My mom is 90, and lives alone. We've never talked with her about her plans if she needs help. I'm guessing her plan is to just count on her children. We'll certainly want to help her, but it'd be nice if we could discuss finances and her plans before something happens. How do we start the discussion?

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One thing I often recommend is to get your own POA and such in order or make plans to. Then let her know what you are doing saying that you don't want your family to have problems handing your affairs if something happens to you. She is likely to say, "maybe I should go with and do the same." If she doesn't bite, you can be more aggressive and say, "Mom, we want to be able to make financial and health decisions for you if you get sick. The new laws are such that we won't be able to do a thing without the proper paperwork. Can we get that done?" During this time, she may be more open to discussion about what kind of care she'd like should she have a stroke or something and need more care. This is never easy - I'm amazed that the family has gone this long without a discussion. Your mom must be exceptional! That's good - but no one lives forever.
This is important to the whole family. Try to let her know you'll all have more peace of mind if you get this done.
Good luck,
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Thanks that's a great way of doing it..
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All these issues are sticky, imho your best to hire an experienced lawyer to help. To begin your search for the best lawyer for the job, contact the local bar association and ask whether it has a lawyer referral service that includes those who specialize in elder law or conservatorships. You can also contact the National Academy of Elder Law Attorneys for a referral to its members in your area.

Keep in mind the lookback for Medicaid eligibility is 5 years. If you think that will be needed to pay for your mom's care, then you should gear your decisions to be at Medicaid compliant asset level by 2016.

IMHO you should have the following done:
- Durable Power of Attorney (not just POA)
- Medical Power of Attorney

- Living Will &/or Advance Directives (DNR) - you can wait on this if you think it will freak your mom out
- Declaration of Guardian in Event of Incapacity

- HIPAA Waiver

- Will (or updating it) or a Living Trust (for those with significant estate)

I'm a firm believer in having an elder care attorney take care of all this. It will not be expensive as most is done by the paralegals. You do want to go in prepared with what the information is for the documents (e.g. the residence located at 123 ABC street, aka parcel #5678; Ann Smith, wife of John Smith, with the info on all the births, deaths & prior marriages) as well as valid ID for the elder. If the decisions have been already made, this should all simple, straightforward paperwork. Should take 1 - 2 hrs for intake & then 1 hr a couple of days later for the signatures.

If mom has assets, then all this should be paid from her assets. This also is important if you ever get challenged. If you pay for all, and you benefit, then other family could go to court to find it a coerced document. Even the most kum-ba-ya family can get strange over $$.

If your mom has a home, getting an attorney who practices in the county where the home is best. They or rather their paralegals know exactly the most efficient way to deal with assesor's, etc. Good luck.
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