Having to use POA to override BPD mother

[Notwendy]

I didn't know these things either. Several institutions want their own POA. The IRS and Social Security do. I can not sign a refund check from the IRS with a POA and put it in her account.  Other checks, I can deposit for her. I cannot access her social security for any information. Some credit cards limit what I can do for her.

This has been a learning process but a good one. I have also learned all about assisted living, skilled nursing, what Medicare covers and how Medicaid works.

Care for the elderly is very costly in the US. Medicaid can help when someone qualifies if necessary. I am grateful that my father planned so well for these needs, even if my mother has no been careful. It's been a big help.

[SaltyDawg]

I didn't know these things either. [...] The IRS and Social Security do. I can not sign a refund check from the IRS with a POA and put it in her account.

My wife, who is a CPA, and shared with me years ago that checks can be deposited without a signature.  Write 'deposit only' where the signature goes along with your mother's account number.  Check with your mother's bank on their policy on this.  It should not be an issue as long as the payee of the check matches the account holder's name (your mom).

[Gemsforeyes]

I am also dealing with a disordered elderly relative, my aunt, who lives in New York City, and I live in South Florida.  I’ve had a POA and healthcare proxy for her since 2009 (and so does my brother), which was set up when I asked her if she wanted the state to manage things for her in the event she needed assistance.  She didn’t so she jumped at the opportunity to have pliable me to do her bidding.  And naive me did NOT realize how she really was… ah well.  We have no other family where she is, and she has alienated my mom (her sister) and my sister.  My brother does help by giving some money and sometimes takes things out of her apartment.  But he won’t call anyone, ask questions or help in real ways.  He calls me “the man in the chair”, whatever that means… I’m a “girl”.  An old one, but still.  And he came here when I had emergency surgery.

As far as exercising the POA goes, several institutions do want their own POAs to go along with a copy of the executed one you already have, since they know you cannot give each of them your original (it seems).  My understanding however is that different states do have laws indicating that your POA must be accepted.  I guess how hard you push against the financial institution depends on the fight you have in you considering your number of daily battles.

As far as depositing checks, that can easily be done without the payee’s signature.  One of my aunt’s home health aides deposits an annual RMD check into a Chase account simply by writing “For Deposit and my aunt’s account number”.

Regarding IRS refunds, I received a huge IRS check refund ($45K) for one of my friends who was out of the country.  I deposited it to her Wells Fargo account with no issue. 

The other thing about IRS refunds is if you establish a relationship with the professionals doing her tax returns via your POA, get them the documents for filing the taxes and include the routing number and account number for refunds, the refunds will be direct deposited very quickly.  No fuss.

Social security is another issue, unless your mother designates you as a payee on her behalf.  Something different happens once you convert to Medicaid, I’ll know more about this soon because I’m about to enter this nightmare territory for my aunt.

Although this may not help anyone else, my aunt loves when I do her bidding, always has, so if I need to get her on the phone with me to get “permission” from some company, she’ll do it.  That has made getting things done much easier.

I too, hope that someday I can drop this ball I cannot drop…. I want to call Adult Protective Services on me!

I hope anything I said is helpful in some way.

Warmly,
Gems

[Notwendy]

Social security is another issue, unless your mother designates you as a payee on her behalf.  Something different happens once you convert to Medicaid, I’ll know more about this soon because I’m about to enter this nightmare territory for my aunt.

Although this may not help anyone else, my aunt loves when I do her bidding, always has, so if I need to get her on the phone with me to get “permission” from some company, she’ll do it.  That has made getting things done much easier.

Yes, let us know how the Medicaid works. From what I read, I think with Medicaid, the Social Security goes directly to the nursing home. Depending on the state, the person is allowed a small allowance - something like $30/month for their personal expenses. If they have family who wants to help send snacks or clothing, or personal items, they can do that -but a disordered person will still do what they choose with them so you and your brother can decide how much you want to be involved in this.

I have a friend whose disordered father is in a nursing home on Medicaid. She brings him snacks but he gives them away. For her it comes down to her own values, boundaries and her budget. Her dad gets X amount of snacks a month and whatever he does with them is his choice. Still she knows she is providing snacks for him, regardless of what the does with them.

Yes, you have also keyed into the dynamics of "doing someone's bidding". To me, designating someone as POA involves trust that they have your best interest in mind. For my mother, I think she sees it as me being able to "do things for her". I think she designated me because she had confidence in me but also there's her need to be in control and her being critical of people who assist her.

[Turkish]

That is how Medicaid (Medi-Cal) worked for my mom. She had a little spending allowance, the nursing home took the rest and Medi-Cal made up the difference (like $6k/mo).

[Gemsforeyes]

From what I know right now about how Medicaid works in NY is this:

There is a spend down requirement, which means a person can have “liquid assets” limited to $30K.  This does NOT include a home.  It also excludes any retirement funds, although you lose access to those retirement funds until the person passes away.  Then they will square up with you, and if any excess funds remain in the retirement funds above what Medicaid has spent, the heirs will receive those funds.  The $30K in liquid assets can be replenished through “gifts” from family members, if they are so inclined.  You do NOT want to transfer any funds out of your mom’s (or whoever’s) accounts in preparation for Medicaid application, unless the money is spent on purchasing a funeral trust.  OR if you’re actually paying for home health care.  But don’t transfer to get the liquid assets down to the $30K.  I’m not sure who holds that $30K if “mom” is in a nursing home, but if you’re not managing the account, you’re entitled to a quarterly accounting of monies withdrawn.

In NY, there is a 5-year lookback for nursing home care.
I believe there is a 30-month look back for in-home Care (I think this is called MLTC).  This may change in April of 2024, I believe.

In NY, the monthly amount of spending money from SSI is $50.00.

Here’s the scary part, at least for me at the moment.  If my aunt is untruthful about the extent of her needs, and says during the assessment that she needs less help with her ADLs (activities of daily living) than she really needs, she will be DENIED nursing home care.  And my aunt wants nothing more than to return to her apartment.  But she may be granted some version of MLTC in home Medicaid HHA Care.  If THAT is the case, *I* have to report EVERY PENNY I spend on her Care monthly to Medicaid before I am reimbursed.  We’re talking food, depends, toilet paper, paper towels, toilet wipes, gloves, blah blah blah.  This doesn’t include her monthly bills, for which something called an “Pooled income Trust” is established.  And that’s when I’ll need to turn her Care over to the state for guardianship.  I’m often on the ledge as it is with her demands.  Her paperwork has taken over my world.

So my advice is to look at your state and research the basics of what is required.  Just understand a bit before you leap.

I’m frightened Auntie Em!  (To quote Dorothy from the Wizard of Oz)

Sorry this is so long.  Maybe someone needs this info?

Warmly,
Gems

[Turkish]

Gems,

All info is good info. Anyone should check anything any of us say here though. Links are helpful. This would be a good Workshop.

• Medicaid Trusts
• Asset limits, etc...

[Notwendy]

I agree, Gems, the information is helpful. I would also add to Turkish's advice that since the "rules" vary from state to state- it's always good to look at the individual situation but knowing there are rules and to look for them is good advice.

What I learned is that there are two main situations where someone qualifies for Medicaid assistance. If someone has no assets, they will likely qualify. The other situation is the person who does have assets but spends them in Medicaid qualified expenses. Medicaid is for people who need it and Medicaid will look back 5 years to be sure of that. One can not give away assets and then claim need.

If someone has assets, then consulting an elder law attorney is a good idea in order to be proactive if they were to have a need to apply for Medicaid. Here is where options such as Medicaid trusts and "spend down plans" are helpful. I consulted an attorney for such information to see if it would be helpful for my mother. What I learned is that to be effective, it needs to be a relationship between the attorney and the elderly person who is motivated to work with them. This seems to parallel the idea of therapy too. If I think my mother needs therapy, and I speak to a therapist, I can learn about therapy, but for her to get help- she needs to be the one to work with the therapist. I can get the information from the attorney but with my mother being "legally competent"- she needs to be the one who is willing to work with the plan.

Like Gem's situation- the person has to cooperate with the regulations. If they don't, they could potentially interfere with the process of getting Medicaid assistance if they were to need it. When a disordered person isn't motivated to cooperate, it's a challenge.