My father has been diagnosed with dementia. He has a long-term girlfriend that is purposely excluding me from his care decisions. She has recently encouraged him to sell his house and is insisting he move into assisted living. This is not what he wants to do. I am his POA and healthcare proxy. They were never married nor have they ever lived together. He trusts her because she was a nurse, but her input isn’t needed. She has also been fired a few times during her nursing career. How can I get her to back off. I am the one responsible for him, not her, but she seems to be in control of him. I don’t feel she has his best interest in mind and she needs to step away. Any advise would be appreciated. Thank you.

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I don't know, from the way you describe their relationship, it doesn't sound like she believes herself to be his girlfriend...meeting for 5 minutes twice a week to give him some food she cooked does NOT a girlfriend make.

Could it be that DAD has some sort of delusions about the nature of their relationship? Has dad maybe been hinting - or even asking outright - for them to move in together? Is he maybe expecting that, as a retired nurse, she is his "solution" for aging in place, first as a companion then as a caregiver? Could THAT be why she's "insisting" that he needs AL placement?

And, sorry - but how do you KNOW that she "insists" he needs to be in a facility? Has she spoken these words to you, directly? Or are you hearing about them second hand from dad?

You say you want her to "back off", but frankly, 5 minutes 2 times a week is about as "backed off" as one can certainly doesn't seem that she is looking for any sort of commitment from your dad, if she's never even been to his house in all the years they've been "together". I mean, how many medical decisions can she make "for" dad in that 10 weekly minutes of time?

And since you, as POA clearly don't want dad to enter into AL, and dad himself seems disinclined to move into AL, then I really don't see what the problem is?
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Lots of people resist the idea of making changes, your father will eventually need to leave his home because dementia is progressive and in the not too distant future he will no longer be safe to live on his own. Perhaps she wants him to be proactive and move to a place that will be able to handle his increasing needs before he has to be dragged there kicking and screaming? Have you ever considered sitting with her over coffee to respectfully discuss what your plans are to meet his care needs, and what she might be able to do to help with that?
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As your dad's POA, what steps are you taking to insure his safety and that his care needs are being seen to, with dementia at play? You seem to think his long term g/f does not have his best interests at heart, yet you do not mention what steps YOU have taken to make sure he's being properly cared for, now and down the road? You do understand what all is involved WITH dementia, and how it progresses, right? And that Memory Care AL IS the best choice for most elders, right?

The g/f lives with dad 24/7; she sees what is going on first hand. How often do you see dad? What do you know about his day-to-day care needs and the management of him? I'm not saying you have 'no idea' what is going on, just asking if you DO know the ins and outs of their daily lives? If not, you may want to know what's happening before you cast judgement on the woman who's caring for your dad!
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Your update below leaves me quite concerned. You say his doctor has recommended AGAINST placement? What kind of doctor diagnoses one with dementia and then recommends against placement and allows the patient to drive to meet his girlfriend.
There is something we are missing here. Maybe missing a lot. Because if Dad can live alone and Dad can drive, then you better believe that Dad an change his POA from you to the Girlfriend. It is up to him.
Can't really advise you because now a man who is diagnosed with dementia is driving around to see his girlfriend and has a doctor saying he doesn't need placement. I kind of am left not even knowing what questions to ask at this point.
If Dad is so well that he neither needs placement nor limitations on driving then really it doesn't matter what you think about the girlfriend or her advice. It is up to Dad apparently to weigh what you say and what she says and to do as he pleases. Seems he may have been diagnosed with dementia but is considered competent. Which means as his POA you do as HE directs you.
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Sighopinion Mar 2022
It is not that uncommon my LO's doctor was against placement but I had a DPoA already so their recommendation fell on death ears. Many doctors and medical professionals are not in favor of placement. I could not even get respite care because they would not sign off the medical paperwork in fear I would abandon her.

Many base the need of placement off functionality not safety. Without considering the toll it puts on the family. Even know I still get flake from their doctor and even the staff at the SNF they are at. Because on a functional level they are correct, but that is moot when safety is a concern imo.
Dariusz, I see that you had posted to clarify that the woman your Dad is friends with is just that, a friend. Not a girl-friend as in a romantic partner.

Since that is the case, I agree with you, she has zero rights to how your Dad should be taking care of.

Many of us here had experienced cases where our parent(s) had refused to move. Usually it takes a serious illness or a major fall where the parent transfers from the hospital to senior living. Once my Dad had moved, he said he wished he would have done that years ago, as his house had become too overwhelming for him to maintain.

Let us know how this works out for you and your Dad.
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Dariusz Mar 2022
Thank you so much freqflyer!
This is all new to me and I am trying the best I can to learn and help. Some of these responses make it sound like I’m covering something up. I live a few hours away from him so I can’t see him every day but talk to him several times a day. The point of posting was for advice or thoughts on the subject. I know my father is deteriorating and soon he will need to go into a facility. I’m all for that. What is confusing me is this friend…by her own definition. They used to be romantic but she has clarified just a friend, that she is not including me in decisions and expects him to sell property while at the same time suggesting he can’t function on his own. She is very contradictory in her words and actions. If she wants to consult that’s fine, but to single-handedly decide what’s right for him is not her place.
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I'm assuming that (a) you haven't raised the issue directly with your father, or that (b) you have but he's still involved with the dominating woman?

There's a question of her motives that makes me wonder. Does she think he's going to give to proceeds of a house sale to her? Or does she anticipate that the proceeds would be used to fund AL? Is she no longer working and perhaps needs someone to fuss over? Try to think what her goals are, and figure out ways to block if not undermine them. Blunt, and perhaps not very nice, but her meddling isn't appropriate.

What do you think ARE her goals? I'm assuming she has no obligation for upkeep of his home, so that shouldn't factor into the picture.

Do you think there's any value in sitting down for a frank, woman to woman talk with her? One option is to meet with in person and advise her that she's overstepping her boundaries and needs to stop.

Assuming there's not, and that she's intent to remain involved, you could consider having an attorney write a cautionary letter to her advising her to cease interfering with your father's care and decision making.

Failure to do so could be to request an injunction against her to restrict her contact. A PPO (Personal Protection Order) would be that kind of option.

Since she has no legal standing to advise, "guide" (or perhaps manipulate) him, what is her value to him? Just friendship? If so, are there family who can step up and substitute their own companionship? Friends? Senior center? Not all of these might be appropriate, but they're options. I think people who tend to rely on limited advice tend less to feel confident in making their own decisions, although your indication that your father doesn't want to sell the house would negate that.

I found that during care for my father, as well as afterward, some people felt very free to express their thoughts on what should be done. This especially included people in his church, some of whom were helpful, but others were just pests, and a few who were just stupid and ignorant of caring for an elder person, especially during the last stages of life. They ignored my advice, b/c they felt they knew more than anyone who wasn't a church member did.

I knew that argument was futile; they were always, always right (in their own narrow minds). So I listened to them just to be polite when my father was still alive, but after that, I took steps to shut them out.

I also had no qualms challenging their so-called advice, but I learned that it was futile. But I'm probably more aggressive than you, and I wouldn't recommend challenging this person in a way that make your father resent your intervention.
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Wanting him to sell so that he can go into a private pay al does not sound like she is a gold digger. And if she’s been over there on the daily, she may have been frontline with situations that she recognizes are beyond her help.

It might well be that as a long term partner, she’s genuinely concerned. If dad is truly 24/7, what are your plans for him to age in place?
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I hope one of his Drs is a neurologist. Because a PCP knows a little about everything and alot about nothing. Dad should have blood tests to rule out anything physical, an EEG and an MRI (verify a Dementia).

I really don't see how this friend he sees occasionally has any influence on him. Like said, she may be just suggesting.

I don't see why any doctor would be against Assisted Living. You don't have to have Dementia to place yourself in one. My Moms AL combined Dementia and those with no cognitive problems. Another AL near me had a MC section for those suffering from Dementia. If your Dad has problems with any if his ADLs, an AL would be a good place for him. He gets 3 meals a day. They take care of his meds. There are activities and entertainment. A bus is supplied for appts and shopping. There were people who still drove at Moms, sat on the porch and took walks. With nursing homes, Medicaid requires a need to be there. A doctor needs to say 24/7 care is needed. Not so with an AL. They work with your DR but you don't need a doctor to OK it. You don't have to wait till Dad gets worse. Actually, its better if they are placed earlier because then they except it more as home. Its not a prison.

I think we all are in denial when it comes to Dementia and a parent. My nephew lived with my Mom and took care of her. Her decline started with asking me to write her checks, then her signing to me writing and signing. My nephew worked so he was out of the house from 8 to 4. He came home one day with Mom crying she had no idea where he was. Another time a pan burnt on the stove. Both times I should have taken her to my house. But no, just told her to let nephew do the cooking. It was a stay in rehab for a UTI that the decision was made to bring her to my house. My daughter is an RN and we realized then it was a long time coming. How many times had Mom sat all day waiting for nephew to come home to turn on the TV because she forgot how to use the remote or the phone. That was another incident, nephew found her crying because she could not remember how to answer a phone.

With my Mom her decline was monthly. Decline can literally be overnight. As I just said in another post, we had a client who one day lived in her own home with just some overseeing and the next morning they were looking for a NH. She had what my nurses called an episode. Dementia has no rhyme or reason. Its unpredictable from day to day. In the early stage they can "showtime" which means they can act normal when needed, like with a doctor. Then there's "sundowning" where the Dementia really comes out.

For me the AL was great. I still had some responsibilities like paying for it out of Moms money. I chose to wash her clothes but there was a laundry room where u could do ur own clothes or an aide would do it for you. I still got her Depends. But her prescriptions were taken care of by the RN. I chose to visit every day because I was 5 min away but I stayed no longer than an hr maybe 15 min. The AL was good for my peace of mind and good for Mom because she could walk all over the facility. Sit in the hallways and socialize. My house is a split so she had to stay in one area. When my time comes, I plan on an AL.
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CWillie, good insights, and a good and more positive perspective. I wasn't able to envision the options you suggest, and appreciate your insights as it helps me re-evaluate what I wrote.
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You say your father doesn't want to move.
And you as his POA don't feel he NEEDS to move.
So what does it matter WHAT the girlfriend says or does. She has ZERO power over him.
She is a nurse. What might she be seeing about Dad living alone that worries her? And if she is a nurse, what doesn't she know about dementia that leads her to have the mistaken idea your Dad is capable of handling a home sale?
If you are health care proxy and POA do know that Dad can change it to her if he can pass an exam in the attorney's office.
I agree with PeggySue that she doesn't seem to be a gold digger if she is suggesting he move into care, as that is expensive and she is feeling he should pay with his own finances.
I think you need to be grown up enough to suggest to her that you meet for coffee. Discuss her concerns; inform her gently of your powers and your Dad's wishes. Ask her what she is seeing, and etc. Working together is not only going to be easier, but it is going to be EVER SO MUCH MORE KIND to your Dad, who is being kind of torn between you.
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lealonnie1 Mar 2022
Except that the g/f is caring for the man 24/7. That's power.
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