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We became medical POA when we were his caregivers and he had no family to help him make medical decisions. We are already medical POA. He has had a couple of strokes. He has since had a couple of strokes and is now in a skilled facility. He has no will, no financial POA, no one making his financial decisions or paying his bills. What is the best course of action? Can they appoint senior advocates or guardianship through the state? He has been estranged from family for over 30 years. When we called a family member who was listed as emergency contact when he had the first stroke, they wanted nothing to do with him. He made his wishes known to us when he was able to make decisions, and we'd like to see that his assets are put where he wanted them. (to estranged family). We also still have his car that is in his name and don't know how to take care of these matters without POA status.

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The state can and will appoint a guardian for him, if necessary. Are you willing to take on the financial aspect of his care (with his funds, of course!) as well as the medical aspects he has already assigned to you? Or would you prefer that the whole responsibility be handed over to someone appointed by the courts?
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Just to clarify:

Power of Attorney is *given* by the person to be looked after to whomever he trusts to act on his behalf. If the elderly gentleman has mental capacity to understand what authority he is bestowing on you and what the consequences of that might be, he can still appoint you to act for him: you will need to download the forms and guidance notes, and given that you are not family it would be best to have the process supervised by a lawyer and/or the gentleman's doctor so that later there is no question of coercion, undue influence or similar goings-on. You will also need to familiarise yourself with the legal accountabilities you will be committing yourself to.

Guardianship is *sought* by the people acting on behalf of someone else and must go through the court system. If this gentleman does not have mental capacity, according to his doctors and caregivers, then he cannot give POA to anyone and so guardianship is required instead to manage his finances for him.
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It was the social worker at the facility that suggested we seek guardianship or POA. Mainly the facility wants his bills paid. Does the state ever step in and appoint a guardianship/senior advocate to take care of those things? (Like a court appointed rep)
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I am assuming your friend is also in Allegheny County. You talk to the social worker at the facility, which may already be working on the Petition for Guardian paperwork. His assets need to be counted and reported, NOT distributed to anyone.
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