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Due to progressing dementia and a stroke this past year, my husband is no longer able to make decisions about our finances, home, etc. We have a durable power of attorney document in place, but I'm not sure how to "act" on it. Do I need to do anything to "take" power of attorney? Is taking guardianship necessary if I am his POA? Currently, if he says yes to things on the phone, or signs something someone brings to the door, I don't think I have any legal way to show we should not be bound by his decisions. I appreciate any advice you have.

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You need to have your husband evaluated by a doctor to see if he can be declared incompetent so that you can file for guardianship which it sounds like you need to protect him from unwise decisions and you from the results of those decisions.
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Do not file for guardianship it is a nightmare. If the court even remotely find you incapable of taking care of your husband they will appoint a state Guardian. You do not want to go there trust me. Protect him the best you can but don't go down the guardian Road
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