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She has vascular dementia, almost totally deaf, very limited mobility and stubborn as the biggest mule on planet Earth! She changed her DPOA in 2012 when my husband and I moved out of state to include a statement that prevents my brother and I placing her into a NH. She now has 24/7 CNA care with weekly hospice nurse visitation. It costs $20-22K per month to keep her there and my biggest fear is that she will live on for 4-5 more years like this with only so much money. Both my brother and I agree she should be in a NH but definitely want this to happen if she gets to a point with hospice where pain management becomes necessary. At that point, will involve me (great distance out of state) and my brother (in-state but poor health) to manage her meds. I want to honor her wish to go at home but this DPOA change feels like she has no regard for how this will affect both our jobs, life, etc to provide 24/7 care. Not sure how to deal with what may be coming soon - any suggestions??

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Are you sure that the directive that she never go into a NH is legally enforceable? In my mind it is like a will that leaves a certain sum of money to each heir yet there is no money to give, it's a nice thought but not based in reality. If you and your brother agree, and if your mother is legally incompetent, then who would challenge your decision to get her the care she needs and can afford?
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worriedinCali Jul 2019
I don’t think it’s legally enforceable. Because what if the money runs out and the person can no longer afford 24/7 home caregivers and Medicaid isn’t going to pay for it either. It’s no different than people who say in their living will that they don’t want to go to a nursing home—it can’t be legally enforceable if they don’t have the money to pay for the care required in order to keep them OUT of a nursing home.
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It costs her over $20,000 a MONTH to live where she is? Did I read that correctly? That's over a quarter million a year.

She has the right and the might to do as she pleases if this is the case. Money is great at smoothing out the wrinkles of caregiving.

In my state, if ALL siblings are on the same page as far as a parent's mental status, they can invoke the POA and basically 'force' the parent to take the care situation offered. (Our attorney says he's NEVER seen this actually happen, so it's not easy to do)

Check with your attorney and see if a similar law exists where you are. Look forward and make plans with brother, but if mom is happy, content and can manage to live alone, then let her. Decide what you'll do if that 'day' comes, and don't worry about her from day to day.

At 96--she probably doesn't HAVE 4-5 more years. You're probably worrying about something that won't need to be dealt with. But do plan ahead, and then put your mind at rest.

If she is in hospice, she will HAVE to have 24/7 care and that is most likely in a NH unless she can afford to pay for round the clock care. A person can't really do hospice without outside support.
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She honestly had/has a right to make this decision as long as her money is there. When the money runs out everyone caring for her now will be first onboard to get her placement on medicaid. She may not last long enough for that to happen. I would just step away from the situation. Periodically call and tell her I love her. That's about all you can do as I see it. She is being cared for; it is her funds and her decision.
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In my state, if you could obtain a guardianship and protective placement, you could move your mother to a long-term care facility.
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I agree that it's her money to spend provided there is enough of it, the sticking point is that if she outlives her money she may end up with very poor care in her final months because she will have to take whatever she can get. And although she is 96 it's amazing how long people can hold on - my own mother is a good example, she needed 24/7 care for years and was completely helpless for the year and a half she was in the NH. Do you have a good handle on how long the money can last, and when you will reach the tipping point?
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