Does obtaining medical POA allow for a caregiver to pay for assisted living for a family member?

The answer is "YES & NO."--You can pay for the ALF with your own money if you want to.  If you want to use your Mom's money to pay for the Assisted Living facility, then you will need to have a "Financial DPOA" to be able to handle your family member's assets and bank accounts and for you to pay for an Assisted Living facility or a Nursing Home using your Mom's money.  A "Medical DPOA" allows you to make decisions related to the family member's health care only.

Copy and Paste URL listed below to your browser.  This website describes options for assisted decision-making in Delaware.

https://courts.delaware.gov/publicguardian/docs/SupportingDecisions2018.pdf

Guardianship is time-consuming and expensive.  The website listed is the Delaware Court of Chancery information about guardianship.  Copy and paste the URL to your browser. 
https://courts.delaware.gov/chancery/guardianship/

In the Court of Chancery, a Guardian is a person appointed by the Court to make medical and/or financial decisions for a disabled person. There are three types of guardianships: Guardianship of an adult person, guardianship of an adult person's property and guardianship of the property of a minor child who is under eighteen.

Notice to the Department of Justice for Medicaid Planning:
The Court of Chancery no longer requires notice to be sent to the Department of Justice when a petition for Medicaid planning is filed, including all petitions to transfer an asset, petitions to establish a Miller Trust, or petitions to establish a Special Needs Trust. Once a disabled person has become qualified to receive Medicaid, the Court will require proof of such qualification as well as a copy of any signed trust instrument, including Miller Trusts or Special Needs Trusts. All documentation is to be sent directly to the Court of Chancery.

The website has a list of Brochures and Resources that I think that you need to review them before you start any petition for Guardianship:
--An Overview of the Guardianship Process
--Is Guardianship What I Need? Brochure
--Hearing Procedures Brochure
--What To Do After the Guardianship Hearing
--State of Delaware Resources for the Disabled
--State of Delaware Resources for the Elderly

{Court Petition Packs and Forms}
The process of petitioning for Guardianship requires that you and your attorney complete a multitude of forms and once you are awarded Guardianship of an Elderly Person, you have to file court-required forms (Annual Update and Medical Statement) each year. 

Copy and paste URL to your browser:

https://courts.delaware.gov/chancery/guardianship/forms.aspx

It isn't easy for the elderly person to admit that they cannot take care of their finances or of themselves.  Unfortunately since your Mom refuses to give POA to anyone, you most likely will have to petition for Guardianship.  I think that the $5000 that the attorney is requesting is just for petitioning for Guardianship and that you might find yourself paying another $5000+ by the time the petitioning is completed.  Your Mom's court-appointed Attorney Ad Litem should be paid with her money.

Research DPOA and Guardianship for Delaware thoroughly so that you understand what each type of "assisted-decision making" can and cannot do; and so that you understand what your responsibilities will be once you are your Mom's DPOA or Guardian.

I expect your Mom to fight you every step along the way if you petition for Guardianship and that fight will take a HUGE financial and emotional toil on your Mom and on you before you get through the process.  Good Luck.

Bella, to get at the underlying issue here:

Your mother needs more care than you can give. You are burned out and exhausted.

You need to tell your mom "No, I cant do this any more".

"If you have an emergency, call 911".

"If you won't give us permission to help with your medical issues, if you dont trust us, then the State of Delaware is going to make those decisions".

I know this sounds heartless. It felt that way when I had some version of this convo with my mom. But it was only by playing hardball that we got mom to agree to move someplace where she could be looked after.

Id also advise taking mom for lunch at a couple of these places so she can see the reality, not what her fears are telling her.

If she won't play ball, step back. Let her fend for herself for a bit.

Hi Silverbella, you may want to shop around for a different attorney. When I was searching for a lawyer to do a POA for my father I called a few different places. There was a very large difference in price between different lawyers. I was able to obtain someone who was quite reasonably priced. Just a suggestion. $5,000 sounds like a lot to me...

Chuckle again - Silverbella, the first thing the attorney ought to have asked you is not "have you got five thousand bucks handy for the guardianship process?" but "is your mother legally competent?"

You say she's in the early stages of dementia. Has her doctor said anything about her mental capacity - whether she is yet at the stage where decisions could legally be taken out of her hands?

If you were to hurry along with the guardianship application, and your mother were to contest it ... I'm not surprised the attorney's keen. It would cost a mint; and although court proceedings related to elder care are generally chargeable (quite rightly) to the elder, I'm not at all sure if that would be true in a successfully contested guardianship application. Anyway: you're a long way from being forced down that road, thank goodness.

Can we go back to what her main objections to the ALF are? And whether you've singled out one you like the look of?

The answer is no. Medical is just it, for carrying out the Principles wishes for her health when she no longer can.

You have to have financial POA in place. Makes it easier to pay her bills. If Mom can pay her own bills, then POA would not be in affect. There are two types, immediate and Springing. Springing u have to prove incompetence.

You could of course use your OWN money to pay anyone you wish, but to use your Mother's money with you paying with her funds, you would have to do the financial power of attorney. I think that as long as your Mother is the one making the decision as to living in assisted living she will not while you are coming to her aid to care for her. If your mother is having dementia as well as the physical failure I think that you may have to assume guardianship. First step would be discussing the changes you are seeing with her doctor. If you come to a hospitalization situation, which surely will happen eventually, enlist the social worker and work on placement from day one. They are wizards at doing what is extremely difficult to do on your own and as a family member.

To give a brief answer, POA medical (sometimes called healthcare proxy) and POA financial are completely separate documents.

I chuckled and thought "no nursing home I've ever heard of would turn down payments whoever they came from" - but then I realised: do you mean, would having medical POA for your mother allow you to pay for her ALF with *her* money? I.e., use her money to pay the fees without having to tell her about it?

If your mother's only objection to moving to an ALF is the cost of the place, I can understand your reasoning - although I don't think it would solve your problem. You'd still have to keep her informed about her finances. But anyway - is that her main objection?

When you say you've been trying to convince her to take this step for over 3 years, does that mean you have a particular ALF in mind?

Silverbella, anyone can pay for your Mom's Assisted Living, they don't need to have Power of Attorney. But if you think that would sway Mom to create a Power of Attorney, go for it.

The major issue is to convince your Mom that Assisted Living would be great for her. Don't be surprised if she digs in her heels, my Mom did. Dad, on the other hand, was ready to pack and move into senior living as he knew the house was becoming a safety risk with all the stairs, and he was tired of the regular maintenance.

Sometimes we need to use what is called "theraputic fibs" to help our parent make the right decision. You can take Mom to visit some Assisted Living places telling her you are helping a friend look and they wanted your Mom's opinion. Most places will give you a tour, plus a free lunch. That will give you an idea on what Mom thinks.

Regarding the VA, I found this article: https://www.agingcare.com/articles/applying-for-veterans-benefits-181517.htm

Is your Mom of sound mind? If so, you can’t make her move any where. The POA, even medical, only allows you to act if she isn’t capable of making her own decisions. To “force” her into getting more help, You very well might have to just back off helping her, letting her sink or swim on her own until she acknowledges she needs more help & will do something about it. That is what we had to do with our Mom, which was very frustrating & sad!

If she’s not mentally competent, you might need to seek guardianship, which is a lot more complex.