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My BIL had a sharp mental decline back in June. He lives alone two hours from any relatives so no one can check on him easily. He refuses to see any issue. He does not have a GP only a few specialists he goes to. My husband tried to talk to one of those doctors about the issues his brother as having but was basically told not is specialty and we should take him to the ER and get him checked out. And of course BIL is not willing to do that.
I told my husband we would have to wait for an event that required him to go to the ER and that happened on Friday. He had fallen and injured his hand last week but told everyone it wasn't bad. My husband went to pick him up for the holiday and discovered it was really bad and took him to the ER. He was able to speak with a nurse and told her what else was going on with his brother and she said she'd get the ball rolling to evaluate him. BIL is angry that he is still there, but we are hoping he will get the help he needs or at least we get a direction on what to do. No one knows BIL's financial situation and we have yet to find the POA he said he did last year. So this could really get messy. The added distance does not help as well as the relatives trying to help are all in their 70s.
The sad part is another relative spoke with the attending doctor and he basically told her his mental issues were not his problem and that should be dealt with on as out patient service. I am appalled that when a relative does reach out to the medical community they get blown off rather than given resources to contact to find help.

The hospital has already tried to talk us into taking him to our home. Told them it was not possible. I did make my husband aware they would do anything to offload the problem back on him.
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Geaton777 Nov 24, 2025
Excellent. Keep telling them no, under no circumstances. He has a history of being uncooperative with care. It is pointless. I'm sorry for this distressing situation.
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I would call APS with any serious concerns. And I would NEVER attempt to be POA or Guardian (esp the latter) for an uncooperative elder. You will eventually get "the call" as many of us do. It will be from a hospital saying "You know we have your BIL here" or from a coroner. There is little you can do about any of it.

Call APS, explain you cannot take long distance responsibility and he is a "senior at great risk due to refusal to see MD and appoint POA". Request guardianship of the state. They will visit him and discuss and will take action if required.

Otherwise any non responsiveness to call check ins will likely go to "wellness check" by local authorities, police or sheriff.

At some point in life, whether we die in our home or in a nursing home a few months added to our lives that we never wished for, is of little import over all.
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CaringWifeAZ Nov 25, 2025
AlvaDeer,
pretty much what I was thinking. You have already said it, so I won't bother.
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Hospital released him. Said he was fine to go home. Husband yelled at the doctor and asked do you really think he is ok to be on his own? They had hoped he could stay with the niece for a few days, but the doctor said he would think a familiar place would be better so suggested he just go home.

The next step will be for niece and husband to go down and have a serious talk with him about the next step. Can't force him to do anything. He is free to make his own decisions even bad one.
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WanderingAster Nov 29, 2025
I'm sorry, I know this is hard to watch. You are not alone, this is a common problem where someone who needs help keeps refusing it.

Things will likely be chaotic, I'm sorry, and you and your family can't deal with everything at once if your BIL is not cooperative. And until there is a POA in hand (for someone who is willing to be POA!) and until he is ruled incompetent to manage his own affairs, no one can make him do anything, you're right.

Perhaps take a step back and reassess: who does your BIL trust? Who will he allow to help him/whose questions will he answer? Maybe have that person approach him as a friend/confidante, and have him show them where the POA is. Have them put it somewhere safe or have them take pictures of it with their phone if he won't let them take it. If he can't find it, it might not exist, but then have that Trusted Person suggest signing another one. Facilitate this as much as possible: whatever your state asks to sign a POA, help him do it: take him to a lawyer, find the form and print it out, gather witnesses for a notary, etc. Get that paperwork squared away. Make sure it is a medical POA, too, not just a financial one!

At the same time (or first), Trusted Person can keep suggesting getting evaluated (again, helping by driving there, making appointment, going with him, etc.) If this is a no-go, then there's not much they can do except try to get him to call them when something happens. Talk to neighbors/friends who see BIL regularly, and ask THEM to call when something happens.

Then, the next time he needs to go to the ER, again engage with the ER staff about cognitive testing. Explain the decline, the bad decisions. I'm sorry that they blew you all off before, that was wrong, but the next time it might be someone else and they might NOT blow you off. This was the case with my own dad, it took a few ER visits and a few different dementia tests to establish that the problems he was coming in for were related to cognitive decline. Once they have a failed cognitive test and is ruled unable to live unsupervised, then that opens the option of the POA giving permission for the ER to place him in a care home. That'll be a whole new question and set of advice, I'm sure.

Good luck. Remember to breathe.
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Contact the hospital social worker and relate your concerns. There will also be a discharge planner to discuss the need for thorough testing and a new plan with
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What is the help you wish to find for your BIL?

Unless you can prove you are his PoA or legal guardian, you do not have power to make decisions for him or manage his affairs. This is not being "blown off", this is how the law works.

Also, dementia is not diagnosed in the ER. Yes, it can be very frustrating.

"...we have yet to find the POA he said he did last year." Do you mean the paperwork? Or an actual person?

If your BIL doesn't actually have a PoA and he seems cognitive enough to send back home, this is probably what will happen. No one should take him home because he seems to be an "unsafe discharge".

Hopefully the social worker may be able to get him transitioned directly into a facility, but this would be under court-assigned legal guardianship - in which case they will take over all of his management, including financial.
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lkdrymom Nov 24, 2025
We have not seen the paperwork. My husband is so unprepared to handle this. I told him the POA did him no good unless he had it in his possession. Still no urgency to get it. The one time I was at home I had husband ask for it. BIL produced a big bag of paperwork that he dumped out. I could tell immediately that there were no legal documents. My husband is so afraid of upsetting his brother he won’t push for anything. So here we are.
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My husband did ask for a social worker. He has made it clear we will not be taking him into our home. They have put him on some medication and are waiting to see how he responds to it. No he does not have any children. A niece has been trying to help but she is also 2 hours away and 70 years old. She wants him to move closer to her which would also be a help to us as it would be closer to us too. Since he lives alone no one knows his financial situation so we don't know what he can and cannot afford. And while he does not like the place he lives in now (55+ community) the idea of moving seems overwhelming to him because he seems to think he will be on his own in a new area.
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Do you know the attorney he used to have the POA papers done? If so they should have copies.
And I suppose the real question is did he really have POA papers drawn up or did he just say he did?
I suspect that if you can't find paperwork the hospital will have to have a court appoint a Guardian until they can be located. Your husband may chose to be or not to be the Guardian, it is up to him how much time he wants to invest in this.
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lkdrymom Nov 23, 2025
We have no idea. I warned my husband he needed to find these things out a long time ago and he said his family doesn’t talk about that kind of stuff. I don’t think he understands how serious this is.
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As with everything in life you gave to she enquiries of start by registering him with a local doctor and point out his problems
poa if one was done the person given poa would have been sent info and would have had to sign firms-if no one did it may be sensible to suggest one wasn’t done
he needs at least home help and to come clear about his finances otherwise you can’t help him
Legal advice might be the best option ?
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Ikdrymom: Retain an attorney.
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jagermeister...this is exactly what I am saying. We are told there is help in so many places but when you actually go looking for it you can't find any. I did find some help for my father like VA Aid & Attendance but I was his lead person. I am not in this case.

wanderingaster..we did ask for cognitive testing and apparently he passed. Not sure how that is possible. He thinks an imaginary person is living with him, he often confuses day and nighttime, has messed up his check book and pays bills wrong, he imagines events that did not happen. The latest was he insisted he was at a restaurant 3 hours away singing the night before and he is mad at his niece for bringing friends to that restaurant that he did not like. He was sitting in a hospital bed at the time he was telling my husband this. He got mad when my husband insisted he was still in the hospital the night before. Telling him he needs help has gotten nowhere. No one lives nearby so it isn't as if anyone can visit and work on him to convince him to do anything. He doesn't know his neighbors and even if he did this is not something they should be responsible for. At 87 all his friends are dead or moved away. That is our biggest concern that he is so far away all by himself. He is resistive to moving closer so we can keep an eye on him. At his age, there is just no telling him anything.
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SamTheManager Nov 30, 2025
Report him to APS. Tell them he is not safe, he is delusional and a danger to himself and others. It's really upsetting to learn you can't do much in this situation, but it is what it is. At least you're aware of what might be coming.
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