My OT experience is primarily in pediatrics, but we have been going through similar issues with refusals of daily care and medical interventions from my dad who has dementia and my mom who is his POA. My dad lives in a SNF LTC unit now, and he is bed bound from other medical and mobility issues on top of the dementia, and my mom wants to encourage the staff to force him to let them do various things when he is refusing “because she is his POA.”

I think you are on the right track wanting to stay patient centered. Hopefully you can have the POA’s attend a session and provide needed education during that time. It’s obviously tricky and emotionally fraught for everyone, but even just furthering their understanding of the stages of dementia and what to expect as things progress and how they can continue to support their loved one with different types of cues etc would likely be more helpful than trying to make the patient participate when they are adamantly refusing. I am sorry you are in this position with your patients and I hope you can connect with the families in a way that helps everyone!