As my mother’s Power of Attorney, is there anything I can do to avoid family disagreements if my mom should require nursing home care?

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Elder law experts or someone who has been through a similiar situation?

Mom (now 89),agreed to a pay to my daughter (or myself) a salary for live-in 24/7 caregiving back in 2006, when she was seriously ill and needed round the clock care but before she was diagnosed with Alzheimer's. She vehemently did not want to be hospitalized - she has always feared hospitals.

Though documented in my copious notes from the time, and made known to my siblings (none of whom have seen Mom in 5 yrs), I never got anything in writing. With Mom being Mom, I was lucky to get a POA! (I am also the Executrix of her Will.) As i had been actively involved with and helping Mom since my Dad's death twenty yrs previously, and as I was a paralegal at the time, I was the obvious choice.

I've been reading lately about family caretakers having lawyers draw up family caregiver contracts, so if the elder eventually has to go into a NH, the salary paid for their care will be viewed as compensation during the lookback, instead of as a family gift that needs to be repaid.

I realize its too late to 'do' a caregiver contract now, as Mom has reached the stage where she can no longer communicate. But I was wondering if there was anything at all I can do to avoid any complications should Mom eventually require NH care.

My daughter cared for Mom in Mom's home for 3 1/2 yrs,Mom's been with me in my home now for 2 1/2 yrs now.

Thanks.

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Much will depend on the jurisdiction in which mom would apply for Medicaid. Some require the applicant to actually produce five years worth of records and if those records show payments to you, your copious notes will certainly be of benefit to making your case. And of course if there was just one lump-sum payment more than five years ago then there are no issues.

The fact that you are POA can also be a saving grace in that most jurisdictions allow the POA to be compensated for services (especially if the POA stipulates this). So, if the "salary" was not too great, you can claim the payments as reimbursement for your out of pockets as POA and for payment of POA services.

If mom still has assets you are concerned about you may still be able to execute a Personal Care Agreement going forward since you are her POA and have the power, therefore, to enter into contracts on her behalf. Some jurisdictions deem this self-dealing are not pleased with this...however others are ok with it. Here in Florida some districts require that the applicant, even if incompetent, at the very least make there mark on the document. Sometimes rules can be so silly.

Some jurisdictions will also allow for lump sum payment immediately in advance satisfaction of the contract based on the applicants life expectancy.

Also, given that mom is now living with you, it is reasonable for her to pay you fair market room and board.

Lots of possibilities to preserve assets to assist with mom's continued care needs whether home or in a NH.

Good luck!
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Ralph you're a sweetie and so informative so I will ask something further.

What is generally considered fair market room and board? (I have looked for this figure online unsuccessfully) Also is the room and board amount in ADDITION TO caretaking salary?

We are in DC metro now, in a home we've owned for 10 yrs. Mom has the lower level - big room and bath and wheelchair access, WIC, her own porch, etc. We expect to be moving with a job to Pittsburgh metro very shortly, and will need to rent out our home, and rent one there.

It appears (I've been looking online every day for weeks) that a similar home in this area of PA, one with enough room for all of us as well as wheelchair access for Mom, is going to cost around $600 a month more than it does here. (The rental market there is very tight)

But we don't have the extra $600 a month. Is it reasonable (and legal) to have Mom chip in for this (she has the funds). If we did not require special housing to accomodate her needs, we wouldn't need the extra money.
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Look up Met Life and Gentworth Insurance companies who put out long term care studies each year, base on the previous year; Usually $15 an hour for 8 hours a day.
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Seniors, who are cared for at home need to chip in for their care and personal items to the extent they can afford. Think about it this way: if your Mom needed to rent a place on her own or go to an ALF she would be paying far more than the $600. dollars a month for room, board, and utilities. In addition, she is receiving one-on-one care from you - can't even imagine how much you are saving her there. In our area, it is $15-19/hr. for a paid caregiver. You are also providing her transportation, errands, financial advice, and other services that we caregivers just forget about each day. Most ALFs charge separately for these services.
It is a great idea that you are keeping records. If you worry what the family will think, gather information in your area that addresses "fair market value" and just have it on hand. Also, I try to pay all Mom's bills with her bank's bill pay option...then I always have bank records too.
Really, I do not feel the need to justify what I do to any family member. If they get more "interested" in the finances of caregiving, invite them to come and visit for a week while you go on vacation...that should clear things up. I would be more concerned about preparing for a possible need for Medicaid and their requirements. And as Ralph mentioned above there are many good ways to preserve her assets well before she may need Medicaid care.
good luck
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