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Thank you everyone that helped me realize bringing my 2 parents (ages 91 and 93, one with severe dementia) would be a very difficult situation. I live out of state and my in state siblings are refusing to help them (will not call my parents anymore or visit them). I am solo in trying to navigate this situation and my parents (nor my brother) will tell me if he has PoA for them. My parents have been pretty independent taking care of themselves in their home. I have been flying back and forth from my home to their home trying to set up a schedule with siblings to assist them in their daily needs (no help and now I am solo). I can not leave them by themselves and they are refusing to go to a nursing home. They want to live with me because they don't want to be along. I cannot figure out how to move them because my dad gets aggressive and very confused in car rides (tried a couple different rides to see how he would react).


Where do I even begin to find quality in home care for them? Are there local agencies I can call?

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In home care for two seniors in 90s with dementia?
You are talking 24/7 care?
Have you checked agencies in your area?
Because that will tell you, I think, that unless you are looking at millions and millions in assets, then you cannot begin to afford this.
You have siblings in the area.
And you are telling us that they REFUSE to tell you if any one of them currently holds POA?
Yet you believe that you can convince them of some sort of schedule?
And you are the sibling who lives out of the area?

For me, there is a whole lot of lack of knowledge, understanding, talking with family, and magical thinking going on here.
There is no way I can even begin to imagine that you can handle this situation from where you are.
I would tell all siblings by letter that you are concerns and feel uninformed as to your parents current status and their needs. That you will be visiting (and you will need to do this for some time so get family leave act information) and assessing needs/abilities/finances/placement options for your parents, and would like to meet with them all so that you can get needs/placement talks started.

This is by no means easy. Were it me I would be loath to take this on long distance and don't see how it can be done. If there is no POA operating currently then with two with dementia you are looking at APS being called in an a temporary guardian being appointed.
Watch what you wish for as the guardian is then responsible for safety, placement, management and record keeping of every penny currently in and every penny coming in and every penny going out, and with siblings like yours I predict problems and threats.

Honestly I don't believe, living away from them, that you are the sibling to take this on.
I might sit back and watch a while. They are in their own home. I must assume no one told you they are in need, in danger? I can't know why other siblings in the area won't communicate with you; that usually means that some troubled waters have been flowing under the bridge for a long long time.
So to be brief:
1. Siblings who won't communicate with you means something is VERY WRONG.
2. Elders in 90s who are demented and living alone when family is nearby is a dreadful situation.
3. You don't live there.
4. Nothing can be done by someone who does even live there.

You may be down to calling APS and asking them to assess just what is going on there and who is in charge of it.
I wish you the best, but I cannot even BEGIN to fathom what is happening in all of this.
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cmv123 Feb 3, 2024
Thank you for your response. Yes, there is a lot going wrong here. My brother recently lost his partner and has become angry and told me that he can no longer care for my parents (which means visits and calls). The anger is focused at me for living out of state (the state my parents and him originally lived in before moving away from me). I am married with children working full time and I was told by both siblings who are not married (no jobs) that I need to step up and do something. I have 2 parents living alone as I take a unpaid leave of absence trying to sort this out as soon as possible. I am trying to read through other experiences on this forum. I am grateful for any advice and for somethings to think over in this journey. There is a lot of things going on and my mother just cries begging to move back to their home state to live with me..... ( father doesn't really understand)
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Local agencies

Direct hire (generally from local referrals.)
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I asked people what agency they recommended for help for my ill husband. I chose a caregiver agency. I was an independent payer. The cost quickly added up. I even had to pay by the minute. I found out that some agencies have fees waived by government agencies. That is what I would look into for your parents. Also I would be sure that anyone sent to the home was truly trained. I had a couple bad experiences with untrained people that I was paying $33 an hour. I also was told that agencies like hospice have lists of independent caregivers. That would have saved Me a lot of money. The only drawback is liability. Good luck with this situation.
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cmv123 Feb 3, 2024
Thank you for your advice. It is appreciated!
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Sadly your parents are now past the point of getting to decide what is best for them. And the fact that you say that you cannot leave them alone tells me that they both now require 24/7 care, which is a lot more expensive if you go the in-home care route than placing them in the appropriate facility.
It now has to be what is best for all involved(including you)and what is best for their safety and well being, and I believe that you already know that the answer to that is having them placed in the appropriate facility where they will receive the 24/7 care they now require and you can get back to just being their child and advocate.
DO NOT under any circumstances allow them to move in with you, as they and their health will only get worse and you will be biting off way more than you can chew.
Focus now on finding the right facility for them to move into. Senior Services, and your Area Agency on Aging should be able to help you get started in the right direction.
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cmv123 Feb 3, 2024
Thank you for your helpful replies. It has definitely been a process that should have been started a long time ago but people have been refusing to have conversations. I guess I am just overwhelmed and don't even know where to start...thank you!
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Here is my answer for this situation where you are going to try to set this up and run it from afar. it sounds like its quite a long distance , as you are needing to fly to get there.
One question that is not clear, do they have a POA established and is it your brother , or ? Who?
if its your brother, that can be ok if he is in agreement with you on everything. He can be POA and you can help him run things, presuming he agrees. Is he far away too?

I had thought about the in home 24/7 care and running it from a distance for both my Mom five years ago (who was in another country at the time! ) and more recently my dad whose primary residence was 1 hour away. The bottom line first of all is, that it will cost a lot of out of pocket money. Are your parents assets enough to handle that?
I recommend going with an agency if you are going with in home care, especially when at a distance. Since you are not local, if a caregiver is out sick or something, an agency will send a substitute in.
If you try to hire a live-in person , and they disappear for a week, or call out sick, you will be really stuck!
I suppose one option can be a live-in caregiver, with an agency on call as backuup...... but it may be risky and the agency may not give you as much priority since you arent using them regularly. BUt I would recommend 100% agency caregivers in this situation if you are going to try to keep them at home, and it will cost quite a bit.
In my area, for 1 caregiver 24 hour coverage, ( three 8 hour shifts), cost is $28,000 a month.

Then, what will you do when they get sick, need to go to doctors etc? Agency care givers can usually drive the elderly person to and from appointments, but they cannot discuss things with doctors or coordinate care. You may also want to look into a geriatric care manager in their area to help oversee that type of stuff. For that, what I have researched and others have corroborated, hiring such a private manager can be a huge help, but they will bill at up to $200 an hour.
So if you can financially pull it off, that is what could be done.
Or as others have posted, if you can get them both moved to assisted living, its going to be much less of a cost, especially if they share a room in assisted living, which should be fine I would think.
I see at Alva has pointed out a number of other issues and questions to ask and make sure are covered..
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cmv123 Feb 3, 2024
Thank you for your honest response. I appreciate you really letting me know how costly all of this can be. I am feel very overwhelmed by this process and appreciate others wisdom in this unknown territory for me. I just was able to get my mother to let me see some paperwork (she has been reluctant to discuss anything and wants me to pack up minimal belongings and move them back home with me). My mother has minimal memory issues at her age and just wants me to take care of both of them. She said she doesn't want to be without family around her and feels abandoned by her other 2 children who stopped calling and visiting. I guess my next step is to really break down the cost for them and see what agencies I can go for help in the area. I am grateful for any advice. This forum has helped me think about things I did not realize. My extended family keeps telling me that I can take this on because I am always the one who gets things done but feel completely overwhelmed by this situation....
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You cannot ‘take this on’ without ruining your own life. DON’T kidnap or rescue either parent, certainly don’t take them into your own home, not even for an afternoon cup of tea. Whatever the reasons why no-one else is helping, it doesn’t mean that you have to do it. Your parents have brought this on themselves, and are still doing so by not providing full information. ‘Crying’ is NOT a substitute for planning, or for co-operating, or for providing full information. Nor is getting aggressive and confused. If they won’t co-operate, they will have to be forced – and probably not by you.

Ava’s advice is the best. “Sit back and watch for a while”. Then call APS and ‘ask them to assess just what is going on’.
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cmv123 Feb 4, 2024
Thank you for your thoughtful advice. These are the things I need to hear right now and feel I am getting more support through this forum then from family and friends. I appreciate honest feedback from people who are dealing with similar circumstances and who have more experience in this area.
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