Does anyone know when and how a durable POA kicks in?

Who drew up the DPOA? I would suggest you ask them, or see if it is in the document.

As this is an International Forum, and even within a country laws may vary by state or province, it is important to get 'official' information as it applies to your situation.

Your profile says: "I am caring for my mother BigA, who is 74 years old, living at home with age-related decline, alzheimer's / dementia, depression, and stroke."

Revoking POA is a process. Your mother can revoke the POA she gave you *as long as she is mentally competent* and with a diagnosis of alzheimer's, I doubt she is. The process involves her *writing* a letter and *signing it in front of a notary public* and *delivering* it to her attorney and all third parties. Does this sound like something she can get done herself???

And she's still driving? How did she win that battle??

Read the POA. Some will say immediately and others will say "when no longer can make informed decisions".

I don't see why the lawyer who drew up the POA would tell your Mom. I think before you do that, Mom needs an evaluation with a neurologist. Also, a good physical with her PCP. You could tell a little white lie and say Medicare requires it. When you get a diagnosis, you can go from there. A doctor can contact the DMV and have Moms license revolked. I am sure my MIL went thru somekind of testing with the DMV when she reached a certain age.

Once a POA kicks in its because a person no longer can make informed decisions. So that person cannot leave a facility on their own. The POA is there to keep them safe and carry out their wishes within reason. If their wishes were to stay in their home but thats just not possible, the POA makes that decision.

You must read the POA, Piper, no matter what type of POA it is. That document will state if you need one or two doctors to attest to her incompetency or something else entirely. You state you're DPOA you must have a copy of it.

Look for "Effective Date" or some paragraph like that.

The ambiguity comes from the question of mental capacity. Does the person retain sufficient reasoning skills to make a specific decision?

It isn't an on-off switch, in reality. A person with quite advanced dementia still knows whether or not he's hungry or she likes a given t.v. show, and has the right to his or preferences - you can't ethically, for example, decide that wholemeal bread is better for him when he says he wants white.

But weigh up the risks and benefits of, say, treatment for bowel cancer? Decide whether a dilapidated house is fit for human habitation, and negotiate the repairs that have been ordered?

In the context of DPOA, depending on what your documentation says, there will be a process by which your mother's competence to make the relevant decisions can be assessed. If she is found not to be competent, a declaration will be made by the parties approved to do that in your state, and you will then have the authority - given to you BY HER, let's not forget - to take over those decisions even if she disagrees with what you decide.

That still leaves you with the practicalities, of course, which is where the ruses and strategies come in.

What is it, though, that you want her to do or not do that she is currently resisting? You mention paranoia, too... mmm. Is she paranoid? Or does she think you're trying to make her do things she doesn't want to do..?

I got called "stupid woman" yesterday by a lady with galloping dementia who is at the horrible, terrifying (for her) stage where she's manifestly demented to outsiders, but for her it's the world that's not working and not making sense. If I'd left her in peace, apparently, she would have managed perfectly well and it was my fault she couldn't find her underwear because I was "badgering" her - she didn't quite get to the point of accusing me of throwing her clothes all round the house (they were scattered through every room) but I think the suspicion was beginning to form in her mind.

What's your mother doing that is ringing your alarm bells (apart from the nifty interstate footwork with her driving licence!)?

Exhausted piper I feel for you. I really do. I have durable POA that clearly states when she becomes incompetent and can’t make decisions. I do have the paperwork in my hands but the attorney was Leary to give it to me because she is competent and of sound mind. He called my mother and said it was ok for her to give it to me. He was Leary because he said technically I had the power to sell her house right out from under her. I won’t and I told him I would never do that. The reason I have it is so I can talk to healcare professionals over the phone and I can do banking business on her behalf. As far as driving my mother got in an accident 10 years ago at age 85. Nothing serious just a fender bender but the cops were called and it was her fault. Long story short they made her take the road test again to see if she could drive. Guess what, I was in the backseat and she talked her way out of taking the road test!! They gave her the license and she never took the road test!! She just talked her way out of it. The driver turned to me and said your moms mind is better than yours and mine combined!!! She is good at smoozing. Fast forward to 3 years ago her card died when she was 92 because the car was 20 years old!!! Her car died I meant to say. So I feel for you. I am sorry you are going through all of this!!! They can be so darn stubborn. There is nothing you can do unless something happens to them. Absolutely nothing!! The law is on her side!!! I am so sorry.

"They can be so darn stubborn. There is nothing you can do unless something happens to them. Absolutely nothing!! The law is on her side!!" Then the only reasonable thing we as caregivers can do is to stop helping them manipulate us into enabling them to manipulate us. Does that make sense?

Maybe we are the ones who need to accept that we can do nothing until something happens. Perhaps we are the ones who are delusional by trying to prevent something bad from happening. I learned acceptance by stopping enabling "them" to live alone i.e. stop doing chores, stop running errands, stop driving them to appointments, etc. For 5+ years I enabled my inlaws to live alone and, if I could go back in time, I would not do it again. I prolonged their decline, delayed the inevitable and, when they finally moved to indy living, they were worse off than their peers who accepted things sooner.

I understand your confusion....I have my mother's p.o.a you are the one in control since she gave you the p.o.a without she has any stipulations...I didn't want to make my mother feel I was overpowering her so I would ask mine what she wanted me to do about certain things ...maybe you should try that ... believe me I know when they r stubborn it's difficult but if it's just a straight durable power of attorney you have the power to make the decisions in ur mother's best interest. Good luck. If I can help any way at all. Message me.

Piper, w/o skimming through all the other answers, can you provide the specific wording on enablement and actuation from the POA document?   That's the determining factor.

My experience with my Mom was having to take her to a geriatric Neurologist, who was able to give an official diagnosis.
I had them give me a signed letter of her condition of Alzheimer’s, just in case I was ever questioned on her condition. Luckily my Mom hated driving anyway, so once she was at an assisted living place, found no need for her car at all. I told her it was costing her too much in insurance, and maintenance, gas, etc.
then go to your Elder Law office team.
they may have to add something more to your POA to incorporate the exact timing of when you can make decisions for her, or they may have a legal solution you hadn’t thought of.
goodluck- I can only imagine we will be just as stubborn about giving up our independence!

I have I have an answer that apparently no one wants to broach, because no one has. But if a dementia victim has a DPOA or a springing POA and they are cooperative with you, your life can be great.

But if they are stubborn, and capable enough to make your life hell, your only option is a conservatorship or guardianship, whatever it's called in your state. It's usually separated into two portions: one of the person and one of the finances.

And, and, you have to go to court to get it. And, it's very expensive. And, if there is an estate involved, it drains the funds because the court will typically rubber-stamp the attorneys fees etc etc. IOW, It's relatively easy to get a conservatorship of person when there aren't finances. If there are finances, there is voluminous receipt keeping and record reporting to the court - - so it's a major stressor on the conservator.

Now, and in your situation, it could be good news. Your mom seems partially cognitive. If you explain to her that she either cooperates with you under her DPOA or you walk away and go to court and get a conservatorship. And you know you will MOST LIKELY get it. because of the doctor that evaluated her for her Florida driver's license, and probably her personal physician as well.

And in the attempt to get a conservatorship, if the dementia victim, is able to vocally object, the court will appoint a lawyer for that person, which is paid for out of that person's funds, if they have money, and the court will also generally a point a neuropsych under the court's authority to do the evaluation. The court has a list of lawyers, doctors and psychiatrists that are typically termed "Friends of the Court" - - professionals whom the court has prior experience with, and whom the court trust to give an impartial evaluation, not having anything to do with family dynamics.

When when I say tell your mom this and walk away - - I reallt MEAN walk away and go file. I know it seems harsh, and it's sometimes fearful to think that you're leaving them on their own, but you don't really have a choice at this point. See an elder attorney. You will undoubtedly need to see a different one from the one who drew up the DPOA, as that one would probably not ethically do it because of conflict of interest. You will PROBABLY prevail and when you do, the attorneys fees will come out of your mom's estate if there is money, and it will usually come from the state if there isn't money. There may be some expense to you if you don't prevail, so you should definitely discuss those questions with the attorney.

It'ss an ugly process - - the dementia victim is stripped of their rights in open court - - driving, voting, any independent decisions, medical choice, etc etc.

Your mom may still be in a place where she can cognitively understand what that would put the both of you through, and perhaps she would relent and let you use your DPOA the way she set it up when she was thinking straight - - the way you're supposed to be able to.

But truly you don't have much choice in order to keep her safe - - sometimes Adult Protective Services gets involved and actually blames the supposed caretaker for not doing the right thing. This process is also often undertaken when there are two family members doing the caretaking who don't agree - - often the court steps in and hands it over to an outside service who does this type of process. That can even happen when there's only one child trying for the conservatorship and the dementia victim is overridingly hostile about it. The problem with that is that it's very expensive and that court appointee also has the power to completely exclude the family from knowing anything about the patient.

This is a hard time for you and your mom and I feel very bad for your situation. In case you can't tell, I've been there, done that and it's a very unpleasant - - if your mom is cognitive enough, your hope is that she will understand and cooperate with you - - else you go to court.

I feel for you! We’re going through a nightmare right now with my mom. She was delusional this summer and she thought my dad was trying to kill her. We moved my 91 year old dad into an apartment while we tried to figure this out. We then started visiting memory care facilities and assisted living facilities. I thought since I had the POA that we could place her in just an assisted living. Wrong! I brought her to the doctor and he said we would have to “activate” the POA which means two doctors would need to evaluate her. He was happy to bring in one of his partners to do that because he felt she had advanced dementia. He said if he does that though, that she has to go into a locked memory care facility not an assisted living. Well she’s not to the level of most of the people in memory care yet and the rooms are tiny. I can’t do that to her. She is home and my dad is back home, but now she keeps asking for her car which we’ve taken away from her saying it needs a new part because it’s so old. That was the only way we could think to take the car away. The incessant questioning about when she’s getting it back is driving me crazy, but we just can’t allow her to drive! She’s now on an antidepressant and anti anxiety and my dad is monitoring the pills so we’re starting to notice some changes, but I think she’s starting to mess with the pills behind my dads back. It’s exhausting!!! Would she visit a doctor with you? And if she will, can you call ahead of time to tell them you would like the POA activated?

I had the same dilemma.
On the one hand, I was told by the manager of an assisted living facility that I could NOT take my mother out of the facility, even for lunch, without my brother's permission as he currently had her medical POA. When I asked more questions, I was told by the ALF manager that "she could not get into this". (My mother did not have a guardianship nor a doctor's certificate that she was incapacitated, and therefore she was legally competent and not subject to a medical POA's agent's decision. Period!)
On the other hand, I read in the Texas statutes dealing with medical & financial POAs and The Resident's Bill of Rights, that my mother could leave on her own volition at any time. (Please note that my brother and the ALF did not "allow" my mother to have cash, credit cards, or a phone---making leaving impossible. They also locked the doors "for her protection".)
I worked and worked with the State's Ombudsman for Long Term Care Facilities to see which scenario was correct. (A long-term care ombudsman is a government official who oversees nursing homes and assisted living facilities and whose duty and purpose is to oversee the rights of the LTC facility residents---per federal legislation. Also, the ombudsman is supposed to be expert in the laws and regulations that apply to nursing homes and assisted living facilities.)
Even though I felt that the ombudsman was "on the side" of the ALF, after pushing and pushing for an answer from the ombudsman, the ombudsman for my mother's facility (there is a specific individual ombudsman assigned to each facility) specifically asked the facility manager if my mother would be allowed to leave with me, and the answer came back on the side of the law---yes she could as long as you sign her out according to procedure.
So, next week I am flying down to Texas to take my mother on vacation, and we will see.
I hope this helps.

It comes down to a matter of "competency". If an individual is not mentally or physically able to care for themselves, then he/she needs their care to provided for. The law in your state and doctors that are licensed in your state have a definition of what "competency" and lack of competency mean. No one should step in to determine another's care/life if he/she is able to make those decisions for himself/herself. Ask your doctor or a family law lawyer what the definition is for your community.

The "how care is provided and decided upon" is also important. It is preferable that every person determines how he/she wants to be cared for in case he/she can't express wishes. The law provides for this in living will and DNR to write out your requests. The law also provides for a "proxy decision-maker" when somebody gives a "power of attorney" (POA) to another person. In elder law, usually that refers to a medical POA and a financial POA - most financial institutions require the financial POA and won't respect a general all-encompassing POA. POAs can only be given if the older person in mentally competent to make that decision. If not, a person who wishes to accept responsibility for all care decisions will need to go to court to get "legal guardianship" which can be expensive. Otherwise, the court can appoint somebody - usually a lawyer type - to be the decision maker.

Then comes the gray area of self determination. Most states consider neglect to be against the law, including self-neglect. So a person who might be considered mentally capable might be forced into a facility if he/she neglects his/her own health needs: bathing, food, medication, home care...

If your mom is making poor decisions and is paranoid, I suggest your first step would be an evaluation by a medical doctor. Go with your mom and give the doctor a list of problem behaviors that you are concerned about. He/she will be able to advise you regarding treatment options for her medical conditions. If she is not "competent" to handle finances, help your mom set up her finances for auto pay of bills and review them online, especially with her. You might consider giving her a reloadable debit card for her personal use instead of being able to dip into every bank account. That way she has money to spend and her finances are cared for.

If she is not "competent" to live alone, then you'll need to arrange to have somebody with her - round the clock. It could be you, family, friends, people you trust, or paid help: aides in the home, adult day care programs, and/or moving to a residential facility. There is no 1 right answer, but there are usually plenty of resources to get help from. Start researching for help where you/she lives.

OK, let's not go to "everyone else" and "advice on the forum that conflicts". Because you need not to take the advice you see here from ANY of us. Most of us are lay people involved in caring for our family members in one wise or another. We have learned a few tricks that work, a few things that might or might not be true about POA and about Medicare and Medicaid and so on. But we are not experts.
So let's keep this about you and not about other stories here. You have a mom you describe as VERY stubborn and as bordering on paranoia. Stubborness is not dementia (though sometime one symptom of a dementia may be stubbornness that was not previously there. Paranoia can also be a symptom, but you aren't paranoid if you are thinking someone wants control over your decisions, and is saying POA. Because maybe they do. So the thing is here that you have not described in my book someone who has dementia, is therefore a danger to herself or others from wandering, forgetfulness, turning on the gas jets and causing fires, and et al.
The best thing you can do if you are DPOA is take the person you love and potentially must act for to evaluation. You will there learn IF there is dementia, what stage, when you should act, and etc.
Bad decisions are something we can make at any age. But the kind of bad decisions that end us wandering in the streets lost, or giving all our money to scams, those decisions need intervention.
Your task now is to find out what is happening to your Mom. Don't take OUR advice. Take the advice of professionals and then come back here and try to tell us what you have learned, what symptoms you saw, what they were diagnosed as, and etc.
Ask Mom's doctor, after evaluation, what other papers you need, and at what point you must become appointed her POA or her guardian. Buy one hour of time with an Elder Law Attorney. They are the experts.
Then come here to the garden of advice, pull weeds, plant flowers, try to get help and give help--more than anything receive the comfort of knowing you are not alone in your confusion. Wishing you so much luck. Hoping you will update us on all you learn. Knowledge is our friend, but we have to comb out the tangles. It is terribly tough. For us all.

When a note from a doctor says that a patient has dementia the named trustees of the POA can exercise it. A patient still can make the determination to have a DNR or not, if they are able to understand what it is. My sister is one of the top geriatricians in the country. The nursing home wanted us to put her on DNR saying that my mom has dementia but my sister has my mom on video asking her the questions which show that my mom understands what it means to have a DNR, to be on life support or the withholding of it and so we left it as per my mother's wishes. My mom doesn't have Alzheimer's and she's mainly with it, making her own bad choices to deny proper care, refusing to walk, to sit up, etc., to take a shower, which she's entitled to do as a nursing home resident. It's frustrating and painful for us but that's what she wants ... so, yes, they can make their own bad decisions...

I don't wish to muddy the waters or insinuate that some answers are incorrect, but there are some issues that need to be addressed.  And I'm not singling anyone out, just responding to a thread with confusing information.

Teddiegough,    the OP is in Florida, so Texas statutes are irrelevant; however, I think it's wise to delineate between Texas law and other states.  

E.g., the triggering factor under the Living Will (medical POA) in my father's estate planning documents is the INABILITY to communicate decisions.  It has nothing to do with not being able to make decisions; it focuses on communication.  There's a fine line to be drawn in such an issue.

There IS an obvious way to make legal changes to any document:  have a qualified and experienced attorney prepare new documents with specific language to override any and all previously executed documents, which is how estate planning attorneys for whom I worked addressed clients' estate plans.

In the OP's situation, court involvement might be necessary, but it's not the only route if the individual who executed the documents is still able to make his/her own decision.   Obviously there are other issues; my point is that the obstacle in this thread is personality driven, not legally driven.   It could become so, however.

Sometimes these issues and the activation triggers become so complex that it's better if the person asking the questions just sees an attorney, a reputable one with a good background in estate planning or the complimentary practice area of elder law.    Legal advice by forum or online sites w/o no detail on who's providing the information is a gamble at best.  

I stress again that it's not my intent to insult or challenge anyone's advice.

If it is signed and notarized and (in my state) registered with the county, it doesn't "kick in," because it IS IN once the foregoing tasks are accomplished...

You might want to confer with an elder attorney.

Grace + Peace,
Bob

The DPOA did not kick in for me until I received two written letters from separate doctors stating Mom is incapable of caring for herself or making sound decisions in order to move her into the care home. You may say you are "tricking" them into a care home but in the long run it was better for MOM and better for me.

I am in Ontario Canada. We had a heck of a time getting my dad in a nursing home against his will. For at least 2 years we were struggling with this. Dad was diagnosed with dementia, but was not deemed totally incompetent. They told us he had trouble making decisions, but no doctor wanted to deem him incompetent. Finally, after several falls and several ambulances which he refused, one ambulance attendant decided that for the interm, the POA would take over. They took him to the hospital on my mom's say so not his. When he got to the hospital, the doctors did a compentancy test. At that point, they decided that he is not capable of making his own decisions and the POA was to take over. At the time, the POA was my mom. Mom is gone now and I am the POA. So my advice to you ExhaustedPiper, is persistance. Keep on the doctors. Keep a record of everything out of the ordinary. Call an ambulance every time your mother falls. I won't say it is easy. It's not. Just make sure everything is on record.

My DPOA kicked in immediately after having it signed by my mother in the presence of a Notary Public. Then gave copies to her doctors and hospital.

It kicks in immediately.

Hi there, I am an elder law attorney in Florida (multiple locations).

In Florida a durable power of attorney is effective immediately (if it was signed after 2011). However, that doesn't mean that the principal (your mother) loses the ability to make decisions.

Dementia is a spectrum, which means that there may be some times when your mother is capable of making her own decisions, and other times when she may not. Of course, it is also possible that her doctor will indicate that her disease as sufficiently progressed to the point where she is no longer able to make decisions for herself. At that point, anyone who is put on notice of that lack of capacity, will have to rely on you.

Unlike a Durable Power of Attorney (which must be effective immediately), a Health Care Surrogate Designation, can be made to be effective immediately OR upon the principal being declared incompetent at a future time.

I hope this helps.

You need some basic information on POAs.
First, there are different types of POAs which "kick in" at different times.

The POA, at least under Texas law, which deals with where the principal (usually the parent) lives, is the medical POA. The medical POA "kicks in" when the principal cannot communicate their wishes concerning health care. The only way to legally override this is with a court order for guardianship.

A conflict or disagreement with the principal will automatically negate any power the agent (usually the child) thinks they legally hold over the parent. (Obviously, if the parent can state that they do not want to live in a LTC facility, they are communicating.) For a legal resolution, the issue must be addressed by the courts in a guardianship hearing.

In my personal experience, I have seen these medical POAs greatly misused and,, sometimes, abused by agents and by long term care (LTC) facilities. By this I mean, that if the principal still communicates their wishes to live at home then, legally, their wishes should be honored unless there is a guardianship stating otherwise.

I know this sounds burdensome, but you are talking about taking away basic human rights and the US does not allow basic human rights to be legally taken away without a review by the courts.

There was a part in my mother-in-law's POA that specifically mentioned permission to determine nursing home or other facility placement. We did not end up moving her, but could have done so legally. When she was still able to discuss it, she said she didn't want to move. It was not a safety or issue so we let it be.

To AlvaDeer - - thank you for your appreciation of my answer. It was a true and valuable point you brought up - - that when the state becomes responsible, the family has no control over where the placement is, and your LO will not always be placed somewhere that is convenient for the family to visit. In fact, the appointed conservator can also limit or exclude your visitation, depending upon perceived circumstances - - they have a lot of control...

But in addition, they also do not have to disclose any personal or medical information - - IOW the family can be kept completely in the dark about condition or treatment and, in fact the family might not even be told WHERE the person has been placed - - it is all up to the appointed conservator, and depending on that person's personality, the more you irritate him/her, the less likely you are to get cooperation. Some are really sympathetic and empathetic souls, but many others are overburdened, completely tired of their job and the family bickering etc etc, so they have very limited patience...

In the in the case of your brother, there could come a time where he will flip on you without realizing logically that he's doing that. It might be good to talk to him about including the following in his paperwork, "IF" he is competent, that he is "nominating" you as conservator. That doesn't obligate the court to give you conservatorship, should it come to that, but they would weigh it very heavily that that was your brother's wish. If it were me, I would also have my brother write a statement about his philosophy and beliefs, and the way he feels about you and why he chose you, along with the statement that he knows what his disease could progress to, and knows that he might come to a point of objection, and hopes that the court would consider his objections in the context of his illness and override any objections of that sort unless there is clear and provable evidence that some kind of unusual abuse is going on, because (he should add) I don't ever expect that of my sister, but I know when I become deranged that I might accuse her of it, as I have learned that many have and do. It would never be my intention to put either one of us through courtroom drama or unusual expenses.

For what for what it's worth, it's better to get a person's personality and beliefs documented when they are lucid and competent...making statements about claiming it later, when your brother may not be confident, will not carry any serious sway with the court.

Reading through the posts you can see the difference of understanding/opinion. Your best bet is to consult with the attorney who drew up the documents, esp if the documents don't specify when the POAs "kick in."

Rules and laws vary a lot by state. Understanding can vary a lot. Several posts have documented that Durable POA kicks in immediately upon signing. My understanding is that it is effective, but doesn't kick in until certain criteria are met, esp if they are listed in the document itself. LegalZoom identifies Durable POA as "A power of attorney that enables a trusted person to handle your affairs if you become mentally incapable requires a durable power of attorney."

I have read that sometimes banks/others won't accept the POAs when presented! Thankfully this wasn't an issue for me, but in taking over for mom, I found out federal agencies do not honor ANY kind of POA. Since laws vary by state, I understand why they would not - it would be a nightmare for them! So, I had to apply to be rep payee for mom's SS and the federal pension she gets (it was dad's.) It made for a lot of extra work! Whenever I needed any paperwork mailed (W2s, statements, etc.) I had to schlep on down to her condo to pick up the mail (cannot forward federal mail either!) It took over a year and a half to get the condo ready for sale, so other than driving 1.5 hrs each way to get her mail, it "worked" until I was approved.

A plain financial POA is used "immediately", to allow someone to sign for you when you can't, perhaps due to logistics or emergency situation, and terminates when the "job" is done or the condition is resolved (temporary use only, maybe while someone is having surgery/hospitalized.) I used this POA to let my attorney sign paperwork for the sale of my previous home (2 hr each way to sign a couple of papers? Nope!) That's all she was allowed to do, and the POA ended when the sale was complete.

I will also say that our EC attorney told us we could not use the Durable anything to force mom to move to MC or anywhere alse, despite it being not safe for her to remain in her condo alone. She was refusing to move anywhere and he suggested guardianship. The facility we chose would not accept "committals", which apparently they consider guardianship to be. This is where we had to use the "trick" you refer to. We could not leave mom in her condo alone, she refused in-home help and refused to move. Would it not be considered neglect to leave her there?

Bad decisions are not really a qualifier for enacting any POAs. Even in MC, staff has told me those with dementia still have "rights." They can refuse treatments, meds, etc. The staff just has to be adept at coaxing the person into complying when it is in their best interest. We cannot assess your mom's condition, so we can't/shouldn't advise about if/when your POA is activated. You have to work with the attorney and doctors to make the determination.

So, for your purposes, consult with the attorney who drew up the documents. S/he should be able to provide information without "telling" mom about your visit. See if there are specific instructions in the document for when it takes effect. If not, the attorney should be able to specify what the laws in your state allow. You have at least one medical document that says she has cognitive issues, but that may not be enough or may not specify the "degree" of competence. Early stages might not have enough symptoms/issues to enact the POAs.

I am curious about the end-run to get a license in PA. Does she own a home there or have some other legal residence? Generally someone must have proof of residence in a state and very often it requires proof that you reside there more than 1/2 of the year! Lookup for PA:

"In addition, you will need to show proof of identification and residency..."
and
"A previous resident returning to Pennsylvania must meet all the same identification and residency requirements as a customer who has never been a PA resident."

Hi Alva - - yes, I read your bio, that you are in California (as am I) and that your brother is older than you. One of my primary caretaking recipients was my aunt with alcohol dementia. She went on in stabile condition for 6-1/2 years until she had her 3 strokes, then it was all downhill for 4 months until her transition.

Everything for my aunt had been prepared by an attorney and I was able to handle everything for her with a durable general power of attorney and a California Health Care directive. She was confirmed incompetent why her doctors prior to the 1996 implementation of the HIPAA rule, so I never needed that, but you would now.

LBD can get sketchy with how patients behave, so I'm still suggesting that you get him to write down his wishes and philosophy while he is of sound mind. It would be easier for you if you never have to get a guardianship, and you might only have to if he becomes deranged enough to object to you taking care of his business and his person. Courts do take a person's wishes into account but they typically prefer objective proof rather than "my brother said..." or "he told me he wanted..."

The more descriptive are his desires, the more weight they would have in a legal context, if it ever came to that. You can decide at a later date, if the need arises, whether you want to take it on or not - - but you can't create proof of beliefs or intentions after the fact.

Hi Alva - - yes, I read your bio, that you are in California (as am I) and that your brother is older than you. One of my primary caretaking recipients was my aunt with alcohol dementia. She went on in stabile condition for 6-1/2 years until she had her 3 strokes, then it was all downhill for 4 months until her transition.

Everything for my aunt had been prepared by an attorney and I was able to handle everything for her with a durable general power of attorney and a California Health Care directive. She was confirmed incompetent why her doctors prior to the 1996 implementation of the HIPAA rule, so I never needed that, but you would now.

LBD can get sketchy with how patients behave, so I'm still suggesting that you get him to write down his wishes and philosophy while he is of sound mind. It would be easier for you if you never have to get a guardianship, and you might only have to if he becomes deranged enough to object to you taking care of his business and his person. Courts do take a person's wishes into account but they typically prefer objective proof rather than "my brother said..." or "he told me he wanted..."

The more descriptive are his desires, the more weight they would have in a legal context, if it ever came to that. You can decide at a later date, when something more happens, if you don't want to take it on, but you can't go back it time and create proof of someone's thinking after the fact.