I have a 65 year old aunt who's been diagnosed with dementia.She's still pretty much independent and she spends a great deal of time alone, as she resides by herself. She has 1 son who is married and just recently had his 2nd child. I'm her only niece and I reside in VA and they live in MD. She is still mobile but I see a decline. She's not at a point where she needs a nursing home, but she definitely needs some help. It's hard to have this convo with her son about certain decisions regarding his mother. He doesn't know what to do and neither do I, which brings me to this forum.

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Some good info in the previous posts.

i went through this with both parents over the course of 5 years or so. Mom has passed and dad is in memory care now.

I think the most important thing to impress on the son if possible, that the more he can do to prepare now the easier this will be down the road. Start gathering all her financial info, medical stuff, doc info, utilities, try to get POA if she’s still competent.

if he waits until she’s in great decline, crisis erupting, getting scammed etc he’ll really be in a fix trying to deal with it without access to finances and information.

I saw it coming with my folks, started laying track so to speak, and when the .... hit the fan I was prepared. It was still no picnic by any means when I had to finally move them into care but having a complete file on them, POA and access to their funds made it much easier.
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I would suggest her son get POA while she can still make decisions. I have cousins who loved my Mom just like their mother but I would never expect them to take on her care.

You could do the research but ultimately the son needs to coordinate her care. He doesn't have to take on the responsibility of hands on caring for her but its his responsibility to make sure she is safe and in a safe environment if that means placing her in an AL and eventually a nursing home. With small children, having a Dementia person around is like have a big toddler. I don't expect him to do that but he can't think this will go away. Be there for support, help when you can, but don't take on the responsibility fully.
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Her son has his hands full especially with a new baby in his household. Perhaps start the conversation with "[name], the last time I visited my aunt I noticed X,Y, and Z." Preferably X,Y,and Z are safety concerns such as no food in the house, lack of personal hygiene, self neglect, piles of stuff/garbage accumulating. Research resources available to your aunt in her home such as Meals On Wheels, visiting nurse service, a housekeeper, an aide "new friend" who helps her with activities of daily living such as breakfast, laundry, bathing, etc. Present her son with these resources preferably in person and then followup with an email for future reference.

If she doesn't already have these things, consult an elder attorney about important paperwork such as a living will and durable power of attorney. If she's in the *early* stages of dementia she **may** be able to sign legal documents. Generally speaking, capacity is analyzed situationally. The general rule is that the signer has to have sufficient understanding of what the document is and the effects of signing the document.

It is important that someone who is trusted have authority to help her with both her finances and medical decisions once she no longer can do it herself. Maybe that's her son maybe it's you. But know that it's a huge responsibility. And, in my opinion, taking on the responsibility for caregiving should not be done without having written authority.
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You can report her to her county's Adult Protective Services offices as a suspected case of a senior in need of care. It took a bunch of reports, but APS eventually visited mthr once there were enough reports. They saw that she needed extra care and offered her many things, none of which she accepted. They did call me after keeping an eye on her a month as she was presenting a danger to herself and others when she started wandering and locked herself out of her house. A report would be a kindness to her and respect for her. Your cousin does not want to see this, for one reason or another, and APS or Council on Aging exisits for this reason. Bless you for being concerned. Don't expect it to change the situation even this year, but to help in the long run.
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