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I am at the end of my rope with my Uncle. Got POA's and Will done in June. Since early July, he was hospitalized 3 times and sent to rehab for 4 weeks. He came home mid-August and fell 3 days later, hospitalized 1 wk, refused rehab and consented to going home with home health care (I live very close by). I visit almost every day, anywhere from a half-hour to a full 8-10 hour day depending on what needs to be done. He still manages independently in his apt., but skills are slipping. He is 92, apparently not in dementia, legally blind, and uses a cane (consistently now since his fall). The 2 significant changes I see since he came home are difficulties with bowels, and getting to the bathroom on time, resulting in soiled clothes and soiled toilet and floor. The other change is how he uses the cane - he takes baby steps and doesn't (never did) point the cane to find direction and reference points, no matter how much coaching I try to give him. The cane is basically for balance the way he uses it. The extremely slow gait could be part of the reason he doesn't always get to the bathroom on time. I set up 3 weeks of PT, OT, and an aide as soon as he was released. He bitched and complained about every one of them and wanted to quit. I told him the DEAL was, either rehab or home health care. He chose the HHC, so he had to stick it out. Now they are all done with him, and all of the opinion that he is doing as well as can be expected, but should not be living alone and ought to be in a NH. Up to this point, he had been completely self-sufficient with dressing, toileting, washing himself (sponge bathing only), food prep and eating, and housecleaning surprisingly well. That is why I advocated for him every time a doctor or other HC professional said he needed a NH. What has declined since August is the toileting issues and cleaning himself properly, and also the much slower walking. I have coached him to wipe down the toilet twice every time he has a BM, but I cannot expect him to get down and clean the floor. So I am there anyway almost every day, and end up scrubbing the bathroom, and cleaning the floors wherever he has tracked the poop (so far not excessive). I wear gloves for all cleaning and handling the laundry, using appropriate disinfectants like bleach or PineSol. I have been doing a lot more cooking for him since Doc said low fat/low chol/low salt diet. Gone are the days of cold cuts and frozen dinners. I told him no more boiling water at the electric stove, & no more getting on hands and knees to clean up kitchen or bathroom floor. He wants to resume doing his laundry in the building, but it is impractical for him to even try, so I have been going to the laundromat for him - pick-up, wash-dry-fold, iron, pack up & deliver-put away. I do a lot more housecleaning as well, since I told him he is not to attempt using mop & pail anymore. Like all other caregivers, I do everything that he cannot do outside the home as well.
He also refuses to allow a mobility instructor to come in and teach him how to use the proper kind of cane. He also has refused hearing aids when he was just diagonosed with hearing loss in both ears. He hears the lower pitches better, so I have to try and speak in a lower register with more volume, and after the third attempt repeating myself, he accuses me of shouting. By the end of the day, my throat is very sore and hoarse. So I have to physically suffer because of his stubborness.
The money issues have become unbearable. He gave me DPOA and now regrets it, accusing me of taking away full control from him. I have arranged Direct Deposit of his SS & Ret checks, and plan to set up automatic bill-pay as well, leaving any remainder in the bank for future in-home health care expenses (I am also thinking of the Medicaid application process in the future). He is having extreme anxiety over not feeling the cash in his hands. This is the sticking point for him - like a fixation. He always cashed his checks and we made money orders to pay the bills, and he kept the remainder. This was a very inconvenient and cumbersome procedure every month. He is used to getting the remainder and keeping it in his wallet, which is excessive and unsafe, especially if I have to start hiring people to come in and help out when I cannot be there. I am quite agreeable to giving him $100 at a time when he runs out of money for incidental expenses, but he is not satisfied with that. Everything hinges on the money for him. He behaves spitefully and refuses to cooperate with me unless I agree to give him extra money. Now he wants to talk to the lawyer and so do I. I am concerned that he will destroy everything I have tried to set up in order to make both our lives a lot easier. In essence, if he refuses the asssistance that will prolong his IL status, he will quickly lose his functionality & end up in NH or on home hospice 24/7 if he qualifies. If I quit, what happens to him?

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Hi Blannie, Jessie, and Julidu - please see update under my other post regarding whether a MPOA/DPOA can assign themselves a reasonable stipend. We never got to consult with the lawyer, but worked a few things out with help of a friend.
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Wish you the best in that situation. You've been wonderful with advice and support on this site ~ speaking from personal experience! Your an amazing woman. I'll be thinking about you. Let us know if there is anything we can do.
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Hi Julidu, I will try to clarify. He has no one else but me, and I never was under any obligation to take care of him. It started out simple several years ago - shopping, doctors, bill-paying, but has grown to 50-60 hrs per month or more, depending what healthcare and personal needs issues he is having. He has become increasingly uncooperative and negative. It's like he does not want to do anything to help himself, but still insists that he will never go to a NH and wants to die at home. I cannot help him achieve that goal unless he agrees to mobility instruction, hearing aids, and relinquishing control of finances so I can manage his money effectively and eventually also hire/pay whoever I need to come in and assist him. I am at the point where if he does not start being compliant, I will just a walk away. Not on the spot of course. As you mentioned I would have to wait until someone was appointed "ward of the state" for him and was actively seeing to his needs and care. That's what I was not sure of and will ask the lawyer how I go about re-assigning him to the state. Basically, it's "my way or the highway". I'm trying to prolong his independent life at home, and he is killing me in the process. If Uncle is so stubborn when we talk to the lawyer, he may just tell her he doesn't want me anyway, even if a stranger becomes his ward. I can't imagine he would be that stupid, but who knows? So either way - he makes his own bed and he will lie in it - most likely in a state medicaid facility. I hope he sees the light before my rope snaps!
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I'm a little confused. So please forgive me. If I put myself in a similar situation ~ wanting and ready to quit (with a touch ofof some guilt) ~ I would not be able to do it unless I knew he would still be ok. Otherwise you would be gone and things would just go to hel... So what I would want to do is set it up for him to be taken care of but me (well, you) out of the picture, or just be there as a friend instead of the caregiver. If so... In the event of no "caregiver" the state would take over. You need to look up your state's rules on "ward of the state". BUT someone needs to inform the state of the situation. Otherwise they will not know.

When lost on some issues I call the agency in question (with fake names when I'm feeling paranoid) and question them to death.

I hope I didn't make it worse. I feel this way about my father in law but fear no one else would step in to help him.
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You are right about his lack of good judgement. I see that more and more everyday. Although he is not stupid, he is not a brilliant man by any means, and I seriously question his comprehension of all we repeatedly try to explain to him. He is chronically fixated on maintaining control, and is simply acting stupid. As much as I want out, I worry about abandoning him. At this point, it is his choice. If he does not want me, so be it. All I can do is pray. Thank you for all your support.
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Orange Blossom, your uncle probably isn't able to make good judgments any more, or he'd stick with you. Maybe when he talks to the lawyer, he'll see the error of his ways. But either way, you've gone above and beyond and what happens to him from her on out is not going to be your responsibility.
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Thank you, Blannie. I was looking at all the articles on this site, and could not find any answers. From what you found, it sounds like even more headaches & heartaches for me, as I could not leave him stranded until the medical professionals decided what to do with him. I have a feeling they would most likely declare him incompetent (at least as far as being able to live completely independently - who would see that he had food in the house, shop, pay bills, etc?) as well as mentally incompetent when he tries to convince everyone that he can take care of himself! I imagine they would take over and put him in a facility of their choice, with no argument from me. As far as the financial management, your info indicates the state will appoint a guardian (not sure how long that woud take) which I would not bother to contest at that point. It seems his stubborness and lack of cooperation will land him in circumstances he will regret for the rest of his life. Your last paragraph states that the POA "allows a TRUSTED person to make those decisions rather than someone the court appoints or a medical staff unfamiliar with the patient's wishes. How ironic for my Uncle to turn against me when he has no other person who has demonstrated ongoing trust and capability, and when we have all his healthcare wishes stated in writing via the MPOA. I'm not sure how this will end but I hope the lawyer can talk some sense into him. Remember that old expression "Don't slap the hand that feeds you"? This is so typical of him - just like buying items he wants and then making me return them a week later! I guess he thinks he can just change his mind about these critical issues on a whim.
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OK, I just googled the topic and came up with this on a website legalnature. No clue of its accuracy.

"But what are the consequences of not having a power of attorney prepared in the case of incapacitation? Generally, decisions about a person’s financial and medical management are made according to the laws of the state they live in. In the event of medical incapacitation, usually a family member will be called upon to make any important decisions in the absence of a power of attorney. In this situation, difficulties can arise if there is more than one family member and they differ on the course of medical action. Even more difficulties can arise if there are no family members available at all. In this case, medical decisions will be made by attending medical staff according to what they feel is in the best interest of the patient, and this might not always be what the patient actually wanted, but the absence of any power of attorney makes this inevitable.

In the case of financial estate management, the absence of a power of attorney can lead to time consuming and expensive remedies for family members if proper planning has not been completed. Generally, if a person has not assigned an agent to act on their behalf, control of financial management reverts to the state. Probate courts usually will appoint a guardian or conservator to oversee the management of a person’s estate if there is no legally appointed agent acting on their behalf. If this occurs, family members will have to petition the court for access to the person’s finances. This, of course, takes time and money and can lead to additional frustration on top of dealing with an incapacitated relative."

A power of attorney, while designed as a beneficial tool for a person in need of assistance with financial or medical decisions, is also an invaluable instrument for family members and relatives. It provides for a definite decision making process and allows a trusted person to make those decisions rather than someone the court appoints or a medical staff unfamiliar with the patient’s wishes. It is a vital estate planning tool that every person should consider completing prior to actually needing one.
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I'm still not clear on what the repercussions will be if I quit as POA and actually walk away from him. I am at the end of my rope with him, and if he does not cooperate with allowing me to manage his health care and finances from this point on (as he appoined me to do), then I want my life back so I can take care of me and try to earn a decent living. My chances are slimmer by the day - I'm 64. I was never under any obligation to to care for him to begin with. It started out with shopping help, bill-paying and doctor visits, and mushroomed over the years due to advancing age and decline in health. He has no other friends or relatives willing to assume responsibility for him. So what happens to him? Social Services evaluation?? Court appointed Guardian?? State Medicaid facility?? Does anybody know? I was hoping to get some information from other people's experience or knowldge before I call the lawyer on Monday.
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Blannie, Love that story about your Mom - what a treat! Uncle will never comprehend technology. He is so afraid of running out of money, and is blind to all other considerations. Today he even told me that I stick with him for his money!! I told him if I wanted a man with money, I'd find one a helluva lot richer than him! LOL
I then actually told him that I don't care if I never inherit a penny, and that whatever money I need to spend for his care is coming out of his pocket , not mine.
I hope the attorney will take the time to speak to us and help Uncle put things in perspective. Today, I took him to male friend of his that lives in a nearby NH, and asked him to be the intermediary for us and I outlined everything you read in my post, but in even greater detail. Uncle interrupted so many times, and only heard what I related to be criticisms, not facts. He took offense at everything and just didn't get the picture at all. His friend told him that he was not taking sides, and would listen to Uncle's concerns as soon as I was done. Once again, his major concern was losing control of his money, and also never going into a NH. We were not able to resolve anything but at least I got a lot off my chest, and I feel much calmer tonight.
The PT lady actually had him demonstrate using a walker - did well, although no sense of direction. The upside is that he would bump into something with the walker instead of his arm or his head (he holds the cane too close to his body). However once again, Uncle refuses to use the walker.
He is using the adult pull-ups at this point, but he really did fight me tooth and nail before complying. One day, he finally had an accident just as we were entering the lobby of his building and had to manage on his own in the men's room to clean himself up before we went up to his apt. I flatly refuse to clean him, so when we went upstairs he had to strip down, wash himself up, and put on clean clothes all by himself. Later on, he put the dirty clothes in the kitchen sink, washed them himself and hung them up in the bathroom. That's when he finally agreed to try the pull-ups, and now wears them everyday underneath his boxers. He does not want to be without them anymore. Tough love works sometimes!
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OrangeBlossom, you're wonderful for taking such good care of your uncle. Too bad he doesn't appreciate it. Our elders just can't comprehend what can be done by computer these days (like auto bill pay and automatic deposits). I try to show my 93 year old mom and she just can't believe it. She can't believe what I can do with a cell phone. I don't know how you make them comfortable with that. I'm lucky since my mom just turned all of that over to me without any question or concern. She'll think she's running out of money and want to cancel the newspaper and I have to remind her that she's got plenty of money for herself and what she thinks is important pleasurable.

Maybe the attorney can talk some sense into your uncle - or someone else he respects who his age? Anyone you know in his age range who has a relative doing what you're doing that could talk about how comfortable they are with it?

And wouldn't a walker be better for him? It would give him more stability and maybe allow him to walk faster. And if he's not able to get to the bathroom regularly, he needs to be wearing adult pull-ups or pads or something. I'm sure he'd fight that tooth and nail though...
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Dear Jessie, Thanks so much for your reply. (Just to clarify, it's my Uncle, not my Father) :)). Yes, I agree on the banking issue. I will go ahead and set up the automatic bill-pay. No he cannot drive, so doesn't need gas money. The money he wants in his wallet, boils down to petty cash, as you mentioned - he just thinks he needs a ton of it! I think it is a very good idea to sit down and make a list of all the items he needs on a monthly basis that would qualify as petty cash expenses, so we can get a better idea of how much he would actually spend out of pocket in a month. I hope that will appease him.
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If you quit as POA and caregiver, the only option I can see for him is to try to make it for a short time on his own, then go to a NH, perhaps with the NH as guardian. You have my sympathies, orangeblossom. You have tried so hard and got things set up as well as can be expected.

The situation with your father when it comes to his money reminds me of our situation here. I set the deposits and bills up to be handled automatically. This makes my mother uncomfortable. She wants me to have the checks sent here and to pay the bills with handwritten checks. It drives her crazy when I do her banking on the computer. I remind her that her SS check has to be automatically deposited and implied that her pension checks do, also -- little untruth here. I simply told her no to cancelling the autopays on the bills. I pointed out that it saved money on postage and check costs, so she accepted it more. (Mainly it saved wear on my nerves, having to sit down and write 8 extra checks a month.)

How much money do you think your father would have to have in his pocket to feel comfortable? I doubt that he drives, right? I don't know where he would spend any money. Maybe you can do what my mother and I do -- every few months I withdraw some money to keep as a petty cash fund. We do things like pay for lawn care, haircuts, or eating out with this money. The money last a pretty long time. If he were managing the petty cash money, maybe it would satisfy his need for cash. Just an idea.

I know that it is hard when they feel like they're losing control. It sounds like you are doing a good job. I hope that things turn around with your father soon so you don't have to worry so much.
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