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I'll try a give a brief background history. Before my mom (85 yrs. old) moved with my husband and I, she lived alone in Philadelphia. Two years ago she needed emergency neck surgery. Things started to take a quick change when it came to caring for her. Surgery left my mom with nerve damage in her left arm. My sister was her caregiver for many years. Taking care of washing her clothes, shopping, banking, picking up her medications, doctor visits and cleaning. She also had her own family and work.
My siblings and I discussed asking our mom to move with me until her arm got better. Her home had stairs which made it very difficult and unsafe. I talked to my mother while she was in the hospital and again when she was in rehab. My mom had all the excuses but, her doctor made it clear that, it would take up to six months to a year for her arm to become mobile again. I left Philly under the impression, I would be coming back to get her. Once I left Philadelphia and came home to prepare. Mom called me to tell me she talked to my sister, because she wanted to try and see what she can do at home. It was a mess!! Everything was left on my sister. Getting her up the steps was crazy! Someone had to lift her arm to grab the banister while, my mom tried to hold on and lift her foot up on each step. I talked to my mom and my sister about the situation but four months went by after that. My sister was getting burnt out! Finally my sister talked to my mom. It wasn't easy but my sister had to think of how this was effecting her and her family. In the past we saw things changing for my mom. The chairs in the house became hard to get out of. My mother ended up sitting in one chair without arms, every day (Falling asleep and ending up on the floor more then once)! My mom has the money to do many things to make herself comfortable.
So...my mom calls me and tells me I can come and get her whenever I'm ready. The undertone was, She'll fix my sister for even asking!!
I figured this would be the best thing for her because there were no immediate plans for getting the things she needed to live at home. Our home has no stairs also. I knew she was mentally trying to deal with everything. My husband and I are retired. He still works to keep busy though. He's 74 (In great health) and I'm 58. He has the perfect hours so he helps me during the day when I need him. I'm also caring for my two grand children during the school year. Ages 4 and 7. My daughter helps me with cooking when needed. she teaches high school and just got divorced a year ago (a surprise to me).
Long story short! lol
My husband and I started preparing our home for my mother's comfort. New toilet, shower bars, chairs that she could get in and out of in every room (Even outside), cut the legs down on the bed so it would be easier for her to get in and out of. My sister was my guide and still helps support me mentally. I found a good doctor for mom, began managing her medications and meals.
This visit was suppose to be temporary. Now, it's permeant. She gave her home to my niece and my mom has adjusted after two years. The problem is, my name is on everything except her, Medical Directive. She only has my sister and brother on it. This was because I live in Texas. I discussed adding my name since she's here with me now. She agrees. We never had a problem with having my name on her documents. She just has a problem with PAYING for it. My biggest problem is that she complains about having to spend money with ANYTHING she needs. She has money to take care of all her needs.
My question is, Should I just leave it alone? Thinking if anything happens to her where we have to refer to this document? I can just call my sister or brother? We all are on the same page. It just would be a problem the situation needed immediate attention. What should I say to her to get her to move forward on this issue. I don't want to make it a big deal if I don't have too. Any advice would be greatly appreciated.

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You can easily help your mom update her advance directive without paying anything. There are several reputable nonprofits that provide these forms for free online. For example, Prepare For Your Care provides a good, user friendly form that is more useful in practice than the typical statutory form that states provide. There is a Prepare For Your Care form available for every state so you can choose the form for Texas and know it will be valid.

And that in itself is a reason for updating. Your mom has moved to a new state and while some states will honor another a directive from another state, it's safer to update while your mom is still able to and prevent unnecessary complications. You should definitely add your name to your mom's advance directive since she now lives with you. Your mom should probably appoint you as primary healthcare agent, and then your brother and sister as alternatives if you are unavailable for some reason.
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You scare me when you say she will not pay for anything but "she gave her home to her neice" now puts her and you into a new problem. She needs long term care possibly sooner than later. What if she falls and can never return to your home? She gave her assets away and there is a 5 year look back. Medicaid will mot cover her for the period of the value of the home. Plus you paid for modifications with your own money never to be recovered.
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Bengentleben Jul 10, 2019
Very good points! My mom does pay for her own medications. I just basically manage them. The only thing she is hesitating on getting my name put on the DPA. I really need to talk to her. You brought up some good points.
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I don't know how much it would cost to *amend* - as opposed to create - a Medical Directive; but I'm sure you could find out. All your mother need do is have your name added alongside your sister's and brother's, and surely not even the cutest lawyer can make much of a bill of that?

Mind you: it might be no bad thing for your mother to take the opportunity to read through her directive again and check she's still happy with it. Perhaps you could ask her if she remembers what instructions she gave, and suggest that a review is only a sensible precaution.

More importantly - have you got HIPAA sorted out? That's going to be far more of a pain should your mother, God forbid, need treatment and not be able to authorise her healthcare team to speak to you at the time. Again I don't know, but I believe that should be more or less free - it's just part of your mother's medical records.

Most of the things you'll need to do for her though are financial rather than medical, even if they are to do with treatment, and you've already got those covered :)
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I agree with Cwillie. A Medical POA and advanced directive are not that difficult compared to legal and financial POA, and shouldln't be costly. It is simply a form that appoints you to make medical decisions if she is unable, and to stipulate to any particular wishes she has (for instance no tube feedings, and etc) , and it would enable you to at least be informed of her diagnosis and prognosis (HIPPA rules) if there were an emergency. Otherwise there you are with her and your sister is in another State. It requires only witnesses in my state, doesn't even need to be notarized. Check with her doctor on where best to get your forms, forms that comply with your State's rules, I am guessing. Then just do it. The new POA shouldn't be costly and you do need it as she is with you. It would negate the other ones done.
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Go on line, make one up for less than $100, easy to do, just fill in the blanks. Rocket Lawyer, Legal Zoom or?
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I think you should get it done, the hassles you may avoid in the future will be worth it. Do the leg work - find the best low cost option and make all the arrangements, then all you have to do is get her in to the office. If it's just the cost that is stopping her you could fib about that.

If you want to go the do it yourself route you should be able to copy her current MPOA word for word, just adding your name in addition to or in place of your siblings (this depends on whether they are named jointly, jointly and severally or as primary and secondary), then have it signed by mom, witnessed and notarized.
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Bengentleben Jul 10, 2019
Awesome! This is exactly what I did for her! Gave it to her to read over too. All we needed to do is get it notarized. She then turns around and told me she would feel better if a lawyer looked over it but, questions how much it will cost. I will have to do the leg work this one.
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