What happens if there is no POA?

Lay it on the line: “just to be sure you are ok with no POA and the state takes over plan” lets go over that process step by step. Please take a moment to think if that will really be in your best interest.”

Boy u have a lot on your plate. So sorry about ur sister.

Have you told your MIL what it means if she does not have a DPOA and Medical Directive in place? It means that State can take over her care. This means she can be placed in an AL if she has the money or LTC if she needs Medicaid. Her house can be sold and her money overseen by a stranger who tells her where she will go and how her money is spent. Wouldn't it be better to have her son as DPOA and Medical POA. And I think a DPOA is immediate and should be at her age. You don't need a doctor to make it effective.

If after telling her that and she still won't be cooperative, say OK Mom if u want it that way, I will honor it. Then let it go.

Yes Way, tell her she could be put in a crappy NH.

Explain that POA is a tool. As long as she is considered competent, she still will be in charge of her life. (Immediate I still think they are in charge just that you don't have to get a doctor involved when she does become incompetent) In both documents, financial and Medical, she can say what she wants and doesn't want. Tell her you cannot touch her money unless its for her. Also, having POA does not mean you have to care for her physically or be at her beck and call. When her money runs out, you are not obligated to support her.

You may want to explain to her how it works without a POA. She is in the Hospital and transferred to Rehab. Its found in Rehab that she needs 24/7 care that ur not willing to give. Rehab will not release her to her home, its considered an "unsafe discharge". Since she does not have POAs in place, the Rehab will notify the State that guardianship is needed and one will be assigned to her. She nor you will have no say it what happens to her. You can visit but the guardian, a stranger, is in charge. If after explaining all that, she still does not want a POA, then let it go.

Has she seen a Dr about her being so hunched over. I had a friend who had scoliosis in her back and was told if she did not allow an operation, her ribs will push on her lungs and cause breathing problems and death.

My mom is the 4th person I have cared for also. BEFORE I agree, all paperwork must be in order, POA, will, medical directive, ability for me to pay their bills. No POA= no care. Most financial institutions want their own paperwork filled out and signed. Do it BEFORE dementia is obvious. With my brother I delegated securing SSD, proper checking account for deposit and handling the day to day stuff at the nursing home to my father. I've been alone in my role otherwise. My kids have helped as they are able, mostly with tasks around my house to make my life easier.

You must already know that if she is thinking and acting more irrationally right now than she had acted when she was younger, say 10 or 15 years ago, that NO ONE can “make her accept help”, and NO ONE will make her cooperate, and SOMEONE will ultimately be the individual to pick up the pieces, make the care arrangements, and arrange for the testing that will reveal that she is no longer competent to manage and be responsible for her own affairs.

None of the tantrums, tears, insults, threats, and whatever else she chooses to do will matter if she’s fallen and sustained an injury, started a fire in her home, or demonstrated in any way that she has lost her capacity to manage her own affairs.

So there’s that.

I’d seek out a meeting for your husband and yourself with a well versed and well reviewed lawyer who specializes in geriatric care. You would at least have a “baseline” concerning what if any your responsibilities actually are, and also know her actual”rights”.

State laws vary. Start with law. You need to know.

Without a PoA and a medical diagnosis of cognitive and/or memory impairment, there is nothing your family will legally be able to do in terms of making decisions on her behalf. Sure, you can set up auto payment of her bills through her bank portal but this doesn't solve the imminent problem that is eventually coming, which is her getting the caregiving that she will need.

So, she will need a guardian and that would be either someone from your family or the county. No one can go on without a legal representative. If you pursue guardianship through the courts, be aware it is very expensive. It is possible it can be paid for from her funds (but only after acquiring guardianship). It is also time consuming, and she won't be cooperative but will need to probably appear before a judge to assess her capacity to care for herself. I would consult with an elder law attorney for sure.

What happened with my stepFIL (with Parkinsons and Lewy Body Syndrome) is that when things got bad enough for him at his home we called in a county social worker who assessed his needs. They stepped in to acquire guardianship. At that point the guardian has all the authority and the family was blocked from all his financial, medical and other accounts and affairs. We were still welcomed to interact with him as family -- we just had no say in what happened with any decisions. Your Mom's house is one of her assets, so this comes under their authority as well. The guardian was Lutheran Brotherhood Family Social Services (in MN), so not a single individual.

If your MIL actually has a Will please have her give the Executor a copy, or have her tell you what attorney wrote it up.

Elder law attorney would get guardianship for the son, or conservatorship. He would assist with filing court papers; it is a court action. You would need letters of incompetency from your Mom's attorneys. That is a much better way to go than putting your name on accounts, which melds assets and gets sloppy for record keeping, taxes, application for medicaid if needed.
You should in any case be seeing this elder law attorney to ask about the inadvisability or the advisability of selling this home prior to Mom's death to pay for care. It may be better to get her on medicaid and allow their doing clawback at the time the home is sold after her death.
As there is no will hubby, as next of kin, would also have to see an attorney to apply to be administrator of the estate (an executor when there is no will nor appointment) and handle probate in that wise with or without the ongoing help of the attorney.
Sure wish you luck. The elders are keeping your husband busy.

seek a lawyers advice on this.

The usual route would be that the courts appoint a guardian ad litem to handle her affairs. This person would not be invested in her wishes but would make sure she was competently cared for - usually in an AL or SNF per a doctor's order. Usually a competent and less expensive place is selected. All assets would be liquidated to pay for the care. Once her money is gone, she would then be able to apply for Medicaid.

Better she gets a person she trusts - a person who knows her wishes well - to be her POA for medical and financial affairs.

Beg her to get the POA, to protect her assets, if nothing else. My sister became incapacitated two years ago (due to a hyperglycemic coma), and it has been a logistics nightmare. I had to pay $4000+ to an elder care attorney and attend court proceedings to be awarded legal guardianship and conservatorship. It took about 5 months, during which time I had no access to her bank account to make sure her bills were being paid. Thank goodness she had everything important on autopay. Her other sister and I paid other incidental costs (such as nursing home expenses and upkeep to her home) out of our pockets.

The awfulness isn't over once you receive guardianship. I had to petition the court for permission to pay all ongoing expenses, and now I have to petition the court each time a new expense comes up. Each petition takes at least two weeks to be approved. Also, I have to pay (out of her funds) $2,000 each year to a "surety bond" insurer. Basically, it's a court-required insurance policy to make sure I don't steal her money. The thing is, I'm NOT GOING to steal her money, so it's just throwing $2,000 into a fire and watching it burn each year.

Finally, if you have to sell any of her property--as we did, to continue to pay her medical expenses--you need to ask permission of the court (takes multiple documents, a court hearing, and many weeks), and then when you sell, the proceeds from the sale are transferred into a restricted bank account, which you have no direct access to except for being able to see the balance in a monthly mailed statement. You have to petition the court every time you want to withdraw money out of this account, which takes another two weeks to be approved. However, we haven't gotten THAT far. We finally were able to sell her property in December, but the bank where we opened the restricted account (the bank my sister was already using--wouldn't have been my first choice otherwise) isn't supplying the court with some stupid form. So, the funds are still off limits. I was informed by my attorney that the court has asked the bank to send this form multiple times. If they don't comply, I'll have to have the money moved to a NEW bank and start all over again.

This snafu will be incredibly costly. I and my partner had paid for her caregiving expenses in the middle of last year, with the intention of paying ourselves back out of the land sale proceeds. Once we paid ourselves back, that money would be tax deductible for my sister as medical expenses and would offset capital gains taxes from her land sale proceeds. Because of the bank, we have missed the window for that. Because of the bank and the court and all the rest of it, it is likely to cost an additional $15K in capital gains tax as a result.

I do have access to other accounts, so have been using that money (money I already have permission to use for medical purposes) to pay for her ongoing caregiving expenses. Because she did not do well mentally or physically in a nursing home, we have brought her home to care for her here, and bring in caregivers. But after nearly two years since this all started, I'm beginning to wear down. This long onerous process, with all of the paperwork and additional expenses that are required, is EXHAUSTING and adds immensely to the depression and burnout that caregiving already entails.

Please show your mother this message and tell her how I cry regularly because of not being able to take care of my sister's overall expenses and property upkeep more fluidly and having to ask the court to do anything on my sister's behalf. Tell her that the lack of a POA has cost me more than $10K to set up the guardianship and pay initial bills and my sister more than $25K in legal fees, surety bond fees, and additional taxes due to having to wait for the bank and the court. Tell your MIL that designating a trusted POA makes an already difficult process so much easier. And she simply does not know what lies ahead. My sister certainly didn't.