Mom had an old medical directive refusing assisted living. She is still living at home alone but cannot do anything herself due to dementia. Her doctor has deemed her incompetent. She also still drives, which is horrifying. My brother has POA and is helping where he can but is exhausted. She is hostile and stubborn and doesn’t want to move. She refuses to let any strangers in the house. Memory care facility won’t admit her due to medical directive. Can we give guardianship to the state? What other options are there?
Take mom's keys away and disable her car now. tell her you will it taken to the local garage but sell it for her. Find a nice AL or memory care and place her favorite things in the room.
Take her there and then sell her house for her. She is no longer able to make these choices. I hope you all pitch in to help your mother not just the POA.
To be honest, I am not so sure you can even put "do not put me in assisted living" in a medical directive.
I would assume that having plenary guardianship would give you control on placement no matter what may be in her medical directive.
Petitioning for guardianship is a very detailed and intricate process, it’s not easy to do the filing and being the actual guardian is definitely not easy, because there’s so much that has to be done monthly for the courts to show that she’s being cared for. Not to mention, very expensive. Getting an elder law attorney is basically a MUST, unless you already know how to petition and file and put everything together the right way. We got an attorney and even then, it was still confusing to us, and it’s a lot. I feel bad for people that don’t have the money to do it, because if we didn’t have one, it would’ve been next to impossible doing it ourselves. It’s also time consuming. So much so, that the guardian is suggested to keep track of their hours performing the duties and receive a pay from mom’s personal finances. We don’t do that though, we’d rather there just be enough of her money to cover the costs of the facility and for her other necessities. The money for her place to live, medical care, and needed items need, as well as all lawyer costs, to come from her finances not yours.
Your question would be a great question to ask an elder law attorney. You MIGHT be able to ask the probate division at the court house where mom lives, sometimes they aren’t allowed to answer certain questions if their answer suggests advice from them. They’re not allowed to give advice. I think your question is one that is just asking to verify a fact or not.
I wish you the best of luck! This whole experience whether you obtain guardianship or not, is going to be one of the most tough things you do- until you get used to it and learn the ropes. It will get easier
If saying or writing down "I don't want to go into a Nursing Home" was legally binding, NH's would be fairly empty.
As one who is not a fan of a facility, sadly in this case, the OP probably has no other choice but to place her. Mom doesn't want strangers in her home, which rules out caregivers coming in, which is practically her only choice at this point to stay out of the facility.
OP and brother have done all they can to honor her wishes to not be in a facility, sadly placement in a facility is now the only solution.
Please read the original post again. This elder is not safe at home and it cannot be made safe even if both kids move in with her. My mom lived with my husband and me and it became too dangerous because she was wondering through the house in the middle of the night and not using her walker, going into closets and pulling thinks down on top of herself. 11 months in, I had to face the fact that I was not the best caregiver for her. I think you have little to no understanding of what it takes to care for an elder who refuses any outside help, becomes combative, withdrawn, refuses to bathe, etc. You have a single experience with your mom but read the stories here and see what we've experienced and stop judging others for doing their best for their loved ones!
No one wants to dump their mother off, we arrange qualified 24 hour a day, 7 day a week care to ensure their safety and comfort when their minds no longer allow them to care for themselves!
My mom was driving when she should not be, her wreck, which totalled two cars and put her in the hospital was what alerted us to how affected with dementia she was. Her grandson moved in to help her and she was certain he was there to take advantage of her so i moved her in with me until that was unsafe. She still thinks, 3 years later that she can live alone and drive!
At the time of your mothers directive it was a "want". This has surpassed a want to a "need" due to her medical situation.
You can give guardianship to the state but I don't believe it should. That is another can of worms you would need to deal with and quite possible be even more difficult than keeping POA and having more control with your mothers care.
Can't your mom live with you or one of your siblings and then you bring a caregiver in to help?
What is wrong with you people that you don't care about WHAT YOUR MOTHER WANTS?? Doesn't she matter??
It sickens me the unbelievable disrespect the elderly are given. It's so easy to just throw around the words, incompetent, and use the word, dementia, so loosely and eagarly.
Have some respect. If this lady put in her Advance Directive that she didn't want to go into assisted living, you don't tell her to her face that okay we'll abide by that but as soon as you think she's incompetent, then you backstab her and you go against her wishes. No, you do everything you can to make sure she doesn't go into assisted living! Otherwise, what's the point in making an Advance Directive??
Get her a caregiver at home if that's what you have to do to keep her at home. Let her move in with one of you.
I gave up my life for years because my mother did not want to go in Assisted Living and my 3 dirtbag siblings didnt want her, even though 2 siblings had 2 homes, all 3 siblings were rolling in money and none of them worked, so there was no excuse why 1 of them couldn't take her. They didn't want to and they were going to force her into assisted living even though there was no reason for it because she was not even incompetent. Her doctor said she was not incompetent. They just wanted to get control of her house and her money.
I promised my mom I would never put her in assisted living, if she didn't want to go. So I moved in and I gave up my life and believe me it probably took years off my life but I'm not going to betray my mother.
I don't believe in traumatizing your parents in the last years or months of their lives by sticking them in a place they don't want to be. It blows my mind how selfish people are nowadays. Treat others how you want to be treated or maybe one day you'll be abandoned to some memory unit where they lock the doors behind you and you're never allowed out.
Your brother steps away from being POA
The Court appoints a Guardian.
In most cases the Court would prefer a family member but if no family wishes to take this on then she would be a Ward of the State.
OR
She accepts a caregiver in the home so that her wishes can be carried out.
I am curious if she has always refused to have people come in? If so the medical directive seems rather short sighted and possibly selfish if these have always been her wishes.
As POA though your brother should disable the care or take her keys away. She should not be driving. I would hate to think what might happen if she were in an accident and it comes to light that the doctor has deemed her incompetent and yet she is still driving. She would lose everything....not sure about your brother if he could be sued as well.
OR
y’all wait the inevitable that she falls and EMS takes her to the ER/ED and then y’all refuse to go and get her and that discharge planner at the hospital finds a NH to send her off to under rehabilitation orders…. and then she remains there to sequeway from rehab patient (MediCARE benefit) to custodial care resident. Then bro as her POA does whatever needed to do a spend down to get her eligible for LTC Medicaid if needed.
OR
Bro formally resigns his POA and she’s on her own. She refuses to go anywhere = she eventually dies in her house. It won’t be pretty.
Her doing a “medical directive” refusing care in a facility is a new one to me. & I’ve been on this forum for ages. That someone could do an Advanced / Medical Directive to state this is pretty horrifying to me. It’s not like declining CPR to be done or declining an ECMO or declining surgery or other truly medical interventions. It ties the hands of the POA to place their elder into a facility that can meet their needs.
It makes no differene whatsoever if she has a 'No AL' in place order on an Advanced Directive document.
If she has dementia and is no longer in her right mind, she doesn't get to make the decisions anymore. We have laws in this country that pertain to vulnerable adults. That is why we have agencies like APS, CPS, and other state-sponsored social services. A person with dementia cannot live safely without proper supervision. The same way a child can't.
Sometimes the law has to go against a demented senior's demands and protect them from themselves. The state will place the OP's mother whether she wants it or not if there's no one to take care of her at home.
Good luck.
There's no fear of a lawsuit if a person has been declared mentally incompetent by a doctor. Care facilities get hostile transfers every day and just deal with it if a POA or conservator/guardian has someone placed.
How many elderly people with or without dementia willingly go into residential care? One in a million maybe. These places know how to deal with hostile transfers and they don't fear any lawsuits.
Then he needs to sit down with a good Elder Care attorney to talk about the nonsense in an advance directive about no managed care for an incompetent elder with dementia.
Good luck to you.
When he is removed as POA, your mother becomes a Ward of the State. Then her court-appointed conservator will put her in memory care.
Don't you think most seniors would make an advanced directive refusing AL, memory care, or a nursing home if it could actually force their family to care for them at home? It can't.
Your brother can easily resign as POA by signing documents at the probate court. I was a POA for a mentally ill relative for a time. I couldn't take it anymore. So I went to the court and signed documents removing myself as their POA. I did not need their permission or anything else. It was easy. Visit the probate court with your brother and in the meantime, put in a call to APS tell them what's going on. Visit the local police and ask them to do wellness checks on your mother. They will and they will call APS too.
Worth a TRY, as a much easier route.
Next, both Assisted Living and MC are not medical care, they are custodial care. If they are considered medical care then health insurance, Medicare or Medicaid would cover it, and none of them do. There's nothing medical about living in a room and having meals prepared for you. I don't see why anyone would honor this ridiculous inclusion to her paperwork. That lawyer did it to humor her, or she did a DIY document.
If all else fails your brother can resign his PoA and reports her to APS. This paves the way for the courts to assign a legal guardian for her. They will get her appropriate custodial care.
Now advance directives do not consider choices for care in future.
That is because someone may need care whether they want care or not.
So it is fine to refuse "heroic" measures such as dialysis, heart transplant, invasive surgeries, ventilators, and etc.
But one cannot make a directive that is "suicidal" if you get my meaning, because suicide is not lawful. If competent, one can refuse food or water and do a VSED exit by stopping eating and drinking, but if INcompetent, then the POA takes over.
Your POA for the mother will now have to arrange care for her so that she isn't in danger of death caused by being alone and helpless.
Hopefully that will make some sense. There need be no heroic measures to prolong her life, and in fact if the doctor agrees she can be put on hospice care.
As to a memory care that won't allow a POA to place an incompetent person due to some that silly in an advance directive (which I as a NURSE never heard of in my life, having read some 1,000s of directives)? I can only say I really can't imagine such a silly place (and in fact find it quite unbelievable; I think there must be a misunderstanding somewhere here).
So I would simply choose another nursing home.
Don't worry, no social worker will allow an old, incompetent woman to die in her home because of something silly written years prior.
Things are no longer in you dear mom's hands; when we are incompetent there are legal means of having our needs acted upon.
Just a PS here:
Now that mom has been DIAGNOSED as incompetent brother does need to remove the keys and the car. Part of his duties as her POA for her own safety and the safety of the general public. Your mom at present is somewhat of a lethal weapon brother is responsible to contain.
I would, in fact, given the level of misunderstandings of what POA is and is responsible to do, suggest a visit for an elder law attorney and getting some of these issues ironed out. It will be well worth the money whatEVER the cost.
Don't worry.
If not, the attorney could go over the details of the process of how your brother could drop POA and then have the state appoint a guardian, if you were to go that route.
either way I think an attorney is going to help you a lot