When to enact POA?

EmilieKOA · April 11

Hi everyone,
I am new here. Both of my parents have dementia diagnoses but it's my mother who my siblings and I have the most concerns about.
In a nutshell- both parents are 86, living in the same home for 50+ years 2 miles away from me, in-home caregiver for 30 hrs a week, Dad has moderate physical care needs (uses a walker, extreme fall risk, bathing, hygiene, toileting). Both have significant short term memory impairment and show some signs of impaired decision making. For these reasons my siblings and I have divided up their care needs among us. I do all health related issues, sister does social, brother does financial. Since I am the only one in town I coordinate and facilitate the bulk of it but have amazingly supportive siblings.
Their safety isn't in imminent risk. Their quality of life is poor.
To address that (quality of life) my siblings and I researched AL and IL facilities and decided on one that offers a hybrid of independent and assisted living. Both parents were on board and signed a 3 month lease. 10 days later they changed their minds. And are now refusing to move.
We have a signed will/trust that grants POA to me upon a determination that either of them is "incapacitated". I am reluctant to pull the trigger and enact it given their issues aren't life threatening or serious safety risk.
Advice?
Thanks in advance so much.
Emilie

terei · April 12

You can either take control now + move them, using a ruse that their home had some kind of issue + you are moving them to AL ‘temporarily’ til the plumbing or whatever can be fixed at their home. After they are placed, there are millions of excuses why they have to stay where they are.

OR you can wait for something to happen that forces your hand..this could be a fall, injury, wandering, hospitalization etc which means you will have to handle the move as an emergency which will be far more stressful for all involved.

Read some of the posts here that describe how others have moved their LO’s that are not on board. IMO forget about getting them to agree. Change is hard for anyone, let alone when you are infirm + elderly.

harshedbuzz · April 12

Just do it.

Assuming your POA is a DPOA (stays in place beyond capacity or springing (need a professional/s) to sign off on incapacity), you just make it happen.

You have 2 options— you can continue as you have so far, researching the best place and making a plan to move now. Or you can wait for a crisis and hope to find an opening while juggling the loose ends that triggered the crisis.

Is the spouse of a PWD— even one with dementia that has progressed further— is removed from the home because of an illness or death, you can expect the remaining one at home to tank. Married couples tend to scaffold the skills of one another. You want to avoid this kind of crisis which could arise from a bad fall or UTI.

Another piece is that, as POA you have not just the right to keep them safe but also the obligation to step in when needed. If a neighbor feels they're unsafe or they have an interaction with first responders (mom wanders off or starts a fire in the kitchen) it's likely APS will be alerted, and you'll be questioned about how this happened as their POA.

No parent ever wanted to move to AL or MC. It has to be forced on them. Yes, they will be angry and possibly a bit more confused but safety comes first. Almost all PWD eventually settle into their new homes. With decent meals, help with ADLs and social activities some even improve a bit. My aunt positively blossomed in AL/MC.

We moved dad using a fiblet that he was seeing a new doctor to make sure he was getting the best care possible. When we visited the next day, we told him the new doctor wanted him to go to rehab for PT. He wasn't happy but settled in with a few weeks.

Since you are moving a couple— the house issue is a great option for you. Create a reason why they can't stay and will need to hang out at a nice "senior hotel" while the water main is repaired or the house is tented for termites. A friend did the former and even shut the water off to the house to make her story more believable.

Good luck. This parent of adulting is no fun at all.
HB

nopost · April 13

"I do all health related issues, sister does social, brother does financial." [ That's great you work together but it's time for an official leader ] & "We have a signed will/trust that grants POA to me upon a determination that either of them is "incapacitated". I am reluctant to pull the trigger and enact it given their issues aren't life threatening or serious safety risk. "

Since you are the DPOA in waiting does this mean your parents can still access their funds today? If so that is a serious risk- they could be wiped out by a scammer and when it's gone , it's gone. Do they still get their financial mail? As DPOA , when active, it is your job to marshall and protect all funds.

"Both have significant short term memory impairment and show some signs of impaired decision making." Currently they have 30 hours care giving, plus your drop in time of course — that's 18 per cent of the time- so that is life threatening and a safety risk. A lot can happen when they are left alone - what if a fire alarm goes off, one wanders , some one comes to the door

It's really hard with parents - their voices sound the same , we're used to listening to them , obeying , they guided us but now it's time to respect but protect them.

Once installed as DPOA you won't need to have those spin in circle discussions like you had about the move that didn't happen. That level discussion is , sadly, no longer possible for PWD and the stress of trying to get them to process the ideas just causes stress and fear .

[When you start your research again - ask if the homes also have MC in case their AL isn't enough- you don't want two moves - what AL provides can vary greatly . Usually AL is just that- some help but the patient can safely come and go - doesn't sound like your folks are at that level since they benefit from 30 hours one on one already. ]

H1235 · April 13

Welcome. From what you described it does sound like there is a serious safety risk! What if there is a fire, would they be able to get out, would they know they had to get out or would they try to put a fire out themselves, what if one of them falls, are they both able to use the phone for an emergency? Moving a lo to facility is complicated. With dementia there is just too much for them to consider and understand to be able to make that decision. Many people with dementia have anosognosia. This is the inability to understand their own symptoms and limitations. This makes it even less likely they would be able to make a sound decision about their care. As DPOA you need to step in and make those decisions. Before a move to Al they would probably be evaluated. Cost is usually based on the amount of care someone needs. Based on what you have described I think they would need a high level of care in assisted living if they would even be accepted. I don’t know how they could do independent living (there might be an evaluation there too). They are not going to get better. A move will be hard on them. Moving them to a situation where they have the lest amount of support absolutely necessary is not the way to go. I’m not really sure what you mean by enacting the poa. I would assume you mean the poa is springform and needs two doctors to sign a letter stating they are not competent to make their own medical and financial decisions. If doctors believe this to be true then I’m confused why you would hesitate. If they are not competent it is your responsibility to act in their best interest. It’s tough! My mom had been in her house 60 years. She was very angry about leaving, but it had to be done for her safety. Good luck.

sandwichone123 · April 13

If you do have a springing POA I would suggest getting that certified ASAP, as it can take some time. Doctors are extremely variable in their inclination to sign, even with the situation is beyond clear, so don't wait until there is something that needs doing right away to get started.

When to enact POA?

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