She lives with my one sister and we are concerned that she will get worse and then we won't be able to help her with bills and whatever needs to be done with health care.

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Naccy008, I was just wondering.... if your Mom doesn't have a Power of Attorney, I was wondering if she also doesn't have a Will, or Medical Directive.

I would highly suggest you seek out an Elder Law Attorney to do the legal documents as this is what they specialize in all day long.
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It's not pasting very well, I'm afraid, but here it is. Where the guidelines refer to particular Acts there may or may not be an equivalent where you live; but as a rule of thumb when one country has established a law about protecting vulnerable adults, most other developed countries will have one very like it, if not exactly the same.

***** taken from the Office of the Public Guardian (Scotland) *****
You should also consider the question of whether you wish to appoint more than one attorney.
You may appoint:
• separate attorneys to exercise functions in relation to property and nancial affairs and in relation to personal welfare;
• joint attorneys with similar or different powers;
• one or more substitute attorneys to take the place of an attorney who dies or
You cannot give your attorney/s the right to appoint a substitute or a successor.

If you appoint joint attorneys they will have to act together and both be involved in any decision making on your behalf. If you wish them to be able to act together or separately, you should include in the power of attorney that you
are appointing them “to act jointly and severally or severally”. Inclusion of this statement then allows each attorney to act as an individual or jointly with each other.

3.5 Possible Powers to be included in a Continuing [Durable] Power of Attorney
You should try to foresee all the property and financial affairs which may need to be managed in the event of your incapacity. You should discuss with the prospective attorney the extent of powers which you wish the attorney to exercise. These could include in particular power to:
• purchase or sell heritable property (land or buildings);
• open, close and operate any account containing your funds;
• claim and receive on your behalf all pensions, bene ts, allowances, services, nancial contributions, repayments, rebates and the like to which you
may be entitled.
The attorney may not need to exercise all the powers that you grant. Either the occasion may not arise to exercise particular powers; or he/she may find that when the principles are applied the exercise of the powers would not be justifed. The important point is that you try to foresee the powers which may be required to meet your needs. For further information on powers which may be included, please refer to the Code of Practice for Continuing & Welfare Attorneys.
It is advisable for you to discuss your feelings and wishes regarding the exercise of your powers with your prospective attorney. For example do you have any views about what type of investments you would wish to make or avoid? Do
you have views about remaining in your own home as opposed to moving into residential care? Do you wish any particular property to be safeguarded as inheritance for a particular person? Do you attach sentimental value to any particular property?
3.6 POSSibLe POwerS ThAT mAy be iNCLuDeD iN A weLfAre POwer Of ATTOrNey
You should try to foresee all the welfare decisions which may need to be taken in the event of your incapacity and discuss these with the prospective attorney. These could include power to:
• decide where you should live;
• have access to your personal information held by any organisation;
• consent or withhold consent to medical treatment for you, where not speci cally disallowed by the Act i.e. your attorney cannot place you in hospital for the treatment of a mental disorder against your will; nor consent on your behalf to certain medical treatments speci ed in regulations. With regard to other treatments, the doctor responsible must obtain consent from your attorney, where it is reasonable and practicable to do so. Arrangements are set out in the Act for obtaining a second opinion where the attorney and doctor disagree. Even where your attorney and the doctor agree, the Act gives a right to “any person having an interest in the personal welfare of the adult” to appeal to the Court of Session about the medical treatment in question. For full details consult Part 5 of the Code of Practice relative to Continuing and Welfare Powers of Attorney.
Please note that these are only examples of powers that might be included. In any particular case, some powers may be inappropriate and others may need to be added. You may wish to refer to the Code of Practice for Continuing and Welfare Attorneys, for a fuller list of suggested powers.
3.7 DiSCuSSiON wiTh PrOSPeCTive ATTOrNey
Although there is no requirement for you to gain the agreement of the person you wish to become your attorney, the OPG will have to be satis ed when it comes to register the power of attorney that the person named is prepared to act. Therefore, it is good practice for you to discuss with the person what being an attorney involves. It will be helpful if you keep a note of the
matters discussed at this time and for the prospective attorney to have a copy. This is because there may be a long interval of time before the power needs to come into operation (if at all).
The purpose of the discussion is to ensure that:
• you and the prospective attorney have the same understanding about what you want to happen in the event that you
become unable to make decisions or act for yourself
at some point in the future and how your incapacity
is to be determined;

• you offer suf cient powers to ensure that your attorney can do what you would wish;
• you make your wishes and feelings clear;
• you provide the prospective attorney with suf cient information regarding your nancial circumstances: income, liabilities and assets; existing arrangements; where certi cates, titles, records, papers, etc. are kept; particulars of professional advisers, etc; details such as national insurance number; and the people who should be consulted about the exercise of your powers;
• whether you want a continuing power of attorney to be exercisable immediately (i.e. before incapacity) or only to start at the onset of incapacity.
• If you are appointing a welfare attorney you should ensure that he/she knows your likes and dislikes and personal welfare concerns fairly thoroughly. In the course of your discussions you and the prospective attorney might cover the following issues, preferably not on a single occasion, but in the course of building up your relationship of trust:
- views as to how you would like to be cared for if the expected arrangements break down, or if you become unwell;
- hobbies and activities and the places you like to visit and the social groups you enjoy being part of;
- particular dislikes and activities, places or people you would prefer to avoid.
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Well, if your mother's going to get this job done she'd better get a move on: the first thing to note is that only she can create a POA, no one can do it for her. You say "early stages" - the key question is, is she still able to understand what a power of attorney is, what its implications are, and how it will be used to assist her?

For the correct legal procedure in your state, you might do best to look it up online, e.g. Google "creating a DPOA in California", and read the guidelines carefully. It is best if your mother then deals with the paperwork through an experienced attorney; and if you really want to err on the safe side ask her GP/PCP to carry out a cognitive assessment beforehand - that way you won't run into problems later on if anyone tries to challenge the validity of the POA.

Does your mother happen to have a lawyer she trusts, preferably one who is experienced in dealing with this kind of family law? If so, that person will be able to explain the advantages and drawbacks of the various options for her.

It would also be a good idea for you, your mother and your sister to go through the information together and discuss the main issues carefully. Joint POA or one of you first, one of you named as an alternate? One deals with healthcare and one with finances, or both required to agree to decisions jointly? Do think these things through, and give your mother an opportunity to record specific wishes she might have.

I'll post some notes from the Office of the Public Guardian in Scotland - the law where you are won't be quite the same but the principles are nicely laid out.
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