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I cannot be there to take care of her. I've told her this. I live in another state. She's in serious denial of her mobility. She has other family close by, but they, too, are busy with their lives. I know they're going to be all over me to come help when she's out. I don't know what to do with my aunt. She's denying at home care, and assisted living, and denying she has dementia. She cannot be home alone. I know I may have posted this a thousand times, but I honestly do not know what to do with her. We're all at ease with her in rehab, but when she comes out, then what? Friends are telling me to move in to help her. No way! I work, live far, and even if I were willing, feisty, stubborn aunt doesn't want help except to clean her house. What happens next?

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Many older people do not trust a caregiver to enter their home when they feel less capable themselves. Sometimes its a loss of privacy and sometime it's a fear or being taken advantage of or somehow intimidated. Many of these fears are very reasonable. Discussing "why you don't want outside help" and giving some reasonable answers to their reasons can help many elders.

My mother have me fits about having someone do heavy housework in her home after her hip and knee replacements. First, my father didn't want "strangers" in the house (are you ready to do the work so we don't need a stranger's help). Second, my mom was afraid the work wouldn't be done to her standard. I pointed out my job didn't allow me to help her the way she was able to help her mother (mom spent a day at grandma's doing her housework each week from grandma's late 60s) and even if the vacuuming wasn't done to her standard wasn't it better than not being done at all?

After I found someone and Mom became accustomed to having someone come in to the house, she began to appreciate the help and even decided on additional tasks they could do or help her do - like cleaning out the freezer. Dad's paranoid personality disorder meant he was never happy but he did learn to live with his unhappiness.
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What happens next is she falls or becomes ill.

If she's lucky, someone will find her and get her back to the hospital.
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anonymous1732518 Oct 2023
A carer live in or otherwise could be the answer.
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Possibly going through this ( home care ) though not to this extreme. Hesitant as well for this help, but searching websites with a photo of the carer as well as the description makes this much easier. I already have at least 3 carers to consider finding it hard (in a good way,) to eliminate any contender

Maybe this could work for your aunt.🙂

Good luck!!
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Tired,

You r a good person. Its called empathy. From all you have described, your Aunt wants things her way or not at all. But you need to tell yourself, there is nothing you can do for this woman because she wants no help. What you can do is call APS. Tell them that you live too far away to check on your Aunt who was just released and could they do a well visit because your afraid nothing was put in place for her care at home. At this point she won't talk to you and family there seems to think she will be alright but ur worried. This does not obligate you in any way. Its easier for APS if they can find family to care for her, but they cannot force you or any of your cousins to do the caring or coordinate caring. Your not responsible for Aunt financially either. Its APS's job to make sure Aunt is cared for. If anything, this call may put Aunt on their radar. Maybe resources can be found for her to stay in her home. It will put ur mind at rest to know APS looked in on Aunt.
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Please, folks, unless your loved one is deemed mentally incompetent, keep in mind that they are allowed to make their own decisions. If they are refusing help and begging you to do it, say no. If they're just wanting to go home, they go home. Like others have noted, I'd rather be home pretty much no matter what. To which end, I've purchased long term care coverage and made my preferences explicit to my family.
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Tiredniece23 Oct 2023
Thanks. She's home, and she's alone, as far as I know. No home care, either. I'm out of it. Just concerned.
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If she does have some cognitive decline, just tell her you hired a "housekeeper", (who is in on the ruse), and who is actually a caregiver. Would that work?
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Beatty Oct 2023
Yes this is a good way.

In this particular case the niece lives out of state so it really is not her responsibility at all to arrange.
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Tiredniece23: It is imperative that you step away and let social services take over. YOU are not responsible for your aunt's care. This should be deemed an unsafe discharge from the rehabilitation facility.
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Let facility he is released from know he has no care at home and a danger to himself. If they send him home just wait for the fall and he will be right back in. Does his doctor say he cannot live alone, if so its not your call
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Hi,
Your situation sounds similar to mine except it is my dad. He is in the hospital right now but will need 24/7 care when he leaves. Long story short, he needs a nursing facility because he has many health issues. But his side of the family, including him, really think that I should be able to it all. I'm not a nurse , dietitian or a physical therapist. He needs all three daily. He refuses to accept the fact that he can not live alone and refuses the idea of a facility even after a doctor telling him recently that if he did get any better/stronger that would be the next step. I work ( new job) and I'm not able. Even if I were not working, I'm not physically or mentally able . I have done all that I could for him since my mom has been gone and that has been over 20 years. Before he went in the hospital, I was doing all the cleaning, grocery shopping, taking to doctors appointments and etc. Basically I'm burned out now. My advice for you is not to take this on! People might talk but let them. I recently came to a realization that I have done all I can. You can not run yourself down.. trust me, it is no fun.
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anonymous1732518 Oct 2023
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I read MOST of the responses.

You are out of the Will and apparently not the POA any longer.

After reading more here, get into therapy with a professional psychotherapist.
You need to find your self-respect / self-love and get out of this situation yesterday. All our support here won't help you if you do not (want to) help yourself.

You do what is in their best interest, after putting your life / needs FIRST.
It is time to realize you need to let some things go - and this is one of them.
You can do so much and then you need to stop and re-evaluate why you are feeling like this and why you continue to ALLOW YOURSELF TO BE emotionally triggered.

Of course you love your aunt.
Still, she has OTHER family CLOSE by. This is their responsibility, isn't it?
Why are you concerned / fearful of "I know they're going to be all over me..."
Do not be intimidated. As you seem to be, consider why you allow yourself to react / feel as you do. Why does their opinion / response matter to you so much?
You are allowing yourself to be their punching bag. Why?

The bottom line is -
(1) if there is no legal documentation set up;
(2) If she is not diagnosed with dementia
(3) If you do not have legal authority, there is little anyone can do.
She will do what happens to many in her position.
* They are both - compromised cognitively and cannot make decisions in their own best interest and their personality doesn't allow for others to intervene (for whatever reasons, stubborn, narcissistic, fearful-afraid of losing independence) so when home, something will happen and she may be hospitalized again.

Don't listen to your friends. It is easy to be on the side lines and give advice, isn't it? Will these friends help out financially and pay for caregivers?

We all have busy lives. This is no excuse as a response from family that live close by. They / perhaps all involved can try to work out a plan together, financially to hire caregivers. If your aunt denies care, then the chips fall where they may. At some point, you have to let this go. You are only one person, living out of state. From what you tell us here, this is not entirely your responsibility. The key is how you internalize your feelings (guilt / desire / wanting to help out). Once you are clear or process how you feel, you will be more at peace and accept what is - and perhaps enlist - with mental and emotional clarity - the family members who live close by.

And, get some new friends who will support your decisions, not tell you what to do.

Gena / Touch Matters
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Beatty Oct 2023
Your reply makes so much sense to me.

I suppose I used to be in that FOG & felt guilt when I didn't step in to appease expectations.

I did look at why.
I began to see clearer.

I recently discussed a discharge with a hospital staff member, calmly, without any emotional triggers.

Your advice CAN work. I wish to state that for the benefit of anyone reading.

Thankyou.
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You simply can not give up your life. Period.
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faithfulbeauty Oct 2023
Amen.. I'm always amazed at how people expect others to give up their life. Most of the time, the people who expect this, will not give up theirs.
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Social services will not step in. The DCF will assess and make recommendations but unless you have her declared incompetent by a judge and are appointed her guardian nothing will get done until she is completely incapacitated. She’s an adult in the eyes of the law. The rehab cannot hold her, even in an unsafe discharge.
please people, educate yourselves .
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Tiredniece23 Oct 2023
You are absolutely correct. She was discharged, and APS will not step in, either. Basically, hands are tied. You're very wise. Thank you.
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Court appointed guardian; make an appointment with a Elder Law Attorney in her area (Zoom).
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TouchMatters Oct 2023
Or ask the family that live close by to hire an attorney.
Why should this person pay for an attorney?
Although I do not know the relationships. Still.
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Don't know if it work for you but worth a try. A friend shared this: Tell rehab she has no safe place to be released to. My understanding is they cannot release her unless she has a safe place to go. Then let the rehab center deal with finding a way to release her. BUT, the minute a family removes her from rehab, rehab is off the hook.
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LouLou123 Oct 2023
Yes! I have heard this also in AZ. You do not have any responsibility to your Aunt or her family or other relatives. Sounds like they are placing you in a stressful situation. Why cant they help out? Why are they picking you to be her caregiver? If she has dementia it will only get to be more responsibility and stress for you! Are they willing to pay you to support you leaving a job or to care for her? Did the Aunt name you POA? Is she going to provide for your future? It's a BIG Responsibility!! I've been there and after 4 yrs, I had to step back and let someone else takeover. My health was suffering from caregiving so long. I was happy I was able to care for this person but it was time for someone else to step up. This person needed 24/7 care and would not go into asst living! It was not fair to me to continue to give up everything. It actually took me to fly to a friend's home and I've been here 3 months now to destress myself. With dementia you have no idea how long a person may live if they have no underlying health issues. They could continue to live for another 5 years or more. Please seriously think about this decision and don't feel pressured by no means! Obviously, no one else feels pressed to step in to care for her. Sounds like your the scapegoat for whatever reason. Praying for you!
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Why should you be responsible for your aunt's care? You seem to be questioning your own boundaries about how much you are willing to do for her. You need to know your limits and believe in yourself. If your aunt is discharged to her own home and is not declared medically or mentally incompetent by her doctors, then she will go home and bumble along on her own. If she only wants help with cleaning, the family might help arrange a cleaning service.
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Jdjn99 Oct 2023
Bingo.
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Say no to the family and live your own life. I wish I had that option. And don't ruin your life for someone who does not want help.
But mostly: This is their problem to solve, and worst case scenario you get the state to step in and be guardian if they will not (we had to do that with my father and they put him in a nursing home. They actually did a good job. But I wish he had died on his own terms but we would be accused of neglect if we didn't help him).
As an aside: I do think our anxiety about our elders is more about us than them. They tell us what they want. Many would rather crawl to the fridge and die from a fall at home than be sent to a home or have to have "strangers' in to care for them. I happen to be one of them. I plan to have a "final exit" in place so no one has to waste their life taking care of me when I am no longer independent.
After my 8 long years with my mother...I am starting to think we really need to rethink how we treat "recalcitrant" elders.
If I had to do anything over again it would be...rethinking the anxiety and time and effort and money I spent to keep my mom alive a few years longer just so she could eventually be relegated to (expensive) care anyway where she no longer can do anything on her own.
I am starting to think we don't do our elders any favors by trying to keep them safe. Safe for what? So they can live longer to become more helpless and dependent and depressed away from everything they know?
Every time I see posts about keeping an elder "safe" and they can't be alone...I was there once, but now based on everything I have seen with my mother and the rest of the elders the medical profession insists on propping up until they become living, suffering statues...it is not a blessing to live longer.
I do think in another, earlier time without all the meds we have to keep people going, people died much more on their own terms.
In any case--just say no and let her family deal. And stop talking about it with your friends. They don't get it. No one does until they have been through it.
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Tiredniece23 Oct 2023
{Hugs}. Thank you.
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Talk to the case manager or social worker. Let him/her know you will not be able to care for her at home. Whomever has power of attorney should make the decision for her follow on care if she is not mentally capable of making sound decisions.
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TouchMatters Oct 2023
I still do not understand why this niece is managing care / talking to the rehab facility WHEN there is family living close by? She needs to involve the family close by in managing follow up care of her aunt directly with the rehab facility.

Who are these family members living close by ... that are busy?
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Dear Tiredneice23,
Reading your post I kept thinking, did I write this? :) I just went thru a similar episode with my Aunt who has some dementia and a load of denial. The dementia means their mind just can't function with reason and logic. It's all so hard. At the point you're at I would call in social services. Then it's in their hands(and talk to them about all the concerns). I tried what I could for my Aunt and now I have to let go. Social Services should monitor your Aunt. Talking with them about how things proceed will help you.
Best Wishes!
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TouchMatters Oct 2023
I still say it is the family that live close by that need to call social services, an elder attorney, and deal with the rehab facility. Why is this niece taking all this on? I'm missing pieces of this family puzzle.
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You posted “She's still my aunt. I still care, regardless”. Of course she’s still your aunt. But you have turned “I still care” into feeling that someone has to make a personal commitment to care for her, and if no-one else will, then perhaps it has to be you.

The state is there for elderly people who don’t have appropriate family members. There is a whole tax-payer-funded industry of people and institutions set up for them. They aren’t just unloaded under the nearest bridge to live in a cardboard box.

If you want to feel better about this, perhaps you should contact the facility social worker, make it very clear that you can’t and won’t help (and neither will anyone else you know about), and ask for full details about what this will mean for aunt. What arrangements will be made for her care? If you know more (and so does the placement social worker) you may find it easier to accept this difficult situation – without ruining your life or blaming the other family members.
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You know what really gets too me, when people don't take NO for an answer. I get p****d. I try not to show it but I am sure my face does. What you need to realize, you cannot help this Aunt. You can have empathy for her but you cannot fix the situation she is in. Its not her fault either. She has no one willing to take on the responsibility of her care. Its a lot to ask family members that are young and dealing with their own lives to even consider it. And I think you have said she is not easy to get along with. The best thing u can do is stop picking up the phone. Make it clear to the Social Worker that you are not and never will be this woman's caregiver and then ask that they stop calling you. Your just making sure that you are no included in the discharge plan because u would not put it passed Aunt to say u will be caring for her. Then the SW will need to do her job and tell the State ur Aunt needs a guardian. Then block everyone. Once Aunt is situated in a NH, then u can visit, send her cards if u feel u need to do something. Sorry N0! Hang up and block.
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TouchMatters Oct 2023
When one understands dementia, they realize what someone else can and cannot do. We don't even know the degree of dementia. Even so, this niece would be more educated if reading / googling TEEPA SNOW and see her website - on how to deal with people with dementia.

Anyone who 'listens' to a person with dementia will continue to be emotionally and psychologically stressed out and not be able to make any decisions that will help anyone involved, esp the aunt.

Yes. We need to set boundaries and that involved self-education, self-respect, and not being intimidated by others' remarks / responses. Otherwise, they are (this niece) is a target for the family's pressure to move in ? or be responsible / involved with her aunt's care / follow up needs. "Listening" to the aunt is at the top of the list to NOT DO as she is not cognitively able to make decisions.

The niece needs to educate herself with dementia --- to find some self-confidence to set boundaries of her involvement, and manage her emotional responses / guilt. It is not an easy situation for any of us - when we care and we are tired, if not exhausted, and have these other variables (distance).

It is important to respect a person with dementia and then do what is necessary. In this situation, from the information I have, the niece needs to let the family living close by handle things. And, remove herself from some / most / all involvement during the [arrangement making/] transition back home.
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You don't need an excuse. The answer is no. Stop listening to family or friends. You aren't even obligated to talk to hospitals, social workers or anybody for that matter. You are five hours away! Do not give up your job to move in with an elderly and possibly someone suffering from dementia.

Do not give up your job because if you do, you will not be able to pay your own bills. You are not this woman's insurance.
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TouchMatters Oct 2023
Of course. The question here is WHY is this niece taking all this on?
There are psychological reasons, if not life-long self-esteem issues, family triggers, if not emotional abuse. Whatever the 'it' is - the niece needs to step away - yesterday.
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"Friends are telling me to move in to help her."

Stop talking about this situation. Your answer has been and still is NO! Remember its a one word sentence. This woman is not ur responsibility no matter what she or other people think. You are not an option or a solution. Its very simple, this woman has no family willing on taking the responsibility of caring for her. So, then a state guardian takes over her care. Your a niece. A niece that occasionally visits because you have empathy for her but that does not oblige you to care for her. Even if u were still a POA, that does not mean you do the care.

You can't be wishy washy here. You have to stand firm. If you have not taken my suggestion yet, you need to. You need to call the SW and make sure Aunt has not made you part of the discharge plan. If she has you make it perfectly clear that you aren't. I think being 5hrs away is a good excuse on its own. Next excuse, there is family lots closer. Next excuse, you refuse to give up ur job and future to care for this Aunt. Then the SW will just have to find other options.
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TouchMatters Oct 2023
Right. No wishy-washy.

Stand firm.

I believe (?) the aunt cannot make this niece a part of the discharge plan without the niece's consent. Even if she is listed, (the niece) she needs to be clear with the rehab facility to take niece's name off the paperwork for anything.

It sounds to me like this niece of emotionally / psychologically very wounded / vulnerable to - thus far - not make clearly needed decisions. She seems to have been a scape goat for the family living close by. And that can only happen with a willing participant.

Still, we don't know all the family history.
Still, the niece needs to dis-engage yesterday.

The niece needs to realize that:
Yes: she will feel really bad stepping aside / standing up for herself.
(She is not used to doing this so new behavior is always hard.)
She needs to build up her own sense of self / self-esteem - and as needed get into therapy to learn how to do this.

And, yes. It can be (is ?) a life long process to reverse wounded emotional history. The point / key is starting and taking one day at a day.
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If aunt is like my mom she’ll agree to everything making it a safe discharge (visiting nurse, visiting OT, PT, aides) and then simply stop answering the phone or door after the first couple visits. By that time the facility will say it’s out of their hands. I know because I called my mom’s facility when she did this. But unfortunately it’s truly out of the OP’s hands. Too bad closer family won’t at least check in on aunt. But it sounds like the won’t.

And yes, “advice” from friends is useless and guilt inducing. They don’t get it.
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The facility shouldn’t allow someone to becrekeased home if they feel it’s unsafe for her to be alone…

how sad… I’m dorry she’s going through that…
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anonymous1732518 Oct 2023
They don't. The therapists and social worker should/will sit down with her and go over her options before discharge or the discharge process won't start.
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Do nothing, she has family there. Either they take her in or she goes to a facility.

Step, back and let social services help her.

It is no longer about what she wants, it is about what she needs.

Friends have no clue, don't worry about what they have to say.

Stick to your guns, Sending support your way.
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TouchMatters Oct 2023
Thank you. Very succinct and clear.
Unlike me, very long winded.
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Tired, I have followed your posts. You have told her and family for a while now ur not moving and your not caring for your Aunt. What u need to do now is call the SW at Rehab and tell her to release ur Aunt to home would be an unsafe discharge. Because...there is no one to care for her longterm. You live 5 hrs away. And family who live near have their own lives. What may have to happen is the State steps in and handles her care. The only other option is, you give up your life to care for her and we all know that really is not an option. In home help is not permanent. Eventually Medicare stops paying. So better she be placed then later.

Who has been seeing Aunt while she has been in the Rehab? A family member there is going to have to be involved to a point. Not care for her but be a contact.

Its a shame your Aunt has no children of her own. That her siblings are old or gone . But her care is not up to her nieces and nephews.
The best thing you can do is make that call to the SW. Its what it is, she needs care and no one can do it.
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Tired, we understand that you care about her! And want the best outcome.

Unfortunately, sometimes, when an elder is uncooperative, the best and only thing you can do is step away and let social services take over.

We had an elderly lady in our community who wanted to say at home, at all costs. We supported her. She came home from rehab. I stayed the first night make sure that both first and second shift aides showed up. Amazingly, they did.

She stayed at home with 24/7 aides (available in NYc) with the help of our synagogue community (mostly helped by her friend who married my ex). It was a labor of love for someone we all cared about; she was grateful beyond anything.

She had stepchildren who were greedy and of no assistance.

My point is that THIS lady had her wits about her and was grateful for the assistance she received (not in a monetary way). She cooperated when she needed to be in rehab.

Your aunt has dementia and sounds high-handed and entitled. That's a whole different ballgame, in my book.
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Since you say that you're no longer your aunts POA and she's taken you out of her will, why are you still so concerned about what will happen to her?
If she refuses home care when she gets out of rehab that will be on her, and her relatives living closer(who obviously want nothing to do with her either)can call APS and report a vulnerable adult living by themselves, and they will come out and do an assessment and take things from there.
It's really not that complicated. I'm not understanding why you're wanting to make it so. Just wash your hands once and for all and let the chips fall where they may.
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Tiredniece23 Oct 2023
She's still my aunt. I still care, regardless.
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If you are her PoA, resign. In my state it isn't possible to assign a PoA without that person also having to sign the paperwork. They get an original copy of those docs for their own records.

If you're not her PoA, tell the rehab that she's an "unsafe discharge", that you are not her PoA nor caregiver and that as far as you know she won't be able to care sufficiently for herself at home, alone. Then have a chat with a social worker for her county as to "what happens next".

Does she have a medical diagnosis of cognitive impairment? If not, they may release her assuming she is making good decisions. You should inform the other relatives who live closer to her that they should NOT retrieve her from rehab unless they intend to orbit around her. You are not interested in being involved any more.

You don't have to do any hands-on caregiving. Don't knuckle under to their pressures or whining or guilting. After you "resign" to them, stop communicating with them if you don't want to be made to feel bad. This is called a boundary.
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Tiredniece23 Oct 2023
Thanks. I have resigned as POA.
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