Sibling has undiagnosed dementia of some sort. He is only 62. Doctor has him set for the full 4 hour battery of tests next month. He has a lot of difficulty with short term memory. He is having hallucinations and is on antiphyscotics which seem to make him more calm about the weird things he dreams up, but do not change the amount of delusions he is having. He lives alone and really has no one except me and his nephew who has durable POA. We both think he would be happier and most important safer, in some type of assisted living environment. We think he would benefit from a routine and people to talk to although he does get on people's nerves as he is VERY opinionated. He is physically in good shape so can still do a lot of things for himself, but needs to be reminded to do things like take a shower. How do you determine what type of setting would be best? Can you make him do it if he doesn't want to? We had thought of somebody coming to his house too, but think he would have an issue letting someone in he doesn't recognize (and he will probably forget them from the day before) and he can be very confrontational. I don't want anyone to get hurt.
It's also great that he has a comprehensive exam scheduled...however getting him there may be a challenge if he resists. Best to have a "therapeutic fib" thought up in order to get him there, whatever you think would work. Plan on leaving early for that appointment just in case.
Your question is basically: Can his DPoA make him do things he doesn't want to? Well, not forcibly, and if it's in his best interest, which also includes making the caregiving efforts less taxing. This is where "therapeutic fibs" are important, because it is not immoral to tell him non-truths if it keeps him calm and gets him to his appointment, or gets him to move into AL or MC.
Sixty-two is quite young so he may have early onset ALZ. If finances are an issue his DPoA can apply for Medicaid to cover the cost of MC. Some state's Medicaid will cover some or all of AL, and some don't cover any. Any facility you consider for him should be one that accepts Medicaid recipients, as not all of them do and they don't always tell you up front.
If your brother becomes agitated, belligerent, and totally uncooperative he made need more/different meds to help with that so he can receive the care he needs. Wishing you success in helping him.
If you aren't given specific care need level information, ask for it. Don't be afraid of getting a 2nd opinion if you need or want also.
Just keep in mind who is giving the advice. An agency may know what clients need based on a medical diagnoses - or not. They may be 'not for profit' or very much FOR profit. Same with care homes.
I have experience of one (unscrupulous) agency advising & charging my relative for un-needed 24 hour care.
This would be something to discuss with the doctor and get their take on the situation.
A lot may depend on the cause of the hallucinations and delusions. And is there a possibility that he could become violent?
Once diagnosed with dementia I would think the POA becomes effective although if he is high functioning I would still give him some autonomy.
My mother is definitely better off living in a Memory Care Assisted Living community due to the level of her needs and how much of a social creature she is. Truth is, she'd be bored stiff living with me because there's no Activity Director or chef or staff of caregivers here. #Truth
See how things play out with his tests and what his doctor has to say afterward. Be sure to let him know about the confrontational behaviors you've witnessed as well, as they will need to be addressed no matter where he winds up living.
Good luck!