Have a family issue and trying to think proactively.

Have an adult male who lives alone and is elderly. Has has health and mobility issues that he seems to be able to manage fairly well. No family close by. Been seeing some sign of cognitive decline. Nothing super major but things like letting the indoor dog escape to the outside not realizing. A small car accident, Angry outbursts, trouble with the tv. Has issues with the computer on occasion and will struggle with finances some and managing apts. as well. Things like that. We see him occasionally. Every six months or so but call him frequently.
He probably is getting close to needing a different living arrangement but doubt he will agree with that. his sister has dementia and lives in a facility. he thinks she is fine and that her family put her there to get her money. a family member does have poa. if things continue t decline what are the options the family have?

quote:

a family member does have poa. if things continue t decline what is the options the family have?

The person who has POA makes the decision.

Elderly with health issues. I’m quite sure he’s qualified for government assistance with daily caregiver. Has this been explored?

quote:

Originally posted by 12131:

quote:

a family member does have poa. if things continue t decline what is the options the family have?

The person who has POA makes the decision.

Elderly with health issues. I’m quite sure he’s qualified for government assistance with daily caregiver. Has this been explored?

Thanks Q, that is a great suggestion. Will look into that.

Regarding POA. Don't know how that works exactly. If the person is unwilling to go into a facility but family thinks it is time for his well being. His assets would be needed to pay for it. But he says no even though there are signs of his cognitive issue being there. What can the poa do?

Depends on the language of the POA. Most general care/dependency POA's kick in when the grantor becomes incapacitated or mentally unfit to make their own decisions. Doesn't sound like your family member is in that category yet, so any powers they have will be restricted.

Yep, got to know the exact wording in it.

Just went through this sorta. POA doesn’t trump the elderly person unless they are deemed/ruled/whatever as incapacitated. If you and he are sitting in the same room and he is competent you can’t make him do anything.

The POA lets you make decisions for him but he isn’t overruled by any means.

The way I described it to my mom as we left the lawyer. You need to trust the person you just gave POA to because I could have cleaned her out if I wanted to. However I couldn’t just overrule her if she was involved as long as she was competent.

Assisted living is probably the best answer but if he refuses the road gets harder. We did in home aid for awhile but that is expensive $$$$.

If he is slightly computer literate set up some video chats. You will have a better idea as to how he is doing.Sounds like mild cognitive impairment. I hope he is not driving.

Thanks guys. I appreciate the thoughts and info. The video chat thing is interesting.
A lot of this is trying to navigate what might happen in the future and being somewhat prepared for it.
Sounds like having the poa is limiting if dementia becomes more of an issue.
How is one supposed to do what is best for an elder if they refuse but are not able to determine that. even if a family member has poa?

A POA, at least in my state, can be written to provide full power immediately. As mentioned this can be dangerous, but it can also avoid issues with when it can be used.

Other things to consider include a will / living will, plus getting the name of the POA person listed as co-owner and/or POA on bank and investment accounts. The POA becomes void upon the person passing, so this can avoid funds being locked up while the will is processed.

quote:

Originally posted by old rugged cross:
.... his sister has dementia and lives in a facility. he thinks she is fine and that her family put her there to get her money. a family member does have poa. if things continue to decline what are the options the family have?

"How is one supposed to do what is best for an elder if they refuse but are not able to determine that. even if a family member has poa?"

You have some real challenges here. No POA can survive the death of the grantor, so having a will is critical. As Bryan11 said, right now the best thing you can do is to get him to allow you to be a signer on his checking account and maybe investment accounts.

From the quote above, he doesn't trust his family. So getting his cooperation might not be so easy. Fact of the matter is, at least right now, your options are pretty limited.

My wife's family has an elderly relative who is now 96. Mentally she is about 90%+, which is probably better than me, but she's getting stubborn. Physically she's at risk of falls and her body is failing. She agreed to be moved into a graduated assisted living place in Bryan, Tx (family lives in CS, but they moved her from San Angelo). She resisted at first, but once she saw the arrangements - and that she would be left alone if she didn't need additional care - she agreed. Her place is about 500 Sq Ft and that bothered her initially but now she likes it. She made new friends, plays cards, and has 24 hour assistance if needed. It's really a nice situation. I'm 68 now and considering something like this in 10 years or so. We all need to make some type of plan to relinquish control to our kids/grandkids/ somebody when we get old. I hope I have the grace to do it and to be gentle on the ones who want to help me. See if your elderly relative will at least take a tour and speak to some of the residents at a graduated care assisted living facility. They aren't like nursing homes of the olden days....

The best option is the tough one. Have him found mentally incompetent. It will make the relationship bad between him and especially whomever the court approves as his guardian. Then the guardian can force him into a care facility. Imho, this is for when he is truly incompetent and is at serious risk of unknowingly harming himself. e.g. get lost outside in the winter and freezing to death.

Some amount of in-home services can be utilized by your relative. He may complain, which my mother-in-law does, about strangers being in the house. They can make sure he is fed and takes his meds. They can clean the house, help him bathe, drive him to medical appointments.

I think most families face your kind of situation. My wife's mom is similar to your relative. She really should be in a senior living situation, and would probably have more joy and less anxiety there. But she refuses to go.

Which brings up the question of how much right does an elderly person have to choose the risk of living alone? My mom is 94 and still quite sharp and physically capable. She lives in an 1850 farmhouse in a tiny English village, with steep stairs. She could tumble down the stairs, or fall in the shower, or break a hip out in the garden. Or have a medical emergency. With nobody there it could be fatal. She knows this and chooses it.

The goal isn't to stay alive the most days possible. The goal is to have the most net joy or fulfillment before passing. What we as the healthy adult think is best or safest for them may not be their choice.

quote:

Originally posted by 12131:

quote:

a family member does have poa. if things continue t decline what is the options the family have?

The person who has POA makes the decision.

Elderly with health issues. I’m quite sure he’s qualified for government assistance with daily caregiver. Has this been explored?

Keep in mind that a lot of assistance doesn't kick in until all of the elder's money and value in their home has been spent. It may be past the time to do this, but getting assets and especially the home in a trust may be a good idea.

Thanks Ryan, he does have a trust. But he has a reverse mortgage and it is maxed out and he cannot pay the interest on it. I do not think the house can be in the trust because of the reverse mortgage? So the RM company is draining most all of the remaining value out of it every month. He has minimal assets, very minimal. Basically lives off of $2000 social security. There is no way he can afford assisted living or similar.

If he sold the house now. Paid of the RM company. He could probably fund assisted living for a year or so. But delaying selling the house the RM will soon own all of its value. He is not willing to do anything it seems.

Having someone declared mentally incompetent is NOT easy. Tom Benson at the time a multimillionare, owner of the New Orleans Saints and multiple car dealerships was declared incompetent by a court. Family members initiated that process. So, Tom got his experts involved who found that he was competent. {The content of both evaluations are online} Eventually Tom died and his wife Gayle inherited the team. The court process cost thousands of dollars.

ORC some good points and info here. I am going through this now with my 90 yoa mom. Recently moved her in with my wife and I, which we had planned if the need ever arised. It has Ben a challenge with all the change, especially on her. She has been living on her own for 25 years now since being a widow. 20yrs ago she made a Will, POA, med POA and a DNR. I have also been on her bank accounts by name. So the transition has been mutual with her and us. And if/when needs arise I can do as she wished and have the power/authority to do so with little legal issues. Hopefully we can keep her quality of life for her and not have to place her in an assisted home. Her docs all saw she's good for her age.

Do what you can for your family. Start with talking to a lawyer to see if he is capable of putting a Will, POA, Trust together at his current mental capacity. These will help going forward. Shop some assisted homes for pricing and what's needed. Make sure he has his medical needs. Good doctors help a lot. Be patient and take deep breaths. Good luck.

Does he have any health care needs where a home
visit might be needed every few days or so?
Otherwise, it's hard without the person being nearby.
Also depends a lot on the funds available.
Otherwise, frequent phone calls are the only other easy way to monitor their well-being.

You mentioned a POA but is it done by an attorney in his state or on an online type form.
You need several documents while he's still capable. Will, healthcare POA, living will and maybe more depending on the situation.

Ask any care giver, most people that wonder about assisted living for their parents, are typically about 8 months too late .

Getting them in is much tougher and stressful for them when they are afraid, apprehensive or stubborn.

Their ability to accept and adapt makes it a breeze.


Best wishes for transitioning at this point.