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I asked for joint POA but she has decided it is best for mom to only have one POA. I am out of state and I do not feel like any of this is appropriate. My sister is not a licensed caregiver and I know that she does not know what she is getting herself into...

A few points here. And some playing the Devils Advocate as well....
I am not a "licensed caregiver" (was not a paid one either) and I cared very well for my Husband for 12 year journey with Alzheimer's as well as probably Vascular Dementia.
He did very well, I did very well. But I had help.
I would not have been able to do what I did without the VA and later on with the joint help of the VA and Journey Care Hospice.
I hired caregivers.
I got the supplies I needed from the VA as well as Hospice.
I got equipment I needed.
I am living in a house that was built Handicap accessible.
My Husband was cooperative, non combative and for the most part other than the Dementia he was healthy.
Bottom line one does not NEED to be a professional caregiver.
Does your mom require extra help with ADL at this time (Activities of Daily Living)? If not she could do well on her own if sister has a job and will be leaving her alone.
If your mom has dementia she may begin to wander, not a matter of if but when.
Just know your mom WILL fall again not a matter of if but when
Your mom will need accessible bathroom, house on one level or at least her bedroom and accessible bathroom on first floor.
Your sister and her family will loose privacy, freedom, their friends and if she has a job she will give up that job.
And if there is a need to apply for Medicaid they may have to sell the house if the need is within the "look back period". Because that money will have to be repaid or the time that Medicaid kicks in will be delayed considerably.
If they are up for all this and they are going into this with eyes open there is not much to say to them.
I would make sure that legally everything is on the "up and up"
When mom's house is sold make sure it is for "market value" so there is no problem again with the look back.

And be prepared to have your sister angry with you for ..
not helping out more, not visiting, not calling, not sending money to "help out" for not...what ever the reason.
She will be stressed, tired, angry and she will not get the help she thinks she will get from her family (husband and children if any are close)
One of the reasons for the stress were listed above but another one is..it is hard to see a loved one decline day after day. Knowing last week mom could get to the bathroom on her own and this week sister had to do 8 loads of laundry in one day. Last month mom could recognize her and this month she is calling her by "aunt Betty's" name. Next month mom will not be able to eat solid food.....and on and on for the next 2 years, 4 years, or ? years......
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robinr Nov 17, 2018
Hi Grandma: Agree this time and most others with your advice...but really, much is uncertain with dementia and it is sort of a hope for the best/ plan for the worst situation, as best you can. But truly not everyone with dementia wanders and it IS a matter of IF, but one should be aware of the potential.
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Give her the AgingCare.com website address, and tell her before she invests/borrows hundreds of thousands of dollars in a new house, and if she values her life and her family life, then she had better look here to see what her future will be like if she moves her mom in with her and be the 24/7 caregiver.

Then tell her she has fair warning and not to blame you for not being part of the future misery.

Tell her in writing in BIG BOLD LETTERS so that she won't miss it.
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YoungestOfSix Nov 17, 2018
BEST ADVICE
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You suspect correctly that your sister is galloping at full pelt straight into a minefield.

No idea what the caregiving will entail, no idea what impact it will have on her and her family and - maybe this will shake her up if nothing else does - probably no idea how to make sure that the spending on the new house is watertight when it comes to her POA responsibilities.

Caregiving for an elder in a shared family home can be done. I did it. I had no idea what I was letting myself in for, either. And without AgingCare and some other key people I would have lost my mind as well as my partner, my career and much of my family.

I promise her through you that if she has it planned out and she is properly prepared and she still wants to do it, then she will have our full support. But to quote my hero Sir Humphrey Appleby: "if you must do this damn'd silly thing, don't do it in this damn'd silly way."

Tell her that if she does nothing else, she must come and join us. PLEASE.
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kdcm1011 Nov 17, 2018
We moved Mom in with us, had care fully (or so we thought) planned out, and it was an unmitigated disaster! The Waltons it was not.

The care plan was 7am-7pm — who knew Mom didn’t sleep at night? Sister who controlled the purse strings refused to pay for care “while Mom was sleeping”, ignoring the fact that Mom slept in 20-30 minute increments throughout the day. 2 months we tried & then moved Mom to AL with 24-hr supervision. This forum helped me realize what was really needed for Mom, forcing me to take off the rose-colored glasses.
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I live two states away from where my dad lived. He wisely made my step-sister his POA. She didn't know what she was getting into either, but she did know that he had long term care insurance which carried him for 4 years until he died. She was able to coordinate 3 caregivers to take care of him in his home. She was the primary person there in the pre Alzheimer's phase and on.

What I'm leading up to is this. You are not there. You have not been dealing with this on a daily basis. You have suspicions and feelings, but no evidence. However, you do have a strained relationship with your sister. I think you and her need to put those issues aside and work together. Can't you have a calm conversation about all of this without sounding accusatory?
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YoungestOfSix Nov 18, 2018
WISE WORDS!!
Pleae take heed, Delta.❤️
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First, your Mom has to assign you POA and with Dementia/ALZ she can't do that. Sister has no legal right to add you on.

Where is Mom now? Hopefully sister is not using Moms money to buy a bigger house because this is a Medicaid no no if your Mom needs it in the next five years. Medicaid does not see it as beneficial to Mom but to your sister. Mom will be penalized and her care would need to be paid privately until Medicaid will foot the bill.

Sister is right that one POA is enough. Especially since she is going to be the caregiver. Very few of us are licensed caregivers on this forum or can afford to pay one. A lot of us have taken on the responsibility because our parent/s can't afford care but need it. We learn as we go. Some good at it, others not but it has to be done. Yes, ur sister is probably looking at this with Rose colored glasses. Early stages of Dementas are not too bad but Mom may not be able to be reasoned with. Will have a problem processing and of course short term memory. As she progresses she will have incontinence and need help toileting and bathing. Her sleep patterns will become erratic. It will come a time when she will need more care than sister can give. Oh, she will be giving up her life to do this because Mom can't be left alone. All you can do is be supportive. Help went you can. Believe me, she will see your point eventually.
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YoungestOfSix Nov 18, 2018
LOVE this comment ... wise words!
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All I can say is that caregiving is not for sissies. NOTHING prepares u for cleaning poop, dumping pee, being roused from sleep in the middle of the night, dressing pressure wounds, smells, noises, etc., not to mention aggression and agitation towards you as u strive to care for your loved one. I’m getting nothing financial out of it, but I’m fortunate that my 103 year old aunt has the means to hire some caregivers to help me some. However, with that, comes NO privacy and people that want to tell u how to do everything from laundry, cooking, housekeeping and lastly caregiving. It’s the hardest thing I’ve ever done. If someone is doing it to get a bigger house....or any financial motivation I would caution them. It simply MUST come from the heart for u to make it thru...
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Monikalabadi Nov 17, 2018
I agreed. I have anxiety now because my mom will wake me up at 0100,0200 any time screaming my name. most of the time I found her with dirty. It is a hard job
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About all you can do is sit back and observe. Keep your own counsel. Sister is making what I call the “Noble Promise” to Mom. She has vowed to care for your mom and as others have said, she has no idea what she’s getting into. Unless her care of Mom is not up to par and something needs to be done, don’t say anything. Now, if you suspect that Sister has $$$ in her eyes, you may need to enlist the help of an Elder Law Attorney. But you will have to have proof that she’s using Mom’s money toward her own gains, and this will have to be after she goes through with the new house. Then, if she wears herself out as a caregiver, she will want to file for Medicaid to put Mom in a facility. Medicaid will see the house as a gift from Mom to Sis and will deny the funding. So, even though Sis is burned out, she will have to continue caregiving or sell the big house so Mom can self-pay.

If Sis, for whatever reason, is determined to put her life on hold for Mom, nothing anyone says will change her mind and may even reinforce her determination. If she has no ulterior motives, she is trying to do her best for your mother. Offer help, visit, do what you can to make their lives easier.
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First, you have given no information as to your mother's health. Why does your sister feel it is time for Mum to move?

When you say you want joint POA, what do you mean? I am my mother's POA and my brother is second, if I cannot act, but we do not act at the same time. You could think of my brother being a back up POA. I live in the same town as our mother, my brother lives 5+ hours away. Having to have two people agree or sign as POA, especially if one is out of state could lead to complications.

Joann has mentioned potential Medicaid problems down the road. This is a really important issue in the USA, and your family needs to sit down and discuss the ramifications of this with a lawyer. If proceeds form the sale of Mum's house are used to pay for your sister's larger house, will she be willing to sell it, to release Mum's funds to pay for a placement in the future?

What does Mum want? Does she want to live with your sister? Is she happy living where she is? Is her current housing, safe and accessible? Is her neighbourhood safe? Does she have a daily routine there? We had an elderly Aunt who was of sound mind, and lived in her home until her death at 96. The neighbourhood had gotten a bit seedy in the 60+ years she lived there, but she had a daily routine, the house was accessible and safe and she was happy.

Not knowing your ages, are there still children living with your sister? Does she have grandchildren that she minds? If yes, she needs to think about the impact of Granny moving in on them. But that is not a decision for you to make for her.

Lastly, what do you think is appropriate for Mum's care? Yes, I put you last, as you are not in the same state, you cannot provide daily care, but you want your say.
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YoungestOfSix Nov 17, 2018
Wise words.
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As a nasty suspicious old lady my first thought ws to question sisters motives and I will leave it at that. All you can do is make sure sister knows the implications of her actions. How ever nice and loving mom may continue to be there is nothing she can do to help sister out when Medicare comes knocking .
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skyelav Nov 17, 2018
Me too. Lol and whatever goes around comes around.
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it Is all so sad... I think I have done more reading and even attended support groups then she did. I was the one to tell her about a durable poa vs just a regular poa ... I have an insurance background so I am conditioned to find holes in documents... it also doesn’t help that my dad died about 15 years ago and it is just the two of us and we don’t have the best relationship. I know there is a ton of emotional stuff involved that needs to be worked on but this situation is just screaming at me... although there isn’t much I can do and that sucks!!!!! I will stay on this forum to get information.. because it will be needed.
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Countrymouse Nov 15, 2018
Give her a hug from all of us. And lots to you, too. This is such a testing time for everyone involved.
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