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So as I posted, Richard's son is considered next of kin and will be making decisions for him unless he snaps back out of this. Richard's sister is saying she may move back to town to help take care of him, so what happens if she wants him to come stay with her, but the son wants to put him in a facility? Who gets to decide?

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Next of kin gets the say. This situation is the reason every person should have a lawyer draw up powers of attorney for financial and medical. Also a good idea to have a will drawn up while you will be at the lawyer anyway.
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Did Richard ***formally*** put Tyler in charge of his medical and financial affairs? If yes, then Tyler gets to decide once Richard becomes incapacitated. As long as Richard is competent to make his own decisions, he can let his sister help him. But, as of now, she *may* only be moving back to town - that does not sound like a sure thing. And no one person can take care of another 24/7.

You wrote on your profile: "I am caring for my friend, living at home with age-related decline, anxiety, arthritis, depression, diabetes, incontinence, and mobility problems." You do not mention dementia, so Richard is still free to make his own decisions.
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Your situation is a perfect example of why I think it is a bad idea for anyone to take on the responsibility of caring for someone without having the actual authority to do so.

You are not going to win the battle for power over your friend, Richard, that you have engaged in with his son. The son is on his bank account. That in and of itself is a big deal and indicates Richard's intentions of wanting Tyler to make decisions.

Given Richard's clear neurological deficits and limited financial resources, his family may have no choice but to find an affordable nursing home that you will consider cheap. His son will have a hard time going after you for any money just because you helped pay for his father's groceries.
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LS2234 Sep 2020
Yes, sadly as my Grandma used to say, " The road to h3ll is paved with good intentions" and "no good deed goes unpunished." I had the best of intentions, but was too naive and trusting, relied on verbal agreements and our friendship. Had I actually been some sort of "gold digger" filled with avarice and evil intent, first off he would not have been a good choice as to his available money, and second, someone like that would have gotten everything signed over long ago, used untraceable means of transferring the money, or perhaps I should just have married him on our cruise to Hawaii ten years ago...Having failed to do any of those things, I am apparently just a kindly old fool who will be left wondering how he even ends up, if the family cuts me out completely....
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Hopefully someone has been given POA. If not, the Son overrides the Aunt, in my opinion. Children are considered next of kin before siblings. So I would say son will hold the authority. Richard should have assigned you POA then none of this could happen. All you can do now, is back away and let family take over. All you can be is a friend, you have no legal rights unless u want to spend money to be Guardian.
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LS2234, below you replied that, "His SSA and teamsters pension would presumably go to a facility for care. We had looked at places before he moved to the apartment, all were way more money than he gets. Supposedly medicaid steps in once you are fully incapacitated. I tried to get him on California version which is Medi-Cal, but they kept denying saying he has too much income."

Yes his SS and pension could go to pay for a facility, but only if he or his PoA acting on his behalf arranged it and he could afford it out of pocket. Medicaid does not "step in" unless he or his PoA/authorized representative or the facility fills out and submits an application. Medicaid has nothing to do with incapacity, only financial assistance for care. It does not act as a guardian, the county does that. You helped him apply for Medi-Cal but didn't qualify because he makes "too much income" and this may continue to be the case as long as he is receiving a pension. He should see an elder law estate planner who is familiar with Medicaid.
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Richards son is next of kin and should make the decision.  If I were Richard, I would suggest to his aunt that if she wants to move closer to her brother, that would be great and she can visit him daily in the nursing home if she chooses.  She can keep an eye on him and visit with her brother without giving up her entire life and stressing herself out.
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LS2234, according to your update the SNF wanted to discharge this gentleman to care, could not reach Tyler, his son, and "sent him home" because he would not go to care, after they spoke to you. If I recall it is his SON who is his POA, not you, and they were wrong to involve you in discharge drama.
If he has the power to decide whether to go home or not, then they cannot deny him, BUT if they talked to you and you agreed to try to provide some care, they thereby sidestep the "Unsafe Discharge" accusations that all SNFs fear (they can lose the licensure).
I tried to tell you some time ago that as a friend you are too deep in the business of this family. That they have now done a discharge that is UNSAFE after speaking with you, and without speaking to his son, has just proven my point.
At present you are going to need to call the EMS to get him back into care. At that point please remove your name from his records. They should now be dealing with patient and with family ONLY. Later, if he returns home you can come by and ask if there are ways you can help that may BE a help. This man sounds way too much care for a Sister who is somehow hoping to move her entire life here to take care of him.
Please step away from the middle of this, and let Tyler, the son, be the person handling this for his Dad.
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LS2234 Sep 2020
It was the hospital that discharged, he never went to the SNF. That is where he refused to go. Tyler did not answer his phone, he turns it off when he is at work. He is a glorified babysitter, employed to supervise teenaged boys in a group home. From what his dad tells me, he basically sits up all night playing xbox with the kids until lights out, then once they are all down continues on the video games. No POA was ever created. When I reached out back in June, trying to tell the kid his dad needed more help, his response was " Yeah dad should have just gone to a nursing home when he decided he did not want to stay in his own house,but did not want to because they would take all his money and he would never go anywhere any more."
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Yes, please post more info. What is he "snapping back out of"? I'm not sure that "next of kin" allows anyone to legally make decisions for another person who is incapacitated. Power of Attorney is what outlines an assigner's wishes and gives legal authority to someone to act on their behalf. If Richard's son wants him to go into a facility, who will be paying that bill? If Richard isn't the actual PoA then any contractual paperwork he signs for RIchard may make him responsible to pay. If the sister is willing to come care for him, is she expecting to get paid? Who is going to pay her (or support her) if RIchard can't make that decision right now? What medical care does Richard need and is his sister even qualified to provide it?
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LS2234 Aug 2020
His SSA and teamsters pension would presumably go to a facility for care. We had looked at places before he moved to the apartment, all were way more money than he gets. Supposedly medicaid steps in once you are fully incapacitated. I tried to get him on California version which is Medi-Cal, but they kept denying saying he has too much income.
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If Richard is well and able to make his own decisions he can make them. If he is not mentally capable of making his own decisions a family member will be appointed to do so, if not with current POA, then with some sort of emergency guardianship arranged by Social Workers.
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Richard gets to decide. If he is competent to do so.
If he is not, the son, who you point out is considered next of kin, lives in the area and has been doing duty heretofore.
You are a "friend" of Richard. I think that it is time that you step away from this situation and let Richard and his family decide together what is best for him.
You mention "his sister". I am assuming that is Richard's other child, a sister who does not live in the area and has not been involved in care. And where her move and care of Richard is concerned, I am certain she has made this offer to the other sibling, and the sibling currently doing duty in same town has decided placement would be best.
This is then a matter for the two children to settle with their father. You have offered your services. Now it would be best to step away before you end this family in a court battle which could lead to POA and guardianship given to the state. In that unhappy circumstance Richard will be placed with NO ONE having the slightest say of where and how.
I understand that you feel that Richard is your friend. But you have been accepting some payment for some care, and that takes things into the iffy area of not pure friendship, but of something other.
Please let this family deal now with what is clearly a hard decision.
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LS2234 Sep 2020
The sister I am talking about is Richard's older sister Jill. He is the youngest of 4 children, all are well up in years. Richard has an adopted son, two biological sons, and a stepson. The adopted son and the older of the two biological sons are both special needs, disabled. The younger biological son, Tyler, is the one currently handling his father's affairs, despite their having had the falling out in November of 2018 when Richard moved from that son's home into his current apartment, where I have been taking care of him. Jill called me today, she has been actively looking for a rental that will work. She spoke with the manager of his current apartment building, and there is a distinct possibility that she may be able to rent an apartment in the same one. That would solve a lot of issues. I am not trying to become Richard's legal guardian or anything of that sort, I simply want the family to come to some best possible solution for him, but I am still willing to provide his physical care. I do have experience caring for people with dementia, on IV and PEG tube feeding, my late husband had a port in his chest for his chemo treatments and was tube fed until he opted to go into hospice. My grandmother had severe dementia, COPD and was tube fed as well. I was caregiver to both of them, as well as my grandfather, uncle, and mother.
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