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I have been chasing down my independently wealthy 94 year old, childless, unmarried aunt for the past 6-7 years and working overtime long-distance to keep her groceries delivered, bills paid, emails read, lawyers notified, social workers informed, healthcare networks linked, timelines tracked, etc. etc. Getting her to make informed decisions has been like chasing butterflies. Thanks to the HIPAA laws, healthcare providers are throwing me under the bus every time I try to confide in them that she is in need of elevated levels of care and that there is a lot of sundowning going on behind all the showtiming scenes.



In 2021, it was like pulling teeth to get her to make it through the application process for an independent living apartment in a beautiful and supportive senior residence. Flash forward a year and she is six months behind in rent, her apartment looks like a storage unit of unpacked boxes, the building inspector gives her a citation and she is trying to rally residents to her side against the kitchen staff for not serving up enough greens.



Things get beyond humorous when she gives her Notice to Quit without having another place to go. Having reached out to family members for support, I realize that we cannot petition the courts for guardianship until we know which county to petition. So we wait.



Tension builds as we are over a month past her deadline to move out. She is no longer speaking to me because I had to secretly rescue her dog from the pound because the senior residence directors felt she was unable to care for it herself. They are all convinced that she needs to be in assisted living. And then unusual activity appears on the timeline and the directors confirm that she has officially moved out into a gated 55+ community. The timeline stops at a resident only bank. She probably threw her phone into a safe deposit box.



According to the directors of her previous residence, she has talked about showing up at my door unannounced to take back the dog. I am expecting her to show up any minute.



Now what?

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When she shows up, take her to the local ER. She has either an undiagnosed mental health issue or undiagnosed dementia. Either one makes her at risk for health and safety concerns. Hopefully, they will admit her for evaluation and treatment. Work with the social worker/case manager to get her the care she needs. They can also guide you regarding guardianship.
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Sometimes you just need to let things play out. Report her to Adult Protective Services and tell them everything. Then wait!
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mcancro: As you state in your profile that Vincenza suffers from dementia, her brain does not possess the capacity for logical thought processes. Perhaps she requires a higher level of managed care.
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This is a difficult situation, I'm sorry. If she is still deemed competent, then she is the one responsible for her own finances/living arrangements/etc. If she wants to move and not tell you where, then she can do that. If she is not willing to give you any power over any of this, then you HAVE no power over it, and she has the legal standing to back that up. Just be aware of this, because it sounds like a potentially tricky situation for you, legally. She could call the police on you for "kidnapping" her dog, for instance, or for stalking/harassing her, even though you have the best of intentions. Whether that would result in anything would depend whether you or she can convince them of your/her version of events, but still, you need to protect yourself, too. Have you contacted an elder care lawyer for yourself? Having someone who can advise you on the legal aspects could really help you navigate both this transitional time and also the future, if you apply for guardianship.

It sounds like you've done a lot for her, and kudos to you. The situation right now seems very up in the air, and honestly, I'd suggest just waiting. Contact her local adult protective services and let them know that she needs help/assessment. Wait and see if she moves into the new place, then once she's a resident, talk to APS/your lawyer about your options to apply for guardianship. Wait and see if she shows up at your door, and as someone else suggested, if you can, maybe use that as an opportunity to call an ambulance and get her taken to the hospital for confusion, at which point they can at least do a cognitive test and mental health assessment on her. See if they deem her an unsafe discharge, and if they do, then try to work with her case worker to find a place she can be placed safely while you work out everything else. (Just note that they will probably default to asking if she can be released to you, but that doesn't sound like what you/she needs - it sounds like she may need to be placed in a facility, and it is much easier for that placement to happen from a controlled environment like a hospital.)

If she moves into her new place but you can't visit her, you can keep asking for welfare checks. Also, HIPAA should only prevent doctors from giving out information to you, it doesn't prevent you from calling her doctors and giving information to them - be willing to keep telling her doctors, ERs, hospitals, etc. that you feel she cannot take care of herself, and ask that that info be noted in her file/given to her doctors. If they choose not to act on it, that's on them.

Also...take care of yourself. You sound like you are very concerned for her welfare, and that is great. But right now you are not RESPONSIBLE for her welfare, she is. If she is deemed incompetent and does not trust you, then becoming her guardian would sign you up to be in a very thankless position of responsibility for her. Be honest with yourself about whether or not you're ready for that. Good luck.
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I suggest you contact APS (adult protectuve services) with your concerns. They will document your concerbs, do a wellness check, etc. She needs to be assessed by a neurologist and they will state she is not able to care for her ADL needs (health, financial, etc.) And deem her non-decisional. Please reach out to an elder/estate attorney to apply for emergency guardianship. They can petition the court to review within 10 days filled under "emergency." Te attorney will request medical files, police reports, reports from APS (Adult Protective Services), get a report from her priest about his concerns, get a report from her previous senior communityshe was living in, etc. This will bode in your favor, as well as hers, though she's not cognitively able to accept that. Guardianship trumps POA. Her doctors, etc. will be legally responsible to work with you. I wish you the best and will pray for her safety.
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What I do know is that she worked with a realtor to close on a condo in this 55+ gated community, so she does legally own her residence free and clear, because I am sure that she paid cash for it. Will she be able to keep up with the bills? My guess is that they would have to be paper bills only and bill payment would still be hit or miss based on whether or not she comes up with a reason not to pay the bill.

Her independent living facility does have her forwarding address and they did send the local PD to do a welfare check at her new residence, even though she didn't appreciate it.

Last I checked, she hadn't turned in the key yet and still had clothes and clutter left behind in the kitchen and bedroom closet. All the furniture got moved. Their legal department is working on it.

As for DPOA, she has made it very clear that she does not want any family members to be her DPOA and gave the last senior residence the name of her favorite priest, who is happy to talk to her but is not willing to be her DPOA. I spoke to him and he is very concerned that she will end up in the hands of state guardianship which is why we, as family members, are so concerned about protecting her from that. Any petition for guardianship from a family member would have to go to litigation.

I have considered trying to somehow introduce her to a selection of geriatric care managers and require her to hire one before i would release the dog back to her, as she and I have joint ownership of the dog. Perhaps i will try that route first.

Last time I wrote to her on a Christmas card, she sent it back to me with nasty messages and last time she called me she was screaming at me about the dog so I had to hang up on her. I am not sure if I should make the first move at this point or wait for her.
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geddyupgo Mar 2023
Can she manage the dog? Sounds scary although I guess her new place does allow pets but I'm pretty sure it sounds like the poor dog is at risk if she is the only one taking care of it.
Maybe try the APS route. APS is better is some states than in others but you should be able to make an anonymous request. If she showtimes, she will probably make them believe she is totally competent ............ and call you and scream at you the moment you are out of the door.
I do think you ought to get and elder care attorney and lay this out for him/her so that you will know your rights and your boundaries. Wish I had something better to tell you but I will think on it and see if I can come up with something else. Good Luck
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Without PoA you have no power in this situation. You can try to report her as a missing person and see what the police do with this.

If she shows up unannounced at your door you have an opportunity to either take her directly to the ER (due to "confusion") and inform them she is an "unsafe discharge" and then work with the social worker on getting guardianship and then placed in a facility (FYI once this happens you will be locked out of any accounts regarding her personal affairs. You will no longer have any insights into her medical or financial situation), or you make a condition of her "moving in" with you that she assign you as DPoA (you can download forms and do this without an attorney like I did with my Mom). Then you must take her asap to a doctor to be given a cognitive exam.

She most likey didn't put her phone in a safe deposit box... at 94 she probably lost it (or the charger). She may not remember where you live. She sounds like a handful so have tempered expectations about helping her at all.
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mcancro Feb 2023
Thank you for your sound advice!
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Where is your Aunt now? Or is that problem #1?

Her independent living management doesn't have her forwarding address? She just left?? Did she take her belongings?

Do you think your Aunt is capable of looking after herself, eating properly, taking any medication, moving home, or at least paying for a hotel room?

If not, I Ihink I would call all the hospitals local to her last address & if not located, then report her as a missing person.

I hope this is not the case.
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