My mentally ill aunt is trying to manipulate my 95-year-old grandmother
February 12, 2015 8:00 AM   Subscribe

My aunt, Anne, is being emotionally abusive to my 95-year old grandmother. Anne is also verbally abusive towards the nursing home staff. She has snuck an attorney into the nursing home in an attempt to get my grandmother to sign paperwork changing power of attorney. Fortunately the alarmed nursing home staff recognized what was going on and immediately called my other aunt, Kate, who has had power of attorney for the last 30 years. Kate rushed to the nursing home and stopped the process. That attorney dropped her as a client but she got another one. Now my aunt is apparently preparing to sue Kate, my dad (he's Kate and Anne's brother) as well as the nursing home. This is all occurring in the state of Texas.

Anne has never been emotionally stable. She has sued her own children, and she is completely estranged from her kids and grandkids. They even keep their addresses a secret so she can't track them down. She has latched onto my grandmother as her "cause" in the last couple of years, finding fault with my grandmother's current nursing home care and making it her mission in life to wrestle power of attorney from Kate. When my grandmother was lucid, she assigned POA to Kate, since she recognized Anne's mental illness. Anne is the oldest and this seems to bother her.

Prior to this sudden interest, Anne lived about an hour away from my Grandmother, but would only visit her 2-3 times a year.

My grandmother suffers from the early stages of dementia. She is incontinent, bedridden, cannot dress herself and often requires help to feed herself. The nursing home facility that she's in provides 24-hour-a-day skilled nursing care which is what she needs. My dad and Kate researched this particular nursing home thoroughly and visited dozens before choosing it. Anne hates the nursing home and thinks that my grandmother should be moved into a 6-bedroom house which serves as a "home for seniors" in San Antonio.

The current nursing home says they cannot ban Anne from the premises unless she is physically abusive.

We've got video of my grandmother stating she does not want to move into the assisted living facility. When Anne is around her, however, she berates her into saying the opposite. My grandmother has moments where she thinks clearly, and moments when she gets confused.

Anne's own living conditions are likely to be substandard. She has 5+ cats and has been unable to use her computer before because they urinate on the keyboard. Anne once visited me in my home 15 years ago and turned on my gas stove but did not light it, filling the kitchen with gas. She also steals books from the library and has stolen her neighbor's cats when she moves.

Anne does have a history of nickel-and-diming my grandmother for money. For example, if she brings my grandmother a $10 bottle of homeopathic supplements, she will turn the receipt into Kate to be reimbursed for the expense. Still, I don't think that money is her only motivation. I think she is just bitter and angry and so mentally ill she's not assessing the situation correctly. We are not sure where she is getting the money to pay for her legal pursuits.

So, what can we do about Anne? It seems that Texas only grants restraining orders if there are threats of violence. We obviously have an attorney acting on Kate's behalf, but we really don't want to get into a long, legal battle. Kate is so exhausted - she is in her mid 70s herself. Still, we're concerned that Anne will somehow succeed in manipulating the situation to her advantage.
posted by anonymous to Law & Government (17 answers total) 1 user marked this as a favorite
Surely your grandmother cannot be visited by people she doesn't wish to be visited by, this is her home and she can deny access to anyone she wishes. Kate, acting on her behalf, should also be able to refuse this unwanted guest unless accompanied by Kate, your dad, you or other approved chaperones. I mean really, could I just walk in and visit your grandmother? Kate has POA, Kate decides. I know nothing about nothing, this just seems common sense.
posted by Iteki at 8:05 AM on February 12, 2015 [8 favorites]

I don't know how things work in other states, and I am not a lawyer; mrs. straw is a co-conservator of her developmentally disabled brother, but...

Can Kate be appointed conservator? I've only seen this with respect to developmentally disabled adults in California, but around here being conservator gives one a court appointed advocate for the conserved who's supposed to watch over the conservators, and is an awesome big club to wield because that's also a way to contact the court and say "hey, this is happening and I don't think it's in the best interest of the conserved, do you agree?".

If there's already power of attorney then it probably doesn't cost all that much, really just involves getting the paperwork in order and showing up for a court appearance.

But at that point you can pretty easily move from having the legal authority to tell the nursing home that it's okay to bar Anne over to restraining orders that can get law enforcement involved.
posted by straw at 8:19 AM on February 12, 2015 [7 favorites]

The current nursing home says they cannot ban Anne from the premises unless she is physically abusive.

I find this hard to believe, that they can't as a matter of law: if this were true, random members of the public could enter at any time. Presumably they're a private entity regulated by the state and they must be able to protect their residents and staff by barring entry to unapproved people.

Basically, they're lying to you because they don't want to enforce it. You or your mother need to call the nursing home director and make it clear that given what you're paying, only approved visitors should be allowed to see your grandmother. They must have security, that's what this is for.

I also recommend, if you haven't done it already, get your grandmother declared incompetent by a doctor. There may be a provision in the POA for that. That way nothing your grandmother does at this point can be legally binding, including re-assigning the POA. Consult with your lawyer on this, I'm sure there is some way to protect your grandmother from her daughter.

Good luck: I'm sure this is very stressful and draining.
posted by suelac at 8:21 AM on February 12, 2015 [18 favorites]

If you have not talked to Aunt Kate's attorney about this specific issue, do so. It may, in fact, be possible to restrict visitors and the nursing home is wrong or uninterested in the logistics of it. Just talking to your attorney about it does not mean you'll end up in any sort of long legal battle. It may be as simple as a letter from your attorney to the nursing home. It may be, as suggested above, a matter of raising the level of guardianship over your grandmother, which is a longer process, but unlikely to be long and drawn out, if your grandmother is that frail and your aunt is already in control of most of her affairs.

Is your attorney saying that the nursing home is correct that your aunt cannot control who visits your Grandmother? In that case, get a second legal opinion.

Texas has an active chapter of the National Association of Elder Law Attorneys and the county where your grandmother resides almost certainly has a legal assistance office or a public agency which exists to protect against elder abuse. Your aunt should call them. Tell them that she has the power of attorney for her increasingly frail mother and has been told by the nursing home that they cannot prevent visits from Anne and that Kate would like to know what her mother's rights--and hers as the holder of power of attorney--really are. Someone will be able to direct her to appropriate resources. (I know the Bexar County Women's Bar Association does a handbook, but I don't know how comprehensive it is. Maybe start with them.

In the meantime, perhaps the attorney can help your aunt Kate escalate her complaint with the nursing home management. Even without a specific law or restraining order in effect, having your attorney contact the higher management of the home may lead them to realize it's in their interests to allow your Aunt Kate to control who visits her mother.

Good luck.
posted by crush-onastick at 8:23 AM on February 12, 2015 [5 favorites]

I don't know about Texas but here in California there are attorneys that only do Eldercare and, more to the point, a relatively robust EPS (Elder Protection Services) arm of the government. (Think Child Protective Services but for seniors.) I think I'd call them to see what they suggest.
posted by small_ruminant at 8:34 AM on February 12, 2015 [2 favorites]

You might reach out to the Long-Term Care Ombudsman for the state and see if they have additional suggestions. They probably also have the authority to compel the SNF to keep out unwanted visitors.
posted by jaguar at 8:45 AM on February 12, 2015 [1 favorite]

I am not qualified to determine whether your relative's nursing facility qualifies as a facility governed by these laws (I can't tell if they're only for Medicaid facilities), but here are the visitation rules listed in the Texas Department of Aging and Disability Services: Nursing Facility Requirements for Licensure and Medicaid Certification Handbook (bolding mine):
§19.413 Access and Visitation Rights

(a) A resident has the right to have access to, and the facility must provide immediate access to a resident to, the following:

(1) in Medicaid-certified facilities, a representative of the Secretary of Health and Human Services;
(2) a representative of the State of Texas;
(3) the resident's individual physician;
(4) a representative of the Office of the State Long Term Care Ombudsman (the Office), as described in §85.401(r) of this title (relating to Long-Term Care Ombudsman Program);
(5) a representative of Advocacy, Incorporated, which is responsible for the protection and advocacy system for developmentally disabled individuals established under the Developmental Disabilities Assistance and Bill of Rights Act, part C;
(6) a representative of Advocacy, Incorporated, which is responsible for the protection and advocacy system for mentally ill individuals established under the Protection and Advocacy for Mentally Ill Individuals Act;
(7) subject to the resident's right to deny or withdraw consent at any time, immediate family or other relatives of the resident; and
(8) subject to reasonable restrictions and the resident's right to deny or withdraw consent at any time, others who are visiting with the consent of the resident.

(b) A facility must provide reasonable access to a resident by any entity or individual that provides health, social, legal, or other services to the resident, subject to the resident's right to deny or withdraw consent at any time.
(c) A facility must allow a certified ombudsman, as defined in §85.2 of this title (relating to Definitions), and a staff person of the Office access:

(1) to the medical and social records of a resident, including an incident report involving the resident, if the certified ombudsman or staff person of the Office has the consent of the resident or the legally authorized representative of the resident;
(2) to the medical and social records of a resident 60 years of age or older, including an incident report involving the resident, in accordance with the Older Americans Act, §712(b); and
(3) to the administrative records, policies, and documents of the facility to which the facility residents or general public have access.
Even if these particular laws don't apply to your grandmother's facility, most facilities do have a resident's bill of rights that they are legally required to uphold, and all the ones I've seen include provisions for barring certain visitors. Again, I suspect the ombudsman's office can help you or Kate figure out how to get the SNF to enforce them. (That's assuming, though, that your grandmother agrees to that. I'm not certain that POA is extensive enough for Kate to be able to limit visitors on your grandmother's behalf.)
posted by jaguar at 8:55 AM on February 12, 2015 [5 favorites]

You might be able to get some information on local resources from the Alamo Area Agency on Aging.
posted by megancita at 9:05 AM on February 12, 2015

It sounds to me like she is not, if she is having trouble feeding herself, in early dementia. She will likely need a neuropsychiatric evaluation for competency, at which point Kate can apply for conservatorship. (I'm in CT, so the specifics of the laws are different.)

Kate, being POA, should be able to make her concerns, and see if they can bar visitors, based on the rules of the nursing home. Social work and the administration are both departments to work with. But they do not usually have internal security officers, at least around here, even in the rough parts of town.
posted by cobaltnine at 9:06 AM on February 12, 2015

I would be willing to bet that the nursing home is afraid that Aunt Anne will turn around and sue them if they attempt to bar her from entering. So Aunt Kate's lawyer needs to help provide the nursing home with whatever they need in order to indemnify them from damages in the event that they get sued.

If Aunt Anne's kids are even keeping their address a secret from her, is there a way to pull this off with your grandmother too? Somehow communicate to Aunt Anne that grandmother has been moved (regardless of whether or not you actually move her, I'm sure you all don't want to) and that Anne does not have visitation rights? Something that your attorney will also need to weigh in on, obviously.
posted by vignettist at 9:35 AM on February 12, 2015 [1 favorite]

You need to be talking to an elder-care attorney about this. Well, not just you, you and the person acting as attorney-in-fact. If you can't find someone who practices elder-care law specifically, someone who does family law and custody disputes would probably be the next-best, bonus if they deal with issues concerning the disabled. That might or might not be the person who drew up the power-of-attorney documents in the first place (which tend to be pretty boilerplate).

Aunt Crazy has already lawyered up, for you not to do so at this point would be a serious mistake. Don't bring a knife to a gunfight.
posted by Kadin2048 at 9:36 AM on February 12, 2015 [3 favorites]

The above advice is stellar. Only thing I can add: if Anne is diagnosed with a mental illness or on disability for mental illness you may be able to intervene in that way too.
My husband's ex-wife, disabled due to bi-polar disorder with anti-social comorbidity, has caused havoc for everyone who's been in her life. We had to appear before a judge several times, as the ex found new ways to interfere in our lives, to extinguish the behaviors. The judge, ex's psychiatrists and social workers eventually saved our sanity. It can be a long road but in the end effective (when the police and simple restraining orders were useless.) I understand "the police" etc are not part of your situation but the judge/psychiatrists can really help.
posted by Twist at 9:47 AM on February 12, 2015

As others have mentioned, naming Kate as conservator sounds like your best bet. But I'll go further: since, as you say, Kate herself is in her 70s, make sure she has a back-up: either a co-conservator and co-power-of-attorney, or at least a legally-defined successor in case of (heaven forbid) Kate's own death or disablement.

Basically, you need to A) make sure that potentially losing Kate doesn't leave your grandmother open to Anne's machinations; B) if possible take some of the pressure off Kate now; and C) make it so that even if Anne does slither in and harass your grandmother into signing things, it would be legally invalid.
posted by easily confused at 9:50 AM on February 12, 2015 [8 favorites]

Has Anne actually done anything to your grandmother herself? Trying to get your grandmother to switch POA, while irritating, is not actually an attack on your grandmother - if anything, it looks more like an attack on Kate, which makes this more of a "squabble between sisters" garden grade variety dispute. This also happened with my own grandmother - her children jockied to be the POA/Executor, but honestly were relatively good to my grandmother herself.

Honestly, seen from an outside perspective, Kate doesn't seem to be looking too good either. Why did your aunt need to "sneak" an attorney in? Is your grandmother forbidden visitors? While Kate may have tried to be protective due to the dementia, from an outside (Anne's) view, it may look as though Kate is deliberately trying to isolate her mother. Your dad and Kate found this nursing home and think it's great - that is a valid view. But so is a suggestion of a smaller assisted living facility which may be more culturally appropriate, depending on your background. Anne's suggestions, from here, don't sound crazy at all. It sounds like the two sisters disagree about their mom's care, not that one sister is being abusive.

While you have video of your grandmother saying she doesn't want to move into an assisted living facility, and clearly think those are her "true" wishes, it's quite possible that from Anne's perspective, you are the people "berating" her mother into opposing something that Anne may well believe are her mother's true wishes. You presumably aren't there when Anne is actually supposedly doing this, and it may be hard to determine the truth - particularly with elders who don't like to deal with confrontation, and may well, as my own grandmother did, push the conflict onto the children to deal with. "Oh yes, I was going to agree with you, but Anne said.." "Oh yes, I was going to agree with you, but Kate said..."

It might be worthwhile to examine your own motivations. From an outside view, it sounds like you, or perhaps Kate, just don't like Anne and are kind of finding reasons to do so - for example, you referenced the fact that Anne has supposedly stolen books from the library in a question about how to stop supposed elder abuse.
posted by corb at 10:26 AM on February 12, 2015

I would say that the attempts to get power of attorney switched in a deceitful manner would qualify as exploitation, a form of elder abuse recognized by state law in Texas. Make a complaint and ask what remedies are available to protect your grandmother. I'm so sorry you're all facing this stress.
posted by goggie at 12:33 PM on February 12, 2015

My family experienced something similar with my grandmother and warring aunts. It is a nightmare.

Does Kate have a lawyer? If not she needs to get one yesterday, or the members of the family (who are not Anne) can group together to retain one. Someone needs to speak to Anne's lawyer and tell them what's happening on the other side here. The vast majority of lawyers are conscientious and good people. The problem is their clients tell them a very specific version of what's happening. The lawyer needs to hear the rest of the story. Preferably from another lawyer.

Anne will look for a way to sue Kate. Count on it. Getting a lawyer involved can hopefully head that off at the pass. I know lawyers are expensive, but don't try to do this on the cheap. Once things progress to a court room, they get exponentially more expensive. A good lawyer can keep things from getting to that point.

The lawyer can also help you deal with the nursing home's reluctance to bar Anne. To second what has been said above, third parties in these situations do everything they can to avoid getting in the middle because, as has been pointed out, they don't want to get sued.

Also, it's not clear how many relatives you have living in relatively close proximity of your grandmother's home, but if you really want to make sure your Anne doesn't exercise undue influence, you all may need to step up and take shifts at the home with your grandmother so someone is there in case Anne tries this again. My family had to do this with my grandfather after one of my aunts tried to have a doctor friend "examine" him and declare him incompetent (he wasn't).

Good luck. I know what you're going through.
posted by dry white toast at 2:40 PM on February 12, 2015 [3 favorites]

The current nursing home says they cannot ban Anne from the premises unless she is physically abusive.

Allow me to echo the sentiment that this really doesn't sound right at all.
posted by turbid dahlia at 8:12 PM on February 12, 2015

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