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There are lots of necessary tasks that a paid 24/7 home care helper would not be required to do - like running errands and yard work. Does your mother drive? So, is she paying for car expenses - including insurance? Your brother is doing more than you think. And, you can probably trust him about as much as you can trust anyone.
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AudreyB4 Aug 2020
Thanks for your reply.

She has an insured car with him as the primary driver. She surrendered her license after having a series of what she called 'mishaps' but which I called 'accidents.' Through some bizarre twist of fate, the local courthouse wiped my brother's DUI record clean at no charge and allowed him to get a driver's license.
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Well she has Parkinson’s
unfortunately that can slowly become worse.
You are 300 miles away and your brother is there every day. He does deserve some monetary compensation and car use , especially if he’s not getting paid for his services.
NJ will pay people to care for someone. I don’t know about your state.
Dont forget its your moms money and it should all be going for her care and we’ll being.
That said
Best to all of you
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AudreyB4 Aug 2020
Thanks for your reply.

Some of her current issues stem from the shutdown. She had been attending a Parkinson's-specific exercise class twice a week before the virus hit. I wish my brother would continue to work out with her--take her for a walk around the block or ask her to teach him what they do in her class--but that's a little beyond him. Exercise is extremely beneficial.
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Keep your Mother in her own home as long as possible. 

There is a certain comfort zone for her to see her things everywhere she expect them to be.  I have heard that when they are in their own home it slows the debilitation.

The problem with dementia is a certain restlessness of always wanting to go home.  The time will come when she will get her purse and say “I got to go home now”, she will repeat over and over and over and over.  If that time comes while she is in your home, you and your family will have no peace.

I know of a person placed in a nursing home was given, with authorization, sedation because of her determination to go home.
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AudreyB4 Aug 2020
Thanks for your reply.

I have this exact concern. She does an amazing job puttering about in her kitchen and the rest of the house. I can't imagine her adjusting to a new location now. (I've noticed that her long-term knowledge is just dandy but short-term is seriously compromised.) She confuses the TV remote and the phone but the newspaper ends up in the recycling each day and her bed is made and her laundry is done. Over the summer we did a lot of work cleaning the basement, and she really knew her way around her stuff. She would be somewhat lost in a new location.

Some of her attachment to her home relates to trauma she suffered as a young girl during WWII when her family's home was lost. I really don't want to mess with her need to be at home unless I absolutely have to.
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You can go to the bank manager and have automatic withdraw from her banking account for her bills. So her hydro bill will automatically be paid for and your brother does not have to pay for it.

Then, figure out how much it cost in groceries and get her a gift card for that much and that is it.

The same goes for the car. Figure out how much money it costs for gas for a month and then get that much in a gift card.

If you can find a police officer or lawyer to sit down and talk with your brother ( make sure it is filmed for evidence )and explain to him that what he is doing is a crime and if there is any more of it he will be officially investigated.

That straightened out my family real quick.

They kept on promising to come down and do work if mom gave them money. Then they would find excuses for not doing the work. Finally she got fed up with it and informed them that I ( her primary care giver- live in care giver ) would be contacting the police if it continued. It promptly stopped.

If he decides to move out talk with your local health agency and Parkinson's Disease representatives in your area and they can arrange someone to do those jobs for your mom and well as have cognitive visits with volunteers.
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AudreyB4 Aug 2020
Thanks for your reply.

Currently, all of her bills are being auto-paid. I think. It's possible there's a bill I missed...but phone, cable, water, heat, and electricity are covered.

I love the gift card idea--would be easy to handle. I checked and can even get her one for the local AFB commissary AND the PX, which is terrific.

He's not going to move out. (Our best hope was that she'd die suddenly--without requiring nursing home care--and he'd get the house while I got everything else. That's not gonna happen now.) It's in his best interest to contribute to her care to the best of his ability. Once she needs to move into a nursing home, he won't have a job or a place to live. If he did move out, I'd move her here in a heartbeat.
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AudreyB4;

I really think you need a combination of medical, legal and perhaps financial assistance to get this all set to avoid issues in the future! The sooner the better! What I want to cover will likely take multiple posts, so bear with me. The repercussions for not addressing any of these topics can/will be negative for her future. There's no way to predict how long she might live or what her future needs will be, so it will be very important for you to address all of these issues. Rather than make multiple individual posts, I will post each "topic" as a reply to this message.

To be covered, at a minimum:
Medical
Social Security
Legal/Compensation/IRS rules
Medicaid
Debit vs ATM

(the order may not match up to importance, so try to find/read/digest the Medical one first!)
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disgustedtoo Aug 2020
Medical:
Before making plans for changes, the first thing you would want to have in hand is a valid Dx (preferably more than one doctor!) from appropriate doctors that considers her cognitively impaired, enough so that she wouldn't be considered "competent." If you don't have this yet, you should get it before doing anything else! She doesn't have to be totally "out of it", just enough that she doesn't really understand what is going on. Sure, she says she wants to take care of him, but she has no clue what he's doing!
Our mother was in early stage dementia and we needed to revisit the EC atty to make some revisions. He took her aside and asked questions, enough that he determined she was capable of signing documents. We had worked with him previously, so we knew he was honest and legit. There are those who for a buck would allow someone like your brother to bamboozle everyone!

Others here have brought up how they had a relative who took the LO and got all the changes done, new POA, sign over house and assets, etc. IF you get valid documentation for a Dx of dementia, specific enough to withstand query, then even if he did try to end run this, it could be invalidated by the courts.

When you get to the legal section, make sure you discuss this with the attorney, to be sure the Dx is sufficient to stand up in court.
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First of all, you cannot get someone arrested for using a debit card that you gave the card, the pin, and -pretty much- authorization to make purchases. You could possibly change over to a credit card to pay for her purchases with a strict limit on cash w/drawals.

You start off saying he has done a good job caring for her and around the house. Also, that he never did work much. So, is he working at all right now to make some spending money?? If not, how much do you think your mom would be paying for all the time he DOES spend at home and handle the tasks that you mentioned. I mean, unless he is taking substantial amounts that exceed what he does for her, do you expect him to stay there without any cash in his pocket? Perhaps, you two could come up with an amount that would be agreeable for the tasks he takes care of - plus all of the hours in a day he spends in the house with her (including the nights).

People need a break. Maybe it would be possible to pay someone to come in for a few hours a day or so per week to let him get out, visit friends, go somewhere. Clearly she doesn't want to move and for now her care seems to be pretty much handled. Would you toss him out on his ear if you took her to your house after what he's handled thus far?

People living at a distance often fail to realize what it really is to live with someone and can be a little more critical when they aren't actively involved 24/7. I hope there is a way for you to make a deal with the brother so that mom can stay in her own home as long as possible. If you think he should be out earning his own money, his limits on care would be the same as your own - she would still be home alone for certain periods of time. You might also invest in a emergency response button and have her get in the habit of using it now. If he was out of the house (or even if living w/you) she could have access to emergency response.
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disgustedtoo Aug 2020
She doesn't sound like she objects to payment of some kind, BUT he is getting free room and board, so that should factor into the amount paid to him. Also, to avoid issues with the IRS and possibly Medicaid, there should be a contract and Tax/SS/Medicare should be paid from this as well - IRS rules are that anything over $2200 for the YEAR falls under employment taxes.

"...to let him get out..."??? OP stated that he isn't even home as much as she would prefer and even went so far as to say if mom came to live with her, because she and hub work, mom would be alone, but really no more than she is NOW! Doesn't sound like he has an issue getting "respite" and going out with his pals...

I do agree that some family who are distant and don't see the day to day don't get it, but in this case bro isn't exactly busting his butt caring for mom 24/7...

Emergency alert would be a good idea. If she can ambulate, the phone would be her way to get help most likely, but if she has trouble getting around OR falls, that alert can certainly pay for itself!
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Imho, consider what perhaps is the larger issue at hand, which is care for your mother if he will be longer be the caregiver due to misuse of mother's money.
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I Agree with cancelling debit and credit cards. I would buy prepaid Visa and with the amount you control.
Then I would get another prepaid card for your Brother as caregiver to your Mom. That way you have control of what he spends.
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What is your brother going to do when his mom dies? Trust me it's going to happen, and he better start thinking about that. He needs to make SERIOUS choices now. It is a very ugly world we live in. And it takes a LOT of money to survive in it. No work = no money, and he has to learn to make his own money WITHOUT mom.

No one is going to want an older unemployed man.

I hope he's not drinking alcohol. That would put your mom in serious danger.

YOU CAN install cameras in her home so you can check on her remotely. I have cameras all over my house. When I took care of mom I had to go grocery shopping but I never left her alone any more than 20 minutes. Pick up groceries and straight back home. I kept my eyes on her with my cameras -- but I still was tethered to her since I was her life support.
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Macduff Sep 2020
Brilliant post. I really think the Police need to be told he helps himself to mom's money as this is abuse!
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Audrey, does your brother have a disability? Is this why he isn’t working and getting welfare and living in your moms basement?
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Lots of great advise here already. Since you said praise works well for brother would making a bigger part of things also work? Sit down with brother and mother and go over how things are set up and that because you want to make sure mother can stay home and get the care she needs and because you need to make sure things are done right you want to make a contract to reward brother for his service. 

Ask the local Elder Services to come and do an evaluation on mom so you know what her needs are. Ask brother what of those needs he can take responsibility for and how much time they would take. Then figure out what it would cost to have an agency cover those needs. An agency will not cover her house upkeep or yard work including snow removal so brother would need to be compensated for those chore services. Factor in that he is also “on-call” overnight and that should cover the compensation for his room. He needs to be there just in case she needs him, if you had to pay for an overnight Aide it would be far more that what “rent” he isn’t paying. In the contract lay out what is expected, when is he expected to be with her as opposed to time for him to do whatever. 

Pay him for his time, you it means that there will be an employee/employer relationship and taxes that will need to be paid but it will be an accounting for monies given to him. Don’t dwell on what has happened in the past, just from now forward. 

Does he help her with her medications? In our area medications must be handled by a Skilled Nurse (RN). Just to sort medication into the pill box is $90.00 a visit. If they administer the medication on a regular basis it is $56.00 a visit.

Now as for the car. How would she get to appointments without it? Does he take her with him when shopping is done? What would it cost to have her transported by a local Cabulance, would you need to have an Aide accompany her to her appointments? What would be your expense to take time off, travel to mother and attend her appointment with her? I have a cousin who has let her caregiver take her car and use it for the last couple of years. Caregiver does not live with cousin and does not assist cousin daily. She does either does the shopping or takes cousin to the store and assists with shopping, takes her to all medical and therapy appointments. While cousin can still drive and has a valid license she chooses not to so the arrangement works for them. It should be part of the contract that while brother has use of the car he is responsible for any tickets he gets or they will deducted from his earnings as a line item.

You have to determine what is going to work best for you on the bank account/ATM issue. Right now I am working to help our son catch up and pay off his student loans. He has is paycheck direct deposited into an account with both our names on it. He has determined how much $ he needs for a week and I withdraw that amount in cash (he hates banks). The rest goes into a savings account and payment for his loan is taken from there. I track any additional expenses all week and on Wednesday (payday) make a transfer from his savings to cover those with notes as to what was paid.
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Just as another thought, the 1099s for my uncle's caregivers were about $32,000 for one year. If your brother's expenses AND those of the caregivers you need to hire would be in that range, it might be "normal." (We are in So Cal, so costs may vary in other areas.)
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For an emergency alert system, check out the Great Call Five Star thing that you can buy online or at Walmart. The great thing about them is there is no base in the house that determines how far the range is for the button to go. It is like a GPS and works anywhere she goes. (When I first got my mom one, she would go outside and from others I reviewed, it would have been possible to get out of range of the base unit indoors - meaning it would not work). It is also the most reason able in price.

The only downfall, is once the rechargeable battery quits working, you have to buy a new one. If it fails during the warranty period, they will replace it. Outside the warranty period, you buy a new one. I've done it both ways. The first one we had failed just short of warranty end date, no problem with them sending new one. The other one lasted about 4 years so we bought a new one. I highly recommend this unit. AARP magazine also recommends it. Great item.
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OMG!! You most report him to the police they will discuss this with him, maybe he will be scared in to stopping this form of abuse. He needs to leave and no your mum does not have to go to a nursing home, she can have care at home. Contact Adult Services explain your brother is financially abusing your mother and also tell them you want them to come in and do an assessment so you can get the right care for your mum. Get that man out of your mum's home!
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I would immediately report him to the credit card company and cancel the cards if you have a POA. Do NOT get another credit card. Have him send YOU the bills and you pay them out of a checking account specifically set up for that purpose with YOUR name on it FOR HER NEEDS.
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