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I will try to be brief. Our 86yr old neighbor is by himself, never married, no children. He has mild dementia. Most days he is lucid and fine, others he forgets everything short term. He has made it clear to us many times he does not want to leave his house even when we have spoken about alternatives. This past weekend one of his out of state nephews visited. I should mention that these nephews only come in once per 3-5yrs; for about a day or two.


We are his lifeline. We have known him for 30 yrs. He trusts us. We visit with him every evening. I have students from my university visit with him a few nights/week. We have him going to bible study and a senior center so he can get socialization. He made my wife durable POA back in 2015. The nephews do not know this. He also stated years ago they are only after his house and property upon his death. He changed his will years ago and also made my wife executrix. Should we tell these vultures that she is POA?


As POA you must act in the best interest of the individual you are looking out for correct? Does this POA give her any say over the nephews intent? As long as he is able to make decisions for himself, then its totally his option as what to do, POA or not. Our lawyer told us the law protects individuals who want to remain in their house even if they have mild dementia. Unfortunately, it sometimes comes down to an accident and they are forced into an other living arrangement.


My fear is if we tell them she is POA, they will make him change it and not act in his best interest.

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If as you said his family was never close why would you expect the nephews to visit more often or even have him move in with them.
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My wife spoke with one of the nephews who recently visited. She said the conversation was good and lasted about 45min. He asked relevant questions regarding his health and long-term plan. My wife was clear with him, that his uncle approached us for help and we did what we would have done with our own family member. We have no hidden agendas. He never felt there was any ill intent. No discussion of the POA was necessary.
In fact, he told us that he mentioned to his uncle he should sell his house 20yrs ago and move into something smaller or an apartment. He recommended we purchase it. This tells me this person has no personal interest in his house or property. It gives me a piece of mind that we can work together.
I can't say the same for the other nephew until I speak to him.

Thank you for all the recommendations.
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Kunkledude, if I may be so bold, might I suggest that your wife not share your plans until she's gotten responses from the nephews on what they will do?   If they know you'll take care of their father, it may allow them to feel he's being cared for now and will be in the future and they have no need to step up.

"Feel them out" first and find out what they'll do or not do before being frank about your own efforts.
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kunkledude Oct 2019
Good advice, thanks.
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So to answer some questions and clarify.
There are 3 nephews and a niece. We have only ever heard from 2 nephews. The other two relatives are in jail or druggies. The two that do contact him are out of state and do not ask about daily regiment or his daily status. No questions about medication health issues, etc.

I agree with most of the replies here that they care about his overall health. But, if they really did they would be in more, or perhaps even have him live with them or visit or one of their children contact their great uncle. In fact, our neighbor has never even met his great nephews and nieces, does not know their names. In my family we know each other’s lives intimately jobs, spouses and such. He himself said, his family was never close.

For the last 20yrs I can count on one hand the times his 2 nephews have been in. And they have not come in when we needed them. Examples: cataracts surgery, pacemaker surgery, a fall 10 yrs ago where he broke his shoulder and was hospitalized and sent to a rehab facility. We called them with updates. None of them came in. We were there to put his drops in his eyes twice a day, visit him in the hospital and rehab.

Tomorrow my wife has a scheduled phone call with the nephew who was recently in. She will be open and honest and hopefully discuss the long-term plan for our neighbor with input from all.
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Have you spoken to the nephews directly, or are you getting the whole story from the uncle? I think you need to have a conversation with them face to face and without confrontation. Then you can determine their motivations for yourself.
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Just because he says his nephews are after his money does not make it true. My grandmother told my boyfriend that I just wanted her money after she died. Seriously....my 'inheritance' was a set of butt-ugly dishes from her. There was no money. I was not expecting any money. What little that was left went to her two sons. She was of sound mind yet that is what she thought.

Worriedincali is right. This is only going to get worse. This man has relied on you for 30 years. Are you prepared to do hands on care giving when the time comes?
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You have covered all the bases with medical and legal. You and your wife have been wonderful human beings to make your neighbors life as fulfilling as you have.

If the nephew makes his uncle anxious he may have to keep his distance. Regardless of what the uncle believes, the nephew may be trying to reach out to connect to family and sees his uncle as vulnerable not knowing the relationship you and your wife have with him.

Try an oximeter to see if it will help neighbor calm down. Sometimes the right numbers appearing on his fingertip can be calming.

If you haven’t already, check our “Being Mortal: Medicine and What Matters in the End” by Atul Gawande. Someone had recommend his TED talk which is also good but it is not about aging like “Being Mortal” is.
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kunkledude Oct 2019
Thank you.
I had that book loaned out from the library but never finished it.

I should mention that my mother is 87yrs old and while her mind is perfect (uses Facebook, bitmoji, etc) it's her body that's failing her. Just the opposite of my neighbor. I have spoken to her about alternative living since she is on her on in her house and she changes the topic as quick as a cheetah. I check on her daily.
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Is your wife prepared to become his full time caregiver? Can he afford full time help? What your wife thinks and what she wants for him is irrelevant. The only thing that matters is what’s best for him. Unfortunately a lot of elders want to insist on staying in their own homes but very few have the financial resources to pay for that. Instead they enslave their family members. They don’t understand that the only reason they are still in their own home is because everyone else is sacrificing their own lives & physical/mental wellbeing. What is your wife’s plan then? Is she going to become a hands on caregiver? Because clearly he needs help. His dementia is going to progress. I guess I question whether or not your wife knows what she’s gotten herself in to here.
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Elders are often convinced that they will go downhill in a facility. My mother thought so. She was wrong. We KNEW she was wrong.

She thrived. She made new friends, ate better, got better, more consistent medical and psychiatric care.

In short, I think your wife is wrong
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Yes, the nephews should be made aware of the POA. Your wife's responsibility is to carry out ur friends wishes. The only way the nephews could override the POA is to get guardianship. They have no legal right to put this man anywhere. Your wife has it.

I would not tell them about the Will. At this point, its really none of their business. Wills are a private thing.
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Perhaps you can still be involved but work toward an acceptable solution, by locating care for him at home, but also researching acceptable facilities for long term consideration.  You're already providing good camaraderie and social interaction.

My father and I went through this, and I'm now surprised to learn that one of my younger relatives thinks I should consider moving to a(n expensive, well beyond my budget) retirement community.   It's clear to me that although the intent is good, the total lack of understanding of my level of independence, and more importantly, financial situation, is lacking from this suggestion.

And I'm a firm believer in staying in one's home as long as possible, utilizing services and making modifications as necessary.

I definitely wouldn't raise with the nephews the issue of your wife's proxy authority.   Anyone who only visits every few years doesn't need to know this.   I am assuming though that other than recommend facility placement they've shown no effort to become more involved?  They don't ask about transportation, meals, etc.?

Since your wife has experience  in caregiving, she could create a plan for as many aspects of his care as possible - camaraderie, meals (such as Meals on Wheels), life alert pendant, lock box with key for first responders, etc.).  

These are preventive and emergency practices, but not ones that would measurably change his life through aggressive intervention.

Emergencies are going to happen; it's almost a fact of life as aging occurs, but you can plan for them to ease the anxiety and confusion when they do happen.

It wouldn't hurt to discuss your plans with your attorney, or his, if he has one, just to keep things above board and avoid the appearance or allegations of interference and self interest, although the nephews may raise that anyway.
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kunkledude Oct 2019
This is very good advice. Thanks.
We have discussed his situation with our lawyer, in-fact he has met our neighbor on occasion. We retained him for the reason you mentioned, keeping above board.
My wife and I have signed him for Share-a-Ride in case we cannot be there to transport him. He went to the senior center today for lunch and commonalty. My wife and I seem to be on opposite ends with his current situation but not too far displaced. I feel he should move into an facility she does not (as of today). HE even told her last night, "if I go into a home I will go downhill fast"
In the last month he has called 911 several times. Always at night. We are in a very small town and we all know our fire chief and volunteers. We see the lights and walk over. Every single time it has been a panic attack. He is lonely and feels the walls are closing in on him. This is even after we have visited him earlier in the evening. Last week he called us and said he was short of breath. My wife who works in health care grabbed her stethoscope and told what to do until she got there. She calmed him as well as my daughter (a doctor). HE concluded it was anxiety.

I would like to state that he calls us. He has for 30yrs whenever he needs help from a leaky pipe or an emergency - not his nephews.
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Something doesn't sound right here. If uncle went into assisted living or NH, which is what you state nephews want, Nephews certainly wouldn't be after his house or property. People who are after someone's house and property would try to keep them home while inadequately caring for them in the cheapest way possible while working to get access to their money. Nursing homes are very expensive but are often necessary for survival of adults with dementia.
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kunkledude Oct 2019
Yes this is correct. However, I do not think the nephews have any idea about this. Our neighbor has been clear in the past and as currently as yesterday that they (nephews) are only interested in my house and property, to sell after I'm gone. He told my wife yesterday, "I know exactly what they are up to".
If he does go into an assisted living facility (which I think he should do) it will not be long until his limited funds are used up, therefore Medicaid possibly putting a lien on his assets. My wife and her family have a long history of caring for older relatives. Her uncle cared for his mother (my wife's grandmother) till she passes at 102. I think this is part of her spirit.
As our lawyer told us, and he is an elder law lawyer, only a judge can order someone out of their house. If they have any lucid moments then its up to them. We have spoken to him about moving into assisted living and sometimes he is open to the idea and other times tells us to stop. His doctor recently suspended his driver's license through DOT. This was due to his mild dementia. He has sold his car. I just don't want to find him on the floor one day - it keeps me up at night. I don't like being in this 'grey' area.
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If that’s how infrequently his nephews visit - no idea if they contact him between visits - they wouldn’t know how day to day varies for him.

Yes there is the issue of increasing dementia - but first priority remains his welfare and happiness. Whilst he’s able to enjoy being at home with caring neighbours watching over it would seem that is best.

Think UK POA’s are slightly different - they have to be registered to be valid and from that point the POA takes control. I used to still chat to dad about his wishes anyway.

If he has has dementia then legally he cannot sign another POA due to this.

We had to write to all relatives about the POA in case there were objections. However, you will need to work with his nephews at some point should his dementia worsen or falls become more frequent.

Difficult when you are trying to enable him and feel they are not really interested in his welfare. I would certainly check that he would legally be unable to sign any new document and then mention it to them if it’s in force

Best of luck, hope it works out
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worriedinCali Oct 2019
The OP isn’t in the UK. In the US it’s legal for someone with dementia to sign a new POA document as long as they are still considered competent. Might not be legal in the UK but it is here.
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I think you are confusing what he wants with what is in his best interest, despite your empathy for his desire to remain in his home in my opinion it is his nephews who can see the forest rather than the trees and are proposing something that is in his best interest. The man is in his late 80's and has dementia, although he is managing now with your support he will soon need more than neighbourly oversight - most dementias are progressive, terminal diseases that have physical as well as cognitive consequences. If your family wish to remain his advocates then you might be wiser to work with the nephews rather than against them.
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