I have had POA for my mother since April. She is currently living with us. Do I need an actual medical diagnosis in order to make decisions?

No, I pay my mom's bills( most are auto pay) and take care of repairs etc. I tell her everything and we "talk" about it. She forgets a good bit but likes to feel she has input into her life. Actually she remembers things that are important about the house and investments that I did not know. I show her her monthly balances and tell her when all her beginning of the month income has arrived... My sister has washed her hands of all the management of moms affairs.... I keep good records too.

Imho, just for clarity, contact an attorney. Prayers sent.

I had POA and Health Care Proxy for my best friend when she was declining and her husband could not do things. Having both allowed me to make ALL decisions, including where to place her when the time came. Because it was notarized by a bank employee, banking was much easier - they knew who I was! Her husband was of poor physical health but good mental health, so we talked about each decision first so that we were on the same page. Her kids lived out of state so they did not question anything - they knew that 35+ years of friendship would not be violated, and trusted each decision I made. The kids were a blessing because there are so many horror stories! However, I must add that her estate did not have a lot of financial or material wealth.

I read on this site about a Medical Power of Attorney (MPA) and wonder if that is the same as a Health Care Proxy, which in my state allows someone to make medical decisions if the person is not able to do so. A Health Care Proxy does not allow someone to make financial decisions.

It might be a good idea to contact a lawyer. Elderly service organizations often have lawyers that are well-versed in what you need and work either pro bono or for a very low cost.

Getting a diagnosis will clear you of any legal questions about overriding your mother's self-direction. You can have her primary care doctor make the diagnosis as well as a neurologist.

Be sure you have a Medical power of Attorney and HIPPA as well. Otherwise should she go to hospital you would not be allowed to make medical decision for her and with Covid would not be allowed to be with her (CA).

If possible (she must be competent enough to sign) a Revocable Living Trust is the easiest way to handle both her needs financially, medically, etc. and eventually if any left to disburse remaining assets. With you (or whoever) as trustee if she becomes incompetent you as trustee can step in to manage her finances, etc.

You can make any decisions for her that she asks you to (if competent) or that you must make if she is NOT competent. For instance, I acted as POA for my brother, and Trustee of his Trust. I paid all bills, gave him a monthly accounting of monies in and monies out of his accounts, arranged for all automatic withdrawals, helped in sale of his small home, arranged for ALF, and participated in contract, signing as POA. He was at that time competent but made anxious by doing these activities and had asked me to do all of this to relieve his mind. He had dx. of probable early Lewy's Dementia and was setting the world in order for expected long slow decline, but died before that ever happened of another cause. Read your POA (hope that you have a good one) and know it deliniates exactly what you can do. You can't force her to see a doctor if she is competent to make a decision not to. You can insist that she have a primary physician and yearly check up and that physician can help you convince her; if there are indications she is failing, you can be more insistent she get checked for her own safety. Any "fight" over something, of course, is problematic without a diagnosis, because a competent adult can REMOVE a POA as well as confer one upon you. If it comes to fight over competency you are looking at guardianship issue.

Does she have a primary care physician who is aware of her decline and can write a letter stating as such? My mom has never gotten a diagnosis (another whole bag of yikes), but her primary care physician offered to give me a letter stating that she had suffered sufficient cognitive decline that she was no longer able to take care of her own affairs. With that letter, I was able to use the POA everywhere.
I did have trouble with one bank where they stared at the POA papers like they’d never seen written language before, and seemed like they were trying to make up requirements that didn’t exist to refuse them. I called their customer service number, and that person apologized profusely and directed me through sending the POA in over email. I can’t speak for all banks, but maybe it depends on who you talk to or how you submit them.

Your best bet would be to read the doc. Sometimes the legal terms/wording is hard to decipher, so a call to the atty's office would resolve your question quickly.

That said - we NEVER pursued any testing or specialists. When I tried bringing in aides for 1 hr/day to check on her/see that she took her meds, they sent a nurse out to assess her (paid by Medicare) and SHE did a thorough dementia test (better than the one a doc office does) right in mom's place with us there, confirming what I already knew. It was good, because she gave us some suggestions and pointers. Her primary doctor must be aware on some level about her condition - if so, using the POA should be sufficient to get/transfer her records.

I used the POA to close one back account - mom was with me, but just stood there rifling through her wallet and purse. They didn't know me from Adam at the bank. I showed them POA and ID. I used the POA to deposit the check from the bank and take over her primary CU acct (YB and I were joint on it, but I changed address to my PO Box, etc.) Mom was with me there too, but same thing - rifling through her wallet, clueless to what we were doing! They didn't really know me (I have accts there too, but never used the primary office before.) POA and ID was enough.

That said, I've read plenty of posts from others who've had trouble using the POA at banks. Hopefully you won't. You mentioned changing her address for Medicare, but nothing about SS. The best (legally the only) thing to do is sign up as Rep Payee for her SS. Federal agencies do NOT honor any kind of POA. For me, I called MY local office, set up an appt and answered all the Qs they had (they never looked at anything I brought with me.) It took a while, but they sent notice to me and my mother regarding the application. Once approved, you'll be notified and the first Rep Payee payment will come as a check. Once approved, you can set up a special Rep Payee acct at the bank, which only you can access, and then set up electronic payment. Transfer any remaining funds to that acct. It requires reporting at the end of the year, but it can be done online and isn't difficult. Just keep records on how her payments are used. They lump a lot of items together, such as housing/food. You report how much of her yearly income was spent in each category, and how much, if any, was saved.

Other places I used POA was CVS/CareMark, for medication, her other medical insurance and a credit card (since closed.) When she was still living in her own condo, I temp forwarded her mail to get the bills, addresses and phone contact numbers so I could have the bills sent to me. I did NOT have to use the POA for ANY of these except the CC.

No one ever questioned the POA. We had NO paperwork or doctor letters, testing, etc to start using the POA. The only other exception was the federal pension (it was dad's, transferred to her when he passed.) THAT was a bear, because POA was useless and so was her PCP (promised a letter after exam, but 9 months and hounding them multiple times/month by phone and online portal yielded nothing! Since we were moving her far enough away, we had to change docs anyway, but it was still difficult to get just the right "words" in the doc letter - took almost 2 years to get that done!)

So, start with reading the doc and/or asking the atty what the criteria might be or what, if any, documentation you need. If you can produce it for those who ask about it and they accept it, why put her through all that testing? It might be stressful for her.

Do look into the Rep Payee for SS (it'll cover Medicare too.) It'll make changing her address again when you move easier. Call the local office, if possible (virus) as the main number is usually a long wait! Once you're approved, you can deal with changes easily over the phone.

Good that you are keeping her "in the loop." Do that as long as she still shows interest. If she doesn't, just do what needs to be done yourself.

Yes, check yours to see how they both read. I have Immediate for my nephews financial but his Medical only comes into effect if he can't make informed decisions. Both Moms were if she couldn't make informed decisions. Where I live, my POA was never questioned. We live in a small town so everyone new Mom and me. We went to the same bank. They saw her decline.

Some POAs require incapacity to be effective. Read yours to make sure

Normally a POA goes into effect the day it's signed. You don't need any diagnosis, you can make decisions on her behalf and for her benefit now.

Is this only Medical POA or Financial, or both. Without a diagnosis you can still serve as POA if you have been asked to do so. For instance it was my brother who asked me to serve as his POA for health and financial and to be Trustee of his trust. We made out the POA papers with his speaking with his attorney seperately as well so attorney could ascertain he knew what he was doing in giving me the POA. A power of attorney is conferred on someone by choice of the person assigning you POA. It cannot be done when one is incompetent. You should be able to assume your duties under the POA as written on the day your Mom signed it. I am assuming you are not speaking of a "springing POA" which takes effect only when a person is unable to make their own decisions and this is attested to by usually two doctors.