I am my aunt's DPOA/HPOA in the past year I have witnessed a sharp decline in her cognitive function. She recently had a severe UTI an had to be admitted to the Hospital. She was hallucinating. She didn't want to go and I forced the issue. She been upset with me for that. At the hospital they recommended skilled nursing rehab. My aunt has been adamant about not being placed in a nursing home. At the hospital I was told different things about her capacity to make medical decisions. A doctor told me she was medically sound to make her decisions. Then I find out in her medical records the psych doctor said she wasn't capable of making medical decisions at that time. An attorney told me I needed a medical evaluation to determine if she was capable. I was told the psych doctor recommendation was time sensitive- meaning only until baseline is back. Baseline wasn't good to start with. I did convince my aunt to allow 24/7 care in her home. Now, I her friends of are inserting themselves in her care and telling my aunt things. My aunt is blocking me from helping to a degree and has deferred to other people. I had a social worker acquiescent to my aunt's wishes. I don't have any idea where I stand. My aunt has since refused care, except for one person. She does seem to be back to base line. But baseline wasn't great. She had lost 18lbs in two months, a reason the UTI was so bad. Since, having care she gained 10lbs. At this point I added more cameras and she is wearing a life line. She also agreed to get a cognitive test and hopefully will follow through getting it. I am also doing this from out of town so it makes it hard. I feel at a loss as to what I can or should do. I feel she has to have some dementia she tells you what you want to hear. She is very smart that way. And, she gets confused. For example, can't tell you why she had an X-ray, let alone say X-ray. She doesn't know if she has diarrhea. She can't remember peoples names she has known all their lives, not even my adult children. She mixes me up with my mom constantly. And, she ruminates on the past and is convinced people are stealing from her. She tells people things and they believe what she is saying and most is not true. Any and all suggestions deeply appreciated
It will stipulate in simple language what you need to enforce the POA.
Usually, and normally that is TWO doctors who attest by letter that the principal is unable to make decisions for herself ongoing; it usually includes a diagnosis of dementia.
While UTI can cause mental changes, they will right themselves after treatment and cure. You say there have been problems ongoing.
If this continues to be an uncooperative and undiagnosed adult there is really no way without diagnosis for you to enforce ANYTHING including testing barring some catastrophy that requires ambulance to hospital and a resulting evaluation and agreement by neuro-psyc.
You do not have to continue to serve as either POA or MPOA if you don't wish to. You have basically been told that aunt is competent. Fine. Send her a letter resigning if you wish.
If you wish to continue to serve her as both MPOA and POA know this will be miserable. It is difficult enough to do this job for people who are cooperative. When there is no cooperation and no medical community agreement, it will be impossible, as you are finding out now.
You are out of town, she is obviously living alone with some level of dementia and memory problems, Showtiming others to avoid getting help, pushing you out of her way to boot, so what you've got on your hands is a big mess.
You'll likely have to wait for your aunt to have some sort of catastrophic event at home, be sent back to the hospital, then to rehab where they will NOT release her back home to live alone. THEN she will have no other choice but 24/7 help in home or to be placed FOR REAL in Skilled Nursing permanently. She'll have a cognitive evaluation then, and you'll know what's happening.
Good luck!
Thus, your Aunt will fight tooth and nail not to be placed, not realizing that Nursing Homes or Memory Care facilities are more like hotels today. If your Aunt can budget for a Memory Care, it would around between $5k-$8k per month depending on the area.
If your Aunt cannot budget for that amount, then you would need to start the process of Medicaid [which is different from Medicare] which will pay for her care in a Nursing Home. Medicaid is State run and funded by the taxpayers and the Federal Government.