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Caregiver advice needed please. My Aunt is 86 yrs old. With signs of dementia. As of now she is competent to make her own decisions. But, her memory is fading and forgetting alot these days. As good days & bad days. She can be very hateful at times on her bad days. My Aunt decided she wanted to get her Living Will done a few weeks back.
So, I took her to her attorney to get this done as she wished to do. She made me her executor of her will. Her attorney told me he felt since my Aunt's memory isn't very good anymore that it's best she has a POA. So, I was appointed her executor and Durable POA as financial & healthcare.

(Keep in mind she is in her sound mind as competent to make her own decisions)
I ask my Aunt many questions as when was the last time you been to a doctor?
When is your next appointment to the doctor?
Who is your doctor?
Do you have a visiting nurce? If so,when does she visit you?
She tells me she was just at the doctor last month. She tells me her visiting nurse comes once a month. I visit my Aunt 3 times a week. I never ran into a visiting nurse at her home. Or signs that one was ever there. Throughout my life I always followed my gut. My gut never done me wrong. My gut tells me that my Aunt is affraid to go to a doctor. Reason, the doctor may find her not competent .
What do I do?
I can't force her to see a doctor. She was never told by a doctor yet she wasn't competent to make her own decisions. But, she has dementia but, not taking pills for dementia yet. Seems I'm stuck anywhere I turn. Her dementia is getting bad. She has a runny nose and cough for over a month now. I keep telling her to go to her doctor. She tells me she has a Dr. appointment next month but, yet to see that happen. I was told I need to take these POA papers into her doctor. Well, I don't know who her doctor is? I asked my Aunt who's her Doctor? She tells me a name I looked the name up and it's a dentist not a health doctor.
My Aunt's lieing to me about things. Now it seems I need to go behind her back to get this information? She appointed me her Durable POA for her financial & healthcare. It's my job as POA to know this information.
By rights she needs a visiting nurse to see her at least twice a week if not more. I need to hire a part time caregiver to help me out. As of now I'm her caregiver. I do everything she needs. She dosn't want to spend any money for a visiting nurse or for a caregiver. She is very tight with her money. I don't get paid to be her caregiver. But, I am her caregiver. In ways it's saving her tons of money for me being her caregiver but, it's hurting me in return. Costing me gas cost and my time from my family. I asked my aunt at the start what does she want?
She replied to me, she wants to live in her home alone on her own. I told her ok. I will do all I can to not place you in a nursing home as agreed.
Now this is causing problems. I'm losing money out of my pocket and my time away from my family and she isn't welling to see a doctor. I feel she is affraid to go to a doctor. If she does they may find her not competent. All I want to do is get her checkedout and her cold.
What can I do as her POA?

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You should be able to find out who the doctor is by going through some old check registers, credit card bills, bank statements, calendars, etc. It seems the attorney should have explained a number of things to you. I would think the POA document has a clause in it about paying you for your time, and not have money for her come out of your pocket. But be very fastidious about keeping receipts for things you buy for her that should be reimbursed. Cover your backside!

Maybe it has been years since she has seen a doctor. She may not have a nurse that visits twice a week, in fact, I doubt it. Unless someone is quite I'll there would be no value in being checked that often.

if you cannot figure out who her doctor is from documents that you have access to, start calling geriatricians, there cannot be many of them. Are there old insurance statement around that would tell you who her doc is? Most insurance requires that she have a primary care physician whose name may be on her card.

This would be terribly difficult for anyone especially without cooperation. I'm certain you will find your way through. Good luck.
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At the moment, you can't exercise the POAs. They only go into effect if she becomes legally incompetent to make her own decisions. At the moment they are just signed pieces of paper that may be used in the future.

If your aunt is not seeing a primary care physician, locate a good geriatrician in the area, then talk to your aunt about setting up an appointment. That will get the ball rolling on providing the things she will need in the near future. A word of warning -- let her know that all of these things are her own ideas and her own choosing. That can take a bit of manipulation, but sometimes manipulation is not a bad thing.

My father had a strong fear of doctors, so he wouldn't go to one. His and our lives would be so much easier if he would have only gone. He lived with much pain he could have avoided. I know what you are going through, and know that sometimes we can only do as much as they let us do. I hope you can get your aunt to the doctor.
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Cont,
The agreement with my Aunt is to avoid her going into a nurcing home.For her to live in her home as long as she can.Well,she's 86 yrs old,forgetting about normal everyday things.Example,I went to visit with her today.Tomarrow she wont remember I was their yesterday.She misplacing things around the house all the time.She forgets my name half the time.Everything she does she has to write it down on paper so she remebers later.She burned her self the other day she told me while cooking on the stove.She never knows what day it is unless you tell her.
All signs of dementia.

She must use her walker where ever she goes.Smell of Urene in her house and she has no pets.Burns things on the stove.She never changes her beding.She has problems bathing.Most of the time I think she just takes fast bird baths.
All signs she needs a caregiver and a visiting nurce.

I am her caregiver I do all the things as a caregiver does.But,I don't get a dime for it.Just the gas cost going to her home to care for her every other day is killing me.
Since,I'm her caregiver shouldn't I be paid something for all I do?I don't mind being her caregiver as long as it don't effect me.But,it is starting to do so.I'm her caregiver and POA.I was told POAs is not allowed to charge for services.Can I charge my Aunt for my caregiver services?If not I may as well go behind her back and hire a caregiver then.
Any advice?
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There are two types of POA's one is standing that can be used any time, the other is called springing that requires some sort of incapacity for it to be able to be used. Which type is yours? If you don't know call and ask the attorney that drafted it.

You need to check with the attorney about being paid for care. Some states do not allow it, some do. Is there a clause in the POA that provides for payment of services? In order to be above board I would think it would be a good idea to hire a geriatric care manager that could determine level of care necessary and appropriate payment. Then have the attorney draft the agreement for acceptance by aunt and you.
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Thank you JessieBelle,
In reply to (At the moment, you can't exercise the POAs).
I was told by my Aunt's attorney to act now and fast before it's too late.I waited a week before doing a thing on this POA stuff.Because.I had not a clue what to do with all this POA paper work.I was never told to holdon to this POA paper work until my Aunt gets bad.I was told to act now for the reason just in case she does get bad.I was told you need to get this POA done at the bank and with her health provider before your Aunt is legally incompetent to make her own decisions.If you wait to long it's to late.Act fast,act now is what I was told.
So,my Aunt needed to go shopping for food and other house hold supplies and she wanted a little spending money to keep on her.Her & I had a appointment to go shopping.I get to her home to take her.She felt ill as didn't feel like getting out and about.So,she asked me if she can write a check for me to do her shopping for her.I said the stores wont take a two party check not in my name.I told her to make a check amount out to Cash as you normally would do.I will take the check to the bank hope to cash it for you so I can do your shopping.I told my Aunt the bank may want to speak to you on the phone.She said ok.Well,I thought this is the best time if any to give the bank the POA paper work since I was going their to cash her check for her.I turned in the Paperwork to the banker.The banker never asked me if she was legally incompetent to make her own decisions.Banker never asked me a thing.I was told a read that Durable Power of attorney takes effect immediately not later or when someone is incompetent.If a person can't get out to go to the bank to cash a check or can't do shopping on her own.Then a POA is required to help that person.Doesn't make one incompetent.Just inable to do some basic things.
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I believe that durable POAs come into effect only after a person is incompetent or incapacitated, so cannot act for themselves.
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It is true that you can use the POA if the person is competent and you have their permission to act as their agent.
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Guess I should explain better. If a person is competent, they can give the POA permission to act as their agent on things they want to do. However, the POA cannot do things they are opposed to. For example, someone holding a durable POA cannot force a person to move into a NH if the person has not been declared incompetent and does not want to go. A POA is acting as an agent of the person in getting things done.
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Jessie, I think only a springing POA is not effective until incapacitation.

Dogabone, now you need to find a geriatrician for your aunt. Even if she had a doctor years ago, having a geriatrician as her primary care provider is a good idea now. She has a bad cough. That is reason enough to make an appointment. Go with her. Give the paperwork to that clinic.

Maybe some states don't allow you to be paid for POA duties -- I don't know. But you can be paid for caregiving duties. Taking Aunt shopping, helping her dress, cooking for her ... these are not POA duties. Consult the lawyer again about drawing up a personal care contract. When you explain the Aunt that you want her to sign this (while she is still competent to do so), also have information available about what it would cost to have an outsider come in and provide these services. Assure her that you love her, but you have needs as well.

I don't see the need for frequent nurse visits (if dementia is her only impairment and if she doesn't take a lot of pills) but there may be other services you could arrange, like meals on wheels, housecleaning, taking her to a podiatrist regularly, and possibly assistance with bathing. These are things that can help her with her goal of staying in her own home as long as possible.

(If she takes medications, has high blood pressure, diabetes, heart problems, and/or other chronic conditions, she may need a visiting nurse. But she wouldn't need a nurse to do things not requiring nursing skills.)

What is her financial situation? Is she able to pay for her care -- either you or someone else?
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gladimhere,
Here is the Paperwork I was given by the attorney.
(1)Living Will Declaration.
(2)Healthcare Authorization.
(3)Appointment of Healthcare representative.
(4)General Durable Power Of Attorney.
In the General Durable Power Of Attorney paperwork it doesn't state anywhere the word springing.
Second page states (Section III: Effective DateThis Power of Attorney shall become effective upon my execution of this document).I reserve the right of revocation,how ever this POA shall continue in full force and effect until I have executed a written revocation .
Section II : Powers Granted The above name Co-attorney in fact shall have general authority to act on my behalf as a fiduciary with respect to the following as the same are defined under Indiana Code& 30-5-5, and are now incorporated in this document by reference.Property transaction,Bonds,Shares,Banking transaction,Business transaction,Healthcare Powers ect.
Section V: Guardenship
In the event a judical proceeding is brought to establish a guardenship over my person or property.I appount this attorney in fact to serve as guardian.
___________________________________________________________
So from what I see this POA is in effect now.Not Springing.
If I would wait until my Aunt becomes worse as incompetent .This POA with the bank may not kickin because,if a person is incompetent they answer questions or sign a thing to the bank.In other words my Aunt is 86 yrs old.She may out live me or may pass away sooner then we think.Who knows.If I wait to turn this POA paper work to the bank.Then if,my Aunt gets sick before I had the chance to take this POA to the bank.The bank wouldn't allow me access to funds to pay for the anything of hers.
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jeannegibbs,she does have high blood pressure and heart problems she's taking pills for that stuff I do know as well as water pills. All in all I think she takes about 5-6 pills a day for stuff. As for charging a fee for POA services that is a big NO. Doing that will revoke a POA. But, I feel you are correct about the caregiving services. I am her caregiver as well as her POA. I can't charge for POA. But, I feel I should be able to charge my Aunt something for my caregiver services? I'm not asking for much.Just for my time and gas money is all. What $200 a month isn't to bad I think. Most care givers charge far more then that in just a week. I go to my Aunt's 3 days a week at a 20 mile one way gas cost at $3 plus a gal .My car is a 1998 not a new car with great gas miles. I know of a lady charging her mother $800 a month for her caregiver services. Something here isn't right. It's not my Mother it's my Aunt. I should be able to get some kind of money for this shouldn't I? Asking my Aunt for a little $5.00 for gas is like fighting tooth & nail. Personally I feel I shouldn't have to ask. She should automatically give it but she don't. Money wise, she has thousands of dollars in many accounts she can afford healthcare. She spends over 70 a week just on food a week just for her self when I shop for her. She's skinny why I don't understand she eats like crazy lol. She has dementia. She does make her own food once in awhile. I talked to her about meals on wheels she is just to tight to pay. I've been helping her because, I love her.And I care about her or I wouldn't be here helping her. But, when the cost starts to effect me and my family. Thats a problem. Theres times I don't have the gas to go see her but, some how I find away to take from petter to pay paul to do so. Shes a very Rich lady that is very tight with her money is why she's so Rich. Many people move money to hide it so nurcing homes don't get it. I careless anymore how much money she has. You help me I help you is how it should be before the main people come in and charge you a arm and a leg is the way I look at it. I lost my Mom & Dad yrs ago. Both was young. This isn't my Mother or father. It's my father's sister. If I can't pay my self for caregiver from Aunt's money. Then can I pay my wife as her caregiver then? My wife isn't POA. Only me she would be POA if I die. As POA I should be able to hire a caregiver. If so,why not my wife as her caregiver? I should be able and safely pay her? That case I can just write out a check to my wife as caregiver and be done with this problem. I am incharged of the book keeping.
I will say this,
No person in their right mind would be a caregiver for free unless their rich or it's their mother or father .I'm not rich and it's my Aunt.I stepped into this because, no one else wanted too.
Sorry for the venting.
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The POA states I can not charge any fees to my Aunt for POA.
But,I'm not only her POA.I'm her caregiver as well.
Let me rephase that,My Wife & I are my Aunt's caregivers.My wife would only be my Aunt's POA if/when I die or no longer able.So,as of now I am only my Aunt's POA.Not my wife.As POA my job is to make sure my Aunt is OK.That includes healthwise as healthcare and planning.When it come to hiring a caregiver or a visiting nurse it's my job as POA to do so as I see fit.Or am I wrong on that?
With my Aunt's dementia she wouldn't even be able to locate/find her phonebook to call a health provider let alone a caregiver or nurce.So,I guess that leaves me to do so?But,she's in her right mind to do what she wants?She's avoiding going to the doctor.Why?so the doctor don't declair her not in her right mind.Sounds like I got my self in a big mess.I'm spending my money to take care of my Aunt.If I can't get any help with gas money to do this caregiver stuff I don't know how much longer I can keep doing this.Any advice on getting paid for caregiving?Can I Pay my wife to be her caregiver as long as I record it in the books?
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Dog-
The doctor will not declare her incompetent unless asked to do that. It is your responsibility to make sure your aunt's needs are met and paid for with her money. If you are caregiving, or your wife is, talk to the attorney about paying your wife. But I can see where this would raise red flags. It is expressly forbidden for you to pay anyone and then get money back from that person. The pay must be comparable to what home care agencies charge, cannot be more, someone even told me once that it cannot be less either.

Talk to an elder law attorney to find out how to pay your wife. It may require a geriatric assessment of her needs completed by an impartial third party. All I can say is cover your backside!

You can pose questions to attorneys in your area on a site called AVVO. You should receive several answers without being charged a fee. The site also has peer and client reviews of the attorney that are on the site. The POA should state something about retaining legal counsel is permitted so it would be aunt's expense as long as you are doing it to provide the necessary care for her.

Good luck.
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I just contacted the attorney.They tell me that this POA takes effect immediately as stated on the POA paperwork (Effective DateThis Power of Attorney shall become effective upon my execution of this document).I then asked when should I act on this POA?I was told immediately.This is not a Springing POA.From talking with you before I became worried as if I acted to soon on this POA stuff.I don't want to get in trouble .So,I guess I'm ok to be doing this now as I did speek with the attorney about this.
My Aunt loses her mail and other things from her starting dementia.I don't live with my Aunt.She lives alone as for now.I need to ask the bank for past bank statements so I can see what is going on if any problems.I would like to either get bank statements or be able to see online as online banking.I also,would like to ask if I can get copies of her bank statements sent to my home address since my aunt loses her mail.By doing this I don't want my aunt to stop receiving her bank statements or she will have a fit about this.It would be easier for me to just create a online banking so I can see all the time her accounts.I called the bank waiting for a call back to speek with someone about this.
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gladimhere,
I'm not asking to be paid for my services as her POA.
I'm asking to be paid as her caregiver.As her POA it's my job to hire a caregiver or a visiting nurce when it comes time to do so.I'm just saying I should be able to get paid as her caregiver.I provide the same service if not better then a caregiver does.I would only charge example $200 a month for my services.That's far lower then any caregiver would charge.I should be able to just note on checks "Memo" caregiver for recording.Again,my job is to hire a caregiver when needed to do so.Why can't I hire my wife as caregiver?She's not POA.I'm not understanding why this is so much red tape to do this.Should be simple to do with no red tape doing so.I have a friend that's caregiver for her Mom.Her Mom lives with the friend.She charges $800 a month for her caregiver services.And she is also,her Mother's POA to.This friend is POA & caregiver how is she getting away with charges her mother for her services?Theres a loop hole I'm not seeing?
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Cont,
From the gas cost to taking time off from work and my time each day or every other day going to my Aunt's house to care for her as addressing every need she has.As bank running to shopping and paying bills for her.This is all starting to effect me and my family as time & money out of my pocket.If I can't get reinbursed for my gas & time as your saying?I may as well place her in a nurcing home for that matter.Sounds harsh to say but becoming true from what your telling me?So,what your saying is POAs is not allowed to be caregivers?Or POA/Caregiver must do this all for free?I understand that POAs is not allowed to charge for services.But,as I am her caregiver I should be able to charge for my services.
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Go to the attorney and ask him to draw up an addendum or caregiver salary agreement that is legal outlining services, responsibilities, respite care, etc so it's up and up. Establish that care will be either you and or your wife. Going rate should be $15-20/hr or you can agree on a monthly salary. Then you should transfer that money out of aunts acct monthly or weekly and pay yourself. Make sure you keep good records including a written invoice for your caregiving hrs and expenses for her care.

Aunt may balk but you just need to explain. Tell her it is this, or expenses will be higher if you hire help from the outside or have to move her to care facility. Encourage her to try it for 60-90 days and then you will open up the discussion again. She'll forget about it I'm sure but this will let her still feel in control.

Good luck but prepare yourself for the hardship and responsibility that comes with caregiving as her condition worsens.
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Your friend may be doing this with out legal paperwork, but should a family member challenge or she has to move mom somewhere and they are trying to figure out where money went it could be challenged if friend isn't keeping good records. Further there are likely tax implications so hopefully your friend is keeping good records and paying taxes on this income.

You will have to pay taxes on this income as well.
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You said she is on several prescriptions. The Drs name should be on the pill bottle. Contact them, let them know you are her POA, want to make an appt. to check out her cough & give them a copy of the POA at the time. Tell her you are concerned about her cough & you want to either take her to the ER to be checked out right now or she can go to her Dr with the appt you have made. Keep track of your mileage to Dr, store, any errands you do for her, including going to her house. The IRS has a figure they use (.58 mile?) and you should be ok at least charging her for that amount. Let the bills, etc continue to come to her house and let her know her attorney advised you review them with her to make sure things are ok. It sounds like her attorney did well by her & you and it's clear you are trying to do all the right things. Just keep good records, maybe a daily journal or log of visits, how she seemed, what you did to help her when you were there, etc. Keep it in the car so you don't forget to jot some brief notes down. Good to help document everything. When her time comes, if there are any other relatives that come out of the woodwork to claim you took advantage, you have all your records to back up the care you & your wife provided, notes from Dr visits, etc to document you did everything in a caring, honest, above board way. She is very fortunate to have you!
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My two cents worth would be that aunt probably can't make the appointments and isn't lying per se, just wishful thinking and remembering something from way back. For major things, sometimes they will want incapacity letters from the doctor, and those letters could help if anyone ever tries to get your loved one to change POA.

If you can come up with any way to get her to a geriatric specialist without it seeming threatening it would be a very good thing - i.e. going to the doctor to make sure your sniffles don't turn into pneumonia, or going to a specialist who will help you stay in your own home safely (they really will do this - some will get an OT and/or PT out to the home and help make it safer with usually minimal modifications).
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There is a difference between charging a fee for your services, and claiming back out-of-pocket expenses incurred solely and exclusively on your aunt's behalf. If you're visiting her, doing her shopping, taking her to appointments, etc. you have every right to claim back the cost of fuel, parking, etc. Similarly if you're making phone calls on her behalf, writing letters or anything else. Keep careful records, don't blur the lines, and you're in the clear - get your money back.
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Countrymouse, is correct and the POA, I'm sure provides for reimbursement, with a statement along the lines of
"nobody shall incur expense on my behalf and should be reimbursed for any and all expenses."
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Thanks everyone,
Legally wise,my Aunt is competent to make her own decisions.As she was never told by a Doctor she's incompetent .For me as her now POA ,This all started when my Aunt decided to have her Will changed.Day after day she kept bringing up "she needs to fix her Will".I kept putting the Will arangments off because,I thought to give her plenty of time to think about her Will and more time to think who she wants on her Will.A month went by my Aunt never forgot about changing her Will.As a everyday talk from her.So,I decided to have her call her attorney to set a appointment.The day of the attorney appointment the attorney felt my Aunt wasn't competent .He stated to me that he was her attorney for many yrs.And she didn't know who he was.He went on to asked her a few simple to know questions as example,What year is it today?She replied 1988.I explained to the attorney that My Aunt hasn't watched TV in yrs.Could be why she didn't recall what yr it is.
The attorney stated that my Aunt's dementia/memory is bad.Because,of that She will need a POA for sure.The attorney agreed to fill my Aunt's wishes about fixing her Will.And I was appointed her POA & executor .And that is how I became her POA.Keep in mind there is no other family member that is welling to care for this 88 yr old lady .If I didn't agree to help her the state would of stepped in I'm sure.

I took the POA paper work to her bank.That is done.I haven't done nothing else but,that.I was told by the attorney and others to act fast with this POA.Before it's too late.To late for what is my question?The banker told me that I now have full access to her bank accounts.When/if she becomes incompetent I am ready.
I did find who her doctor is from looking at her pill bottles.I'm yet to talk to her doctor and show the POA.I guess I'm waiting for the right time to do so.Because,my Aunt 's dementia as good days and bad days sometimes brings bad days to the table.As of now my Aunt is legally competent.She can do what she wants.As of now she does pay her bills and cooks for her self and lives alone.I can't just step in and take her check book away from her she's legally competent.Doing that she'll call the cops on me from taking her check book lol.
Truth be told my Aunt I feel she isn't competent.Many signs shows she isn't competent as Urene smells in her home & bed,lack of bathing and low weight signs of not eating proper.She forgets when I go to visit her.I can visit her today and she won't remember tomarrow.She forget's my name half the time and I was her nephew over 40 yrs.She's my God Mother at that as she don't remember that.

So,what your explaining to me is,It's my job as her POA to tell the doctor my Aunt's not competent?You would think that the doctor would see she isn't competent by talking with her.Why is it me "The one" who has to tell her doctor she isn't competent?That makes me the bad person in my Aunt's eyes towards me if she finds out I'm the person that told the doctor she isn't competent.My Aunt would disown me if she would find out I'm the one that made her incompetent by a doctor.I care for my Aunt and our freindship together & history.I'd rather see the doctor take the blame then me lol.Let the doctor tell her as keep my name out of it lol.I apologize for the long thread here but,this POA and caregiving isn't as simple as they all say it is.

As POAs legally your not allowed to charge a fee for your services as a POA.
With that said,I understand I can't charge a fee for acting as her POA.
But,I'm not only her POA.I'm also,her caregiver.As her caregiver I should be able to charge a fee for my services as her caregiver.I have a friend that is caregiver over her own mother that charges $800 a month for her services.And she is also,her mother's POA.So,if that friend can charge her mother $800 a month for her caregiver services and she is also, her POA.Why can't I?
I was told since,I am my Aunt's POA that it's my job to hire a caregiver,nurce,funds ect.
With that said,I should be able to hire my self as her caregiver or hire someone else as her caregiver.Can I hire my wife as my Aunt's caregiver?I can hire a friend not my wife?If my Aunt demands my wife as her caregiver then can this be done?
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Good for you in finding out who her Dr is. It is NOT your place to decide if she is incompetent. You need to contact her Dr, give him a copy of the POA & let him know she needs to see him ASAP for her cough and an overall evaluation. You tell her you are there to take her to the Dr, it sounds like she wouldn't remember she hadn't made the appt. You can tell her she needs to see the Dr to get her RXs refilled and to check her cough. He can then make the determination of competence.
I think the reason the attorney said to take the POA to the Dr & bank before it is too late was to make sure you are recognized as the POA ASAP before she deteriorates to the point of being in a really bad way medically & mentally. Evidently he feels she is less competent to handle things than you think she is. If she is not always remembering your name or that you were just there yesterday, she is already further gone than you realize. If it gives her peace of mind, let her keep her bills and checkbook at her house. You have authority to review things and make sure it is correct and nothing is overlooked. The POA lets you be a signer on her checking account to buy groceries, etc. The bank will have you sign the checking account signature card.
It sounds like she does have many symptoms of dementia & may need someone to help her bathe & do heavier housework like laundry, etc.
I would ask the Atty about paying yourself or your wife as caretaker and follow that advice. I wouldn't go by what someone else is doing as you have no way of knowing if what they are doing is the correct legal way. Keep accurate records & document everything to avoid any legal or tax problems.

1. Get her to her Dr ASAP with the POA and 2. Talk to her atty about paying yourself/wife for her care and your expenses involved.
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I'm quite surprised that the attorney didn't conclude that your aunt was not competent to give you POA. Strictly speaking, if she failed to recognise her own lawyer of many years' standing… Never mind, it's done now.

POA is not simple (who are these people who are saying it is???). I hope it was explained properly to you that you were under no obligation to take it on, apart from anything else? But your caring and long friendship with your aunt are good to hear about, and the best reason for you to want to look after her. Just don't always expect to be popular with her!

This may sound rough on your aunt, but if she's legally incompetent and you have Durable POA, she can't disown you. That's kind of the point - that she will have given you permanently the power to act on her behalf and always in her best interests. It's a really serious responsibility, and it's a good idea to keep a complete diary of everything to do with her: not just the money management, but appointments, notes of what advice she's given, possible care and home support options, everything.

Caring for someone with dementia is tiring, hard work and takes skill - especially if she's not co-operative. In your position I'd ask her doctor to explain her needs to you in detail, and get advice from your local social services about how you can best look after your aunt and what help might be available to support you and your wife in doing that. It sounds like it's going to be a challenge! Best of luck with it.
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I think the best thing that you can do as POA is to hire other people for some of these things. Home health aide is who I would look for. 4 hours a day 2 or 3 days a week. Then keep track of your expenses and make out a check for them monthly from your aunt's bank account. You probably should also charge for a few hours a week just to go over there and be sure the smell of urine is gone, and that she is bathing regularly. Remind her who she is while you are there because you will be her lifeline to the real world.

I believe that being declared incompetence is the action of a court based on the findings of two doctors.

POA gives you the right to sign for her based on the assumption that she wants you to and you are doing her a favor by doing so. The other type of POA kicks in when she is incompetent and I think that requires a court finding, this would only be challenged however if you wanted to change her residence or do something permanent that would change her financial situation, like if you wanted to close or change a bank account. That is why you have to be careful. It is actually so easy to take advantage of her in this situation that your actions will be scrutinized if there is any reason for anyone to check them. To protect yourself, you have to write things down, keep good records. Gas purchases are the hardest to prove, keep track of the number of trips you take weekly and come up with a dollar value for driving there.

If your Aunt has a lot of money, who is her heir? What does her will say? Will it be you? If so, I would do all this knowing that you may one day receive quite a bit of money, on the other hand, track your expenses and charge an hourly fee for your time, because you may find that all the money she seems to have evaporates by liens or close relatives who can claim everything regardless of whether or not they ignored her in her old age.

You should not have to do anything for free, you should however keep careful records, and you should not try to do everything yourself. Charge for the time it take to oversee her care. Cleanliness is important. An infection caused by improper bathing is very common in elderly ladies and will cause an altered mental state that mimics dementia.

Also, my experience with dementia is that there are times when the person is totally 100% mentally compentent and times when she can't remember how old she is. That's why a doctor can't just determine it by a visit or an interview. Dementia is a physical state that can be documented, but not all people with dementia are incompentent.

Take your time to document all you do and be careful who you talk to and what you say. She needs you to care for her needs. It sounds like she should be able to stay in her home, and it should cost less than a Nursing Home. The kind of place that would take her might well be hell on earth. Help her stay home. Please. Someone will do the same for you one day.
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