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When he won't or can't sign forms and she can't be power of attorney? He doesn't want to live at a facility, won't go to the doctors, won't take his meds, is in a lot of pain, and now my Mom is too ill to care for him, nor able to perform duties as power of attorney, conservatorship, or probate. Neither my Mom, nor step-Father can afford help, as in a lawyer.

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Immediately file the initial paperwork to the VA so your case timeline starts for both parents benefits. Very important. Then you can gather other info to send to them. Important or you lose benefits during the gathering time.
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Correction: they can NOT cooperate.
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Have him admitted to a psych or behavioral hospital. They will thoroughly evaluate and get him on the medicines he needs. He may need vitamins as well as antidepressants. And when an Alzheimer's or Dementia patient hurts, they can reason or cooperate. Don't just send him to a nursing home, they won't properly evaluate him. Also make sure he and your Mother are both getting what they are entitled to from the VA.
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Contact your VA Patient Advocate for help. And/or VA Social Worker. They have a home health team plan that might help. Evaluations are done in the home, which should give you some relief while you figure things out.
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Debdaughter -- you are right! Sorry, I'm getting my conversations with our social worker mixed up. When I talked to her she said the VA would not pay for nursing home care at our VA hospital (unless service-related) but that has nothing to do with Aid and Attendance. I have not really heard of anyone using A&A in a nursing home though, maybe because generally the cost is so high that most vets qualifying for A&A need to apply for Medicaid anyway when that time comes.

Regarding the A&A for senior vets: an individual vet, a vet and their spouse, or a surviving spouse may qualify for the benefit. I am not sure exactly how the VA figures their numbers, but it's worth looking into whether your mom might qualify for something too. It might just be that whatever time or money you are spending on her caregiving, medical expenses, etc. would be factored into the amount they decide to give them as a couple. It doesn't hurt to ask.
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Debbie, I think you've gotten your answer re the pension and A&A; it's just more of one for higher level of need of care; like my dad would have only qualified for $300 just pension, which, in everybody's mind, wasn't really worth pursuing, but when he began to need the "Aid and Attendance" of another person, then he could get much more in order to pay that person; I'm glad you're going to a seminar; that's where I first began to learn about it; at the time when I went to the Veterans guy at his clinic, he didn't even know you could get it to stay at home, but only for assisted living, but, which if that's what you're trying to do anyway, they should be able to help you anyway; at least the one my dad was going to go to had someone they worked with to help you with it. We did hire the actual caregiver but before and during that we also had a homemaker/personal aide from the actual VA that the social worker at his clinic got for us - not a specific geriatric social worker at the big medical center; his didn't have a specific geriatric department, like some do, but I haven't found them to be too helpful, as they have one as the one hub's uncle's under but it hasn't worked out too well.
I know you would hate lindy's solution but that might be something you might have to consider, but let me go back, you say your dad won't go to the doctor but if he's in the VA system, as you say, he has to go every so often to stay in it, so does he and just that's the only time he'll go? when my dad fell and broke his neck and was sent, not to a VA facility, since the one he would have had to go to, since his couldn't handle it, was so far so he was allowed to go to an outside one, but placed in a C-collar, and was giving me fits, that's what I was told I would need to do if I couldn't handle it but I was able to get him calmed down. I, too, am wondering if you've discussed this with your dad's primary VA doc but I know, too, that in the case of hub's uncle she just brushes it off and it did take the fall with dad for the social worker to get involved; possible it wouldn't have had it not happened but not sure.
All of dad's Aid and Attendance went to pay the caretaker, so there wasn't much involved to keep track of; they took care of everything else as part of their job. I'm not sure what Lindy's talking about re if you get your dad placed because I thought it would need/could be used to pay for that, if it had to be done, if he didn't qualify for Medicaid, which could easily be the case, that he could qualify for the A&A and not for Medicaid; the requirements are very different, but I don't see it being something your mom could qualify for if you place your dad, but then I'm not seeing that that's an issue anyway.
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I'm not sure I can add anything here but thought I would throw this in. Not sure what your dad's diagnosis is so it might not fit. I found this out with my in-laws and father that a lot of times they think of the Old nursing homes. Today's nursing homes or assisted living facilities are so much better (at least the majority). After looking at many, I picked out three for THEM to choose (unless they are unable) and went with that. We even had lunch or dinner so that they could see if they liked the food. A lot of elderly people who have lived through so much are afraid there will not be enough food or the food will be awful. I also had to show my dad on PAPER how much it was going to save him to move to one of these facilities instead of living in his house with all the bills and maintenance. We were very lucky due to the fact that my in laws and dad were pretty compliant (however no one wants to move out of their home). My dad was main care giver for my mom until she had to go to dementia/Alzheimer's facility after his heart attack. That's another thing you could possibly tell your dad depending on his illness.....he needs the help because he's been taking care of your mom for so long that now it's his turn to let someone take care of him. Anyway, all of the above are great posts. Good luck and God Bless.
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Debbie3, Aid and Attendance is a special pension for veterans and their spouses who demonstrate medical and financial need. It is designed to keep vets and spouses in the community (home, Assisted Living, or Independent Living) and out of nursing homes. It can be a big help if they are in financial need and need assistance with daily care. If your stepdad goes into a nursing home, your mom could still apply for that benefit herself.
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Debbie3, have you talked to the geriatric social worker at your closest VA? They aren't always helpful, but it's worth a try. Explain your situation and your concerns about your mom's safety. See if she or he has any suggestions.

Another possibility is if your stepdad is prone to rages, and he won't see a doctor, call 911 the next time he has one and see if he can be admitted for a psychiatric emergency. I know it's not nice but it sounds like your mom is at risk. You have no control over your stepdad and he is non-compliant with dr's recommendations for whatever reasons (dementia or ego?) Caring for someone like that will wear your mom down fast and I would try to focus on getting her safe and properly cared for. Have you discussed your stepfather's condition and the toll it's taking on your mom with her primary doctor?

As Debdaughter wrote, fiduciary is a financial responsibility. If you, your mom, or another family member isn't up to it, the VA can appoint someone to handle it. You need to be able to keep track of his VA income and how it gets spent, so if you are already maxed out, it is fine just to tell them you don't want that role. You don't need to do physical work of caregiving, but need to be able to keep track of receipts/paperwork if someone else does shopping, bill paying, etc.

I'm not clear on what benefits your mom and stepdad are already receiving, but your mom may be eligible for Aid and Attendance if she isn't receiving it already.
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Yes Deb, my father is in the VA system. What are the differences between "Aid & Attendance" and his pension? I am going to a VA seminar on getting his pension. I did print out papers to apply for "A & A", and will bring them to the seminar. Our VA homes are also a state facility, partly funded by the VA. The waiting list for "Skilled Nursing", required for alzheimer/dementia patients are 2-3 years. My Mom can't take care of him that long. Did you hire the caregiver or was he/she from the VA? I appreciate all who have wrote in. Thank you.
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Debbie, fiduciary was only financial; I had to get his actual A&A VA monies; you have a very different situation that I don't have time to get into right now; you've gotten some good answers; I had a caregiver for dad, who took care of all the rest of the stuff; I just took care of paying him; he got his meds and took him to the doctor; I only really got involved to give him respite and when dad had to go to the hospital; The VA is who appointed me fiduciary but they came to my house, after going to his to determine that he needed one; if you don't get anything else done with your dad before - no, you can't; you have to have a doctor first - don't see where you've answered whether your dad is actually already even in the VA system - is he? we also have a very good system where we are; the VA guy who handles the A&A is located in the clinic; they have that here as well, just that it's new and no one really knows it yet and she's knew so doesn't know much about the A&A either, but, anyway, this guy also came out to dad's house but he's known him for years, used to do it through a VA Service Organization, like the American Legion, who, at least where we are, is actually the POA for the VA anyway, so if you have something like that where you are, you might talk to them; was your dad involved with anything like that? dad was for years, so that helped as well - the nearest long-term care facility for dad as well was 2 hrs. away, but like somebody mentioned, it was actually a state facility, so, actually, again, that could be a whole other issue anyway; his actual VA center no longer does long-term care; they contract that out with local community ones and I don't think they did with any of the actual local - as in his actual town - ones anyway so that was another issue, plus he had dementia as well, so not really how any of that would have worked out, either. But the first thing, not that it has to be, just makes things easier, is he in the VA Healthcare system?
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Both my Mom and I are ill. From what I read, the fiduciary is required to do a lot. The courthouse, is in Oroville and the VA center is in Chico. The nearest VA Long-term care facility is in Redding. I live in Magalia. "debdaughter", who appointed you to be fiduciary, the VA. What are you required to do? Get meds? Take him to the doctors?
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Call Adult Protective Services.
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why are you not able to be his fiduciary? I was for my dad
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I might add, my step-father, served in the Vietnam war. He was in the service 7 years. He is 72 years old, with bad alzheimer. In-home will not come out, because there is a chance he may be violent. We can't take him to a facility against his will. My Mom, nor I, are able to be fiduciary for him. We live in Northern California. I believe he is on social security.
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Agree, a social worker is who got my dad on the home-based program for a homemaker/personal care but he was already enrolled in the VA system
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I am a nurse manager of a VA long-term care facility. In order to be admitted to a VA facility for long-term care (to live there) or to be eligible for the VA to pay for long-term care, he has to have a service-connected disability rating of 70% or more. Keep in mind, though, that although it is VA, it is still considered a nursing home. Some VA facilities no longer provide long-term care services. If he has dementia, a facility that has a dementia unit may be more appropriate. Not all VA facilities have dementia units. If he qualifies for VA-paid long-term care, there are community nursing homes that the VA contracts with for services. Also, you might want to check with your state veteran home(s), which do not have the same admission criteria as VA-based homes. He needs to be evaluated by a physician/nurse practitioner to find out if he has a treatable condition or at least manage symptoms. If a physician's opinion is that he has a life-limiting condition, with life expectancy of six months or less, he could qualify for admission to a CLC facility regardless of service connection. As for his refusal to see a doctor, your local VA should have a nurse practitioner who could see him in his home under their home-based primary care program. The home-based program also has social workers who can help you with resources such as homemakers and personal care, and options for placement. (I am assuming he is already enrolled in the VA system.) Start with a social worker.
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Call ur local Office of Aging. They can come out and evaluate the situation. See if there is a doctor who will make house calls. He can call an ambulance to take ur Dad to the hospital. Once therehave him evaluated. This is the easiest way to get him into a home. Explain to Social Services at the hospital that with ur Mom he can't come home.
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Contact VA Patient Advocate and Social Worker at VA facility nearest you. If he has VA primary care physician, the PCP can contact social services for you and also request care placement. You have a certain number of days for evaluation. Medicaid will cover long-term care. Did you apply yet? Your local ADRC oiffce can help with the application, no charge. If you don't know where they are, google it.
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You did not mention his diagnosis or age? There are waiting list for sure. But some of the skilled care/ nursing home will move him up on their list for condition. Go to VA ER and see if they will admit him. It would be easier or have his doctor put him in the hospital for three days and then they would except possibly. Also I did not where you are located? Too have Hospice come in for an evaluation. Another thought is you can have your doctor order home health in the home. Why does he not take his medicine? Does he have a UTI? or prostate issue?
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So many issues here that have ramifications for VA applications and benefits. Going to a local VA office may be your best bet. Try a local Disabled Veterans Chapter as well. Your Congressman's office may provide some advice as well.
Best to you.
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I seemed to have left out an important part, my step-father has advanced dementia/alzheimers. So there is no reasoning with him.
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Something to consider is that you could be the agent of POA's for either of them if they wanted it.

My father wasn't open to any help or advise about anything legal or financial or related to estate planning until it was absolutely necessary and I had things to show him proving he could not take care of things anymore on is own. Then after agreeing he would not follow the plan. Sometimes it would undo or lock down things so I could not pay his bills. I had to severely disable his car when attempting to prevent him from driving. Anyway, a first step is to kindly suggest that you do things for them. Eventually you may gain enough authority to make arrangements and eliminate many steps before you ultimately have to persuade them to do something of the utmost significance like moving from home to a care facility.
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Are you participating in the VA's Aid and Assistance program now?
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In this case you petition the court for a Guardian to be appointed. Or, you call Social Services to take protective custody of him. Your call.
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