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Hiring an optional companion while in AL is quite unusual.
My mother is 98 and in AL, we see no need to hire someone else to sit with her and hold her hand.
She has activities, made friends, meals are cooked for her, room is cleaned and they do her laundry as well.
Why exactly are you paying for a companion?
If you are not the FPoA you have no power other than to make your case to your brother. Please stop paying for it out of your pocket. This isn't fair to your own spouse and family. It's unsustainable and probably unproductive -- but I understand your desire to do it.
I am afraid that your choice to spend money on a "companion" is your own choice.
There is little you can do to change others. So I am afraid that you are left with things as they are.
Certainly you can visit an elder law attorney to explore any options you may have, and perhaps to suggest some mediation between yourself and your sibling.
If "she" has been diagnosed with Alzheimer's, "she" HAS Alzheimer's.
A person with dementia living in Assisted Living and "requiring " a companion needs to be in Memory Care Assisted Living.
It is not "elder abuse" for a POA to refuse to pay for companion care in AL on top of the astronomical costs of AL in the first place.
Son and family not visiting does not constitute elder abuse either, if it's even true. How would you know such a thing from 500 miles away? Relying on info given to you from a person suffering from Alzheimer's? I'd visit my mother who'd call me later to say she was alone like a dawg all the time because nobody EVER came to visit. Take what's told to you with a grain of salt. It's also very difficult to visit a loved one in AL with such a condition. Not everyone is equipped to do so on a regular basis, either, and passing judgement from afar is easy to do when you aren't doing the visiting, up close and personal. #Truth.
You can do nothing if the financial POA refuses to release funds to pay for a companion in AL. Unless you'd like to pay for your cousins companions yourself, I'm sure there'd be no argument from her son.
ALZ like any Dementia can come on slowly. Short-term is the first thing to go. The ability to reason, too. My Aunt lived for 12 years after diagnosis, some people 20. It can be a slow progression or fast. Who tells you brother doesn't visit, Mom. Well that short-term memory has her forgetting that your brother may have been there an hour before. My Mom went to visit the Aunt mentioned above. On the way out she met my other Aunt going in. When this Aunt got to her sister's room she said "I see Peggy was here." My other Aunt said "no Peggy hasn't been here". Like said, take whatever someone suffering from a Dementia says with a grain of salt.
There should be no reason Mom needs a companion. My Mom walked around inside of the building. Visited in the common area. Aides to take care of her needs. What does the companion do for her? Does she make sure Mom is involved with activities and outings. This person should not be doing everything for Mom. She needs to rely on the aides.
Your brother is putting out big money for Moms care. Trying to hold on to as much as possible so Mom can stay in the AL as long as possible. The added cost of a companion would eat into Moms money. You feel she needs a companion, he doesn't. So paying for one is your choice.
You have more control over the private care person you pay. You could ask that they work to integrate your cousin into the community where she is.
Have her take cousin to activities and ask the staff at the ALF to help her as well. She has gone to the ALF to live and needs to be part of her community. A companion that keeps her from that is not helpful. If that is the case. I’m not trying to say the companion is doing anything wrong.
You might try visiting yourself and see firsthand what the situation is. Cameras are also helpful to tell how the person is interacting and spending their time. Are you able to call your cousin on the phone? Perhaps you could zoom with her or face time.
No neurologist has ever diagnosed my dh aunt with Alzheimer’s either but she gets that label regardless. She clearly has dementia and it has robbed her mobility and most of her ADLs so she is forced into the care environment where she can have the care required.
I wish she had more visitors as well.
I try to get her as many services as possible because that gives her interactions with others. To do that sometimes requires I work with her doctor. Hard for the fPOA to avoid the doctors orders. So try looking for a therapist who will visit or a church who will take her communion or different services her particular insurance will pay for.
You didn’t design the system she must live in, nor did she or even her son. It won’t make her feel better to be reminded that he doesn’t visit if that is indeed the case. Move on and do what you can do. You are kind to care for your cousin.
"She was diagnosed with Alzheimer's and recently had a stroke."
Your cousin now lives in AL. Will no doubt make connections & find companionship with staff & other residents.
Are there reasons you want her to have 1:1 companionship?
I'd kindly suggest to check if you are overlaying your own ideas about being 'in care' without family onto her situation?
My relative did just that. Oh she's be lonely, scared etc. Our LO was FINE. Lived in the moment, joined the activities, enjoyed interacting with the cheery upbeat staff.
I love my own son. But I have fun with people my own age, with shared music & those up for a sing-a-long 😁
"We were close growing up".
Are you experiencing grief?
Grief at the loss of the close cousin you knew? Feeling sad about her disagnosis & recent stroke. That's totally understandable.
Are video calls to your cousin something you could arrange or be helpful?