Who is responsible for finding a nursing home or long-term care for the aging parent: The adult children or the health care proxy?

The only clue about the mother's condition is that her doctor has deemed her unable to make medical decisions, and the Health Care Proxy has been activated.

That would seem to argue that there is some degree of cognitive impairment.

HCP needs to :

Get an accurate measurement of what level of care her/his mom needs

Work within the limits of mom's resources to secure care.

Resign HCP if s/he cannot work with financial POA on how to pay for care.

Or take the issue to court to force POA to use mom's resources for her care.

If there is a reverse mortgage, then the minute the 'mortgagor' goes into an assited or nursing home, the amounts due and owing on the reverse mortgage are due at that time. NOT when the home is sold. If contemplating taking out a loan or reverse mortgage, mother would need to be fully competent to sign paperwork but doubt a lender would approve given her age and health conditions. If poa remains in home, who will be paying for the everyday upkeep and long term maintenance? Property taxes? Insurance? etc. Don't use your mother's assets to pay for the place if she is no longer living there.

And should mother be admitted to a facility, POA staying in the home could create a tenant situation, and could become a squatter - and in some states, like mine, the squatters have more rights than the actual homeowner. And then THAT becomes a messy and expensive battle.

Consulting with an elder attorney is the best move, who can guide you along the way. Well worth the cost.

dnajaras: Your aging mother should pay for her own care from her financials.

Retain an elder law attorney.

It's me again...just to reiterate when "help" services are brought in for the loved one, they are only there a short time.

For example, the nurse, home blood draw, physical therapist, occupational therapist, etc., they are not on duty 24-7. It's the person who lives the elderly loved one.

The one left doing the hands on caregiving--in the trenches on a daily basis coordinating everything needs to be still standing after everything is said and done.

Another family meeting--does your brother plan on buying all of you out. Or, are you will to wait til he passes to get your share. Also, in all honesty, have you checked out some of these facilities--nursing homes.

After the Pandemic, every place is depleted. Most of the residents are heavily medicated and the places stink of urine. Usually the lobbies are lavish but check out the place at night time.

Every place is short-staffed, overworked and underpaid. It's not that easy. Say to yourself, could you live in that facility 24-7?

I was flabbergasted when I went looking even in the best places. They can't get the help because they don't pay anything. There are better ways to make a living than working as a CNA.

The people who own the places make the $$$ not the workers.

Help your brother in whatever way you can.

If your Mother is of sound mind she can refuse being admitted to a NH . She makes the decision .

Duties should be shared. Sharing is caring.

Good Morning,

I am in agreement with Justwow123. There are 4 adult children; share the wealth and share the care...Amen.

A question, if there are 3 of you, why are you not willing to split up Moms care?

Has dnajaras answered this question? I feel like it has been asked several times and she skates right by it.

In answer to your response to me.

Caring for Mom is one thing but I would not care for a brother. I would find options first. I oversee a disabled nephew. For now he is able to live on his own with help from the State. I am 74 to his almost 34. I will never be his Caregiver. When that happens, his care will be turned over to the State. I am sure his deceased Mom would have expected her siblings to care for him until his or our deaths but we are all retired and getting older.

Never feel you need to care for your brother. Don't let him tell you you need to. My mantra:

I am here to help people find a way, not be the way.

You’ve already met with an attorney so you have your answer. Is your parents home set up an a trust or a life estate? I would recommend that happen ASAP. Speaking from a caregivers perspective you are very lucky to have your sibling taking care of your parents and living with them (if they are doing what they are supposed to). The rent free part is not enough compensation either. Taking care of an elderly parent is the hardest job in the world, people who are not on that side have no clue. I would have to side with the sibling who is taking care of the parent. Let the parent go to nursing care, protect the assets by Setting up personal service contracts and then applying for ICP Medicaid. That will pick up the tab 100%. Nursing homes are $10,000 a month I am sure you can calculate the math. As for the house again it should be set up in a trust or a life estate that way when the parent passes it will be spread among the siblings equally. If the other sibling wishes to continue to live there than they should be paying for the maintenance and upkeep of the house. If you don’t want that to happen go back to your attorney to ask what to do next.

The one big question you have not answered is why brother has been living with Mom? And why does he feel he does not need to pay rent? Does he pay for anything? Does Mom support him completely?

Does he work? If not, why not. Is he disabled in some way?

If you would give a better overall picture of what is going on, you may receive better answers. And, there will come a time when Mom may not be able to get her wishes met. It will be what she needs not what she wants. And you three will need to figure out if you want to sacrifice to keep her wishes. She will become 24/7 care. She will need bathing and toileting. She will be incontinent, paranoid and have hallucinations. Its a big responsibility to take on.

Good that u finally consulted with an attorney about your responsibilities as a Medical POA. But the only solution I can see here is one of you becoming Moms guardian. Brother's POA will be revoked. Its pricy but maybe you can get a loan and the rest of the siblings can pitch in paying the loan off. You all could be guardians but really better only one.

Taking out a reversed mortgage is not a good idea. I am not even sure a POA can do this. Me as a Mortgage lender may not allow it. Mom is not able to sign a contract. And as said, once Mom is no longer in the house, the loan will be called in. Continuing to take out loans is not the answer either. There's only so much equity in a house and those loans need to be paid back on a monthly bases.

Mom's illness is going to get worse. To the point she will need 24/7 care. That is very expensive. No one person should be expected to give Mom that kind of care. You have options. Medicaid "in home" is income based. If Mom fits the criteria, maybe you can get an aid in. Call Office of Aging to see what they offer.

Realize that brothers POA gives him the ability to place Mom. But by doing that he may be cutting his own hand off. Because, him living there for ten years and even saying he was Moms caregiver will mean nothing to Medicaid if he can't pay bills, taxes and upkeep on the house. Once on Medicaid, any Social Security and Pension Mom gets will go towards her care. So him pushing for Mom to go to a NH, does not mean he will be able to remain in the home. He needs to realize this. It may mean he will change his mind about placing her.

Does Mom have a Will leaving her home to all 4 of you? That may be another problem. Even though a house is exempt for Medicaid its only that way while Mom is living. Once she passes, it becomes an asset that Medicaid can recover from. Its one thing if brother was an only child, he may be able to stay in the home and then Medicaid will put a lien on the home. But there are 3 other children in ur situation that are entitled to their inheritance. So with me, Mom still had her home when she passed. She was on Medicaid for 3 months total recovery by Medicaid 6k. The house had tax liens and I had out of pocket. At time of sale, all liens and out if pocket were paid and the balance if proceeds were split 3 ways. This is a question for your elder lawyer. How does brother fair in all of this. I am just rambling here but IMO as Financial POA brother is the only one who can make decisions about Moms care. I do think he needs to look into his rights about being able to remain in the home if Mom goes into care or passes. He may find out he has no rights. I really think, from ur posts, that he feels he has lived in the home 10 yrs, he is entitled to stay. He maybe surprised to find out that may not be true. If Mom dies, for him to remain in the home, he may have to buy the rest of you out. And if he can't do that, you maybe able to force a sale. POA is over once Mom passes. Then an executor or administrator takes over. No Will, the State determines who inherits.

A question, if there are 3 of you, why are you not willing to split up Moms care?

One post says brother has been living with mom for 10 years, now it's forever. Come on!

Brother is struggling with major medical conditions now and the only concern of the absentee sibling is that she doesn't have to do anything about the situation, all under the guise of not putting poor momma in a nursing home. No offer to take momma, just trash the brother that has been the boots on the ground caregiver for 10 long years.

OP, shame on you for all of your manipulative behaviors.

Perhaps I missed the answer to this question on a previous thread.
But I had suggested another sibling take Mom in with them if you are all so adamant of Mom not going to a nursing home . Has anyone offered to take Mom in ? Is anyone willing or able to do that ? I’m not saying anyone should .
I just don’t see paying for caregivers to be in her own home sustainable .

Maybe I’m wrong , I’m not a lawyer , but it boils down to who is POA which is your brother . If you don’t keep giving money to pay for caregivers at home he says he will place her in a facility . I don’t see that changing .

Right or wrong this is what you are left with
1) you can keep paying out of pocket for caregivers for Mom to live in her own home .
2) Another sibling takes Mom in with them , if Mom is willing .
3) You stop paying for caregivers in her home and POA brother puts her in a nursing home.

You and your sibs will have to decide which approach to take.

Your mother’s ignorance , which is common , is what set this up . She should have gone to a lawyer and it had put in writing that your brother was a tenant and would have to eventually sell the house to pay for her care if such care was needed. But that would never occur to her because in her mind she was never leaving her house .

The FPoA has all the power here. The others shouldn't pay a dime to keep her in her house. BUT, if she doesn't qualify for Medicaid (meets financial and medical criteria) then there is still a facility to pay for. Nonetheless, it should come from her actual assets (and not loans, or a reverse mortgage). This may mean selling her house. If he doesn't do this and the others stop enabling him by giving money, then eventually he'll have to make a decision. "Bullying" adults? Please... he has no power over anyone unless they voluntarily give it to him.

All of your questions seem to boil down to you have a recalcitrant brother who - at least according to your somewhat vague descriptions - wants to remain in your mom's house after putting your mom into managed care, for which he doesn't want to use mom's assets (ie. the house he is currently living in) to pay for; but rather wants his siblings to pay for care out of their own collective pockets. You keep asking what can be done about this; I'm very sorry, but if you've seen an elder attorney, you should already know what your ***legal*** options are. No one here is going to have the magic words you seem to be hoping for that will convince your brother to "do the right thing".

The only thing you really can control now is how much are you, the rest of the siblings, willing to kick in financially. You say he "attempts to get his siblings to pay for her in-home care by bullying and unreasonable demands." Well, in my book there's a simple solution to that - tell him no. You will not be willing to kick in any more money so long as there is a house that can be sold, and those assets used to pay for mom's care. That is not an unreasonable answer. It is not an unkind answer. Whether or not you can afford to continue to finance this situation - and most people can't afford to finance something like this in the long term - is not the point. Mom's assets are used for mom's care. It's a very simple concept.

Insofar as your brother "not willing to take out any more home equity loans or a reverse mortgage loan and has for the longest time" - there comes a point when there is simply no more equity left in the house to draw on. And those loans have to be paid back. If he takes out a reverse mortgage and then places mom, most of those loans have language that states the owner of the home (mom) needs to reside in the home, otherwise the loan can be called in immediately. In which case the loan company will force the sale of the house, if mom can't come up with the money to pay back the loan. It could very well be that, if your brother has taken out multiple loans on the property already, he and mom are struggling to pay those loans now.

As hard as it might be, your only option at this point might be to walk away financially and let mom and your brother sink or swim on their own. Are you and your siblings willing to do this? I don't know that I would be able to, to be perfectly honest. But unfortunately, it might be the only way out of this quagmire.

As is quite often the case D, your question isn't making a whole lot of sense, so I think it is best to refer you back to the Attorney in your area.

Health Care Proxy's don't have control of financial things in almost all cases. So they wouldn't be do placement care.

It is important to know who the POA for financial, the general POA is in this case.
I think that isn't you.
I would allow those doing the POA financial work for this elder to handle things with the attorney.

I'm no attorney, but I seriously doubt a POA can take out any mortgages or home equity loans in someone else's name, so that's not an option unless you learn otherwise from a bank/lender.

The POA's job is to use the parent's assets for their care, but that might mean selling the house. The remaining siblings aren't obligated to pay for care at all. Selling the house would get the squatting POA out but give them access to all of Mom's assets from the sale of the house.

What you should be doing as siblings is demand a monthly accounting of Mom's expenditures and to see her bank statements. Technically you don't have the right to this information, but maybe your POA sibling won't know this. You can also have a lawyer write a strongly worded letter if you believe her money is being mismanaged.

Is Mom completely incompetent at this point and unable to assign another POA? If not, you might work on her to change her paperwork or add a second child to the POA. It's rarely a good thing to have co-POAs, but it might keep the squatting sibling in line a bit more.