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I have durable financial and healthcare POA for my mother. She is 88, with significant cognitive impairment - cannot understand or pay bills, or any financial business at all. I handle it all for her, and track every expenditure / income on a spreadsheet. She lives alone in her house, with home help several days a week, but her mental status is worsening. She has become aggressive and hostile, blames us for everything wrong with her, and hangs up on me and my brother regularly when we speak to her. I am seeing posts here when people are in terrible situations where they have to turn their parent over to hospital / state / social worker management for placement, and some commenters say "it's GOOD you don't have a POA" because then they cannot be forced to take care of the parent. I am beginning to worry that we are approaching a similar situation, but I HAVE the POAs already, which are in effect in the case of my mother becoming incompetent (she has not been declared so yet; a recent hospital visit declared her of "full decisional capacity"). If she reaches that point and I have the POA, does this force me to continue to manage my mother's care? Mom lives in Arizona, which does not have filial obligation laws. I live a thousand miles away, and there is NO WAY ON EARTH I can take her in under ANY circumstances. Period. The last year has been the worst misery of my life, and I am at my wit's end. Anyone been here with experience to share? Thank you.

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Good news about POA:
1. Don’t worry. POA doesn’t give you obligations. It’s an opportunity to take action, but not the obligation to take action. For example, some people have POA, but sit on it and do nothing. That’s allowed. (Under some circumstances, it’s kinder towards the principal if one resigns and lets someone else be POA, if one really has no intention to help at all. The principal will have to sign a new POA)

2. The only obligation is: when you do take action as POA, that action must be in the best interests of the principal (your mom).

3. Don’t resign from POA. Keep it, in case. Even if you take very little action helping your mom, keep it. OP, you have control over finances. You decide medically. Don’t resign, because: (1) There’s no one else in your family who can be better POA than you. And don’t let non-family become POA. Even if you do little or nothing to help, suddenly in the future you might want to help make a big medical or financial decision. (2) Your mom has dementia, maybe too severe to even sign a new POA.

4. If you really want to walk away completely, that’s allowed too. Then resign POA. Call APS. The State will take over everything.

5. “The last year has been the worst misery of my life, and I am at my wit's end.”

Me too. Managing all the caregivers, etc., etc., problems don’t end. By the way, problems continue also in facilities (you advocate, help).

If you want, try to set up a system for her at home, so that you can be as uninvolved as possible. Live-in caregivers?

I organized live-in caregivers for my mom at home. But (1) LO must have money for that. (2) It’s VERY HARD to find caregivers who don’t steal, do a good job (not sloppy), etc., etc. (3) What if the caregivers want to leave? Then again you must look for new caregivers.
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If you don't want to be her hands-on caregiver but retain and actively be her PoA you can consider transitioning her into a facility close to you. Then of course you need to get her into the facility, and before that will need to activate the PoA, which probably requires at least 1 medical diagnosis of impairment.

You may have to just take the hit and go visit her for at least a week and be sure to bring the PoA paperwork. While there, call 911 to say she is aggressive and delusional and you suspect a UTI or dehydration but can't get her to the Urgent Care or ER on your own. Show them your PoA paperwork. The EMTs will take her away.

At the hospital you show up with your paperwork and ask to talk to a social worker about her being an "unsafe discharge" and that there's no one home to care for her. Make sure any and all of your Mom's local family and friends are told to NOT give her a ride home if she calls them (and she very well might). Depending on the outcome of her visit, it may be possible to transition her directly into a facility (maybe MC, seems like she's past AL). But, she will need to have the means to pay for it. This is where you need to decide about resigning PoA... in most states the Medicaid program only pays for LTC. So unless your Mom is bedbound or has a progressive and profound illness that is very debilitating, she won't be assessed to need LTC. With no PoA she can then become a ward of the county and they will then take over.

This seems drastic but when she doesn't have a diagnosis and is totally uncooperative, there aren't many other options. You can call APS but their conclusions may be iffy and may take a lot longer to play out. You can call a social worker for her county to discuss strategies on how to get her the help she needs.
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