I just moved my mother into my house, her caregiver husband died. Mom has dementia. I am her Power of Attorney (POA) and caregiver now. I was told by an Elder law attorney to spend down her money to get her into a nursing home and on Medicaid. I am reluctant to do that. Mom doesn't have that much money, I'm afraid if I spend it then I can't find a nursing home that takes Medicaid or has a Medicaid bed available. The lawyer said she would rewrite the POA so mom would qualify for Medicaid and I could pay myself for caregiving. Could I write a caregiver agreement and let mom pay me for care, room and board, without going through an Elder Law Attorney? The attorney wants to charge $750 for the POA. I have found caregiver agreements online from AARP, and Alzheimers Organizations. If I spend her money on respite care, pay myself a modest amount would that count against her getting Medicaid when she needs it?
If mom has a hospitalization and you find you are no longer able to provide the care she needs, placement can happen quicker, but not necessarily to the facility of your choosing.
Having a diagnosis of dementia does not eliminate the ability to sign new POA documents. She only has to understand "in the moment". The attorney will determine that. Doctors are often hesitant to sign statements of incompetentcy.
Each state is different so you may need an Elder Care Atty. Good Luckm
I would read your current POA very carefully, it probably states that you can not be paid for doing POA requirements or activities. That doesn't mean that you are on the hook for day to day caregiving, that is not part of a POAs responsibility.
You would be better off interviewing several attorneys, most will give you a free consultation, if not don't interview them. Get other opinions on your best route to take.
You can charge your mom for her living expenses, but it needs to be fair. You can actually find a place for her and self pay until she meets Medicaid eligibility. That would be the most ethical thing to do. But I would not have her sign any legal documents, that could end up very poorly for you, it smacks of fraud and the attorney is recommending it, waiving red flags.
Have her physician write a statement of disability. It does not have to be lengthy or involved. It can simply state:
____________ (name) is unable to care for herself due to altered mental state in the form of dementia. She requires 24 hour care and supervision.
_________________ (signed by physician) __________________ (date)
Add the physician's address, phone number, and license #.
Make multiple copies.
Once this has been done, you can initiate a contract where you receive a stipend for caring for your mom. To be safe, have it notarized and keep in a safe place.
Medicaid will accept the board and care agreement and it will not affect her eligibility for Medicaid.
Hope this helps,
Donna
I used the local lawyer to do the POA with us, as Rose was still competent. Our state had just put out a new form, so the form we did in the other state was not enough. Then we asked about the Will and a care agreement. He immediately said he does not do them, but he recommended an excellent Elder Lawyer who knew all the state laws. First thing the new lawyer did was take Rose in a room alone to determine if she was competent to decide, and if we were treating her right. Did she feel safe, was she happy. Then they rewrote her will also without us. The only thing she discussed with Joe and I was the types of care agreements and their legal needs. Excellent, worth every penny! Covered all possible pitfalls.
Can the lawyer even rewrite the POA when your mother has dementia?
The other thing I want to echo here is that if your goal is simply to spend down her funds to prepare for Medicaid you might be better off simply placing her or getting her on the list for the residence of your choice (or top 2-3) while she would still be self pay and let that spend down her savings so she gets a bed in the place of her choice when she needs it (wait is usually less). Just make sure the chosen residence takes Medicaid residents as well so when it comes time she can stay there. This way the facility will often do the lions share of the paperwork and dealing with Medicaid too. You may find doing a mixture of rent and or care giving contract now while you look for and get her into a residence is the way to go too, much depends on how much there is in assets and her income but again this is different state to state. You are being very wise and a responsible POA planning this out as carefully as yo can and doing your research! Don't forget to stop and enjoy the love through this journey with mom.
Before you implement the Agreement you could have your state's Medicaid office look it over to ensure that it meets their requirements.
Best wishes
https://careconversations.org/
I have found it informative and it has links to the state websites for Medicare and Medicaid as well as discussions about planning for the future of an elderly person.
I agree that you need to continue consulting with the Elder Law Attorney as they know the "little" details that pertain to the state that your Mom lives in and they can make your Mom's life and your life easier as your Mom becomes more and more dependent on others for care.
I could not agree with you more. I shake my head at some of the advice I read here. There are organizations that will give senior citizens with limited means free legal advice. Yes, Medicaid looks at five years of financial resources and use. Medicaid is regulated by both federal and state law and you need an in-state attorney who knows medicaid rules.