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Father diagnosed with vascular dementia with paranoia. He refuses to sign a POA saying it gives me too much power. I know that I'm going to have to file for guardianship, (he says he will kill himself when I do this). If something happens before the process is completed and he's unable to make a decision then who will make the decision? Several years ago my FIL was unable to make a decision about care after being hospitalized with nothing in place and the doctor refused to discharge him to anywhere but a nursing home. Am I looking at the same situation again?

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THANKS TO pstiegman & ThereisNoTry......for taking the time to answer my question.......very thoughtful indeed......big THANKS
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avcidy, a POA becomes null and void (ends) the moment the person dies. If the beneficiary is dead, it would (I assume) become part of the beneficiary's estate unless there are other laws about it - but a stock is like any other asset.
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avcidy, they will be honored, not to worry.
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By TOD WHICH MEANS TRASFER ON DEATH ....I HAVE STOCKS WITH A BENIFICIARY NAMED,,,,WOULD THEY BE HONORED WITHOUT A POA ?
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Idle threats of your father. Go ahead with the guardianship and try to put a rush on it. I don't know where you live and laws are different in each state. Check with your bar association or local library. People with dementia and paranoia do not know what they are saying, so don't take it personally...
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Even with guardianship my dad had to sign they came to the nursing home.
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Your father makes the decision if no POA or guardianship are in place. Under guardianship you are stripping him of all rights to make a decision. POA allows you the authority to sign documents, that he understands, but is physically incapable of signing. POA is less restrictive, than taking away a person's rights to make their own decisions. If you need outside help, and he won't agree to an attorney, you can call you local Department Children and Families (DCF). They will come to the home, do an assessment and place him under emergency guardianship if he is not capable of taking care of himself. The court will decide who is deemed the responsible party to make decisions on your father's behalf. Anyone can call DCF to make an anonymous report.
You may be able to start the process by asking his physician to have a home health company do a safety assessment in the home. Home health can provide a psych nurse and social worker to advise the best situation. If they find he is not safe in the home, and he refuses to accept help, they will have to call DCF, as they are obligated to report unsafe situations.
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You are wondering who makes decisions for your father if there is no power of attorney or guardianship in place. There is probably a law in your state that spells out the priority in making decisions. In our state, Pennsylvania, it is Act 169 of 2006. You probably have a similar law in your state. In some cases a hospital ethics committee might make some decisions if no family steps forward. However, you should act swiftly to be appointed guardian. There are other considerations not explored in this answer that make it important that you step forward to be appointed guardian sooner rather than later. There are usually provisions in state laws to be appointed emergency guardian very quickly. Title 20 Chapter 55 of our Pennsylvania Code provides the laws. Your state probably has a similar section of laws.
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Do not, not, not agree to care for anyone without a POA. The living hell you'll go through isn't worth it. I should know. My mom wouldn't give me a POA either. All her assets were in her name. After a decade of care giving, I was done and wanted out, it was just too much to handle.. Unfortunately, I found out the hard way that without a POA my mom very effectively trapped me in the care giver role because I couldn't sell anything to get her placed. I finally ended up having to abandon her to the state for that purpose, which resulted in so much hardship for my family since I had lost my job caring for her and her accounts were then frozen. Do not care for anyone without POA or guardianship...ever.


If you're working and have a family/life, do NOT give up everything to care for your father. If he needs a NH, so be it. Better that than the 24/7 alternative.

Jesus, you abandon him to the state. They'll place him in a NH and you can visit as often as you like.
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where do you go father suicidal for attention has moderate dementia and clinical depression he lives on negative thoughts where do you put him with very little money?
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Which TOD definition do you mean, please, avcidy?

Life insurance - check the policy conditions, but - with named beneficiaries: this is a contract which must be honoured. Why wouldn't it be?

sbackers - I agree with PS, assuming you haven't already taken steps. Your father's threat is his way of saying he's strongly opposed: but he has vascular dementia and paranoia, that's rather the point. Not saying you shouldn't respect his feelings and take them seriously; but I wouldn't take what he says too literally, either. You have to do what is best for him even if he doesn't see it.

If it's a medical decision, his doctors will make the decisions if you can't and the patient can't. In the UK (it may be different in the US?), doctors have the final clinical say in any case, regardless of POA or guardianship. In terms of ongoing care decisions, a hospital team should consult the next of kin but will not necessarily be bound by their wishes (and when you think what some next of kin get up to that's probably just as well…).

I'll keep my fingers crossed that the process gets completed promptly for you.
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will be waiting for an answer to this myself...would also like to know if TOD"s &life insurance with named benificiaries would be honored ?
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Get a lawyer ASAP and start the guardianship procedure. You are indeed looking at the same situation again, and if the MD says he needs a nursing home, he is acting to protect the patient from himself. Heed his advice.
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