My brother lives with my mom, she is in rehab and I plan on keeping her there long term. Can my brother take her home?

The NH cannot discharge her to an unsafe situation. Should she insist on going home despite needing medical care, they may apply for emergency guardianship.

Read the health care document and see what it says. It may require you to have the doctor write a letter stating that she is incompetent before you can make decisions for her. It may require two doctors to agree. The doctor at the rehab might act as one of them if you just have a personal physician for her now. Once she has been determined to be unable to make decisions for herself and you are making the decision that she needs to be there, then she would have to stay. You might have to put her in memory care (where she might belong anyway) to keep her from leaving as I believe they are locked facilities.

Will Brother be able to afford to continue living in the house? Can he pay taxes, insurance, utilities, etc. out of his disability income? On Medicaid Mom will no longer have any income to contribute ... all her income will go towards her care.

Brother is certainly not your responsibility, but I have a feeling things will go more smoothly if his living situation is worked out.

I agree that seeing an attorney specializing in Elder Law would be a very good step at this point. They can answer about the competency issue. You can use mother's funds for this expense, as part of her spend-down process.

Thank you everyone for your responses. I have POA for financial and legal, I am 1st heathcare proxy on her advance directive. My question is if mom wants to go home or says take me home can they listen to her. We keep saying you can't since you have a fractured leg and in a cast. I don't believe she knows what she is saying, as she says why don't we come see her and we have been there almost every day.
Can the NH take that as she wants to go home they say they can't keep her against her will. But who decides if she knows what she is saying?

Montana73,
If you make all the calls suggested, doctor, Area Agency on Aging, Adult Protective Services, whatever you have in your area, then you wouldn't be legally responsible but when you say things like "guilt me" then you are not going to let yourself off the hook as easy as the government might. You may need to ask the County to step in and take guardianship if you don't have the authority to make these decisions with a POA from your mom. I know it's not what you want but if mom does end up at home AND she has medicaid or traditional medicare, she can get some help at home. Home Health agencies can come in and do her pills, check her vitals, bring in a bathing aid. PT can do follow up therapy at home. Medicaid I believe allows for some house keeping. You could set the bills up on auto pay to relieve you of that. This would most likely just be a band aid and not long term as your moms needs will increase. In some states brother could stay in the home after mom goes to LTC as it could be said that he enabled her to stay home longer than she would have. I think it's two years. He's been there 25 years so if your state has that medicaid provision then he might wind up with the home until he passes if mom goes into care now. In other words, the lien that medicaid will put on the home won't be called until brother is gone ( I don't know any of this first hand, have just read about it on this forum). Others might give you more advice on this subject. Do you think he's afraid of what will happen to him if she doesn't come home? A visit with an elder attorney who is well versed in medicaid might help protect brother. Your mother is going to want to know that he is okay. This is a big ole problem, no doubt. I wish you luck with it. Be sure to come back and let us know how things go. Take care of yourself. It's tough now but you have made the decision that you can't continue to care for her in her home and that is a big start on getting things worked out. Hugs.

I expect it is more a case of willful blindness on his part, it sounds as though he has a lot to lose when mom moves full time to a NH.
How close are you and bro? If you can work together to come up with strategies for his future as well as mom's it may go more smoothly for her and save you a lot of headache over the long term. Obviously he should be able to figure this all out himself, but I have a feeling that isn't likely.

You can definitely tell him no.. as can the facility. If the doctor is recommending 24/7 care, then in order for your brother to sign her out, he would have to sign that he will be responsible for her care, therefore alleviating you of any responsibility. Just do not sign anything stating that you will help care for her if she goes home. Have your mom's social worker speak to him. The social worker can explain the limitations and also the paperwork that he would need to sign stating he is liable. If that doesn't work, call Adult Protective Services and let them know what is going on.
Good luck!!! Please keep us updated.

Thank you. Her doctor has already recommended 24/7 care. I have already applied for Medicaid, which she will qualify for soon. Since mom and brother have this strange relationship she tells him to get her out of there, even though she doesn't realize she can't walk yet still in cast. My brother might just sign it and say he can take care of her, and then as he normally does guilt me into doing things. I want to tell him NO.. enough she is safer in NH if you take her out don't call me. can i do that and not be held responsible or abandonment. He cannot see her dementia..he doesn't get it she is getting worse.. thank you

Speak to the facility and let them know if she goes home it is an unsafe discharge. They have a responsibility to her not to allow her to go back to an unsafe situation. Let them know that you are unable to help. Your brother can take her if he signs off that he will be responsible and you do not have durable power of attorney. However, let the facility know that you will not be responsible. You cannot be charged with abandonment if you do not sign her out of the facility. If your brother insists on taking her home and you feel it is unsafe, you can also contact Adult Protective Services and let them know what is going on.

Who communicates with her doctor about her care and treatment? Are you the Durable POA or Healthcare POA? If so, you would be able to make the decisions about her care. And to put to them in writing that she's not safe going back to her home.

I wonder if you explained the situation to your doctor, he could make written recommendations about her care. Does she need skilled nursing care, regular AL, Memory Care AL, etc? If you can determine what level of care she needs, then that might help.

I might explain it to the Rehab social worker too, so that she knows no one is in the home to provide proper care for her. I read on this site a little while ago where the facility was requiring someone to sign a document that they would provide continuous care before the patient would be released. Would your brother do that? That would put a lot of responsibility on him.

I would explore how her LTC will be paid for. Does she have the funds or does she need to apply for Medicaid or some other state funded program if she needs AL or Memory Care.

I hope you'll get some more responses.