POA and Financial Management/Obligation

iman&asSakeen

 Hello All,

First off thank you in advance for any assistance or advice anyone can provide. My heart truly goes out to all caregivers and their loved ones. Sorry, this post is a bit long.

In January of this year my mom started displaying alarming behaviors that called for myself and family members to seek medical advice for. She was and still is adamant that I break into her home and steal common everyday household items like her comforters, silverware and credit cards/ purse,etc. All ultimately impossible because I live 600 miles away. I came home in March with hope that she could be seen by a psychiatrist as soon as possible however her referral appointment was scheduled at the end of April. After spending a week in the home with her , the sundowning had gotten so bad we had police come out to the house twice within the same week, the final time I had called the cops because she woken up at 2 AM, adamant I had stolen her Fitbit and proceeded to hit/drag me out the house. I returned to my home shortly afterwards since I still work remotely and could not do so outside of my moms house, so going back to my home was my last resort especially since the paranoia is deeply rooted in me being the protagonist in her life. She continued to exhibit alarming behaviors and at the fear she would wander off on her daily walks or wasn’t eating enough I opened a case with the department of social services so that they could come out, make and assessment and ensure she get the care she needs or at least bring to light the circumstances I was dealing with. They kept the case open for 30 days and their final determination was that she didn’t have enough ADL’s she wasn’t capable of doing but the paranoia and sundowning was worrisome and she should not be left alone. As a result I hired home health aides to come in 3x a week; it was the most I could afford at the time and being shut out from my mom I don’t have the resources to have her use her insurance or finances to cover her care.

In late April we were finally able to get the first diagnosis of Lewy Body Dementia and she was prescribed Memamtine and Acripet. I still was unable to return to household and kept the hired a home health aide to come in to make sure meds were being taken and my moms overall welfare was being looked after. Around June I was finally able to get her to see why home health aide was necessary and she agreed to start covering the costs of her care. She also became attached to one of her home health aides and seemed to be reacting well to the meds and our relationship was on a path to being better. The paranoia still existed but there were no longer calls to the police and she was finally able to sleep through the night.

In August ( also note I come back home every 3-4 weeks, stay at a relatives or if possible at my moms and then go back after 3-4 days, I didn’t own a car at the time and she lives in a rural town with no public transportation so I rent a car everytime I came home), her meds were up for refills and the home health aide she had grown attached to was now branching out to start her own home health aide service company. They both agreed to transfer her home health aide service through the new company however during this transition my mom fell behind on her meds and payments. I stepped back again and have resumed paying for her care.

Between August and November my mom remained non compliant in taking her meds. Despite having home health aide come in, my reminders and attempts to be at home to provide the supervision and care the paranoia and sundowning  returned and my mom resumed calling the police multiple times a week.

I have finally be able to get her prescriptions refilled and picked up (however she takes them some days other days will not and will shut me down when I try to get her to stay consistent and take her meds). 

We’re also at a point it is no longer conducive for my mom to live in a rural town and Ive tried throughout the course of this year talking to her about senior living communities to which she agrees to but says she’ll think about it at a later time. There is property tax and income taxes that are due soon and I can only keep up with so much as I’m not privy to a lot of information and try not to agitate my mom about these things because it triggers her paranoia against me.

Going into next year I will no longer be remote working and will have to go back home to at least go into the office a few days out of the week. I also have other financial obligations (car payment, rent, student loans) that will resume and it will make it impossible for me to cover her care too.

I have had POA conversations with my mom, we even visited her lawyer ; she remained tight lipped and did not disclose who is in charge to help her with these things. I’m her only child/daughter and my father is out of the picture. I’ve debated taking legal action but do not want to as I think that would really place a rift between us and I’ve loss too much of my mother over the past year. 

Any advice would be appreciated. I’m unsure of what to do next. 

• Thank you 

Rescue mom

So, as I understand it, she has been diagnosed with LBD. And you and she went to an attorney, but…does anyone have a POA? Did the attorney do or tell you anything? Has the attorney done any of those for her in the past? That would make things much easier. 

If it hasn’t been done already, you yourself need to get with an attorney who’s expert in elder care issues, and get started on Medicaid qualification, ASAP. (Unless she’s pretty wealthy). 

You also can Google the national Alzheimer’s Association and get their 1-800 hotline number. Ask for a care counselor, or care consultant, who can give you free expert advice on how to handle, long distance, a relative with LBD who is noncompliant. (Not sure if hotline runs on holiday weekends, but certainly during the week).

You seem to be caught by a mom who absolutely has major cognitive problems, and refuses to do anything about or for it. Others here have dealt with this and will have more direct advice.

I know a few people with a LO with LBD in same situation. It took a major crisis involving cops and hospitals, to be able to get the PWD into help. Just me, but it seems like you are past worrying about a “rift,” you need to ensure she is safe and being helped, before something truly bad happens.

iman&asSakeen

Thank you so much for this.

1. Her lawyer stated that she did not have a POA but she has been adamant that she does. When asked who it is or how can we get in contact with said person if anything was to happen she keeps stating that she has it handled and is fine, specifically I should stop asking her about these things.

2. My mom is not eligible for Medicaid. She has Medicare. The area she lives in has very few to no home health services covered by Medicare. If so they would cover the cost and then her secondary insurance would kick in. Hence why we’ve been paying out of pocket to date.

3. I will look into the the attorney and contacting the NAA for a care counselor/consultant immediately, you’re correct we are past the rift and I want to make sure she is taken care of in the long run, I’m trying to not agitate her any further  but I can only do so much 

iman&asSakeen

Re her attorney: Her attorney only explained to her different types of POA and confirmed that she had a will only. He didn’t push any further than that.

Rescue mom

You’re right; Medicare is basically no help with the “custodial care” most dementia patients need. Most insurance does not pay for that, either.

But Medicaid can still help pay for a facility—which you will almost certainly need unless you can pay for home help 24/7. That’s prohibitively expensive for most people, but a facility is more affordable, especially with Medicaid. So many think they won’t qualify for Medicaid, but they can. That’s why you need to check with an attorney who knows Medicaid rules.

Until she produces a POA you probably have to assume there is not one….

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