My mother is 85, has been suffering from severe depressing and isolations for quite a few years. She keeps saying, I just want to die. I recently visitied her from out of state and found her house in foreclosure, and many bills not paid. I convinced her to allow me to take duraable POA to take care of her finances. I have about 1yr before the sherriff shows up at the door. She lives with her husband whom she verbally abuses quite severly.

I have vistied her 3 x in the last year and each time She is sitting in the same chair in th same place. She sleeps in this chair and sits and stairs all day. She is severly depressed and is isolatiing. She just sits there and says I just want to die. I call her frequently but she hangs up the phone...and if she answers it, she iw hearing impaired, so having a conversation on the phone is almost impossible

I cannot affor priviate senior commumnity or assisted living. I live out of state, and cannot be here all the time. She will not move, and to be honest, I could not handle her living with me. I feel she needs medication for depression, and be sure she eats healthy meals, and takes her medicationl.

My family feels all she can afford is OHA housing with sliding scale. They just want to do the OBLIGATORY{ DUTY to be sure she is in a safe and clean place, after which I know they will rearely call her if they even do that.

My concern, regardless of what she did to us growing up she is still out mother and needs to be treated as a human being.
Since I don't have guardianship I cannot MAKE her doing anything she does not want to do. going to a doctor to get evaluated for the type of care she may need is something she will not volunteer to do.

I cannot afford the cost of $10,000 or more to request the courts determine her incompetant to ge guardianshop.

I am at a loss as to whom I can contact in the SS , Medicare or SeniorSvcs dept to, show her medical records, and videos I take each time I see her toas an example of delcined, and find someone who can evaluate what type of services she needs and if she should be in convelescent home. I don't feel she nor her husband will be able to handle the change in their environment when I do have to move them. Their only source of income is SS. Is there an agency who can come in and evaluate her, and most importantly, have the authority to determine she is not competent to live on her own and assign both of the to a convelescent home? There must be something in place for those who cannot afford cost of guardianshp, that gives someone the authority to determine they cannot take care of themselfs. They are physically healthy, and not totally incompetant, but with out family living near by...what else is available.

I can stay a few months to help thru the transisiton. And visit 3-4x year to check on them. Its important to me that someone be there to validate their fears and tell them it will be ok...and help adjust to the transition.

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How difficult for you and also for your mom and her husband.

What powers does your DPOA allow? I am DPOA for my mom and I basically forced her to move from her home to IL and then from IL to a NH (bypassed AL).
It's not easy emotionally but you have to go with your gut on what's best for them and be realistic about the caregiver options. Which it sounds like you have done.

Getting them into a NH when they are coming from living at home or in an IL (like with my mom) has it's own set of challenges. Most NH admissions come from them being discharged from the hospital (like from a fall) to a NH for rehab and then after rehab days run their course (Medicare pays for this part), they end up staying in the NH and it's either private pay or they apply for Medicaid. The whole hospitalization and subsequent rehab @ a NH creates a nice fat medical file so they easily qualify for the "skilled nursing medically needed" aspect.

But when they are @ home, there is no detailed medical history. What I would suggest is that you look into and visit several NH and find out who is the medical director (an MD) of the NH. Then schedule an appointment with that doctor in their private practice, that will get the ball rolling for admission into the NH and the MD will know how to structure your mom's file to make it work for NH admission and the skilled nursing requirements for Medicaid. Sometimes this can be something simple like changing how a medication is done (for my mom it went from Exelon pill to Exelon patch which she couldn't do; or changing medication from a pill to something that needs to be compounded daily, again something you can't do at home). Sometimes they can have a critical condition - like loss of weight more than 10% in 30 days or low H &H - that enables the MD to write the orders for critical care admission into a NH. By being the patient of the medical director, all this should go so much smoother as they understand the nuances of the system.

You probably need to limit your NH choices to those that take residents "Medicaid Pending". Some are awful and some are outstanding but you need to find one that will work with you and your family in getting this done. You can move them from 1 NH to another too. My mom moved NH when her gerontology group had a split.

I think a harder issue is going to be your mom's husband. I'm assuming this isn't your dad....what is his family situation? Does he have family and what is their relationship like with him and towards your mom? Is he OK health wise to remain living on his own? If so, then there is a whole "community spouse" financial aspect of Medicaid to deal with that affects your mom finances and therefore her application for Medicaid. You will kinda have to deal with this one way or another. If he has kids, it would be great if you & them could come up with an agreeded upon plan. If there isn't anyone, then he could become a "ward of the state" and the county will appoint a guardian for him and you kinda are left out of the picture from that point on as you are not family.

About the foreclosure - well at least you don't have to spend another penny on anything on the house. If mom applies for & gets on Medicaid and it's before the tax sale or foreclosure is done, the state will have the ability to place a lien or claim on the property via MERP (Medicaid Estate Recovery Program). This will cause issues with clear title on the house, maybe not at the sheriff's sale but eventually
as being on Medicaid causes an "encumbrance" on the property via MERP. So keep that in mind. If it were me and I got my mom on Medicaid and BEFORE the foreclosure action happened, I'd send whomever the foreclosure letters are coming from (if it's sheriff's and a mortgage company and an attorney, then you ned to do this for each) a copy of the MERP agreement information that is part of the Medicaid application in all states. Send it certified and return registered mail (this is the green postcard at the postoffice) so you as DPOA have done your duty and have the return registered signed-off card(s) to prove it later on. Good luck and try to keep a sense of humor in all this.
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