Mom's early dementia is interferring with my sister's ability to care for her and Mom's home. My sister has POA for health and financial decisions, but Mom had called one of the banks to try and revoke it. Sister then couldn't submit bank statement to reduce Mom's real estate tax. Mom racked up a huge phone bill by calling 411 constantly, so sis had to have 411 removed. Mom desperately needs new carpet and house painted but calls to cancel appointments that my sister sets up for her. When her garbage disposal jammed, my sister called a plumber. Plumber said nothing was wrong; the plumber my Mom called had fixed it the day before but Mom didn't remember calling or that he had been there. To give my sister a much needed break, I tried getting Mom a volunteer to take her places or just for companionship, about which Mom was initially enthusiastic,but then cancelled all their appointments or simply didn't answer the door. She'd call the volunteer to cancel appointments that didn't exist.

My sister is suffering from burnout but I live several hours away and have a handicapped adult child that I care for so I'm not much help. I've suggested that my sister get guardianship of my mother so Mom won't countermand all her efforts to help. I think my sister is afraid of the repercussions of the guardianship proceedings (Mom's narcissistic/borderline personality) and said that the only reason to get a guardianship is if Mom is admitted to assisted living, which Mom can't afford. I disagree.

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Yes, someone who is declared incompetent can still live alone in their home as long as the guardian monitors the residence.

A guardian is appointed to oversee someone's health and financial business once a person is declared incompetent by the court. But even if your sister becomes guardian and your mom continues to live alone there's nothing stopping your mom from picking up the phone to cancel appointments or to make appointments.

As guardian your sister can make appointments and not tell your mom but your sister will have to be there when the person shows up to make sure your mom doesn't turn anyone away. And if your sister does this your mom is going to fight it tooth and nail like she's doing now. Guardianship doesn't mean your mom has to like it. Is your sister willing/able to be at your mom's for these appointments to ensure mom goes along with it? Is your sister prepared to fight your mom on all of this? Her being guardian won't make much of a difference since your mom lives alone and can cancel an appointment just by picking up the phone. And obtaining guardianship costs thousands of dollars in legal fees.
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Go for Guardianship if you can afford it, but realize that an incompetent person should not live alone. Assisted Living would be a lot safer and she would have lots of social activities.
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