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‘I’d hate to turn her over to the state’: Mother with Dementia Refuses Facility Care – What Options Exist?
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Families facing a parent’s dementia diagnosis often encounter a heartbreaking dilemma: what to do when that parent vehemently refuses care, especially placement in a long-term care facility. This situation,increasingly common as the population ages,presents legal,emotional,and logistical hurdles. The core issue frequently enough revolves around a parent’s retained legal capacity and their right to self-determination, even when those decisions appear detrimental to their well-being.
Understanding the Challenges
The refusal to sign a power of attorney is a frequent sticking point. Without this legal document, adult children may find themselves severely limited in their ability to manage their mother’s affairs, including healthcare and finances, even as her cognitive abilities decline. As one daughter recently expressed, She has never been willing to sign a power of attorney.
(Fottrell, 2025).
Did You Know?…
Approximately 6.7 million Americans are living with Alzheimer’s disease in 2023,and this number is projected to rise to nearly 13 million by 2050 (Alzheimer’s Association).
Legal Pathways and Considerations
When a person with dementia lacks the capacity to make informed decisions, families may need to pursue guardianship or conservatorship through the courts. This process involves demonstrating to a judge that the individual is unable to care for themselves and that a guardian or conservator is necessary to protect their interests. This is often a last resort, as it involves a loss of autonomy for the individual with dementia.
| Step | Action | Timeline |
|---|---|---|
| 1 | Initial Assessment | ASAP |
| 2 | Legal Consultation | Within 1 Week |
| 3 | Capacity Evaluation | 2-4 Weeks |
| 4 | Guardianship Petition (if needed) | Ongoing (varies by state) |
Before resorting to legal intervention, families should explore all possible alternatives.This includes open and honest dialog with their loved one, involving them in decision-making as much as possible, and seeking mediation services. Home healthcare options, adult day care programs, and respite care can provide support while allowing the individual to maintain some independence.
Pro Tip: Document all conversations and attempts to provide care. This documentation can be crucial if legal intervention becomes necessary.
The Emotional Toll and seeking Support
Dealing with a parent’s dementia and their refusal of care is emotionally draining. Families frequently enough experience feelings of guilt, frustration, and helplessness. Support groups,counseling services,and educational resources can provide valuable assistance in coping with these challenges. The Alzheimer’s Association offers a 24/7 helpline and a wealth of data for families affected by dementia.
“It’s a really arduous situation when someone doesn’t want help, and you’re worried about their safety.” – Dr. Maria Carrillo,Alzheimer’s Association Chief Science Officer.
State-Specific Resources
Laws regarding guardianship and conservatorship vary considerably by state. It’s crucial to consult with an attorney specializing in elder law in your specific location to understand your rights and options. Resources like the National Academy of Elder Law Attorneys (NAELA) can help you find qualified legal counsel.
The fear of turning her over to the state
(Fottrell, 2025) is a common one, driving families to exhaust all other avenues before considering guardianship.However, understanding the legal framework and available resources is essential for ensuring the safety and
