Starting to see the writing on the wall. Where do we go from here?

I'm sorry you are going through this. This is and will be a huge learning experience.

The costs keep coming and coming and coming. If you think your Mom is going to be on Medicaid, do NOT use any of her money on anything other than her own expenses. Do NOT accept or give any gifts with her money. Be very careful of changing titles to things, like her car. Medicaid will look back on all of her expenses and potentially, ask for that money to be returned to her.

Then there is the issue of taxes and expenses after her death. I'm assuming that your Mom is under the federal exemption amount. However, the state exemption amount is considerably less. In my state, considerably less...and then there is probate (which not only costs money, but also takes time) depending upon how things are titled.

People do things like prepay for funeral and burial expenses to lower the value of assets. In some ways, I agree, however, in some other ways, I do not. If going the cremation route, urns can be purchased quite inexpensively from Amazon so that all you would have to do is pay for cremation costs. Cremation costs vary a lot. If I had purchased a burial plan for my Mom prior to her death, I would have been out a lot more money than doing it the way I did.

We purposely kept one checking account as joint between my Mom and my sister. This was because we had heard stories of people who passed, and all of their money and safe deposit box, being "locked" up, therefore, no one could access that money or "safe" boxes after her death. In my state, that is so very true.

As expensive as it seems, yes, consult a lawyer. However, you and your brother should get an accounting of all of her financial assets and the title to the accounts, prior to the visit. Do it while she is still lucid and can change the titles and change who is on the accounts. Once she becomes mentally incompetent, it is much more difficult, if not impossible to change.

My sister and I actually had done what we thought was the "right" things before my Mom's dementia got bad. However, 2 years later, we are still struggling to get certain items closed....like cashing out her stocks, of which one just underwent a merger, and a bank who refused to tell us how a certain account was titled (luckily I knew that the amount in the account was less than $30,000), even though I showed them the document that said I was successor trustee and we had all the death certificates of the other siblings who could have been potentially named on the account.

If your Mom had a POA drawn up by a lawyer, go back to that lawyer. If your Mom just drew up her own POA, then go find a lawyer in the state she lives in and go for a visit.

This will be hard on all of you. Tempers will fly, etc. Talk to your brother (and any of your other live siblings) ahead of time to come to an agreement of why you want to talk to the lawyer and the goal of the discussions. As others have noted, it is time and money well worth spending now, rather than later (and your Mom's account should be paying for the lawyer expense.)

Also, do some research. Don't just get the least expensive lawyer or the lawyer that is expensive. Find a lawyer that has experience in the assets that your Mom has and the situation and future that you and your family see your Mom.

These are tough times. Planning is important.....and so are relationships.

While an attorney may seem expensive now, if you do not get professional legal advice and documents in order, it will end up costing you / your family much more in the long run.

Yes, I understand you are in a panic. This is why you need to contact an attorney ASAP. See if you can find a pro-bono attorney although they usually work with low income individuals in need - not people who own property.

You/r family needs to get their ducks in a row; be on the same page to move forward. Realize that you can only do so much.

You will / may get excellent advice / experience here ... you/r family needs to do what is in the best interest / need for your mom / everyone concerned which means professional legal advice to get everything in order.

Gena / Touch Matters

Your family will get advice soon when they say she needs 24/7 care which is impossible for both of them. It may be too late for anything with the home but maybe she needs a Personal Needs trust set up to at least shelter her savings. The financial repurcussions are already upon her. Maybe the 3 of you would be amenable to seeking the help of an geriatric care manager to see what the future holds and pull out your brother from denial.
Once 24/7 care is accepted then the home should be sold at fair market to use up what funds she has left to spend down. At least see a funeral director to set up a funeral trust or saving account to take that expense off the the Medicaid table.

I really think you need to consult legal advice - not just fir the money side but to align on what’s best for your mother
People need to be made legally accountable and be willing be upfront about it as well

Find out if her POA is already in force. My husband's appointment of me as POA was immediate, before he ever got sick. A springing POA would have needed doctors to put it into effect. I'm glad he didn't have that kind.

To clarify, you said you and your brother are her medical PoAs... you said nothing about being her financial PoA. Does she have one? If so, who is it? The FPoA needs to work closely with the MPoA as there are often overlapping areas of decision-making. Her original Medicare pays for her 3-day hospital stay and 21-days of rehab. If she doesn't progress or cooperate, she will be released. I guess it's up to your brother and SIL whether they are up for caring for her at home. If you don't agree with this plan, you don't have to participate. Yes, they'll be angry but they'll see that it's unsustainable sooner if you stay out of it. In most states Medicaid pays only for LTC. Not AL or MC. She will need to be assessed by her doctor as needing LTC. That's the first part of qualifying for Medicaid. The other part is financial. Don't do a spend-down until you apply for her and they tell you about the spend down. She needs to first qualify for LTC. If this happens (and your brother agrees) then you should research good facilities that accept Medicaid. FYI in most facilities, being on Medicaid usually means a shared room, but not always. When she goes into such facility on private pay, then when she is close to running out of money (like 5 months) then apply. Once they receive her app it will take approximately 3 months to know if she has financially qualified. That's when you can figure out what MEdicaid will allow for spending down. Note: if your Mom doesn't have a pre-paid funeral or cremation policy, this is something Medicaid will accept. Usually it's approximately $3k for simple cremation. You don't mention if your MOther has cogntive or memory impairment. If not, then she still is calling all her own shots. If she is compromise, then she will need an official diagnosis to activate the PoA authority. FYI my own Mom's annuity required me to send in an affidavit, the PoA docs and a letter of diagnosis signed by her doctor on the clinic's letterhead. So, you need to start figuring out what it will take if she needs to take a lump sum payout. They are a pain to work with in my personal and very recent experience. Do it now because it takes time. Medicaid will allow her to own a house and a car but they will put a lien on the house that will need to be satisfied by the new owners/heirs. I'm wondering how it's possible your Mom is still paying off that house? Did she borrow against its value in the recent past? You can consult with a Medicaid Planner for her home state, or a certified elder law attorney who is knowledgeable/experienced with Medicaid.