My mother is 91 and very competent. However she is financially irresponsible. How can we get control of her finances for her care?

Medicaid was established for the truly needy. Not for those who simply waste their assets and spend at random. The look back is primarily for gifting and asset transfer. However, Medicaid can question what large checks are written for. And the rules are headed for a major tightening in 2020 and also large cuts to the Medicaid program itself.

Yes a lawyer is needed plus a notary to draw up a durable POA for finances, but that window of opportunity sounds closed. The only other thing you can do is file with the court via a lawyer for guardianship, but that would mean having two doctors testify that she is incompetent. That normally costs $5,000 and I have heard it said that you can repay yourself from the person's money once you become guardian. I'm not sure of that.

No one that I've read has answered HOW you get a hold of her money. (except the ones stating to go to an elder care attny) but who's going to pay for that?? I've read replies that say the POA should be in charge of her checks/money.. I'm POA to my Mom but it's for medical only. There were papers at the heart hospital that she signed and the nurses witnessed. There was no lawyer, so I'm assuming a lawyer is needed for a Financial POA? My mom is no longer competent enough to make good decisions on things but I'm only on her checking account as POD, payable on death. How do I get my name on her checking account without going to an Elder Attny? I doubt the bank will just put me on if I take medical poa papers in to them? I hover over her when she writes checks, as she writes in her check register the same check number 3 or 4 times or the wrong amounts and I have to correct it. but she's also 'here' some of the time and doesn't think I need to be on her account. HOW do I get on her account? If I'm not mistaken Catscall15 that's something along the lines of what you're asking?

First - from what I am reading your Mother IS NOT "91 and Very Competent". No one in major debt and physically not capable of taking care of themselves is truly "competent". The fact that she cannot understand and accept that she is responsible for her own bills (not your sister or your nephew's responsibility) is a major indicator to her lack of compentiency. You say your sister has POA. Is this a durable POA? If so, your sister already has control of your Mothers money. See the attorney who drew up the POA and get clarification on just what it says. Does your sister have rights to sign checks for mothers bills. If not this should address immediately.

As much as we love our elder parent(s). we must also see them for who they actually are at the advanced age of 91 and what they are still capable of doing. Help your sister find a good AL in your or her area. Or higher a good In Home Care Agency. You could end up burying your sister before your mother as this stress, etc. is dangerous (ask me - as I finally found out just how it has affected me and I am now doing what I need to do for myself). And yes My Mother did not completely understand just how her behavior affected me. She did have dementia. Which is something you can address with her primary care, along with her current behavior and medical needs. Realizing dementia is very sneaky and is never obvious in the beginning. Getting it diagnosed is not that difficult with assistance of her primary care.

Take each step in getting under control with love in your heart, determination to provide the best for your mother, but accept it may take some serious changes for all of you. Hugs, love and prayers for each small successful step in moving forward.
Mom will probably fight you all the way on these things. Talk with Sis and present a UNITED front with your mother. She may try keeping you (and nephew) divided in order to get her way. Stay UNITED and it will be easier for each of you.

Your sister is the Only One, Hun, POA, Who Would have this Authority to Try and Help with This. But as Long as Mom is Strong, IT can go On until her Death and Then...Living Trust Kicks In...Would That Then Be Sis?

You need to hire an elder law attorney. She will be the one paying for her own care.

EC attorney is the best option. Although you provided some back ground, what exactly is a 'living trust'? Mom and dad had a revocable trust back in the day. Later we went to EC atty and set up irrevocable trust, with mom as trustee (dad was needing more help.) Even later, after dad passed and mom started down the dementia road, we set up a new irrevocable trust (she cashed in the other, unbeknownst to us, and put most of it into CDs, earning less money) and put her condo into a Life Estate trust. The latter was, in the end, a bad idea. We needed to sell it before she passed (96, still ticking) and it has ramifications. But, for the "liquid" assets, i.e. cash/CDs, including the proceeds from the sale, all went into the trust and we children are the trustees. WE can use the assets for her benefit, but basically she entrusted everything to the trust and is NOT allowed to touch it.

You also say nephew is executor - generally that term is used for the person assigned to handle the will and assets after death. Do you mean he is the trustee of the 'living trust'? If so, then most likely HE is the one who has access to the funds, not mom. But, it all comes down to what is a 'living trust'? Looking it up just now and reading briefly, it appears this is a revocable trust. At any time, if mom disagrees, she can revoke it...

Again, your best course of action is consult with EC atty - S/he may have a course of action that can be taken. Even with taking control of mom's house sale money, there likely won't be enough to last very long. AL isn't cheap (we had to go to MC, which is more expensive), but mom's condition might require NH, not AL. When I checked our area, the least expensive was $15k a month!

You say that your mother-in-law is very competent. Then you say she is bedridden and is using money completely inappropriately, is not paying her own bills (why in the WORLD does the Nephew pay her bills out of his money?).
So I am begging to disagree with the diagnosis of competent and I think it may be time for the woman to be examined by doctors for competency.
Dependent on the outcome of these exams it is either a walk away moment (should she be adjudged competent but still refusing to pay for her own care) or a moment to seek guardianship, placement, and management of her finances for her own care.

The Nephew being an "executor" will not figure in anything until this lady dies. The Sister she lives with, being POA is what interests me, as you say that the Mother is refusing to pay her bills, and etc. Generally it is the POA who handles the bill paying for the person, though of course if this woman IS competent she certainly can direct the POA to obey her wishes.
IF the Mother is refusing to pay any of her own bills I would myself not serve as her POA. I would be aiding and abetting fraud by a person taking services and refusing to pay for them. And she certainly would not be living with me. She would be in care, and whatever happens with her and her bills after that point, if she is in fact competent, is on her.
You can only do so much. But the short and sweet answer is that if she is competent you cannot do anything about what she does about her money. Sadly, someone paying her bills for her means she has no consequences of her actions.

First, you should check into putting a lien on existing funds to reimburse bailout of her bills! You can always choose to then use your money to fund a Trust for Personal Expenses and another for Medical not covered by insurance...like OTC meds that are needed!

Ypu might need to break the following exercise into 2 parts:
What will her SS pay for? So she sees how she sill5 live when house $ are gone.
Then her house windfall.

She grew up in an era when family always cared for their elderly. She obviously feels she was owed having her debts paid off...or that the executor will get it back when she dies. Not true on most cases.

Set up the DR table with stacks of real or photocopied cash. Start with all the money in cut out of her house. Then take away debts paid off by family. Put it on a black piece of paper or in. Shoebox. She owes that money...or Medicaid will take it before paying future medical needs.
Set places for increased utilities (extra person in house), food, her personal supplies..toothbrush, toothpaste, shampoo, etc.

She probably needs the visual not a lecture! She sees herself as A)Having stumped and saved and spent on her kids& now is Her Time or B) She had a standard of living to which she feels entitled and you are trying to take her money.
She needs to see visually how much all of this costs. In many areas utilities have recently jumped. She probably never paid for car maintenance, repairs, plates etc

Also have her plan the kind of funeral she wants. Go to several funeral homes. Do this first then have a pile of box for her funeral costs. She needs to see the money disappearing. Take away money she spent, by category, since the house sold! She probably does not realize how much went to closing costs. In her head she thinks that money is still somewhere. Het cost for LTC insurance...and costs of what it won't cover...maybe put the LTC costs on a side table...again visually not $ you are spending now...but need to be spent...like the funeral funds.

It is her money..if it doesn't belong in the trust...

So when you both can see what is left, let her decide how she wants to budget it. Use green paper for catagories she spends on or wants to spend on. Ask her how long She thinks she has to live. Use envelopes to divide that money into months left!

In her mind she sees a pile of Her $$$ for what She Wants..Now! Her reasoning is like a child at Christmas.
She should get a pile to splurge now...she deserves it and it will help her feelings of being controlled. But let her see how small that pile is& how she is taking from her future fun & clothing $ to put $ in the Splurge pile.

Plan this out ahead and it will be very useful. Numbers on paper don't have the same impact.
It is worth the Splurge to copy actual bills, rubbernbands, construction paper,& envelopes. Male sure you make them all the same denomination!! This is a visual exercise! Of a dollar & a 50 look the same, she will not get it!
I have done this with many clients. All ages. It is visual and tactile...have her count out and put $ in the piles! It makes it real!

Known expenses should be written on the boxes or construction paper for her to count out the $ and move it there. The only questions should be on what She wants...for the funeral...how often to the hairdresser...new shoes..etc. And how long does the money need to last.

KatieKat raised an important issue as to whether funds from the sale of the house should have been available for your mother's use or were destined for the trust.

How was the house titled?   With your mother as Trustee (or Settlor), of her Living Trust?  If so, then the funds should be handled in accordance with Trust dispositions.

Since your brother is executor of a Will, this suggests to me that Pourover provisions exist, linking the Will to the Trust.   

And it may be that the funds are designated for the Trust, but your mother as existing Settlor/Trustee has free reign over the funds.    And if so, and if she's spending those funds now, the Trust wouldn't have the benefit of those funds when she passes.  

It's worth checking out.

Regardless, there could be some complex issues here, depending on the

If I had a nickel for every time I heard "it's MY money, I'll do what I want." Finally got it into her head she couldn't give it away to SILs and why. Asked MIL what she thought it cost to live in AL, 800 or 1000 cuz they feed you and no other bills, plus they do your laundry.....um, no. Gave her the true prices, asked her where she thought the extra money would come from, her daughters? Welllll, no they couldn't help, my son would have to pay. Told her not going to happen if she gives them money and she needs help. It's HIS money to do what he wants to, nope, it's mine too, I worked hard to save enough to retire (also financially supported her since 1995) Has anyone sat down with her and talked about her finances and what she is doing to herself and her family? I hate to say it but all junk mail needs to be put thru the shredder immediately after coming into the house. You may be able to block tv shopping. Does she have a cell phone? Put "child" guards on it so she can't shop online. Hope you locked her house sale funds up in a CD, sorry mom we can't access that money until it matures otherwise you will have to pay the bank a penalty fee and you'll lose interest on your money. Talk to an elder law attorney. Did the person who paid her bills have a verbal agreement with her that she would repay him after the sale of the house? Lawyer should be able to help with that problem so it is not considered gifting on her part. Was she or her deceased husband a wartime veteran, honorably discharged, she may have access to benifts for care thru the va. Make sure mom spends money on things she needs ie, hearing aides, dental work, glasses etc. before placement or while self pay at AL. as money is spent down she will get to the point of Medicaid eligibility. Look into programs your state offers for disabled seniors. Senior center has alot of information available and can also help with the paperwork. Sister can charge mom rent, have lawyer draw up rental agreement for her to sign. Extra costs of what it takes to run the household and standard rent for a bedroom in that area. Most bedroom rentals are x amount a month plus a part of the utilities depending on how many bedrooms are in the house 1/3, 1/4, etc.

I see you’ve already said that you’re going to consult with an attorney who specializes in elder law. That’s the best thing you can do. I wish you all the best.

It's her money to use as she pleases. If she uses it up, she can go on Medicaid. Back off!

Are you sure the sale of the home money is not supposed to go into the trust?

I'm trying to wrap my head around the practical realities of this - if she is truly bed bound and sister works who is caring for her during the day? How is she getting meals? How is she going to the bathroom? How is she gaining access to her credit cards and managing to blow her money with frivolous shopping sprees?

I wonder if you all have been trained throughout your lifetimes to jump when she barks, because the person who hold all the power her is not your mother, she would be very wretched indeed if your sister chose to play hardball and cut off her access to the phone and internet. And no, that wouldn't be abusive so long as eyes were on her throughout the day (human or virtual) and her basic needs were being met.

Your nephew ought not to have paid off all her bills with his own money. That just means that your mother now owes her grandson that money. You, you the family I mean, had better get all of these transactions documented and straightened out before things go haywire and misty and hard to track, or that lad will be seriously out of pocket.

You say your mother has "all her wits about her." Really? What sort of person who has all her wits about her does not understand that she must pay her bills? Is she a fraud, is she almost psychopathically manipulative, or are you calling her stupid? Because if it isn't one of those unpleasant things, then you are saying that she cannot understand the significance and operation of money, which does not equate to having all her wits about her. It means that the financial wits, at least, have gone missing.

What sort of POA does your sister have?

Sounds like a circle of codependents here, why in the world would your nephew pay her bills? Hopefully he had enough sense to make a claim to the POA for his money spent on her.

Is your sister on her checking account? If not, get that done like now. Someone needs access to her money to be used for her.

Tell mom that she needs to pay for in home care, if she refuses then she will need to be placed in a home, these are her two options, set your boundaries, and stick to them. She is manipulating all of you.

She is managing you all by FOG, Fear=Obligation=Guilt, time to stop the cycle and get back in the driver seat. My best!

Your nephew needs to be reimbursed for the bills he paid off for your mother with his own money.

You are a good sister for being so concerned for your sister. Your mother needs to get out of your sister's house, and it sounds like she needs a skilled nursing facility.

Will she qualify for Medicaid once the money from the house sale is used up? What is your mother now spending it on?

Please consult an elder attorney. The sticky part here is that your mother is apparently still of sound mind.

As a first step can your nephew not make a claim against her for all the debts he paid - at least that would put some of it into someone else's care. Then could you arrange a meeting with her, her Dr and an accountant who specialises in elder management and let them draw up a conclusion having met her and discussed her needs and her monies. As a last straw if she refuses to pay for care where she is - which ever of you she is living with - tell her she will have to go into a facility because sister cannot manage. - you are in the fortunate position of having money, so many on here are without any assets. She needs to pay for help or pay a facility (and make sure she signs the papers). Tough love needed.

Why in the world would your nephew pay off her bills with his own money when it appears she has the income. At the very least I'm sure your nephew repaid himself after the home was sold. I would suggest contacting the local social service agency or a state social worker and get them involved. Maybe an outside authority telling her what she needs to do will help getting her compliant. at the least, they will see she is a vulnerable adult in need of care.

repeat sorry

Why do you think she is competent? Sounds like she can't understand her financial situation like a business person would. That's not competent. Get her evaluated by a geriatic doctor or psych for competence and before the appointment tell him or her what is going on. Y'all need to stop paying her bills for her. That will be a wake up call if she is really competent.