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There is a large monthly giving that was paid out for years. This will cut down a lot on the years she has in savings for her care. Is there an easy way to explain this so she will stop her charitable giving.

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Okay, try to explain to her that she needs to keep her money for her. Stop the money going to charity now and she will be to give them more money after she dies. Maybe, she would like that. It is her choice to give money to ever she wants, but she can give, and maybe she has not thought about, using her money to live on now or in the future, so talk to her about giving more money to the charities later. Might work. As far as, her medically or physical care, maybe some of that cost for care could be handled by insurance. If you will be or are dealing with Medicaid spend down, the money can not be in her bank, so giving is understandable.
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I live with my Mom, and I don't know your situation. I don't know if your Mom does it by seeing it on TV or from things she gets in the mail. However, I am the only one who gets the mail (locked mailbox). Alzheimer's Association also recommended my Mom have her mail forwarded to a PO Box or another address. You may want to consider that.
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I'm a little confused here. Pstiegman, the penalty period begins on the date of transfer, not the date of eligibility for Medicaid? Assuming that we are talking about mom in your example and the pronouns should be "her" and "she" since she is the one applying, there would actually be no penalty because she would be eligible in January 2010, one month before she applied? I thought that anything that was transferred during the five years prior to application would be treated as a penalty starting on the eligibility date.

I am dealing with situation, too. I have managed to stop the donations to charities (many of which were very low-rated), but mom still wants to donate to her church. I was advised that if you can show a long-term pattern of "reasonable donations" (no definition given), these donations would not result in a penalty. Medicaid is looking for transfers done to hide assets and benefit heirs.
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Your mother does indeed have the right to do what she likes with her own money, assuming she is of sound mind; but that does not mean that her kindness will not rebound and kick her in the behind in the future if she has divested herself of funds she later needs for her own care: the law places other priorities ahead of Christian virtue. You are right to be thinking ahead for her.

Would it help to suggest that she lists her preferred charities and leaves them a proportion of her estate in her will? E.g. x% of the residual assets, to be split equally among them, or on whatever basis she decides. That way, her own responsibilities to fund herself will come first, but she will still have done all she can for her charities.
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Unless she has some sort of dementia, she has every right to give her money to whomever she wishes.
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It sounds like your mother has set up a monthly draw on her account for her charities. What a lovely, caring mother you must have, but not very savvy. She needs to put her own care as a priority now. If you have POA, you need to contact her bank to put a stop on the payouts. An alternative to her donations would be to have others donate in to her charities as a "present" to her. She could receive cards stating what had been donated in her honor for Christmas or her birthday. This way she could avoid the situation in pstiegman's answer and her charities would be benefitted.
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I understand how difficult it is for you and for your mother especially with something as personal as her charitable giving. I applaud her sensitivity to try and help others. We had a similar situation with my 81 year old mother. She probably got 50 beg letters a week and it breaks her heart when she can't send a little bit of money to them all.

What worked for us was to sit down with her and prioritize her giving. Since she is a cancer survivor-- that charity sat near the top of her list. She has a soft spot for children in need so we had her choose one US and one international charity that supports those causes. My mother was placed on a budget of a max of 20.00 per charity for a total of 60.00 per month. During the Christmas and Easter holidays, we came to an agreement that she could donate an extra $50.00 to two other charities of her choice. A reasonable approach and negotiation made her feel better because she participated as part of the "solution" and yet she was still able to help others. In my mother's case, she happens to have a high enough income so this monthly amount doesn't impact her pension overmuch. It also made my siblings and myself less apprehensive about her finances.

Oh--- and the only solution we could come up with to stop the beg letters? Sounds a bit macabre, but if you write "deceased" on every envelop and drop it back into the mail-- the beg letters eventually stop.

Good luck-- Chris
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Try discussing with her the option of giving after death as a bequest so that she can ensure she has the care she needs during her life. Perhaps she'd even prefer to leave a legacy like that (a lot of organizations give bequest-givers some kind of special status).
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Who is Mom's Power of Attorney? Does Mom have dementia or Alzheimer's?

My mother gave to every charity and person who called on the phone. I left the house one day to run to the nursery and run home. I found a man at her door taking money from her and having her sign a form to allow them to withdraw money from her account each month! At that moment I picked up the phone and called my older sister and told her I was taking over as her Power of Attorney. Mom would not listen to reason, she paid her church tithe and more, Cancer Society, St Judes, Heart, Diabetes...you name it she gave to everyone....this man at the door put ME over the top and I knew it had to STOP.

It was hard as Mom would not listen and did not want to give in. She thought what she was doing was fine and she thought she was mentally fine as well, but she wasn't. When that man left her front door, she asked me what she had given him in that "bag!" I almost freaked out, "what bag Mom, did you give him a bag?" I began checking everything trying to figure out what she had given him and to this day I do not know.

You cannot always make them understand, but if you are POA you have an obligation to look out for them and take care of their finances. Mom and I have had some arguments over me taking the checkbook and not giving it back to her, but she would hide it and not remember where and then scream at me for not knowing where it was and accusing me of losing it.

If she is mentally fine, and no one has POA you need to get one now as you may need it in the near future. In the meantime, you may have to take her to an Elder Law Attorney and have him explain her circumstances and let her know that although she means well, she can no longer contribute to these foundations. Intercept phone calls and mail if you have to, I did and still do.

It is a necessary battle to protect her assets. If she spends all of her savings now and plans on Medicaid handling her medical or nursing home bills, she is sadly mistaken as they will penalize her. If she does not "get this" then she may have some dementia and need you to step in anyway.

Good Luck! It is never easy!
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If she ever needs Medicaid to pay for her care, they will assess a penalty on a dollar-for-dollar basis. So for every $1 she gave away, Medicaid will refuse to pay $1 for her care. They look back five years from the date of application, and any money that cannot be accounted for her care becomes a penalty.
EXAMPLE:
Mom applied for MLTC in February 2010. In December 2008 mom transferred $98,611 in cash to her son. $98,611 divided by $7,406 (avg. NH cost) is 13.31. Mom is ineligible for 13 months beginning with the month he transferred the assets. His penalty period starts December 2008. He would be eligible again in January 2010.
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