, not with one of us. She's fine...NOT.

We checked out some places and settled on one. We brought her there, nice free lunch, toured the various options and although she ooohed and aaaahed over it (mostly the AL apartments, not the MC) and the people "escorting" us thought it would be a snap to give a little push and she'd agree.. obviously they are NOT the MC trained people. Shortly after the drive home started, she was already forgetting why we were there. By the time I got her home, she said "Thanks. That was nice, but too much, I won't go next time." So clearly she had no idea what/where this was about. The next day she told one brother on the phone that we were looking at houses for the other brother, and it was too much for her to do...

The dilemma we ran into was our attorney who set up the trust/poa, etc said we cannot 'drag her out of her house', however the facility said they would not do 'committals' - so where does that leave us? Guardianship is what they considered committals. I can understand to a point why they say no, because some 'committals' are for serious mental issues. However she was still in early-mid level dementia, not a mental case. We know we cannot leave her alone in her home, but she will not agree to go. After a few months, she refused to let the aides in (we hired them to check on her only 1 hour/day at that time - hoping to allow her to remain in her home for a bit longer.)

Brothers were scheduled New Year's weekend to prep moving her. She managed to injure her leg (does not recall how, and did not inform us or seek treatment. The neighbor called to tell me just the day before one brother was scheduled to arrive.) She developed cellulitis (serious infection) and had to go to the ER to get treated/meds. One brother concocted a letter from the "elder" services at the hospital saying either she moves to the place we selected or they will move her to where they deem best. She was madder than a wet hen! After reading it multiple times, she finally relented, although not happily.

I had suggested he mess with the thermostat (he installed a wi-fi enabled one) and tell her we need to move her to get the heating system fixed (it was mid-winter!) In the end the system really was on its last legs and was just recently replaced. Some kind of ruse - roofing, painting, something that needs doing that requires she temporarily move, UNLESS you can get her to agree to having hired help come in. That depends on her level of competence - if she is early to mid stage, and will allow help, that might work. Without knowing what her needs and lack of abilities are it is difficult to make suggestions. Getting a doctor to determine via letter that she is no longer competent is a lot less expensive and often enough to "activate" your DPOA powers.

I do suggest you inquire at any facility you are considering whether they will accept a "committal" via guardianship. No sense in going through HUGE expense for nothing. As others noted, not only would there be court and attorney costs to proceed this way, if she contests it then the courts will ensure she has an attorney to protect her. Once done, if the court agrees, if you are assigned as the guardian/steward you have to provide regular reports on how her assets are used. Do you really want all that hassle?
Helpful Answer (1)

Virtually all elders fight being placed.
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Where do you & aunt live - that can change how things are done - more info please
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I had no problem using my POA. Just make sure u use POA after ur name when u sign for her.
Helpful Answer (3)

Try to avoid guardianship at all costs. Does your aunt deserve to be a "ward" of the state? Do you really want the courts involved in your life? If you have a durable power of attorney you have the ability to work with her, her MD and perhaps a social worker to get her in the environment that is best for HER. Attorneys frequently recommend guardianship but least restrictive measures for the elder should be considered first.
Helpful Answer (4)

Does the healthcare POA/proxy allow you to make decisions as to placement? If so, does it have any conditions as to when you can arrange placement? How far along is she in her dementia status - is she potentially in imminent danger? Or is she still relatively self-sufficient?

As to guardianship, yes, it may provide the necessary authority, especially if your POA does not. But your aunt will be allowed to participate, and most states require an attorney or guardian ad litem to be assigned to your aunt to assess her cognitive abilities and determine her wishes, etc. to determine if guardianship is in her best interest and to establish the needed powers for the guardian.

Sorry that I tossed back a lot of questions, but a lot of an answer is a "it depends". POAs may provide such authority - check the terms of your document. As a legal professional, it's almost a standard thing for me to recommend talking with an elder law attorney because inevitably, it's a lot of moving parts and a lot of "it depends". An attorney could certainly listen to the situation, review your documents, determine if applying for Medicaid or the like may be necessary or explain spend-down requirements and advise as to a guardianship/conservatorship.

Best wishes and best of luck.
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