Being a POA for an elderly parent causes problem. Any advice?

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I have a friend that lives in the state of Illinois that cares for his elderly Mother. She is in the late stages of dementia and needs 24 hr. total care, (she cannot feed , bathroom or dress herself) She is on medicare and medicaid. Since he is there caring for her 24/7 he cannot work. He is her Power of Attorney for her so this makes him ineligible for financial assistance to help out with the bills and for her care. Does anyone have any info that may help someone in this situation?

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I suggest hospice in the home if he can't get herin NH. At least he can get an aide. Again, if she ends up in the hospital/rehab have her evaluated or NH or hospicein a NH. This is one of the best way to get her in. See if a Dr. can reccomend hospice in a NH or hospice center.
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If she is on Medicaid (not the same as Medicare) AND he can find a facility with an available Medicaid bed; that's where she should be transferred ASAP. If there are no beds available, she can be added to the facility's 'wait list'. Her doctor can write 'orders' for any necessary DME and Home Health Aide needs until she can be transferred. Depending on who owns the home - be careful of Medicaid assistance. There is a MERP process 'Medicaid Estate Recovery Program' that allows them to place a lien on the residence to recuperate the expense spent on the care of the mother. Medicaid is very happy to waive the home and car as assets for qualification purposes - only to put liens on them later.
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Miss Lynette, a "facility" is not always the answer, nor is it always wise. Many of them are terrible places. I had my husband in a rehab facility (one of the "best" in the county) after he had been dismissed last winter from five days in the hospital, and as his advocate I went around demanding this, that, or the other for his basic safety. They were short-handed and some of those who were on duty didn't give a rap. I was with him for hours every day; might as well have had him taken home from the hospital. As I said, this facility was supposed to be one of the best in the area, adjacent to one of the most expensive and luxurious retirement homes in our city. In fact, the facility my husband was in was supposed to be the "assisted living facility" that was part and parcel of this luxurious, expensive retirement home. Bleh!
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There can be great abuse of power if the person who is responsible for your life decisions is also being paid for your care. That is why many states, the ones who will even pay a caregiver through the Medicaid program, will not pay the person who holds power of attorney.
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Because of how much assistance I received from an elder care attorney, I would recommend getting an initial, evaluation app't from one....to at least get a list of resources locally to contact and start the Medicaid application process. If his mother is the wife of a veteran, there are other benefits also available. A local council on aging may have lots of free advice or can refer to a local elder care attorney who gives initial free advice. IF dementia has been diagnosed, there may be lots of resources available from the Alzheimer's Assoc locally too. Medicaid will pay for placement in a memory care or dementia facility or even a small group home for dementia residents. It may all seem daunting to accomplish while providing 24/7 care, so it may be an idea to hire some part time in home caregivers, while doing all this planning for a better situation. Also, his mother's physician may be a resource. The physician ought to be able to fill out paperwork to get hospice involved with home care, if mom is really declined with her dementia as mentioned above. There are LOTS of resources short of the son being the 24/ caregiver and handling all affairs as her POA and if he doesn't seek some of them, depending on his age, his future ability to work and earn a decent living may be affected. I have taken on this role for both of my parents, but as a coordinator of care, because I do not live near them. Fortunately, I am almost 71 and was retired/disabled from my RN career when I started, but the time required helping them is still affecting our long term retirement income, because it is ruining my home based business which was set up to grow and be sellable this year so as to supplement what we lost in the 2008 crash. The time involved, even from afar, and without direct care giving is horribly time consuming and stressful...and I have the assistance of a eldercare attorney and his team of people in my parents town. Medicaid application will go faster, if Mom is out of major assets other than a house and a car. Sometimes, approval can come within a month of completing the application, and without major assets, placement in a facility or payment approval for in home help can come much faster. We had to spend way over $100,000 before we got approval for my Dad. Now...two years later, we re getting ready for the same process with Mom, who is at home with caregivers, but her approval will be much faster, because assets have declined so much in the past two years. I cannot imagine how I could have been the 24/7 caregiver, with no one to assist me at all, and done all that was required in the last 3 years myself!
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He should contact his local Agency on Aging, and they should be able to provide advice and assistance. He can search by zip code at
http://www.eldercare.gov/

He should also look and see if there are any PACE programs (Program of All-Inclusive Care for the Elderly), they are often a great option for people who have Medicaid.
http://www.npaonline.org/website/article.asp?id=12&title=Who,_What_and_Where_Is_PACE?

Or he can look for advance day health care programs, they are similar to PACE programs but less comprehensive as they don't provide primary care.

If she has Medicaid and is fully dependent, she should be eligible for a residential facility, although it can take a while to find one to accept her. He also may not want to put her in a residential facility, especially if he visits and has concerns about the quality of care.

Re hospice, it can be a great option however for dementia it's not enough to be fully dependent and in last stage; the person also has to show signs of the final terminal decline (weight loss, recurrent infections, skin sores, unable to swallow, etc).

I hope he finds some solutions. Generally there are more options for people who have Medicaid, since the state has an interest in supporting anything that is cheaper than a nursing home.
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FYI. The reason the op said he can't be paid while being poa is that medicaid programs that allow you to choose your own aide that medicaid will pay for will not pay for the poa to be the aide. They probably made a case that there is a conflict of interest but the real reason is probably something around not wanting to pay. Think about it, who would care about someone enough to give up their life and be that person's full time aide? Chances are, a person like that was trusted enough to also be made the POA. We have no way of knowing this, but if she's really that close to death, home hospice would be a much kinder, and I think more appropriate option than nursing home care.
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Needing that much care, she needs to be in a facility for her condition. Then he can get back to work and visit her on a regular basis. Being her POA has nothing to do with her care. That is to care for her bills and such. Medicaid and Medicare pays for a facility. POA ends when she dies. My guess, which is hard for all of us who have cared for our elderly parents, is that the hardest part is for the relatives doing the care. WE feel the loss when they go in a facility. We feel like we let them down, gave us, etc. which is NOT the case at all. It is the wise and best thing to do when they cannot do anything themselves for their basic care to let them live out their remaining years in a facility that is prepared to care for them. Then we can take care of ourselves, our jobs, our life from there, while visiting them. THAT is the wisest and best for everyone concerned!
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Social Security check PLUS mom's Medicaid will pay all nursing home costs. If there is not. Bed nrarby, the Medicaid social worker can find one somewhere else in the state. If there's none in that state, move to another state. Son needs to be working at real job not living off his mom's Soc Sec check, because once mom dies that Soc Sec check is gone, and what good does 3 yrs of taking care of mom look like on a job resume? Unless he wants to eventually be a nursing home aide (which is a very low paying job). He needs to keep his own life vital, up to date in his own career, and most of all socially--how will he have any personal relationships with the Real World if he spends every waking moment with mom? That isn't a healthy lifestyle.
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