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After our mother passed 54 years ago, our father remarried our stepmother. Our father passed several months ago, and the stepmother that we 3 children have known for 50 years now has advanced dementia, and can't recall events that occurred the day previous, is falling daily and can no longer care for herself. She has a 49 year old son with our father (our step-brother), but no one has heard from him in over 10 years, as he has chosen to go his own way and not stay in touch. Our stepmother does not want to give us any control to help her, but we are the only "family" she has left and someone needs to obtain POA, and medical POA because decisions need to be made and soon to get her help. She is not paying her bills, is forgetting to take medication, is falling and can't get up and is accidentally mixing pain medication and alcohol among other things. Since she no longer can cook for herself, we have cooked dinners sent to the house, but she can't find the food as she has forgotten what the refrigerator is for. How do we obtain POA, and can we do so if we are not "blood relatives". Time is running out. Thank you!

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Is she living by herself? I would call Adult Protective Services and request a welfare check.
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The best route now would be Guardianship.
You will have to keep records of what is spent, where she lives, medical appointments....
Once a year you will have to present to the court her status as well as a financial accounting of what was spent and on what.
Talk to a lawyer versed in Elder Law.
It is possible that whoever will be caring for her can get paid from her estate, that would be a medical deduction that could also be written off come tax time.
If there is no money or if it will soon run out now might be the time to apply for Medicaid. Again a lawyer versed in Elder Law may help.
(If step Mom was a Veteran contact the VA for assistance as well. )
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Guardianship seems to be your only solution. Moments of clarity can not be scheduled so if a judge asked her in 3 months and 2 days later, she probably would not remember executing the document. It could also open you up to legal actions by your half brother.
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I was told by an attorney that elders with dementia have "moments of clarity" and that if she could get a "moment of clarity" then the attorney would witness and allow her to sign POA designation or any othr legal documents. I did not find out what is involved with this process but I imagine the backbone of it involves more than one credible witness (doctor(s) perhaps)and may even involve video. Do not take my word for this however consult an elder attorney about it. As you may know many attorneys work with doctors on an ongoing basis however maybe a doctor not associated with the attorney would be more credible.
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Since she will not sign POA you should contact an attorney and get a court ordered legal guardianship. It will cost more but will certainly help you get the job done right.
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