Has anyone else had this issue? I can’t be alone here. My dad was rushed to the ER back in February with kidney failure and cognition decline. They kicked on the POA and I stepped in to manage the situation from out of state. His PCP had mentioned to me over a year ago that she was noticing signs of cognitive decline so I had hired a home healthcare service to come and take him to appointments and grocery shop/visit with him a few times a week. This was up until this major event that occurred back in February when it was made very clear by multiple doctors and nurses that he can no longer live on his own. Long story short, his kidneys bounced back though he will likely have to have a catheter for the rest of his life, but his cognition continues to be problematic and the doctors don’t believe he will recover back to where he was at previously. Since his PCP noticed this decline for a year+ now, the neurologist he saw one time last month said he thinks this is his new baseline. He diagnosed him with a “major neurocognitive disorder” but couldn’t give me a clear diagnosis of whether it’s Alzheimer’s etc. and said this is fairly common in men of his age. He scheduled him an MRI of the brain in a couple of weeks but said even that might not give us a clear diagnosis. I am beyond frustrated here because I was designated durable power of attorney, but I am having difficulty two months into this not being able to get on his IRA as well as one of his bank accounts (the only one he did not put me on because it doesn’t have much in it - however ALL his money counts as assets so the state looks at everything when it comes to spend down). We have been able to private pay for the SNF he is at, but only for a couple more months. I am a preparer, I am an only child with no family, and I live in another state so I want to get myself in line to liquidate this money when the time comes to pay for his care there towards his spend down before applying for Medicaid. I have a letter from a physician at the facility he is at but it only deems him incompetent to make his own medical decisions, not financially. The bank with the small funds in it and the bank with the IRA doesn’t accept this and needs a letter deeming him financially incapacitated as well. However I’m getting the vibe that the facility he is at does not want to be on the hook for putting that financial part of it in writing. What gives?!?! I’m literally just trying to do right by my dad here and get everything ready for when the time comes so that I’m not left scrambling! I work three jobs myself so I need to do things as soon as possible. What the hell am I supposed to do here?? If he was told he was “good to go” tomorrow of COURSE he’d say he wants to go home, but then what??? Leave the stove on and burn the house down??? Not know how to make food for himself because he doesn’t remember??? Not know how to write a check out to pay his bills?? It is clear he cannot return home and needs nursing care. What do I do here?? Reach out to the neurologist he saw one time who gave him that pseudo-diagnosis of “major neurocognitive event?” I am so sick of the system and trying to do everything “right” and “by the book” in this situation I did not ask to be put in, but it being treated like I’m doing something wrong here. There has got to be a better way.
So I do have experience with this now, there are just two banks that are being real sticklers about this. Luckily I am on his main bank account which is the one attached to his Social Security direct deposit as well as 99% of his savings which we have to go through prior to me doing anything with his IRA anyways. I’m just trying to be proactive here so that I’m not left panicking and scrambling the way that I was back in February when this all started going down getting everything sorted. Mentally it really did a number on me. The POA document does have the proper wording for me to take on all of his financial business, however nowadays many banks also require a letter of incapacitation from the attending physician. Most doctors only want to include medical incapacitation and not mention anything to do with finances, because it gets them into a tough spot, at least this is the way it seems to me. The physician’s letter of incapacitation I have was from the time he was first admitted to the rehab facility, it only mentions medical incapacitation, it does not mention anything about him being able to handle his finances. However if you think about it logically, he’s medically incapacitated due to lack of cognition. You need cognition in order to be able to make sound financial decisions for yourself. So yes, he is financially incapacitated!
I guess I just came here to vent. I’ve been in contact with the social worker at the facility he is located at, and she is reaching out to the attending physician to have him draft up a more thorough letter that includes incapacitation with regards to making financial decisions. if that turns up a blank, I will go to the neurologist whom he has met with only one time, but made that determination that he has a major neurocognitive disorder. If that combined with his primary care doctor letter stating he has had a decline for a year now is not enough for the banks, I’m not sure what will be. No one has had a problem with my durable power of attorney and the way it’s written up, they just seem to want an added layer of documentation, to which to a certain extent I completely understand because the banks are just protecting my father and I get that. Anyone can say that they’re someone’s power of attorney, I understand needing legitimate proof that that is the case. However, POA is such a grey area sometimes with certain things, because like you said above, doctors don’t want to put themselves on the hook for mentioning anything in terms of finances because that’s not their realm, however if you step back and think about it logically, you’re deeming him incapacitated due to cognitive decline and dementia. You need sound mind to make financial decisions for yourself. It’s not rocket science! There’s physically no way I can move back closer to where he is at. I work three jobs, and one of my jobs is tied to my rent to own situation. If I quit everything tomorrow and moved back there I (and my boyfriend) would have nowhere to live, I would have no job or source of income, no one would rent to me because I have no source of income, etc.
He’s got some money in savings to get him through this time, I’m doing the very best that I can, we started private paying two months ago at the SNF so the money is going to go like lightning, but in the meantime some of these things are just so stupid and frustrating on so many levels. Like I said, you try and do everything the “right” way within your capabilities cause I’m only one person and I have no family or anyone else to assist me with this so I do what I can!
You have done a tremendous job and your dad is blessed to have you as his advocate. Keep on keeping on!
So, it is a matter of wording.
I, personally, would call a few attorneys (certified elder law attorneys) in her state and ask them how the Doctors need to word the diagnosis to ensure it invokes your financial POA authority AND meets any state requirements. I bet they would give you the answer on the phone call. Even if you have to pay, so they will email the verbiage, it would be minimal for a short question like this.
Prayers that this gets sorted out and isn't so much of a challenge.
I found it did eventually bottom out but, it is still a lot, so heads up. Strong time boundaries are your new best friend.
My Moms was immediate and I had no problem getting her CDs liquidated for her care. She had no IRA. Her Medical, a doctor did need to invoke it.
A Springing POA is when a doctor or doctors need to say Dad is not competent to make informed decisions. Call the Neurologist and tell him you need the financial invoked, even the PCP if more than one doctor is needed.
This will mean family leave if you are doing this long distance as this will take several months to get set up with all banks, gather all documents, see attorney for guidance.
Taking on POA is a terribly difficult job. I was made Trustee of Trust and POA by my brother as soon as he got early diagnosis of probable early Lewys (and NO dementia diagnosis is definitive until autopsy after death; medical makes it's best guess and your letters for your POA simply need to say your father has dementia and cannot do his own executive functioning, so his POA will take over ALL FINANCIAL MANAGEMENT.
How everything is set up is IMPORTANT. You are going to be signee on all his accounts. He will have nothing but a small personal account. And your record keeping and files must be meticulous. To be honest this first year of setup is almost impossible long distance. I was only across the great state of California from my brother. It was constant plane trips to him to get it all set up.
This is a huge job. Not to be done lightly and I came here kicking and screaming and totally CLUELESS almost exactly five years ago because of that.
See an attorney to start. That will help you know how to begin to set everything up. You will be anxious and overwhelmed and there will be a new something every day. I was on the phone once with Spectrum re a simple landline phone that accidentally was turned off in his ALF for 10 hours. I kid you not. I swear I talked to different folks all over the country and in a few other nations. I almost went stark raving mad with it.
Wish I had better news. But at the end of one year I got his bills, paid them, kept records for him and anyone else who needed to know, sold his last small home with him and chose ALF with him and visited him and we laughed and we cried and we yelled and screamed and it all got done. If I lost my mind temporarily, I got it back.
Good luck. Do know that SS is a whole other bag--doesn't do POA and you will have to be representative payee if you need to change bank account where it goes. And IRS and Medicare will work with you and him to get copies and cooperate with insurance supplemental, but they also don't recognize POA. So there's THAT as well.
No one on this earth should ever take on POA lightly, and I would never do it again for anyone, but am so glad I could help and reassure my bro then.