How do we as a family come together to help our mother age in place after our mother gets dementia and turns nasty and refuses care?

你需要让妈妈一个神经学家形式al diagnosis of Dementia and the type. Different meds work different on different Dementias. When you do this, then you ask for a medication to help with the nastiness.

When you have a formal diagnosis, check ur POA to see how many doctors are needed for diagnosis, your POA is now in effect unless you have an immediate one. Then you have to tell yourself, I am the POA and the final decisions are mine. You must be willing to take the heat. The brother 9 hours away has no idea what is going on. Your Dad was probably able to cover up alot when it came to Mom. Now you see how bad things really are.

Its no longer what she wants, its what she needs. Depending on where she is in her Dementia, you may want to sit her down and tell her if she wants to stay in her home, then she needs to except help and be nice about it. I am not beyond a little threat. Also tell her if she doesn't allow help then the State could come in and take over her care and they will not allow her to stay in her home. She will be placed somewhere of their choosing.

痴呆症是如此不可预测的，没有押韵或理由。在早期阶段，该人失去了理性的能力。短期记忆丢失。最终是长期的。他们变得像小孩子一样。他们及时回去了。这一切都落在你身上，因为你需要带你考虑。你需要忽略这个兄弟，即使阻止他或没有接听电话。妈妈是为你分配了她的POA的原因。您的责任不是要做身体护理，而是保持安全，如果这意味着AL或LTC，那么就是这样。 To spend her money on her and her care. When its gone, then you apply for Medicaid. Never use your own money if u can help it. Get siblings to help in that area. You should also keep good records. For me, Moms bank statement was my record. A check was written for everything to do with Mom. You saw the money coming in and going out. My bank, for a fee, has copies of my check printed on my statement. If I bought something out of pocket, I reimbursed myself once a month by check and kept the receipts for that month in an envelope with the ck# on it. I will bet the brother 9 hrs away will one day question your spending.

Mom will not be able to stay in her home forever. She will need 24/7 care that may go beyond what you want or can do. With u 2 hrs away, what you are now doing for her is going to become too much for you with running 2 businesses. You are going to start, if not already, feeling resentment. Your best choice would be to get her in a nice AL near you. Do what is best for you. If brother thinks he knows best, tell him he can take over and walk away.

护理安排需要为接收者和助理人员工作。现在是接收者，你的母亲，有痴呆症，绝不应该呼叫任何镜头，因为她正在制作你的“工作”繁重，并且不再在原因和逻辑范围内运作。如果他在这种情况下没有任何法律权威，你的兄弟，需要提醒他的建设性投入很好，但如果它为你创造了额外的负担，他就不会确定你妈妈的最终护理计划。

The biggest problem here isn't your brother, it is your uncooperative mother -- assuming that your PoA authority is now active per the requirements stated in the PoA document. If you don't know what that is, please read the doc today. If there needs to be 1 or more medical diagnosis of impairment, and she has this -- you are over one big hurdle.

If there are no medical diagnosis, this is a problem if you can't get her in for an appointment. You can make the appointment for her and use a "therapeutic fib" to get her to her doctor. Then discretely hand then a note outlining you are her PoA and she is exhibiting XX behaviors so please give her a cognitive/memory exam and test her for a UTI. At this same appointment ask for the Medical Representative form (HIPAA form) and have her write in your name and then she signs it and then her doctor at that clinic can disclose her medical results to you without needing her permission or presence. This is what I did for my MIL. The staff is usually happy to help you.

If none of this seems do-able then I would consider resigning the PoA and telling your brother she is all his, and let the chips fall where they may. Both of you will have to watch the train wreck happen and wait for APS to acquire guardianship. Then she will finally get the care and protection she needs, legally.

如果你有2人打击你,你的倦怠imminent because "helping" or "managing" will be 100% unproductive. Please read other posts on this forum regarding uncooperative LOs.

Turn everything over to the brother and walk away with the door left partly open. It will not change until the power struggle becomes between two not 3. Tell brother to handle this because you cannot physically or emotionally make good decisions (I know, lie, but it is a lie with truth in it). It will be terrible to watch, but sometimes it has to hit the fan before it gets better. Just have a game plan ready when it all starts to unravel. Sometimes the anger is directed at the safe person, keep that in mind. You may need to contact a social worker or discuss this with her doctor.
It is so hard to be the realist in a family situation. Call local elder care support for help.

I'm confused because you say your brother works against your mother's wishes but that he is a "teammate" with your mother. If she really has sided with your brother in the decision-making I'd just step back and turn your POA and Health care POA over to him. You aren't her guardian so you can't impose your wishes on her. You will see that this will result in a crisis that you are trying to avoid but sometimes it takes that crisis to get things resolved.

Only you can decide how long you are willing to/can provide this care. For me, I personally could not. I am so sorry. There is so little else we can say. It will not change in all likelihood, and will only become more tough to do. We all are human beings, not gods. We all have our limitations. For all intent and purpose, who your Mom was no longer really exists (or if she was already always this way, I fail to see why anyone would sacrifice themselves; it is again an individual decision).
我肯定祝你在这些艰难时期中最好。