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Mom was hospitalized with UTI, had confusion, evaluated by psychologists, while hospitalized. Upon admission, the psychologist said patient was incompetent. When mom was being discharged and re-evaluated, she was more coherent and deemed competent. Several months later, while staying home and being cared for by family and nurses, mom is not taking meds, losing and forgetting things and is gradually getting worse. It's time to begin process to obtain POA. How do we proceed so that we can get her to an assisted living situation?

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I am a bit confused.

Generally a POA is assigned when a person is competent and is triggered/sprung/activated when the person is no longer considered to be competent. So if Mum had not in the past designated a POA and is now deemed to be incompetent, you may have missed the boat on getting a POA.

Alternatively a person can assign a POA while competent and have the POA take over some of their finances. I personally know of several situations where this has happened.

But assuming Mum assigned POA while competent at some point in the past, you will have to have her doctor (in some places 2 doctors) state that she is no longer competent to handle her affairs.

Keep in mind that POA generally covers financial dealings a Healthcare Representative Agreement (often referred to as a Medical POA) covers health care decisions.
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Having someone deemed incompetent is a very big deal & is an expensive & very involved process, per the attorney we were using. It strips the person of all there rights. We were told my mom would be “served papers”, a court appointed Dr. would examine her, & there would be a court appearance. Judge will rule who is in control of money, recipes, etc. submitted. We decided we just emotionally couldn’t do that at that point.

POA is supposed to be done when the person still has a sound mind. Attorneys may have different view points on how sound a mind the person must have. It is a simple signing of paperwork, no court involved but we did have an attorney draw up the papers. He did a great job & it’s very detailed with broad power. Somehow we convinced Mom to assign POA for financials & medical to us. Thankfully, that’s all we’ve needed. Her feelings didn’t get crushed, we didn’t feel like we took anything away from her, the POA just gave us authority to help her.
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It is my understanding that “GUARDIANSHIP” may be a lengthy, somewhat complicated, legal issue.
In the state where my LO is living, the determination of “COMPETENCE” is based on assessment by a trained geriatric psychologist or psychiatrist and a medical doctor who is familiar with the ongoing physical and cognitive condition of the client. This determination may or MAY NOT lead to a guardianship hearing.
A determination of competence must include formal standardized testing and anecdotal records.
The formal objective assessment cost us $300, Silverbella 10, and once done it is assumed to be the standard by which your mom’s cognitive status is considered when moving forward with providing appropriate care for her.
A POA must be designated by a person of sound mind (at least in our state) to assign responsibility for their care IF they should become unable to care for themselves at some point in the future.
The POA cannot become functional until/unless the designator of the POA IS deemed incapable of managing affairs for him or herself. By that description, it is too late to acquire POA from your mother because she is assumed to already be unable to manage her own affairs.
As mollymoose and tothill have stated, it is necessry to have a LO declared incompetent in order for the POA document to become legal, but it is NOT necessarily essential to acquire guardianship.
FRANKLY, the whole process can become a really confusing tangle. I got A LOT of help through the social service staff at My LO’s AL.
Please feel free to correct me, Anyone, if you believe you’ve received information different from mine.
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Our POA was not helpful in trying to get our mom removed and in memory care. We had to do a guardianship which trumps a POA.

I won't lie to you. They are expensive. But they are the authority of the court. A POA is cheaper and much easier to get. But they are abused. That is why many banks will not honor.

Yet, one deals with businesses quite often, who will only deal with a POA. It is so very frustrating.

Once your person passes away, a POA no,longer has authority. It is so frustrating.
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NeedHelpWithMom Feb 2019
That is true. POA no longer applies after death. segoline, thanks for sharing your experiences. You have educated others in confusing and frustrating matters.
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My mother's assessment was in a geriatric behavioral health hospital based system, 67k. Her Medicare and insurance paid. But her attorney could request a specialized eval at 3k. I objected to that. But I paid the bill. It is still a sore spot with me. Why would an added cost be there if she was in this facility? Objective. Hospital based. Don't get me started.
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I had totally independent psych assessment done of my relative by M.D... Was expensive...$1 000. But was worth it
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When my DW began to really show signs of dementia, I consulted a certified eldercare attorney for guardianship. I did this because of some legal stuff and a police investigation was going on in our area regarding professional guardians. It took a few months to get the paper work done and a court date. I paid $2k for the whole thing. Of course this will depend on your area and how much the attorneys charge. Here it only required certification from one Dr. We were lucky that that is all that was required in this state and the letter of certification was provided at no cost from the Dr. The Dr. works for the Cleveland Clinic here and specializes in memory care. Our PCP referred us to them.
I feel really lucky with the way ours was done. DW is still seeing the Dr. at CC periodically.
If you are interested in what was going on here with the professional Guardians search for "April Parks in Las Vegas."
DW is, as expected, getting worse but the court here is very helpful in this area.
I do have to file and appear in court annually since DW is now a ward of the state and in my care. There are sever restrictions on what I can and cannot do. But I am pleased with the out come. The judge even brought up the subject of her eventually requiring commitment to a SNF of some sort and advise me on the finances involved. We do have separate savings and checking accounts, so if and when that fateful days comes for commitment and asking for medicaid it will go much smoother for us.
And if some may think I am planning on getting rid of her, the answer is no. But I do believe in being prepared.
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NeedHelpWithMom Feb 2019
Gosh, things can get complicated.
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