Helping Aging parents

[sturge]

Tough discussion for sure. Until recently my MIL (91) has lived alone 5 hrs away in central Maine. She has done remarkably well in this situation since her husband died 16 years ago. Wife is only child so they always talk 2X/day and are very close. I recently brought her down to our place (CT) in Sept for a 1 week visit. She got very sick and was bed ridden for 3 weeks. After finally getting her hooked up with much better medical expertise than she had in Maine, we now know she has a "severe" case of COPD. Suddenly, we all realized she can't go back to Maine to live on her own.

We have a new member of the household. I converted dining room into a bedroom (all other bedrooms are on 2nd floor). I've hung a couple of doors, wired up Cable TV, etc. We are fortunate she has come to grips with the reality that this is her new home. She is of sound mind and is all for the POA so we are moving in that direction soon. There is a will and we are working through all accounts to ensure wife is named as beneficiary, looking into adding wife to car reg, etc. I've made multiple trips to Maine checking on her house. At some point we need to sell. Good luck to all...this is tough!

 

[OldShooter]

Most states have centralized information resources for seniors. I suggest you find the one for their state and make contact. Your phone call will not be a new thing for them to deal with and they may be able to point you where you need to go.

For example: Council on Aging , Services For Seniors | Council On Aging Services For Seniors | Santa Rosa

 

[RetMD21]

@JBTX, just to make sure the vocabulary is correct, you want to get a durable power of attorney.

.....If you have online access to your parents’ accounts without a DPOA or a conservator appointment, then you’re technically violating the law. However if you’re acting in a fiduciary manner for your parents, and if the financial corporation can officially ignore what you’re doing, then you’ll probably get away with it.
......

A general DPOA is ok but in my experience banks (and Vanguard) prefer their own form. It can make your life easier. Also they are not necessarily fussy about assessing mental capacity they just want signatures. Electronic access is great. One time I wondered if the bank employee really thought she was text chatting with an actual 88 year old. She didn't ask and I didn't volunteer excess information.

 

[JBTX]

@JBTX, just to make sure the vocabulary is correct, you want to get a durable power of attorney.

A regular power of attorney becomes invalid when the grantor is no longer mentally competent. You might be able to get things done with a POA, but as soon as the financial corporation knows that the person is mentally incompetent then they’ll stop working with you. And frankly, financial corporations have seen these issues a lot more than any of us.

If you’re unable to obtain a DPOA and the financial corporation won’t work with your POA, then the next step is typically filing a petition with your local probate court to appoint a guardian and a conservator.

Even when you have a conservator’s letter of appointment, many financial companies still won’t work with you (especially the national ones, and possibly even your local banks). In this situation you’d only get the justice you can buy (with a lawyer and another court order) and it’d still take weeks.

If you have online access to your parents’ accounts without a DPOA or a conservator appointment, then you’re technically violating the law. However if you’re acting in a fiduciary manner for your parents, and if the financial corporation can officially ignore what you’re doing, then you’ll probably get away with it.

If you haven’t done so already, it’s time to contact an eldercare business or a geriatric care manager near your parents. Do the interviews now (while you have more time than you’ll have during a crisis) and hire someone to open a file on your parents (their ages, addresses, health histories & issues, medication requirements). Then when you get the 2:30 AM phone call from a first responder, you can redirect them to the GCM (and contact the GCM yourself) to help with the crisis while you’re heading to your parents’ location.

Feel free to post more questions here or send me a message. I was my father’s conservator for over six years (Alzheimer’s) and I learned a lot— the hard way.

Thanks. This is very helpful.

Yes DPOA.

I’m going to take a run at getting DPOAs next trip this month. Not sure how that will turn out.

Where would you find “geriatric care managers”?

 

[JBTX]

A general DPOA is ok but in my experience banks (and Vanguard) prefer their own form. It can make your life easier. Also they are not necessarily fussy about assessing mental capacity they just want signatures. Electronic access is great. One time I wondered if the bank employee really thought she was text chatting with an actual 88 year old. She didn't ask and I didn't volunteer excess information.

If/when i go to get DPOAs I may also download and get executed the DPOAs for the brokerages just to be safe.

 

[Nords]

Where would you find “geriatric care managers”?

Every community has their own vocabulary for this, and you’d want one who lives near your parents.

You could search for that exact phrase, or try terms like “eldercare services”, or take a look at community services from the town or county government. In some areas you can call 211 to ask the call center for the right agency.

You could also cold-call care facilities or assisted living facilities in your area and ask for their referral to a GCM.

If/when i go to get DPOAs I may also download and get executed the DPOAs for the brokerages just to be safe.

Please understand that if you can’t get a DPOA for legal access to those accounts, then your only other legal alternative is petitioning a probate court for conservatorship.

A general POA is invalidated as soon as the grantor is found incompetent, no matter when they signed it. A durable POA will also require a notary. The notary will want to be personally confident that the grantor is mentally competent and not being coerced into signing.

I never had a chance to get any sort of power of attorney for my father, and it took nine months for “our” lawyer and the probate court to appoint me as my father’s conservator. During those months I was able to access his Vanguard & Fidelity accounts with his logins & passwords (the technical illegality I mentioned earlier), but the manager of his local bank also heard the small-town gossip that he was dealing with dementia and pre-emptively locked me out of his checking account— the one that received his pension & Social Security deposits. By the time we straightened out the conservatorship and his long-term care insurance claim, I’d spent $25K of my money on his care.

When my spouse and I first granted a DPOA to our daughter on our Fidelity accounts, Fidelity found “flaws” in the local notary’s stamp and certification details. We eventually took all three of us to a Fidelity brick & mortar customer service office where they could talk to us all face-to-face and could use their own office notary to properly notarize the forms.

You want to get the durable POA forms for each financial corporation & bank where your elders have accounts, and you want to get those forms notarized when the elders are having a good day. You might not have much time left to get it done. And if you get a DPOA for one set of their investment accounts, then maybe it’s worth consolidating all of their assets at wherever you get the DPOA.

 

[youbet]

I

This is a sad part of life that DW and I promised to not put our children through. We signed up on a CCRC wait list at 62 and said call us in 10-13 years.

• Been thru this with in-laws and on the journey with my parents who are currently living independently. Both were out of state. In a crisis you can jam a lot thru someone who is in a shocked condition. If they are stubbornly independent – chip away over time before the inevitable crisis.
• Basic necessary steps:
• Durable POA, Health Care POA and Living Wills. None of these matter in the moment if they are not preregistered with Primary Care Doctor, and POA is not preregistered with the bank. Keep a Health Care POA on your phone for emergencies. It takes awhile to set this up but it is most important.
• Set up a simple will in accordance with state laws and try to obtain prior concurrence of siblings.
• Avoid probate and set up primary and secondary beneficiaries: bank accounts, stocks, CDs, auto.
• Sign on to any Safe Deposit Boxes and know the inventory.
• Verify identification is not expired and renew if necessary. (Real ID for plane flights)
• Know the Medicare poverty rules for your state. Not all are the same.
• Know if a parent is eligible for VA benefits such as Aid and Attendance. (e.g. wartime vet who may not have even been in a combat zone) Get a copy of any DD214s.
• Write down dates of birth, social security numbers.
• Get a copy of last year’s Social Security Statement.
• Get a copy of ALL identify documents including marriage certificate, government IDs.
• Get a copy of Medicare, supplemental insurance, prescription insurance cards.
• Make a copy of all current medications and medical aliments.
• Know how to pay the bills down to the account number.
• Put all of the above into a folder for you to keep at the ready!
• Perform annual Check with providers to ensure Insurance continuity.
• Get to know the neighbors, their friends and give them your telephone contact.
• Place a list of important telephone numbers on their refrigerator.
• If they have cell phones, ensure you are listed as ICE.
• In case of dementia – get a specialist diagnosis before whatever event happens. You just can’t stick Mom in Memory Care after Dad dies without a diagnosis.
• Go with them on their annual checkup with their Primary Care doc at a minimum.
• Know the local community resources – in detail, before they are needed.
• Have an open dialogue about ‘Honoring their wishes in the autumn of their lives.’ Write it down. Have them sign it. Can help if you need to get guardianship.
• Have frequent but noncontroversial discussions on driving ability.
• Share with them alternatives such as Uber/Lyft (which you can order from your phone no matter your distance to parents), senior transports, UberEATS, grocery delivery etc. It helps with giving up the keys for them to know they are not trapped.
• Go out and look at some local senior living options. Talk to the staff and residents during tour. Understand their payment structure and levels of care. Identify which ones accept Medicare.
• Set aside about $10k to help them transition if they are in spend down to Medicare. You will not get them into senior living without personally signing as guarantor. Medicare approval is not automatic nor is it fast.
• Set up an insurance policy for burial/cremation before spend down is complete.
• Ensure you have spouse or sibling support. The time and emotional toll is heavy.

I think you're confusing Medicare with Medicaid in some of these points.

 

[ivinsfan]

Following up on Nords comment. We used the local (county office) for elder care. They were exactly what we needed to help us with the process. If you need to spend money having things laid out beforehand is very valuable. Since you have a trip upcoming I would call that office now to make sure you get an appointment for the valuable free information and help. This office is usually connected to the Health and social services department.

 

[RetMD21]

If/when i go to get DPOAs I may also download and get executed the DPOAs for the brokerages just to be safe.

The Vanguard limited agent authorization just requires signatures no notarization. It is the easy way out. Part of the limitation is that they will mail checks to the owner but if you have electronic account access you could adjust that. Fidelity has limited and full access options that can be completed online I.e.no . I am sure that other brokers and banks have similar systems. You can call them DPOAs if you want but the institutions don't.

I was disappointed the first time I showed the fancy attorney created witnessed and notarized DPOA at a bank and was told they wouldn't honor it. The attorney told me that we could get a court order but I was able to take my mother in, close the account and get a cashier's check. We took the check to her credit union. They were willing to accept the DPOA and send it to the legal department but offered the alternative of signing their form. We both showed ID and signed the form and were on our way in 10 minutes. I had legal access to her accounts that didn't depend on her continued competence,

I was fortunate to have cooperation from my mother. I know Nords had a very difficult situation, I was surprised to learn about the problems using general DPOAs.

I know state laws vary but if you can get a non springing DPOA it eliminates a step.

 

[MichaelB]

It seems like the only choices are to move there near full time or wait for something catastrophic to happen. Any discussion of assisted living or in home help are swatted down quickly. This is only going to get worse.

Curious to know how others handled such situations.

Sorry this is happening to your folks. It sounds like their condition has moved beyond “early stages”. They are a risk to themselves and at risk. It’s so good of you to want to help. You may have a tough road ahead.

When my mum was first diagnosed she didn’t feel her condition was serious. We (one brother and me ) didn’t make much headway getting her to take her condition more seriously, so we enlisted the aid of her PCP and a neurologist. That was a big deal. At their recommendation she agreed to stop driving. That first step was difficult but made everything else much easier. I then got her to see a geriatric physiologist who helped us build a care program that allowed us to take control over an increasing part of her daily activities, and just as important, take steps to protect her assets.

The heavy involvement of physicians also helped us deal with sibling issues (we are 5). In all aspects of her condition and care we found that involving her physicians helped her see us not as a thread or challenge but as loved ones who could help her stay safe.

 

[Koolau]

The Vanguard limited agent authorization just requires signatures no notarization. It is the easy way out. Part of the limitation is that they will mail checks to the owner but if you have electronic account access you could adjust that. Fidelity has limited and full access options that can be completed online I.e.no . I am sure that other brokers and banks have similar systems. You can call them DPOAs if you want but the institutions don't.

I was disappointed the first time I showed the fancy attorney created witnessed and notarized DPOA at a bank and was told they wouldn't honor it. The attorney told me that we could get a court order but I was able to take my mother in, close the account and get a cashier's check. We took the check to her credit union. They were willing to accept the DPOA and send it to the legal department but offered the alternative of signing their form. We both showed ID and signed the form and were on our way in 10 minutes. I had legal access to her accounts that didn't depend on her continued competence,

I was fortunate to have cooperation from my mother. I know Nords had a very difficult situation, I was surprised to learn about the problems using general DPOAs.

I know state laws vary but if you can get a non springing DPOA it eliminates a step.

Probably the first (and possibly most important) step is to get access (signature authority) on the checking account. That saved me no end of issues as I navigated my mom's final years. MOST of her money went through the checking account and it was SO much easier as the POA I had was "iffy" due to her increasing dementia and financial institutions natural reluctance to honor it. BUT with signature authority on the check book, most situations were simple. Of course, mom didn't have extensive Vanguard/Fidelity accounts so that wasn't at issue.

 

[JBTX]

Every community has their own vocabulary for this, and you’d want one who lives near your parents.

You could search for that exact phrase, or try terms like “eldercare services”, or take a look at community services from the town or county government. In some areas you can call 211 to ask the call center for the right agency.

You could also cold-call care facilities or assisted living facilities in your area and ask for their referral to a GCM.


Please understand that if you can’t get a DPOA for legal access to those accounts, then your only other legal alternative is petitioning a probate court for conservatorship.

A general POA is invalidated as soon as the grantor is found incompetent, no matter when they signed it. A durable POA will also require a notary. The notary will want to be personally confident that the grantor is mentally competent and not being coerced into signing.

I never had a chance to get any sort of power of attorney for my father, and it took nine months for “our” lawyer and the probate court to appoint me as my father’s conservator. During those months I was able to access his Vanguard & Fidelity accounts with his logins & passwords (the technical illegality I mentioned earlier), but the manager of his local bank also heard the small-town gossip that he was dealing with dementia and pre-emptively locked me out of his checking account— the one that received his pension & Social Security deposits. By the time we straightened out the conservatorship and his long-term care insurance claim, I’d spent $25K of my money on his care.

When my spouse and I first granted a DPOA to our daughter on our Fidelity accounts, Fidelity found “flaws” in the local notary’s stamp and certification details. We eventually took all three of us to a Fidelity brick & mortar customer service office where they could talk to us all face-to-face and could use their own office notary to properly notarize the forms.

You want to get the durable POA forms for each financial corporation & bank where your elders have accounts, and you want to get those forms notarized when the elders are having a good day. You might not have much time left to get it done. And if you get a DPOA for one set of their investment accounts, then maybe it’s worth consolidating all of their assets at wherever you get the DPOA.

This is what I hope to accomplish - in terms of DPOAs. But I’m not sure if my dad will be willing. He either doesn’t grasp or is unwilling to admit the state he is in.

 

[Dtail]

Interesting discussion. I need to shore up a few things.
For Ally, I go through the back door and since my mothers' name is not obviously female, it works, but I understand I need to get it corrected.
For Fidelity, I have their POA to control the accounts but not DPOA.
For BOA, I am also an owner of the checking account so no issues there.
There are POD's/beneficiaries on all the accounts.

 

[FLSUnFIRE]

My parent's CU wanted their own POA form and not the DPOA. Most other assets are now in the trust and can be acted on as trustee... Another benefit of trusts I hadn't considered. They set it up with a firm in their state that specializes in estate law and will be a resource if/when needed... I'm still a bit nervous how things will go when the time comes but in much better shape than we were.

 

[JBTX]

Things have taken a turn. Visiting parents this week, father took a fall while I was not at house. Went to ER they found blood clots in lungs so likely will be on blood thinners rest of life. Given he is a fall risk and on blood thinners I’m not sure he can go back home. Brother and I are here, we aren’t sure my mom fully grasps all this.

 

[atmsmshr]

Same on these bullets - did you mean Medicaid? I think nursing home and similar places sometimes take Medicaid, but not Medicare.

Good catch - Medicaid. Or the case of Arizona, it is called ALTCS. Merry Christmas!

 

[Route246]

This can be an extremely complex problem. Luckily for us it was not as we were local to my parents and we had very cooperative parents who had full trust in us doing the right thing for them. In my case as the eventual trustee I had no need or interest in my inheritance, in other words, I was not waiting for my parents to die in order to secure their assets.

POA, access to all of their accounts and a viable plan moving forward are all very important as mentioned here. A trust and will makes things so easy.

One thing that is intimidating and unpleasant is dealing with LTC. It doesn't matter how well prepared you are, including financially, it is a daunting and emotional problem to deal with. I got lucky as my late father was very compliant and appreciative of what we found for him and how we dealt with it. It could have been a lot worse. When he needed 24 hour care we were able to find a very nice private residential care home a few minutes from where we lived and we were able to visit daily without much hassle and it was a private home with private entry to his private room with very dedicated, long-tenured staff who were very loving and attentive. We hit the jackpot in this case and they were able to take him all the way to transition while in hospice. It was not easy and it did not fall into our laps and it was quite an ordeal to plan, screen and get setup.