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I have the DPOA for my mom's business affairs as well as healthcare.  Her cognition is markedly changed. Our current documents were prepared 10 years ago, when my father passed. My mom's cognition is clearly altered now. The documents state that I am to carry out the responsibilities as POA, but that she may revoke them at any time. How do I go about having her evaluated and if the evaluation shows dementia who needs to see that form in order to bring the POA into irrevocable status?

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Ahh yes, the issue of did the right thing years ago and protected assets and health. The revocation issue I think is a mainstay in these issue, i.e. change it all, every excuse in the book from the grantor who is having medical issues to keep from accepting the real issue: mild, moderate cognitive impairment possibly. If the primary doctor is a long-standing physician of your mother, i.e 5-10 years plus, this gets tricky I think also, because if the doctor does not see that she is seriously ill, the doctor will not refer her for evaluation by a neurologist or clinical psychologist that can perform the evaluation.

The only alternative is guardianship, which requires an attorney on retainer, probably, and then a judge in the district court of the state you live in, will process Special Guardianship for 30 days, so that an evaluation can take place. The cost for that court-appointed evaluation is just as much as placing an attorney on retainer, so first things first.

Someone has to determine full financial risks, if not completely resolved, assets, trust, if in place, before you consider guardianship. It can be costly at first, and I mean $5000 to a lot more just to get it done, by sometimes this is the way things go. The trust stays in place but even another guardian has to be appointed to handle the transition which can have all power for the entire year, to see that the elderly person is taken care of first, and things like inheritance are no longer considered.

What is important is she is alive. Sometimes, the temporary guardian will then return the guardianship powers back to the active co-trustee later after these serious issues are addressed. It is a cost issue, and private insurance probably lowers the cost. Court costs come out of the assets or your own, and you may not get paid back, unless an attorney (who will require $2500 for retainer, and then hourly rates of $300 or more to resolve) confirms to you that you have a fiduciary responsibility and the full assets of the trust will pay for managing the trust. Very tricky path you have to deal with. Review all financial first asap, and I mean everything: real estate, insurance, income, then talk with a financial adviser about the pros and cons of this decision.

Just my 2 cents. Good luck!
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Her doctor could do an evaluation - it usually costs around $120 - 140 and Medicare does not pay for it, but you would have everything in writing. If you need to get a guardianship, I know that you must go through the court for that.
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