How can my mom get her husband into a VA long-term care facility?

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.

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.

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.

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.

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.

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.

Are you participating in the VA's Aid and Assistance program now?

I seemed to have left out an important part, my step-father has advanced dementia/alzheimers. So there is no reasoning with him.

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.

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.