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I have an aunt (86) who has lived independently on the other side of the country from me. She has done fine until the last year or so when she had a fall and slow recovery. I tried to get her set up with assistive services, but she sent the caseworker away and turned down all help. She hates where she lives but rejected my proposal to help her try to find somewhere else. Today, she called and basically read her suicide note to me. She is depressed and "ready to go" and unable to think of what might help, but she is open to a visit. So, I'm flying out there, but where do I start? I have to accomplish as much as possible in one week.


Should I try to get POA? Would that enable me to talk to her doctor?


Her only income is SS and she is in a HUD senior community. I still think moving to my state is the best option for her. I have read on the forums here that doing that is difficult, and I've called HUD offices in both states without getting any clarity on how to approach it. Any advice? Neither she nor I can afford to pay for her to live here to establish residency (if that's required). I read somewhere that if I get POA, that can qualify her as a resident here, while she's still living there. Is that true?


Someone at the Office of Aging recommended that I call Adult Protective Services for advice. Advice would certainly be welcome, but would making that call enable the state to take away her decision-making ability? I don't want to trigger something even worse than the way things are now.


All advice is welcome! Thank you!

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Whoa! That all sounds like a gut reaction to ride in on a white horse to save the day.

STOP.
Think.
Call your Aunt.
Listen.
Ask.

Then, only then start making any plans.

Call 911 for her if her suicidal talk continues.

If not, keep listenting. Rushing onto a plane will do what?

PS Call a crises line yourself. Report your Aunt's suicidal statements & ask for direction.
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Get POA and health care proxy the Minute you can get out there . Go to her Bank with her and Have the forms Notarized - you can get those forms off the internet . Call her doctor and set up an appointment . Go with her to the doctor and they can set up a social worker or therapist and Have a VNA Nurse check on her . She is Isolated and depressed . Maybe she would be willing to come Visit you . Sounds Like she has been isolated and alone . You could contact the Housing authority where you live and tell them of her circumstances . usually HUD and the Housing authorities will help elderly people in need . Contact your Local housing authority tomorrow or drop by and speak with some One . Wishing You Luck she is calling Out for Help . I Hope the situation works Out for the both of you .
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You need only for her to sign a HIPAA form for you to be able to talk to her doctors.

I would prioritize (making appointments now for next wee) for her to be seen by her doctor for a full physical and perhaps a psychiatrist for an assessment of her mental state.

"Swooping" and trying to rescue someone who is resisting help often leads to very bad outcomes.

Do you want to be responsible for arranging your aunt's care, if all she does is send it away?
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Do you see how confused you are right now?

I guarantee that where you are now is NOTHING compared to taking on POA for someone not organized, not understanding where she is in her life, unwilling to do ANYTHING (other than move in with you and make your own life a misery, I imagine or have your constant visits to her) she needs to do.

There is nothing you can do for your aunt.
Do as Barb suggests, and see her doctor with her, get the permissions filled in for medical information, and get a full diagnositic workup. Including for depression.
If she won't do that then it is basically "Good luck, Aunt. Nice visit" and when you get home turn her over to APS.

Let APS and her doctor know she is suicidal and without care and you cannot function in a position of POA/guardian for an uncooperative woman.

In all honesty, MANY seniors are ready to go and cannot. I was an RN. With my own Dad and with 100s of patients I was, over and over, told they are ready to go, want to go, have had quite enough of where they are and where they are going. And these are people who had wonderful lives and know it. THEY WANT TO GO NOW. We can't understand it when we are not there, but I am 81 and to my GUT I am aware of all they meant now on a very personal manner.

I wish you luck. You didn't cause this. You can't fix this. She may require guardianship of the state which becomes the norm for those of us who live too long and have no one we trust to watch over us.
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ElizabethAR37 Feb 23, 2024
Agree! At 87, I get the concept of being "done"/ready to go. I'm not afraid of death, but I do fear what could await me in the U.S. end-of-life system. I've lived a long time and accomplished all that I'm going to. Not only am I no longer contributing as a worker or volunteer, but I'm unable to do much of what I once enjoyed. (Even with assistive devices, my hearing and vision aren't great, and walking/housekeeping/grocery shopping are becoming more difficult.) I still function as fully as my deteriorating body allows, but I can see how old-old people can be amenable to making their Final Exits. Unfortunately, the law has a different take on it.
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Call APS now, for a welfare check. Then visit in person after that. We call it "boots on the ground".
If she is suicidal, a week in a behavioral health unit can manage her medications.
She could become much more cooperative or amenable to making healthy changes for herself. Believe me, they do not want to keep her.

Calling in authorities for a little help does not mean that the state will be taking away her decision making abilities. You can advocate for her at that time if needed.

As a mandated reporter, I failed to send timely help for a neighbor, persuaded by other neighbors to not do that. After a fire in her home (preventable), a hospitalization, she is now homeless. She was unable to live alone and there was only a six month time period for an intervention to prevent disaster.

Regrets...I try to avoid them.
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Thank you all -- a lot to think about here. I spent the day on the phone, reaching out to neighbors, and have bought a plane ticket. Aunt is happy about me coming for a visit, but not cooperative, at this point, with my plan to arrange a doctor's appt for while I'm there. I'm coming around to the idea that solutions are unlikely to happen on this visit, but at least I can get a better idea of what is going on and maybe discuss some options with her.
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Beatty Feb 23, 2024
Yes. This sounds realistic.

A 'boots on the ground' fact finding mission.

A chance to see & hear how your really Aunt is.

For your Aunt to see you & hear she has your support.

She may benefit from a companion as she starts to process what her coming challenges will be.
- Accepting independance is sliding a little into semi-independance can be an unwelcome & bitter pill.
- Accepting Help is another.
(Yet, accepting help at home can lengthen living at home & delay assisted living)

These ARE choices your Aunt has power in. That's the thing that elders tell me helps: Maintaining choice & control.
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Before you turn your life on its head, it might be a good idea to find out more about what your aunt actually wants. You say that in the phone call she “is depressed and ‘ready to go’ and unable to think of what might help, but she is open to a visit”. Earlier she “turned down all help, ...and rejected my proposal to help her try to find somewhere else”.

Being ‘open to a visit’ might be a ‘goodbye’ visit. She may still reject ‘finding somewhere else’. Or it might be on terms you can’t accept – like moving in with you. At age 86 without much going right, she may still want to stay where she is, and just wait for the end. It’s her right to do that, even if you don't agree.

Perhaps it might make sense to go and see her, without making plans about what you can or will do to change things. Take it one step at a time!
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Don’t automatically jump in to help without knowing all of the details.

HIPPA laws require you to have permission to speak to doctors.

All you have to do is to ask your aunt to sign the required consent forms for you to have access to her medical records. Then, you’re good to go.

Take things one step at the time. Know what is involved. Know what your limitations are. You can serve your aunt by being an advocate for her, rather than taking on all of the responsibilities of her care.

Wishing you and your aunt all the best.
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I would not get POA papers off the internet. Your Aunt needs to assign you and I would be very careful on taking on this responsibility. A lawyer will make sure she is competent to make decisions on her behalf. There will be a witness and a notary. IMO this makes the POA more effective. You need to understand what ur responsibilities are. I would take this slowly."I read somewhere that if I get POA, that can qualify her as a resident here, while she's still living there. Is that true?" You do not get a POA, your Aunt assigns you in the State she lives. A POA does not help establish residency even if Aunt moves to ur State and has the POA written in ur State.I think getting APS involved is wise. Don't put the cart before the horse. Its really what Aunt wants. If she choses to come to ur State do not have her live with u permanently. Find her a place of her own or an AL if she has the money.

I would not count on HUD in your State to find her housing. IME, they only have open enrollment once year and only so many openings. The HUD senior apts where I live have a 2 yr wait period. But, it does not hurt to check it out.
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Thank you all. This has been an eventful few days. My aunt is now in the hospital, having collapsed at home. The reason why isn't clear, but it doesn't seem that self-harm was involved despite her statements. I wonder whether something had happened to her medically (small stroke?) that made her feel particularly bad and prompted her to talk about imminent death earlier in the week.

She is conscious but confused, so getting POA isn't possible now, but I have talked to the hospital social worker about next steps. It sounds like sending her home is off the table, which I am very glad about. That will provide 20 days to figure out next steps (hopefully an AL placement).

Maybe it's unkind of me to think of this medical event (whatever it was) as a blessing in disguise, but I think it will help her get the kind of care she needs.
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Stay out of it. Let APS in her state handle it. You are opening a can of worms that you will never be able to close again.
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Holly, welcome back!

It SO a blessing in disguise!
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