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I'm named as the person to make decisions (and use the Trust's funds to pay for care) but I don't know what to do once we've visited the doctor. I'm also out of state and my aunt is completely alone.

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I contacted the law firm that created my mother's trust and provided them with the medical paperwork indicating that she was diagnosed with dementia and unable to handle her affairs.

They issued me a Certification of Trust naming me as the new trustee while my mother was still named as the trustor.

That was sufficient for me to legally take over as successor trustee.
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Reply to Scbluheron
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The Trust will be written to explain exactly how the "successor trustee" takes over, when, under what circumstances, and how.
This is complicated, legally. It is crucial that you have a Trust and Estate attorney to guide you through getting your Trust organized, understanding your duties as Trustee and understanding how crucial it is to keep meticulous records as you go along. You will need letters testamentary to give to all entities involved in the Trust.

So off to a real expert. Remember, no matter we may have served as Trustee of Trust for someone (and I did) you cannot take the word of strangers on how to manage this. Wishing you the best.
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Reply to AlvaDeer
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A Trust should already exist to be its own entity. By its very nature, it exists.

I’m guessing that Aunt did some type of Trust (Revocable, Irrevocable, or possibly another type) with her as the grantor and with naming you as its Trustee???
You have to speak to the law firm who drew this up for her and clearly go over what type of Trust it is and how you as its Trustee can manage the assets in the Trust to be used / drawn from on her behalf.

If this is something you can’t do on your own, that law firm should have attorneys that will act as a fiduciary for the Trust. Or it could be that Auntie has a fiduciary - maybe a long time financial advisor of hers - that is to become this for her once she’s unable. Neither should be a beneficiary of the Trust or a Trustee; their role is only as fiduciary.

the answer to this really truly is attorney work. Go thru the paperwork and contact the law firm.
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Reply to igloo572
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I would consult with the elder law attorney who drafted the trust and ask for guidance. You will now need to make a decision about her care: either you transition her to a facility where she currently lives (and manage her care long-distance) or move her local to you where you can oversee her care more easily.

I do not recommend trying to keep her in her home with caregivers as this will require a lot of management by you, and will exceed the cost of a good facility.

The trust probably has a provision to pay for any legal consultation in administering it.
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Reply to Geaton777
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