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We have concerns about a relative living alone and is starting to fail mentally. Can't remember to eat, prepare meals, is needed more and more help. We want to get more help for her but POA does not. How do you get around the POA?

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Try Adult Protective Services. Is the POA a relative?
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I agree with above, Adult Protective Services, be prepared for being "involved."
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The name of the agency may vary from state to state - Department of Elder Affairs, Department of Children and Family Services, Adult Protective Services, etc. There may be a 1-800 line which you could call and share your concern. You may also have the opportunity to request local law enforcement to make a health and welfare check. This call would likely be better on the non-emergency line instead of 911.
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Health and human services may be another name for an organization you can report to, just depends on your state.
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You don't say if you are involved in the care of your relative or not, or how involved the POA is in the relative's care. Is there a caregiver at least part-time now, or is the POA in denial about how much help the relative requires? Before reporting the POA to elder care services (which you don't want to do unless absolutely necessary), please make sure he/she is aware of the laws in your state and what can happen to him/her if the law gets involved. Let the POA know that if "someone" should report them, that the relative can be removed from the home which will be extremely traumatic for her. Better to have care set up now to prevent that from happening.
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Give heed to purplesushi commentary! If you feel the need to continue, best to talk to a representative of your local area agency on aging first. Locate the nearest one at www.n4a.org/ . I do recommend keeping a good record of all contacts, dates and reasons for concerns to protect yourself, the elder and even the POA caregiver during ensuing actions if APS gets involved.
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I, as parents POA, was told by eldercare attorney, when issues started to crop up and others started to question what was happening at their home...(and I live 5 hours away....) that a minimal home visit plan from an agency caregiver, would keep APS at bay if someone called them to report. If there is no agency involvement and APS is called and thinks things re not going well, they can have people removed from their home, and then the judge and other agencies decide what is going to happen and where they are going to go, if not back at home. They will try to get family to take them in, if they can find family. So if you report and you are family....then WILL expect you to get involved. The person who has the POA needs to understand that their responsibility is to assure the others are safe that they are responsible for...and perhaps they need help understanding that even 4 hours/week of a caregiver coming in, would safeguard both those needing care and the POA who is responsible. And elder care attorney can advise. I am glad I have one to help me!
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As a social worker I made home visits with APS. Options were discussed. No one was removed from the home in those situations. Perhaps in my state the regs are different. Good luck again.
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The STATE and even the COUNTY you are in, and their protocols is what determines how a governmental agency reacts when they are reported to. Many civil employees, doctors, social workers, teachers and therapists are considered "mandated reporters", meaning they MUST report a problem portrayed to them, but again depending upon the protocol list of what is a problem.

As already suggested, you should be cautious about the first steps you take in handling the problem. It is generally wiser to attempt to make inroads with the POA as well as keeping excellent documentation about time, date, what you said and what his or her response was, etc. This documentation could become the foundation of more intervening action should that become necessary.

Some counties are somewhat lax and layback in their approach to problems with seniors while others have a zero tolerance policy on what they perceive as abuse and move very quickly to make examples of "offenders". This often DOES mean the courts getting involved, taking over and many times having a non-family "neutral" party appointed, who then CAN, and often DOES, make decisions for your loved one without ANY family input.

This can even include moving them out of their home and into a facility. This can be a blessing if the person was not being well taken care of but, if they could have been taken care of at home and are moved anyway, it can be a very disorienting travesty and it can lead to further degeneration of the person.
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CarolLynn makes a number of good points which I absolutely agree with. I would add, however, that that the consequences can be much more severe than just further degeneration. A good friend of mine was taken from his wife/caregiver of 46 years, denied contact with selected friends and family and was killed in a memory care facility within 60 days (his health was just fine until he was incarcerated). You would be absolutely shocked (as I was ) to find out how far APS authority (by law) exceeds their individual competence.
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Unless that relative is declared incompetent, a POA is limited to what he or she can do. I have DPOA for my mother, but she refuses to get additional help she needs. She has not been declared incompetent by her doctors even though he thought her living alone was not a good idea. I cannot force her to do anything against her will at this point in time. I would not want APS coming down on me because of my mother's choices.
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these are such sad and tragic experiences ...it would not occur to me and the APS worker to have gone to such extreme measures unless a person was really in danger
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