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My aunt is in assisted living because she is ill and has mild dementia. She has become belligerent because she does not want to be there. She screams and calls me or my family 15x a day to take her home. She can’t be home alone because she forgets to take her meds and forgets to eat. And it is safer to be there. I’m afraid she will leave the facility and be in danger. The facility also can’t stop them if they actually want to leave. I am her POA what can I do if she decides to leave on her own? I know it will be dangerous for her but I have my own family so I can’t be avail all the time for her? Do I just let her go. She won’t even let me hire a caregiver at her home to make sure she is safe and taking her meds.

She has anxiety and this ends up in her frequently calling family and threatening to leave. Talk to her doctor about her behavior. Ask about anti-anxiety medication to help calm her fears so she can enjoy the life she has now.
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Reply to Taarna
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POAs cannot legally override the decisions of the person.

First, I recommend engaging a dementia and geriatric expert (e.g., geriatric psychologist; social worker) to discuss options to help your aunt adjust to the new living situation. Even a call to the Alzheimer's Association hotline could be a good starting place.

Second, perhaps there is another assisted living facility that would be more appealing to her? Does she have friends who live in a particular facility? See if you can find out what she objects to in the place where she currently lives. Maybe they can be addressed. It is a big change from going from ones home to a more regimented situation.

Finally, I recommend talking with an elder law attorney. As her dementia gets worse, you may be able to petition the court to become her guardian, in which case you will be able to make decisions for her. SEE https://www.naela.org/
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Reply to elisny
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Lizzza: She requires a higher level of care. She requires memory care now. A malfunctioning brain cannot plan anything, e.g. "decides to leave on her own" has no real dynamic.
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Reply to Llamalover47
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Thank you everyone for your response. They all have been helpful. It’s just a very difficult and sad situation we all have deal with at some time.
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AlvaDeer Jun 20, 2024
Hope you will update us when things calm a bit and all is going better. Thanks for weighing in, and know we all wish you luck.
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She now requires a higher level of care. Find a memory care facility that has restricted access, that is, Residents are kept safely confined within the property, and are watched by staff. They are not free to leave.

Tell her it is a luxury apartment, with helpful staff always available to help her with anything she needs. Make it clear to her that she can not safely live on her own.

Block her calls, but be sure YOU call her daily, at your convenience, so she doesn't feel forgotten. And be prepared to hear her complain and express her frustrations. Just listen. You can repeat the mantra, "This is your new home. You are safe and cared for here. You can't live safely on your own."
At some point, it will be useless to give any explanation, and it won't really matter to her. Try re-directing her attention to something else, more positive, instead of getting sucked in to a futile argument.
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Reply to CaringWifeAZ
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“She can’t be home alone because .. she would forget to take her meds, or we would find them scattered everywhere in her home.. and she forgets to eat”. I’m not suggesting that you deliberately allow this to happen, but if it does happen, is it really such a tragedy? If the behavior kills her, it’s her choice and she’s not missing out on years of happiness.

We often disagree with modern medicine keeping people alive far longer that is appropriate, while overlooking the way that family do much the same thing.
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CaringWifeAZ Jun 20, 2024
Margaret, I was about to say the same thing! Lizzza should not worry about protecting her.
However, she says she has POA, which makes the niece responsible for the safety of the mentally compromised aunt. So, I wondered if she, the niece, would be held accountable if something bad happens. I don't really know what the consequence would be.
If she did not have POA, I would say, so what if the aunt lives on her own and doesn't take good care of herself?
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My mom kept leaving her AL and needed to be moved to memory care for safety..locked doors! She also packed possessions dragging them in the hall behind her walker. Sad.
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Reply to Sadinroanokeva
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I believe that the agreement with my mothers facility was signed by both her and myself with POA by my signature. Most facilities has a check in/out policy so I don't think she can leave on her own. If you are on the contract, you have a say in the matter. The only way to make sure she's not going anywhere is to have her moved to memory care or take her footwear and coats or money for transportation? I don't know how you can stop her from harassing the family, it's all she has right now. How long has she been there? There's usually a few weeks that family shouldn't be there so she becomes familiar with her new environment. She needs to make it her own and get things that make her feel comfortable there. The calls should be ignored, it's when you don't hear from them you worry more. You made the right decision to protect her,she needs to understand, somehow. The safety factor, she could be taken advantage by strangers/scams. The home is too large to take care of,less cleaning. The home needs to be sold for her health care,she's not taking care of herself. Most importantly, be honest, tell her you're scared and you don't have any other options. She is loved and would be missed if she was left on her own and something happened.
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Reply to JuliaH
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I doubt that a facility can legally allow a person medically diagnosed with dementia to leave a facility. I believe they are responsible to keep her there. Ask them about the protocol / procedures, and what your legal rights and responsibilities are as a POA. You need to know this anyway. Contact an attorney if you need clarification on your legal responsibilities.

Gena / Touch Matters
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Reply to TouchMatters
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In AL you can have a tracker put on her that she wears. Ideally the facility should be set up with alarms that sync with the tracker if she tries to exit her building. Otherwise, she may have to move to a memory care unit. Your situation is not uncommon. There are support groups for caregivers that you may consider attending. Best of luck.
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Reply to DianaFS
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They can stop her from leaving if she is in danger when she does leave. Especially if she is experiencing cognitive decline. Several states have charged assisted living staff for failure to protect the residents by having safeguards preventing them from leaving, That can be extreme heat, coldness, or hit by an auto.
I have been my mom's POA for 12 years now and I was unable to make any of her decisions until 2 years ago when the doctor determined she was unable to make rational and safe decisions for herself. When residents move into AL they go through an adjustment period, depression, anger, thoughts of leaving,saying they wish god would take them. In a supportive environment with the right interventions and redirection and of course professionals therapist these residents do adjust but there is no crystal ball to say when.
When my mom moved into a long-term care facility 2 years ago, she eloped once and was very verbally abusive to staff, I was able to change her behavior and her wanting to elope by using what I call a therapeutic fib. I told her that I got a fine for her cursing and her eloping it was a small fine but it only got higher each time and I can't afford to be paying thousands of dollars. My mom was always very thrifting and concerned with spending money so I knew that would work and it has for over 2 years now
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Reply to NJCALA
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Lizzza,
Any updates on your situation? I would love to know where this all stands.
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Reply to AlvaDeer
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You have choices. If she is cognitively impaired and unable to make appropriate decisions, you are responsible for her as POA. You can continue or resign. If you resign she may not be able to appoint another POA and the state will eventually become her guardian. If you and other family members are OK with this, it is a valid choice. She can then take herself home if she is able to do it, and you can call APS as needed, but don't take care of her yourself or you will get stuck in a repeating loop.

If you continue as POA, get her a functional and cognitive evaluation before making any decisions. She may need a different level of care than AL or will soon from what you are describing. She may need medication for anxiety. She may even be suffering side effects from medication. Talk to her doctor about all of this.

All of you have the ability to block her from calling. I suggest doing this on a rotating schedule. She can only reach one of you on any given day or in any given week. She won't understand this and don't try to explain it. Eventually she may stop calling out of frustration. If she asks, just tell her "We can't all be on-call for you every day."

Finally, as her POA, you should be preparing a plan to sell her home if you know she cannot return. It should not be sitting empty, and you may need those funds for her care. Perhaps that extra money will allow Aunt to move to a nicer facility with a bigger apartment where she will have better QOL. Best of luck!
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Reply to DrBenshir
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fluffy1966 Jun 20, 2024
Dr. Benshir, great advice to seek a cognitive eval., and to have her doctor evaluate her current medicine regiment. Unless Auntie settles down, she may need both "calming medication" and a facility with a higher level of care, that can prevent her from wandering out into the streets.
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I was in the exact same situation. I am POA for my cousin. After a two month battle (she escaped and landed in the hospital), we moved her to a well-equipped memory care center, they only have dementia patients. Well worth the extra money. She has no access to a phone. She is 90, and in good physical health, but has no memory. They know how to handle her. And after three months she has accepted being there. She actually likes it.
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Reply to Woolnutzi
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Your aunt needs to have her phone taken away. She also needs to be transferred to a personal care home for memory care. They have pendants to alert everyone when they try to leave. Your aunt needs to be in a locked facility if she gets too combative with staff. Discuss your options with the director. If they can't stop her from leaving, you must move her somewhere else. You are her POA, so it's on you unfortunately. If no one else wants to take responsibility, reach out to an Elder Attorney.
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Reply to Onlychild2024
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Here is what I learned on this forum and the approach I took:

If indeed she has not been deemed to have no decision making capacity, and your role as POA as per your contract is that of a typical POA not more like a guardian, then technically she "can" go back to home to live .

Your power is not in "stopping her" per se, but in that you can refuse to do things you feel inappropriate, unsafe etc. If she was able to get a ride from the AL to her house by someone, you are under no obligation to help set up any system at home. You could, even now, pre-emptively say that you are opposed at trying to live at home, and if she did find a way to go there, you will wash your hands of everything, not help a bit, and resign your POA. hopefully other family members will support this. Hopefully then she will realize should could not pull it all off on her own.
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Reply to strugglinson
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Assisted Living is not a locked facility. residents can come and go as they wish.
This is the primary reason I say that anyone with dementia should NOT be in Assisted Living unless they are living with someone that is cognizant and can monitor them. (typically a spouse)
With dementia your aunt should be in Memory Care.
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Reply to Grandma1954
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AlvaDeer Jun 17, 2024
I think she is talking discharging herself, not going out for lunch or a walk. In that case any ALF has a discharge process to ensure safety of resident leaving.
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It sounds as tho your aunt will soon not be able to stay in ALF. She may require MC or one of the locked unit in-between care units.
In ALF people are, as you observed, usually free to come and go, though there usually is a sign out expected and sign back in. They are not free simply to leave without any notice whatsoever.

As she is in ALF I am assuming, you as her POA were involved in admitted her into ALF.
Is that correct?

What talks have you had with the administration lately regarding her deteriorating mental status, and this fear/danger of her leaving without care without discharge?

It will help to have more information about yours and your Aunt's history with her admission into care, and just when her behavior became so worrisome to you.
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Reply to AlvaDeer
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Lizzza Jun 16, 2024
Hello, thank you for your response. My aunt was hospitalized for heart failure. She has had three mini-strokes which led to the diagnosis of mild cognitive impairment. I believe it has now progressed to dementia. The main reason we decided to place her in assisted living is because we wanted her somewhere safe, and more importantly, to ensure that nurses could give her medications that were dangerous to miss. Previously, she would forget to take her meds, or we would find them scattered everywhere in her home. She didn't want caregivers in her home. When we hired one for her, she would fire them. My aunt has no children, and my cousins and I are left trying to help her, but we all work and have families of our own and can't devote all our time to her. Hence, the reason we placed her in an assisted living facility where she would be cared for. Her memory and confusion are deteriorating more every day, but just recently, it seems to be deteriorating at a faster rate. She has been hostile because we’ve told her she cannot go home it is not safe. And had threatened to leave on her own. I have emailed the facility regarding her change in behavior and yet gave to discuss it.
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My Moms AL was semi lock down. Meaning the front door was keyless entry. The fire doors were not but had to be push 15 seconds before they opened. Those of us visiting knew which residents were not allowed out. Since this facility allowed Aunt to be a resident, they also took on the responsibilty of keeping her safe. I doubt they would let her out the door. You need to discuss this with them.

If you are POA and she has been declared incompetent to make decisions, your in charge. Does she use her phone to call anyone but you. And if she does call others, are the calls complaining and want to leave? If so, lose the phone if a cell. She does not need it. Tell the AL, the only calls you want is for emergencies. They are not to allow her phone access. She needs to except the AL as her home and being able to call you 15x a day is not allowing her to get settled in. Once she does, then maybe you can rnoeturn the phone and have a certain time of the day to call her. Make sure staff knows u took the phone so they don't spend time looking for it.

Its no longer what your Aunt wants but what she needs. Your are her representative and you make the decisions. As soon as you except that you arevin charge the easier things will be. They is going to be a lot of fibing going on. Lets hope she does not remember from day to day what you have said. When she asks about going home, tell her you will work on it. When she asks again, I am working on it or just have not had the time. You know Aunt, that I work and have a family so have to do things for you when I have time. If she has a home, sell it asap.
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Conniejay Jun 21, 2024
When my mother demanded to go home, I asked her where home was. She didn’t know there was some silence, and the subject was changed. Also, when she wanted to go home, I would tell her she can go home if the doctor allows it. Well the doctor never will allow it but she doesn’t know that. But that gave her hope and cheered her up. I would tell her I want her to go home too !
Now it’s been a while and she doesn’t mention it as much.
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My mother’s assisted living would stop her . My mother was like that in the beginning as well . Mom had a bracelet that would set off an alarm if she tried to leave the building . Not every assisted living will do that though.

The other option is locked memory care unit for your aunt.
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