My dad is in the hospital and my aunt is living alone now. What will happen?

You have said that your aunt does have a PoA, in another state. She is HIS "problem", not yours. You must contact him and tell him to read his PoA to see how his authority is activated. He's a physician, so this is very helpful in your situation. He doesn't know that he has to act unless he is informed of her deteriorating condition by you. What your aunt is doing at night is called Sundowning (a common dementia behavior)... or, she has an undiagnosed UTI. I would perhaps take her to Urgent Care to find out if she has one, because it is treatable and would help her confusion. But, if her dementia is advancing, that's another thing. The PoA needs to come out there to deal with it all. You deal with your dad if you are his PoA.

If Dad goes to rehab Medicare pays 100% for the first 20 days. That does not mean he will be discharged after 20 days. The 21st to the 100th day Medicare pays 50% meaning Dad will be responsible for the balance unless he has a good supplimental. He can be discharged anytime in that 100 days.

If it is found he needs 24/7 care, you will need to show that he will get it when he goes home. So, you tell the SW, I cannot care for my Dad in his or my home. He cannot afford aides. His sister is not capable of giving him 24/7 care. The Rehab cannot release him if its an "unsafe" discharge. What he wants will not matter. He will be transferred to LTC. If he has no money, he will need Medicaid. This means his monthly income, SS and any pension, will need to be used for his care. So, as said, this means you or the Aunt will need to pay the bills.

I would check out how Dads life estate reads. I agree, the house is Dads until his death, usually. The problem I see hear is how will Medicaid look at that house. Is Dad on the deed at all? If he is on the deed, Medicaid will consider it Dads home they can recover from. If its the 3 of you or two of you, then 1/3 or 1/2 of that is Dads. When he passes, the house would need to be sold to satisfy the lean Medicaid will put on it or you will need to pay the lean if you want to keep the house.

Your Aunt, you will need to tell her that she is going to need to find another place to live. Without Dad there, she cannot live alone. It depends on your relationship with your Aunt. I have one I would have done anything for but had another that I would have let the State take over her care. If she is hard to get along with, you may need to get APS involved saying she is a vulnerable adult. Then the State takes over her care. If u want, I would try and get her to assign u POA, I would not get guardianship. Its expensive and very hard to get rid of. It took a friend of mine ages because the State would not allow her to resign. She had to go thru a State Senator and he was able to get the State to take over. Problem though, they wil, not tell her where her cousin is now. Woman is 80 and just couldn't handle it anymore with a husband suffering from Dementia.

Since it sounds likely he will have a Medicare stint in rehab (I think for 20 days?) you have a little time to work things out. I would make sure you impress upon him that he must NOT discharge himself from rehab prematurely because you and husband cannot provide enough care for both your aunt and him.

Who is your aunt's PoA? If she has only the beginning of dementia, why can't she be left alone? What is she doing currently that is endangering herself? Maybe her dementia is more advanced than you think? If you believe she can retain a conversation, you can discuss options for her care going forward: you may have to sell the house to pay for your dad's care until he qualifies for Medicaid -- if so, ask Auntie where she would go in this case? She cannot live with you so be prepared for this suggestion. For now this is a hypothetical scenario but it would cause her to start having to really thing about it (if she's able) and gives her notice in a way where you don't appear as the "bad guys".

If your aunt has not assigned a PoA and you don't want to pursue her guardianship through the courts, then the county will eventually need to acquire it in order to act as her advocate and legally manage her affairs and make decisions on her behalf, and she would be transitioned into a facility.

All you can do is lay out the likely scenarios and discuss how the care would have to be provided and paid for. Maybe consult with a Medicaid planner and an elder law attorney.

You will need to come to terms with there being no pleasant way to work through all of this, and your dad and aunt won't like any of the real-life solutions, but keep reminding yourselves there is no other work-around, there's only working through it. May you receive much wisdom and peace in your hearts that you are doing your best for your LOs.

Jolo, if you don't step up to provide the 24/7 care your dad won't have any choice, unless he can arrange in home care. If he is mentally intact, he is still able to say what he wants and do it. But let him do it, don't do it for him.

The best thing you can do is to tell the hospital and rehab discharge planner that he does not have 24/7 care at home. Regardless of what he says, it doesn't exist. (My dad tried to pull the I have 24/7 help and I told them it was not so. It stopped he being discharged home.)

I wouldn't just jump in and boot your aunt. If she has the beginnings of dementia, it will show itself in the lack of executive function. She will become an obviously vulnerable adult. Instead I would tell her that dad can't help pay any bills and if she is going to stay she needs to pay them. This includes property taxes, homeowners insurance, all utilities and all maintenance (that must be kept up). Make going to a facility a better option. Get brochures for facilities that are like resorts. She will probably get lonely with dad gone and the idea of others might appeal to her.

Sometimes we have to step back so people can get the care they need. Both your dad and aunt will have a say in what happens to them, it doesn't mean you need to prop it up. If dad wants to go home and is able to pull it off, you just have to step back and let him do it. That doesn't mean you become his solution.

Best of luck. Such a difficult situation dealing with 2 very elderly adults.

If she is considered competent she makes up her own mind on where she wants to live. I wouldn't want to be the one to evict her so I could get dad's house, if that is even possible. Sounds like you need an attorney consult to learn what you can and cannot do. It may be the case that the house has to be sold to pay for dad's care. When was the life estate setup?

It is not yours until dad passes. A life estate is property, usually a residence, that an individual owns and may use for the duration of their lifetime. This person, called the life tenant, shares ownership of the property with another person or persons, who will automatically receive the title to the property upon the death of the life tenant.

Because dad setup the life estate it would seem that he wanted to die in his home. Would it be possible to get dad the care he needs in his home. Would you be willing to provide it to make it possible for the home to become yours?