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We are working on getting my mother into the NH where my father is. She is now in rehab because she had Covid. She can no longer be alone at night. She does not have enough money to pay for 24/7 care at home. We are working on submitting her application for Medicaid.


She does not have dementia but is not capable of going back home. We dismantled her caregiver arrangement because she did not want to pay the ladies while she was in rehab. They are looking for work. Even if she came home, I doubt they would want to come back because they know this work arrangement is no long term guarantee.


My sisters and I cannot do this any longer, she needs more help than the three of us are capable of providing. My sisters and I have obligations to other family, not just to her.


Sadly she cannot live with any of us so that will not be happening. She is difficult and nasty and it is too emotionally difficult for any of us to do that.


My sister is her power of attorney. Can our mother be kept in the facility or is she free to leave?

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She can leave but where would she go? Stick to your boundaries do not enable her to leave, do nothing, she will get the message real soon.

Don't "What If" this continue on your path and see what happens. If you do not give her a soft place to land she will have no choice but to stay in a home.
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Just tell her this is the way it is and you all are not going to try and find her new care givers, that ship has sailed. I am sure she doesn't give a damn but tell her that all 3 adult/elderly children are done. They are not able to keep propping up her fake independence and her money is running out (sooner rather than later). Who knows you might get lucky and the confrontation and reality will kill her (I kid but maybe I don't because your mother has made your life a living hell with her demands and behavior and overall nastiness).
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Your mother is not incompetent. Therefore she is free to do exactly whatever she chooses to do. HOWEVER no one should enable her to do any of this. That is to say no helping with hiring people, no NOTHING!

I might also inform my mother that I will resign POA the instant she leaves and have no further contact with her other than an occ. phone call to say "Hi".

She is not physically able to manage on her own. She is counting on all of you to arrange and get everything back as it was. It is time to tell her you are finished with that.
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If she is "coimpetent" then she can leave.
You can inform the facility that it would be an unsafe discharge.
Inform the facility that you nor any sibling can help or will help at home.
When mom says she wants to leave you must:
Not offer help
Provide no help.
If they discharge her she must arrange her own transportation home.
Your sister can resign her POA. I would send a letter to the attorney that drafted the original paperwork, I would also send a letter to mom as well as the facility if she is still there.
The "problem" with doing that though if mom later is diagnosed as incompetent she can not do another POA (unless the lawyer thinks she is competent enough to understand the document and what she is signing) If there is no POA then Guardianship may have to be done and that can be time consuming and expensive.
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97yroldmom Sep 2023
Just want to add to what Grandma1954 mentioned about not taking her home. Alert any and all likely suspects among family, neighbors or friends that they are not to take her home.

She may connive with a social worker to call up grandson Joe who works at the dealership down the road to pick her up. If he is caught off guard, he might be dropping her off at home or at your house. Some people don’t have a clue that they are being manipulated.
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If Mom is deemed 24/7 care, Rehab cannot release her if there is nothing in place in her home and u refuse to care for her, its an unsafe discharge.

I would talk to the Social Worker. Explain what you are trying to do. Get Mom placed with Dad. Where I live, Rehabs are in the same building as Long-term care. Maybe she can be transferred when the time comes to there until you can get her in with Dad. If she has no money for private care, then Medicaid will have to be applied for now. Ask how that will work when ready to transfer her to Dads facility. You may need to have Dads facility help u when the time comes.

You are aware that Medicare does only pay 100% for Rehab for 20 days. The 21st to 100 days are 50%. If supplemental insurance does not cover the other 50%, then Mom pays it. Those 100 days are not a guarantee. If Medicare feels Mom has hit a plateau they will have her discharged. So, get this worked out ASAP since she can't be discharged to home.
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Hothouseflower Sep 2023
Yes I am aware, we have consulted an eldercare attorney. We have three options on how to proceed. We are trying to figure out the right one.
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Your sister needs to read her PoA docs to see what triggers the authority. If it is a Durable PoA, then it is already in effect for financial affairs, but not sure about medical management.

If your Mom goes into the facility but then doesn't qualify for Medicaid, what is the back-up plan?

Most states' Medicaid programs only cover LTC and this has to be medically assessed as necessary by a doctor.

Like others have asked, if she left, where would she even go? Is she capable of arranging leaving? If not then DON'T help her.
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Isthisrealyreal Sep 2023
DPOA does not automatically come into effect immediately, it depends on how it is written and Medical is a DPOA. So not necessarily for finances at all.

Durable for any POA whether it is Financial or medical or mental health is ALL about level of authority and whether there is an expiration date involved.

Otherwise it would be a general POA with specific authority and an expiration date.

Obviously this is all for AZ. I know we are not the only state, so please don't state that the DPOA is immediate because it can cause confusion. People need to read the actual documents and look at their states statutes if they don't know what the rules and laws are.
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Would she be in the same room as dad?
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Hothouseflower Sep 2023
Eventually it would happen that they'd be together. But at least they can see each other which has been very difficult. It is hard to get her out of the house and into the car. It is a huge ordeal for her and she is exhausted by the time we're back.
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She is free to leave if she is not mentally incompetent. Your POA is not active unless she is.

If she wants to go home and it's an unsafe discharge, she will have to sign paperwork releasing the rehab from any liability from releasing her. It will be recorded in the discharge papers that she is leaving 'A.M.A.' (Against Medical Advice).

Pretty much all you and your siblings can do is tell her that you can try to get her into the same care facility your father is in.
If she refuses this and demands to go home, let her know that you will not be party to that and she will be on her own with no help from you or your siblings.
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Just an update, my sister had a Come to Jesus Moment with my mother and father this morning at the NH. She told them that we can no longer take care of our mother at home. She told them this is causing a lot of friction with her husband. She told them it could be possible she'd be divorced by the time this is all done. She can't stand that she has to wait for me to come in every other month to be able to have a life. She also cannot stand that our other sister gets a free pass and gets to do what she wants whenever she wants..

She told her there is no choice anymore. She told her I had a consultation with the lawyer to start the Medicaid process, which went over like a lead balloon. My mother says I don't communicate with her any more. It's true, I stopped communicating because if I do she only rips me a new one, so why bother. This in addition to the fact that she is severely hearing impaired and to make yourself understood is VERY difficult. She does not hear everything.

Anyway now she want to talk to the lawyer about what's going to happen. I really wish she was not competent at this point. It would make all this so much easier. She will not relinquish any control.
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sp196902 Sep 2023
Great news that your sister finally laid it all out to your mother. Too bad mom didn't seem to give a damn. But entitled elders are gonna do that because they only care about themselves. I am looking forward to you and your sister getting mom into the nursing home and getting back to your own lives. You both deserve it.

Every time I see someone celebrating a person who has lived past 90 I always wonder at what cost to their own elderly children.
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So sorry that your mother can not recognize that her daughters can no longer be her plan of care. Besides that, I thought you had said her money is almost running out anyway so caregivers coming to the home is not going to happen either. I;m assuming she was renting , so no home to sell to pay , since you mentioned Medicaid.

What if you told mother shes has no money left and needs medicaid and no longer has a choice? You could also maybe tell her she could become a ward of the state if she attempts to live on her own without help, and the state would put her wherever, and that you are trying to get her to be with your Dad. Maybe that will get through to her.

Maybe someone else has a better suggestion . Good luck.
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Hothouseflower Sep 2023
I consulted with the lawyer on Friday and he laid out three options: Medicaid with a promissory note for gifting, Medicaid with intent to return home, or Community Medicaid where she will return home with at home care. We think the intent to return home is the best option for us.

Medicaid will put a lien on the house and at her death when we sell the house at fair market value, Medicaid will recoup the money.

There are choices in life. If my sisters and I wanted to see an inheritance, we could have chosen to work out some sort of arrangement to keep her home. But given we are all in our 60s, I'm the oldest at 68 (with a husband of 72), we want the time and freedom, not the money.

We tried as best we could to honor their wishes to be home. Hoped they would have gone peacefully in their sleep by now, but they just keep declining in tiny bits and pieces. The attorney said my mother's life expectancy is another 3.5 years. I don't want to invest that much more time in caring for her.
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Are you thinking she would get 24 hour care at home from Medicaid? Very unlikely that the state would cover that. Just too costly.
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waytomisery Sep 2023
I was wondering about that also .
I also was wondering what the differences were between the 3 choices hothouse named. I may be in a similar situation at some point with my MIL who lives in NY . However she has a partner and they co own the condo so that is an added variable .
I looked up the 3 choices , looks like the choice that hothouse intends to use does not guarantee the mother will go home . It looks like it’s a way to postpone selling the home so IF someone gets better and is well enough they can return home . This may be the only way to get the mother to accept care in the nursing home that she needs . After her death the house is sold and Medicaid gets paid back. . If I’m reading it correctly .
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A further update about my mother. She has been very nasty and mean to the staff at the NH. She does not want to be there and is making sure everyone knows it. Yesterday it was my parents 71 wedding anniversary and the staff had a corsage and bouttiniere for my father and mother and a cake and balloons. They had a mass and renewed their vows. I am not there in NYC but according to my sister she just p***ed on the day and what the staff did.

she is nasty to everyone she encounters. She is getting a psych eval and hopefully she will be put put on antidepressants. This woman is the person who raised me. The social veneer is gone and this is the woman of my childhood. Funny I actually feel validated knowing that there actually is a problem with her. It’s not all in my head and that I cannot handle relationships with my family.

I am not there right now, flying back Tuesday. I am not sure I can take much more of her. Right now I don’t think I want to see her ever again.

The stress of this is making me physically sick.
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sp196902 Sep 2023
Hang in there HotHouseFlower. You and your sister have got this. Mom is no longer in control and she will fight like the devil to pretend she is.

I am glad her veneer is gone and you have closure about who and what your mother really is.

Who knows maybe medication will make her become somewhat human. And she will go from this 👹 to this 😼

There was another poster whose mother was like your mom and at the facility she finally got her mom in they medicated the mother properly and for the first time in her life her mother was a normal human being.

In the meantime sending you some good vibes that mom gets situated in the facility soon. 🤞
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Hothouse,
You deserve to take a break.

Maybe consider just coming to do some of what needs to be done in the house, and skipping the visit to your mother this time.

Or, maybe just skipping the whole scene for a couple of months!

Cheering for you!
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I think that was very nice of the staff and feel for them. You Mom is a nasty piece of s***. I would not spend my time or money on her. I would also tell her how nasty she is. Its one thing to be that way to family another to be like that to others. I would leave her in the NH. I would not lift one finger to help her. All her basic needs will be met. Its up to her to make the best of it.
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CaregiverL Sep 2023
Joann, You seem very angry 😠
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She’s not in any condition to leave. You’re not in any condition to visit right now. How do you know for certain that your mother definitely does not have dementia? Was she seen by neurologist ? Did she get brain MRI? Let admin know she is not allowed to leave. Nobody will be there at the house to care for her! I know how you feel. I empathize with you. You have been so lucky to have your sisters helping you along this miserable journey. Let your mother get adjusted. It will take some time. Her condition will only get worse. Your patience will get shorter. Leave her there. Hugs 🤗
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MargaretMcKen Sep 2023
“Let admin know she is not allowed to leave” is not the right way to put it. Anyone can leave, it’s not a jail. What admin needs to know is that it is ‘an unsafe discharge’. That makes the facility liable if M goes home with no support and is injured. Make sure the facility knows (preferably in writing) that no-one will be providing any support at home – M will probably lie!
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So funny in a way, resident talk to LPN about the other resident yelling "Help help" only for she to turn around and do practically the same but it's "Jeff" lol
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