My brother's are thinking about having my Mother declared incompetent so they can put her in a NH. What can I do?

Your very first response had the right answer. Get to an eldercare attorney or at least an estate planner with the three of you, don't base decisions on recriminations or misconceptions. Mom is not going to be "hurt" in the sense of being harmed - she is going to get the care and supervision she needs. She does not like that idea of being less independent, but who does? You cannot base good care decisions solely on what Mom wants, because with dementia comes poor reasoning abilities and poor decision making. You can respect her wishes as far as possible, but you will find some of what she wishes is not possible. As to the question of whether she can still be left alone at home - again, diagnosis of Alz and a stroke does not necessary equate to a "no" - maybe with a LifeLine or similar service, med reminders, other things that are very individual it might be OK.

It sounds like there is no POA and that it might (or might not) be too late for one - and that said, having a diagnosis of Alzheimer's does not automatically equal legal incompetence to manage your own affairs. Possibly, the doc is trying to give you a chance to get POAs done before making an actual declaration that she is not competent. Once you HAVE a POA, you typically need the letters or even two letters of incompetency to "activate" it for really major moves like selling a house, etc. If its possible to go that route, by all means do..though it may be a pleasant surprise if she'd willingly sign one even if everyone agrees on which of you it should be! If she really can't manage on her own - OR with the care you can take turns providing, plus whatever community waiver options there might be (have you visited with your local Area Agency on Aging about that?) - you might even need a guardianship which does require legal involvement if she insists she will remain in her own home as she is, and she's a danger to herself or others. Again, if you are not sure about that, there is yet another option for help - see if there is a comprehensive geriatric evaluation team in your community that you could bring her to, and see what their assessment and advice is; if a second incapacity letter is needed, that could be the best resource for it (my mom had a primary care doc and a geropsychiatrist do them for me...by the time I was even asking it was very obvious, I just dragged my feet hoping things would get better, but of course they only get worse for the most part...) Typically they have a social worker who knows local resources and options pretty well too, for whichever route you decide to go.

This is all one very steep learning curve. You three are just now getting on it. It is emotionally fraught and very hard to tell which caveats you read are valid and which are myth. This would be a really, really good time for all three of you to pull together and learn together. It sounds like possibly you do not trust one of the other brothers, but you have to ask how realistic that might be - is he an addict, a user, a history of theft and entitlement issues? Bear in mind that estates are not "seized" right up front - there is a certain amount that is exempt from counting assets, the rest is "spent down" before Medicaid covers long term care expenses, and if someone has ongoing income that would disqualify them for Medicaid, there is an option referred to as a Miller trust where the excess is set aside for care. It IS true that Medicaid is not in the business of preserving inheritances for children, and there is "estate recovery" of the exempt assets after they pass on. It is also possible she would qualify for an assisted living facility that you and she could afford long-term, with or without any long-term care insurance she might have.

If you truly do not trust your brothers, find what papers you can abut her income and insurance policies, and go to a lawyer alone - otherwise, again, see if the three of you can see eye to eye and share the understanding of where Mom is on her need for care and how best to provide that. It is not easy but it needs to be done, and it sounds like either your brothers are already taking the lead or taking advantage - hopefully the former! Learn, learn, learn and don't assume bad things that might not be true. I wish you all well, seriously....

If you want some ideas on damage control, John,you'll need to open up and tell us a whole lot more which is why all of the questions. Is the future of your mother's estate what's going to cause collateral damage or the tension among the brothers related to the estate breaking your mother's heart in a time when the focus needs to be on her, her care, what are the most helpful for your mother options that are realistically available.

So, let's back up and answer the questions concerning the facts of this very troubling situation that you find yourself in. When we have more facts, we will be better able to see the whole picture and from those facts have some input on how to help you. Many of us have dealt with or are dealing with similar issues, but everyone's situation has unique variables. We are all ears and want to help. Please talk to us.

John, I don't think posters were "condemning" you but rather your brothers. You seem to be the problem solver in the group, but you are apparently dealing with brothers who aren't. That makes it very difficult as your goals are different.

I thought some of the suggestions were good. And we ask questions so that we have a better understanding of the situation.

You asked where to start and what to do, and posters responded. I'm not really sure now what kind of answers you're seeking.

It's not my intention to argue, but if you're not satisfied with the answers perhaps you could explain why or what exactly it is that you're seeking. Maybe we're all just confused.

John, I'm sorry if I come off as preachy. But the way your worded your question, I think, struck some of us as odd.

Your mother has dementia. And has had a stroke. You don't say what her current living arrangements are. Is there a reason that the status quo is not working? What about it needs to change.

It's the dementia and stroke that are hurting mom, and those are not under your, her, or anyone else's control. If mom needs a higher, more intense level of care, that's not hurting her, that's a help.

Is there dissension in the family? Are your brothers likely to respond to "doing what's best for mom"? Is the breakup with your brother's part of what you see as collateral damage?

Your mom's money should be used for her care. Who has control of her accounts? Is there someone who has power of Attorney.? Nursing homes in the Northeast run about $15,000 per month, private pay. When mom's resources are down to about $2000 in assets, she might be eligible for Medicaid but only if you can produce 5 years worth of documentation that her money has been spent on her, not gifted or hidden. A good eldercare attorney can do a Miller Trust which can create a pool of money that will be recouped by Medicaid later on, but will allow her to qualify for Medicaid when her assets are depleted. This can be useful for folks who have relatively healthy pensions that are above the Medicaid limit but come nowhere near the price of a nh bed.

I think you are probably a very private person who dislikes disclosure of too much information . We are all like that here. Hope this helps.

oh, one more thing. Get hold of Roz Chast's book Can't We Talk About Something More Pleasant ? " it will make you laugh and cry, which is what we all need to do.

If you could give us some more information about how she was living and who was taking care of her it would help. You haven't given us much information to work with. People with dementia can still live at home if someone is there to take care of them. Would your mother have in-home care if she stayed home, or would she be able to afford to pay someone? If you will give us a bit more background, you'll probably get some very good suggestions.

For those of you who think that my brothers and I should be lectured, if it would give me the answers that you didn't give me, I would gladly take it. Everyone involved is going to get hurt and what I am desperately trying to do is limit the damage because my mother will be hurt the worst of all. Save your judgements, the verdict has been passed and we're all condemned. If you know of a way to let me pick up the pieces please post a reply.

John, you ask "what can I do?". Have you spoken to mom's doctor about whst s/he actually thinks mom neds?. You say mom doesn't want to b be "committed". Has she visited any continuing care or assisted living communities? The ones that are like cruise ships? What is her understanding of her disease, or is she beyong that? What is your main goal here? Who has POA and who is on HIPAA forms?

In situations like this, i remember that my parents hammered home the fact that we were never to expect any inherited monies, that anything my parents had would be used up by them. They started telling us this as fairly young kids, probably had something to do with having read Dickens...

This is really a feel bad question. The only question really should be where the mother would receive good care. There is too much concern with the estate here, instead of with care.

1. Doctor "allegedly" said...did he or didn't he? Do you have HIPAA authority to find out? I think this the first step. What kind of doctor was this, and was he involved specifically for the purpose of a dementia declaration?

2. Has your mother executed a Will or Trust, DPOA, and/or Living Will/Advanced Directive? If so, which one or are all of the brothers designated in each, and is responsibility to be shared or can one act independently of the other?

3. BabaLou makes some good points. Commitments as I understand the law in Michigan are made through court action for a mentally ill person. People with Alzheimer's aren't committed. The law used to require that someone signed a petition for commitment, a hearing was held, the person was examined and tested, and sometimes committed for a limited period of time, sometimes not committed. It's a different process than placement in a nursing home.

4. The issue of state "seizure" suggests to me that someone has a little bit of knowledge but not a lot about Medicaid and how it's funded as well as how it collects funds for someone receiving it. This is a good issue to research if your mother lacks asset to pay for any nursing home care.

Seizures can take place in criminal actions, such as when authorities seize fruit from the poisoned tree of a criminal enterprise. That doesn't apply to nursing home placements though.

However, since you're used the term "seize", I suspect that one of the brothers has some nefarious intentions and needs to be reigned in.

5. Where is your mother living now? With whom? What are her strengths and limitations?

6. Babalou again is right; anyone attempting to "seize" an estate while your mother is alive is attempting to appropriate assets that aren't available to him until your mother passes, unless her estate planning documents provide otherwise.


The first thing to do is straighten out the issue of what the doctor really recommended, as well as what exams he did to support his determination. If the brother who wants a nursing home placement was the only one speaking with the doctor and misrepresented information about your mother, you have a whole level of lack of honesty to deal with.

And on a separate note, I think it's really sad that there are 2 brothers thinking of your mother's estate while you're literally left out in the cold to figure the situation out and your mother is kind of the pawn between the two other brothers.

If you do see an attorney, hopefully he or she will include a lecture to get together on what's best for your mother.

johnlavender, I agree with what cmagnum had written above. If your Mom isn't of clear mind she should be unable to declare anyone to be her Power of Attorney. No Attorney would let her sign such legal documents.

As for your Mom not wanting to go into a nursing home, depending on her age, most elders visualize nursing homes to be dark and dank with unsmiling faces. It's an old stereotype from the far far past. So of course Mom won't want to go there.

What you do is think of her best interest first.... how will she get the care she needs full-time as with Alzheimer's it doesn't get better, it sadly only gets much worse.

Boy, you and your brothers really need to get some factual information.

Mom is not being "committed".

No one is going to "seize her estate". If she has funds, she will need to use them to pay for care. Once her funds are gone, you can apply for Medicaid on her behalf, if she hasn't given monies away.

If your brother tries to spend her funds in a way that is not to her benefit, it's called "theft" and you call the cops.

If mom has enough money that you think of it as her "estate", ( and it's not an estate till she's dead, actually), then you must also have a family lawyer. Get a referral from her to a good eldercare attorney who can explain this to all of you, while you're in the same room at the same time.

Someone getting POA may be a mute point with her doctor already saying she's not competent.

Where is she living now? Who is taking care of her? How old is she? Does she belong in a nursing home for her own safety? Does anyone have POA?

I cringe at your brother worried the state will seize her estate if she is put into a nursing home. She saved all her life for a rainy day. It's pouring outside. And son #1 is worried about her money being used to care for her?? Really?

Anyway, about mom . . . Believe me NOBODY is raising their hand saying, "Send me! I can't WAIT to go to a nursing home!"

In a nursing home, mom will be safe, be presented with nutritious meals, be surrounded by perky, smiling faces, have social opportunities, be kept clean regularly, and not have to worry about anything else other than, "How long 'til lunch?" There are worse places. And often those worse places are in their own or a loved one's home.

Mom has had a stroke and has dementia. She should not live alone, and at some point (if not now) she is going to need 3 shifts of caregivers, 7 days a week. For most of us this means a nursing home.

Nursing home care is expensive. 3 shifts of in-home care is expensive. So your mother's estate is going to be needed for her care. This will be true no matter what route takes her to the nursing home. Once she is there she will have to pay for her care.

POA does not give someone the authority to "seize the estate." That would be a punishable crime.

I think the three of you should visit an Elder Law Attorney together, and here the facts about options available. You had better all adjust your inheritance expectations downward.

Start with legal advice you all hear together.