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She has recently begun asking for rather uncharacteristic demands and becoming very depressed and disoriented. How do we go about executing the terms of the POA?

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Having been doing this for over a year now, I wish I had been given a check list myself. But I am also trustee of the parents trust and working to do all the required paperwork for VA long term care benefits and medicaid benefits for Dad's payment in his dementia care unit. So, my advice...as other said, first read it carefully. Then take all paperwork to the bank and set up a new checking account called a POA checking account. My has parents names and my name on it as POA. My understanding is that the POA can be utilized as soon as there is a problem in that specific area: Durable POA or DPOA or a Medical issue Medical POA. We did have to have 2 doctors declare my dad incapable of handling his own financial affairs, but that was because AFTER I started paying the bills, he hit a point where he wanted to change it all back and decided he was perfectly fine. The eldercare attorney told him that they needed to have his docs agree that he was OK, since he had gone in and asked to do the POA due to his dementia. Of course they did not and the attorney told Dad that in another meeting. Never heard another word about it after that. He also does ask sometimes, if he still has plenty of money and if Mom (who is still at home) is OK with enough money. Anyhow, the next step is to send copies of the POA to every place that there is any kind of account whereby you may have to make financial decisions....savings accounts, investments, stocks, bonds, IRAs, insurance companies etc. For me, this was a major headache because some places want only the front page and the signatures, and other places want the entire 20 pages and some places wanted the signature page and then fill out forms of their own etc. I changed many of my parents bills to auto deduct just by going on line as though I were my Dad...BUT...the problem there is that the bill still goes to their house and if I want to change addresses or terms or anything, THEN I have to go through the whole POA process. So I would say, just 'tell' everyone and give them what they want. Take the Medical POA, if you have that too, to all the regular doctors, so that you can get info about visits if you don't personally take them. I live 5 hrs away from my parents, so sometimes it's a caregiver and sometimes Mom goes alone. I always fax the MD with my list of concerns/questions and things the parent wanted discussed but might not remember. And their main physicians will phone, email or even call and discuss things during the visit while I am on speakerphone. If one cannot go with the parent....ask about those options for communicating. I also am a retired RN, so I at least know how to tell the MD it will help them in the long run if they will work with me! I don't have siblings left to share with, but I do make a point to try to keep Mom informed about what we are doing and why we are doing it. She's had the worst time understand the 'spend down' period in order to qualify for Medicaid.....and initially it appeared we would have to do a Medicare annuity or take a chance that Medicare would get their house. Mom wants to be home as long as possible so that was a bit of a fight with the attorney's people....but I just said that for now....their house was off the table and they would have to figure out how to work around that issue! For me, it's the Medicaid thing that is the most confusing. I am doing OK on paying the bills and I have advisors who tell me which is the best investment to cash in when we need to do that. I know that one other aspect of having POA, is that who has it is then responsible for the safety and well being of the person needing it.....so it's much like me being the parent and them being the children. They don't want caregivers; they think all is well, but they leave the stove on, they fight and the cops are called....So finally for us, we had to place Dad elsewhere, and basically 'order' Mom to have the caregiver for awhile to assure that we had an agency involved and regular check ins as to how she was doing at home alone too. Attorney said, even if neighbors call APS, IF there is a HH agency involved and a minimal amount that a caregiver is coming, then APS would have no authority to step in and cause trouble. Mom also has a good home alarm and wears a panic necklace, when she chooses too....but at least it's there and paid for. She is a real pistol about remaining independent even those she is diagnosed with early dementia herself. So I hope this is helpful info about how to get started!
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First, read the POA. It should state clearly that if your mother cannot or chooses to not make any decisions relating to her money, property, personal property, etc. then her sister and you can make decisions for her. Just tell and show that document whenever you have to execute any transaction that she would have done herself. Having Alzheimer's disease is a form of dementia and there are many forms of dementia. Different areas of the brain are affected and patients who have been diagnosed with dementia leave a paper trail from doctors. Tests are performed to rule out other organic diseases. Get the doctors who are treating your mother to give you those tests which will contain the results in easy to understand language. This will help you as well as how you proceed with her care. Not all patients respond to medications and just because a neurologist prescribes them (Exelon patch, Namenda, Aricept), does not alter the terminal state of the disease. Each patient is unique, and each patient should be treated with their own unique body reactions to chemicals. As a nurse, I have refused drugging my dementia husband because his body does not tolerate any drugs (except one for hypothyroidism), and he is still in Stage 1 with one neurologist saying he could last 20 yrs. (as of 2009). Do read all the material from alz.org to educate yourself on your mother's disease, and go to support groups where you will learn and share more. My best to you and your mother.
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Read through the entire DPOA. My moms was written so we could not make decisions for her until she was diagonsed as incapacitated by a neurologist. Once that happened, we went to moms elder law attorney who filed all of moms accounts and estate under my sisters name as trustee and executor. We work together on all decisions and it works for us. If we disagree we set that topic asside to discuss later.
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You may need to collect a couple of doctor's statements that Mom cannot manage her own affairs, sometimes for "bigger" things like selling a house, some party will need or want evidence that the person cannot do it for themselves. Unless there is concern she would get confused enough but still communicative enough to revoke or change POA, you do not necessarily need to go through guardianship.
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Power of Attorney is given and only the person who gave it can take it away. If they are incompetent and things aren't going well, that's usually when the issue comes in. But POA goes away when the person dies.
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If you have POA there is nothing to do but whatever you need to to take care of her and her bills, decisions, etc. You will need to have a copy of the POA on file at the bank or anywhere they would need proof that you have legal ability to execute her wishes. But that's it. You can open an account or whatever you need to do. Joint POA usually means either. Depends on how she wrote it up. You can talk to a lawyer to clarify if need be. It is easy. Getting an elderly person to give over the POA is usually the difficult part!
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Make sure you get everything noterized and you have a lease 2 witness who are not related to sign the document. I am in the process of doing a POA for my sister, but it's only a medical POA. I think a POA would work the same say. Also, check out the guidelines in your State. Best wishes
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One doesn't move from dementia to Alzheimer's Disease. Dementia can be caused by a number of things with Alzheimer's Disease being the most common. It seems that what you are saying is that the dementia, regardless of what is causing it, is getting worse.
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I agree with Augie and will add that your profile gives no details, but it is my understanding a DPOA cannot be executed till the person is deemed incompetent. You don't say what kind of POAs you have, one is for while the person is competent, the other comes into effect when the person is incompetent and you can have both of course. I would get her into a Geriatrician and take it from there.
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My comments are addressing your comment about dementia and alzheimers. I do this because life for caregivers and loved ones is much easier if they understand and are informed as they can be about what is afflicting who they care for. Alzheimer's is a form of dementia, and there are many forms of dementia, each with their own characteristics and similar characteristics. My mom had 5 different diagnoses. Over a 5 year period, there was a multitude of tears, frustration, stress, etc... and the more that I researched and learned about all forms of dementia and the more I learned about caregiving the easier it was to handle. It gave us more happy times. Many times different forms of dementia can overlap.

In retrospect, taking the time to find out what was happening to mom was a great investment. In the long run it saved us time and money by knowing what not to waste time on and things that were unnecessary. It taught me how to listen to mom and look for clues that worked for her and made her happy, because what works for one person is different from the next. The biggest misconception that I see is that alzheimers is the same in everyone that has it and if you put on the patch, they are happy campers. The biggest benefit was that we had a more rewarding 4 years before she passed away. Remember to take care of yourself in this journey.
Bless you for being there.
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My brother-in-law and I share POA for my mother-in-law. However, I'm the one with the checkbook, and I'm the one that pays all her bills. All her sons are on her account with her so when she dies the POA duties will end, and the boys will take over what they need to do. It has worked out fine for us so far, but that's because they trust me. When I'm having an issue with my mother-in-law's account and I need to move money from savings or her CD into her checking account, I always talk to him first and keep him in the loop. Open honest communication and trust is what makes this work. You can do it to if you have that. My mother-in-law hasn't seen her checkbook for years, but she'll ask 'how's my money doing?' which means she's concerned whether she can afford $3500 a month at her asst living. She also has dementia and is legally blind with macular degeneration.
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