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I now have both my mom 85 and stepfather 89 living with me & my husband. My mom has all her documents in order and my stepfather refuses to put anything in writing eg Living Will DPOA etc. He has 3 grown children of his own grandchildren and great grandchildren. They refuse to help me obtain these things and say "he is of sound mind and if he doesn't want to get his documents in order they will back up his decision." And yes he is of sound mind but extremely difficult in everything. They cannot afford an AL and because mom has vascular dementia she is now very confused & doesn't understand what's going on except that he refuses to cooperate with us. I have 2 sisters that are equally not understanding that for my husband & I to take them both in then they both need to have their documents in order. He refuses to have any conversation about anything that pertains to End of Life eg Living Will, DPOA, what happens when they can no longer drive or cook or bath etc what do they want at that time of their lives. Neither one of them have any savings they live on social security, they keep their money separate, and each of them give us $325.00/month for their living expenses. That's hardly enough for their living expenses. We are at our wits end and don't know how to proceed.

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Ex MIL passed a week ago. She was of sound mind but had a stroke and heart attack and was not able to speak for herself. She has set up Advance Directives and POA. Without those documents hospice may not have accepted her and they would have tube fed her anything to keep her alive. These documents are extremely important to have in place, regardless of who has the power. I don't think anybody would want to be kept alive with tubes, ventilators and such. Maybe it is his fear of death that prevents him from normal preparation. Would he want the State to make these decisions for him? A very real possibility especially if family does not agree.
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They may be able to afford Assisted Living if he was a wartime veteran. Look up VA Aid and Attendance at va.gov or go up to the Money and Legal tab above and click on Veterans Assistance. AL may look expensive, but when you factor in rent/utilities/meals/activities/transportation/care/aides it is just about break even.
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NurseRN,
Why is your mother and step father living with you if your step father is truly of sound mind? Is he able to take care of your mother? You say your mother has her documents in order, but your stepfather does not. If he is of sound mind and can take care of himself, then I wouldn't worry about him right now in that capacity. What I would do is have a conversation with him about your mother and what is best for her and her care as she progresses in this disease of her mind. There are options...they could move into a subsidized apartment community for seniors and have home healthcare come in to help with the care giving. Is there a possibility you could become your mother's legal guardian?
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If stepdad is unable to speak for himself, they will by default want his spouse to express what she thinks he would want and make decisions. Maybe you could get him to give financial and healthcare DPOA to her, with you as secondary, and if she is unable to actually fulfill those duties, she then resigns and leaves you in charge. The real risk is that when he is in medical care and either unable to speak for himself or truly not competent, you could find the medical staff feeling they cannot legally communicate with you without his explicit consent and you could be shut out of medical decisions they make until you formally obtain guardianship; some places overlook this when it is obvious the person can't speak for themselves, others will feel that HIPAA precludes any use of common sense or compassion.

Is there any reason you know of for the alienation/estrangement that has occurred? This has got to be terribly upsetting, but maybe they are not just horrible people and something happened or was said that could be revisited. Sorry you are in the middle - literally - of this sorry state of affairs for your family!
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Thank you all for your reply's. It funny as a nurse working mostly in ER and ICU I see how not having these documents in place alleviate frustration during a difficult medical emergency. I never in a million years thought I would be one put in this situation. I made decisions based on emotion and not logic. I was thinking safety and feeling sorry because no one was helping them, What made me think we would get some support from them is beyond me. I just always thought that although we all lead different lives mm was the common denominator and we would all do what was necessary to help her as she needed. I counted on his children to help me with him because they said they would. Now they want nothing to do with him. His son said "Call me when he's dead." They are now visiting my aunt and I don;t honestly think I can have him come back into our home. I also realize this is more than just getting his documents in order after reading so many different posts here. Thank you all so much.
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If he dies intestate, his assets will be distributed according to state law.

But if he needs life-saving medical care, that's a separate issue and the one which would make me uncomfortable having him in my care. It's this issue that could also split the family.

If his children, grandchildren and he won't specify his wishes as to emergency and/or life-saving care, you and your husband could be putting yourselves in the middle of a contentious situation in which no one agrees, yet you're left "holding the bag".

I think I would e-mail or write (i.e., document) this concern and ask his adult family what their intentions are if he needs this kind of treatment. I would also ask who wants to be notified in the event of such a situation.

Failing specification, you and your husband will make the decisions. That might get them to move.

But I still would feel uncomfortable having that responsibility. It's unfortunate that you're the only looking and planning ahead.
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Having a health care directive (living will) for my husband was a good comfort for me. It was something that all of our children (his/mine) could read and understand. There were never any seconding-guessing of decisions I made for him. On the other hand, such a document can never cover every possible circumstances and I still had to do the best I could, guided by my knowledge of his beliefs.

We were never able to convince my mother to do any of the documents. I and my three sisters wish we had such official authority. But we do our best to make the decisions we are called upon to make and to advocate on her behalf. The care she is getting really wouldn't be any different if she had done the documents. But there is no family conflict and our relationships weren't/aren't dysfunctional. I am sure that makes a huge difference.

You cannot (and should not) try to force SF to plan ahead and provide the authority and information you would like.

You can, of course, make decisions about your own actions. For example, you can put this issue behind you and let his children deal with it when the time comes. Or you could insist that you will not have people living in your house who have not provided that paperwork and ask them to leave. Or you could decide to make everyone miserable by nagging about it everyday.

The $650 you get per month for the couple's living expenses is a separate issue altogether. Again, you are in charge of your own decisions and actions.

Decide what amount would be acceptable. Charge that amount. You might research Assisted Living costs for a couple in your area, just to show your Mom and SF while you are discussing the increase in their costs. I'm not suggesting the you charge what an ALF does, but that you use their alternative costs for their education.

And get this financial arrangement in writing! That is probably even more important that having their living wills. See an attorney specializing in Elder Law and draw up a room and board (and possibly care) agreement spelling out what you provide and what they pay.

Why is this critical? There are all kinds of relatives in your situation who may have opinions and animosities about the money now or later. If either parent needs Medicaid in the future, you do not want that money to be considered a "gift" to you.

You have taken on a huge and very compassionate responsibility. You know the old saying, "No good deed goes unpunished?" -- protect yourself as best you can!
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NurseRN, I can understand your frustrations, if StepDad doesn't want a Living Will or DPOA that is his choice. Therefore, best to forget about it, thus he will need to live with his decision, and let his own children deal with the consequences.
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You cannot make him do the advanced directives if he doesn't want to. The advanced directives should only be done at his choosing, and not because he feels forced to do them. If he chooses not to, then just let it go. You won't get in trouble if he won't give someone POA. It will just be inconvenient. It happens to a lot of people when they don't make decisions in time.
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