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I have POA for my 93 year old female cousin. She has no children  and lives in a gated golf community 4 states away. She has stayed in her home because she has three neighbors and a step niece who have been helping her. She fell last week, was found by neighbors the next morning, went to hospital and is now in rehab. She smokes (on a patch while in hospital and rehab), doesn’t want to give it up. She drives, refuses to stop. She has savings and her house, but is spending money beyond her means. I am afraid she will live beyond her means. Her friends and niece are tired of all her needs, but won’t walk away which is enabling her to continue. She refuses to leave her home wants to go “feet first”. I am exhausted too. We travel to see her. Her disposition, which is very demanding and cranky, has left my husband washing his hands of her. We all believe she can’t be left at home alone, but can’t get her to move though we see her capacities failing. She isn’t so far along we can have her declared incompetent. I’m ready to give up POA!

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If she is still competent and your POA is "springing" then it's not activated until she's been declared incompetent by one or more doctors. If your POA is not yet active then she is just like any other adult in the world, free to make as dumb of decisions as she can. This is the exact position I'm in with my mom. She is both competent and unwilling to listen to any reason so she remains alone in her gross house until (yet another) terrible accident sends her to the hospital or worse.

Think for a moment about all the phenomenally awful decisions people make every single day. Substance use and abuse, gambling, risky sexual behavior, becoming hundreds of thousands in debt, you name it people are messing it up. What I've had to accept is that my mom and maybe your cousin aren't going to do what's best for us. They're going to do what they think is best for themselves even when they're wrong. All this is to say give up on being God or Superman, resign your POA, and make a good faith effort to make sure she assigns POAs to someone else. Someone young, ideally. There's an expression I love: you're not required to set yourself on fire to keep someone else warm.
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Rosie365 Aug 2022
I went through the same thing. The gross house, they have a name/excuse for it now. It's called squalor syndrome. The person is so focused on accomplishing daily personal tasks like mobility issues, food issues, etc that get increasingly difficult, that the things like house work and bathing go to the wayside. My mom was falling and needing paramedics, police, neighbors and family to pick her up several times a week. She would always refuse to go to the hospital and they would put her in her chair and leave. She was crawling on her hands and knees with brown bags food hanging from her teeth and the system said she was using good judgment to prevent falls. They all supported this foolish,, unsafe, lifestyle because hey were able to bill her insurance for on average $6000 a month to come tend to her pressure sores and do blood work etc. They kept telling me "as long as she knows her name and where she is, the POA couldn't become active. That was a lie because they had never seen it. It wasn't until this last fall that I was able to get her out of their grips and get her out of the way of herself. I love your expression....I'm feeling pretty toasty these days...I wish I had seen that saying 2 months ago.
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I'll be surprised if rehab agrees to release her back to living alone and doesn't insist she move into managed care of some kind. If they do agree to release her back home, to smoking and driving, falling and refusing this that and the other, then I agree with the others. Relinquish your POA and let her live what's left of her life on HER terms, safe or not. You can't save a person from herself, or you can wind up in need of medical care yourself trying to accomplish the impossible.
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robandjane Aug 2022
Well said. Hardest thing to do as a family member with POA is letting them live on their own terms. Broke my heart to hear my Mom say she wouldn't give up smoking even knowing they wouldn't give her oxygen until she did; knowing she would die within a year; and being reminded that she could live longer and have her grandchildren around her; but we eventually came to peace with letting her live her life her own way.
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Step back.
Resist trying to fix or save.
Allow your cousin the dignity to fight her own battle - to negotiate a safe discharge with rehab herself. Don't get in the way.
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What did your cousin intend when she gave you POA? What did she want you to be able to do on her behalf? Is there anything you're able to do for her that she will agree to, such as hiring in-home support, getting a falls alarm, asking an OT to visit the home and advise on adaptations?

If there isn't, and the reality is that the OP is refusing to consider any practical support, then it's pretty pointless your having POA and you may as well resign it on those grounds - it isn't a matter of pique, but your having POA may mislead other agencies or services into believing that your cousin has a stronger support network than she really does have.

Meanwhile, the neighbours and step-niece should start the laborious and tedious process of reporting every incident to APS, APS saying they can't do anything because the cousin has mental capacity, neighbours/step-niece keep reporting, APS keeps asking, and so on and so on until...

something happens that even your cousin can't argue with, such as a broken hip or a stroke, or
your cousin has a nasty moment followed by a change of heart or
your cousin passes the point where anybody can continue to consider her competent.

To avoid swallowing their own tongues and tearing their hair out in frustration, *everybody* should remember:
that it is cousin who will break her hip and be sorry, and not them;
that this is cousin's life which is becoming a daily challenge, and not theirs;
that no one individual is under any obligation to run cousin's errands, do her laundry, take her to appointments, or answer emergency phone calls. Encourage them to step back if they're providing more support than they are able and happy to, and be frank with your cousin about what demands she is placing on people.

Treat her like an adult, respect her decisions, but don't spare her feelings when it comes to discussing choices and consequences. If the situation blows up in her face, it'll be her responsibility and nobody else's.

You'll probably find she changes the subject, and it gets extremely irritating I can tell you. But then again, it is also not your responsibility if the local volunteers keep volunteering - you can only advise them not to if it's becoming too much.
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I would follow your husbands lead and I'd give up POA too. Listen to your exhausted body!
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As others have said, I recommend allowing the rehab/hospital system to determine whether she is safe to return home, and then just letting them do what they have to do. It is not a POA's job to ensure a competent person's safety, it's that person's job. When talking to the hospital/rehab, though, you CAN be clear to them about what services she has at home. She may tell them, "yes, I have people who help me at home, sure!", giving them the impression that she has 24/7 help, when in reality she just has neighbors that check in a few times a week. Knowing the facts will help them determine what she needs and may affect when/to where they release her.

Similarly, she may run out of money, yes. That's, frankly, her problem and not yours, until she is declared incompetent. Until that point, you have no legal power to restrict her spending. It may feel like watching a train wreck, but that's unavoidable. Still, you may want to contact her Area Agency on Aging or similar and ask them what your/her options are when she does run out of money/needs to move into a facility/etc.

Also, consider that being POA does not HAVE to require you to manage her. Your power of attorney does not override her choices. If she is competent, then her decisions can be all her own. If anyone contacts you, and it's a decision you don't want to make, just say, "my cousin is competent and should be allowed to make this decision." I'm not a lawyer, but I believe you could just "keep" the POA, but stand back and not "use" it. I say this because keeping the POA authority, even if you don't use it and instead defer to her for all decisions, will allow you to step in easily when/if she IS declared incompetent. At that point, it would be a hassle for you to regain POA (if you want it). (If you're Done With This, on the other hand, then of course, by all means, give it up officially.)

Good luck.
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robandjane Aug 2022
Very sound advice all around.
I would hang on to the POA and just not use it until it's necessary.
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Read your POA. See if the word Immediate is used. If so, your cousin put you in charge at the time she signed the paperwork.
If it says that a Dr or 2 are need to make it effective, then you cannot do anything if she is still cognitive and can make informed decisions. If she still can make informed decisions, then your POA in not in effect.

While she is in Rehab, have her evaluated for 24/7 care. If found she needs it, tell the Social Worker that it would be "unsafe" to send her home where there is no one to care for her. Because u live so far way, you are not in the position to care for her either. Rehab should not release her based on this info. She then can be transferred to LTC. You maybe then able to pay her bills out of her money. Sell her house house for her care. When the money is gone, then apply for Medicaid. Maybe instead of LTC u can place her in a nice AL.

Or, maybe the niece would not mind taking over the duties of POA if cousin is still of sound mind to assign her. Your POA will be revoked when cousin assigns a new POA.

You being 4 states away is too far for someone who holds complete POA, financial and Medical. POA needs to be held by someone who lives much closer. If the lawyer who drew up the paperwork is still practising I would contact him and tell him its getting too much and you are too far away to continue to hold the POA and you want to revoke it. I would do the same thing in your place.
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robandjane Aug 2022
POA's can be tailored to handle only very specific items; like real estate, stocks/bonds, benefits, etc. - and only if the box allowing 'all of the above powers' is checked and signed does the POA have broad authority.
Even in those cases; every entity will require a copy that has to be verified by their 'legal department' before they will put it in their system.

All that to say, if her POA isn't broad enough to handle the situations she feels competent to handle, I agree - she should give it to a lawyer or her niece if she will take it.
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Give up the PoA. This is way too much to go through, especially for a cousin.
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This discussion could not be more timely for me. My Uncle is 92, lives in a 55+ apartment community and still drives a car even though he’s getting lost all the time. He falls in his home several times a week. His wife, my maternal Aunt, died several years ago and I stood by to support him. 3.5 years later - here we are. I do everything for him. Until last week when he got lost and wrecked his car for the third time, was found wandering by the police and they called EMT and us. He spent a week in the hospital for testing. Basically he came out fine was not declared incompetent etc. and he was discharged. I’m his POA but he doesn’t and doesn’t have to listen or do anything I say. I’ve decided at this point he should now live his own life as he demanded. So, he is and I’m out of the picture per his request. He CANNOT manage is self care or finances but I’ve turned it over to him as requested. My husband keeps telling me he is making me his useful idiot. Sounds harsh, but … if the shoe fits, right? I’m leaving his legal paperwork as is. Just stepping aside. He has another party named as alternate POA who can step in if he wishes. The problem is I FEEL GUILTY and continue to worry myself over him. The above answers from others have been very confirming and helpful in showing me what if anything I can do until he is declared incompetent. Thank you ALL so much!!! ❤️
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Beatty Aug 2022
The midlands between competent & being deemed incompetent.
Awaiting the crises to effect change - crazy isn't it.
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The fact that your cousin is still alive and somewhat with it at 93 that is remarkable. The fact that she still smokes even moreso. She's not quitting smoking at 93 and no one should expect her to.
You as POA need to have a talk with her. That either she allows a live-in companion to move into her house to help her, or you will surrender POA over to the state. The state will most likley "place" her due to her age alone.
She lives in a gated golf community. That is heaven on earth. I wish I could take the position myself because your cousin and me would be on that course every day. I was a smoker too. I don't think it will be too difficult to find live-in companion help for her.
Advertise and look for a fellow smoker. Believe me when smokers know they can smoke on the job, they're be lining up for that job.
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