Emergency Guardianship not recognized, please help me understand what now?

[luvavacation]

I posted here not long ago about my mom and seeking guardianship due to her dementia and prescription drug addiction. She ended up back in the hospital again, and was transferred to the behavioural services unit for seniors where they help her until she is medically able to be released.

Her doctors stated that I must seek immediate emergency guardianship. I was in court yesterday with the lawyer and was granted this. I have temporary guardianship of my mom and her estate/financial matters. In 3 weeks I have a hearing for permanenet guardianship. I thought all was good.

This morning, I went to the bank. I have been looking for assisted living for dementia patients, as the doctors have said she needs a facility that is secured because she wanders (which I know, but now they see it, too). So, I need to know what she has in her accounts, and I need access to her accounts to pay for her care. The lawyer said to go to the bank first thing this morning with the court order, so I did. Also, the judge wrote on the guardianship that I am bonded to $100,000, so I can spend no more than that before the hearing for permanent guardianship. Though that would make for a great Disney trip, I only need enough money to pay for her entrance and first month into assisted living.

My mom banks at Harris. They denied me access to her funds! They said that first of all, the bank must be listed in the court order, and that they never grant access to funds for temporary guardians. My lawyer, and I, are both just shaking our heads. Even with a court order naming me guardian, albeit temporary until 3 weeks from now, they won't give me access, nor tell me if my mom even has enough money to go into assisted living without going on Medicaid.

I can not find any of my mom's bank statements beyond 2006 to know if she has money, or how much. She apparently shredded everything last week with the thought that she doesn't want me to "steal all her money". I am so stuck now.

So what do I do now? The hospital said she must be out by tomorrow morning at the latest. The doctors said she can not go back to her own home or come live with me due to her dementia and drug addiction. The two places I have looked at for my mom are willing to work with me and wait until I can sell some stocks I have to pay for her entrance and first month, but if my mom doesn't have the money (though I am pretty sure she does, but hey, who knows?), then I just have to move her again.

I am so upset. I am so frustrated. I hate Harris bank. I may be completely missing something here, and as frustrated as I am I totally realize that,
but I figure you all gave me great advice before, maybe you can help me again.

And I just paid my eldest's college tuition a few weeks ago, so I don't even have access to that money, because I depleted my quick-access savings, and the rest of the money we have will take a few days to access. But again, if my mom doesn't have the money, then I am still stuck. Ugh. Did I mention how much I hate Harris bank? Who knew a court order meant nothing.

 

[TheZue]

I wonder if she called them while she was shredding? Maybe have your lawyer contact them.

 

[golfgal]

If she is on Medicare for insurance ask her doctor if this current hospital stay would qualify her for her 100 day stay at a nursing home. If so, get her transferred from the hospital to the nursing home--DO NOT let her go home in between or Medicare won't pay. That will at least give you some time to get things worked out with the bank.

If she has the money in her bank accounts is pretty much irrelevant at this point, either she does and you use that or you start the paperwork for Medicaid. You probably want to start the paperwork for Medicaid anyway because you will most likely need it anyway and that will start your look back period.

Contact the local senior ombudsman, now, and find out how to get started with this. She will have a social worker assigned to her case and will be able to help you through all the guardianship issues too.

 

[JessicaR]

You need to call your lawyer and get further assistance on what your next step should be. If your lawyer is shaking his/her head, you need a new lawyer.

 

[The Mystery Machine]

Have you contacted the social services at the hospital she is at? I know that they can be helpful in situations like this.

Again do not pay out of your own funds. You need to get her admitted under Medicad. That is what I would do. That will start the legal process on their end.

You may never get the money back that you put into her home. If she does has funds, you may not be able to get that money reimbursed. I know the home said that they would "work with you" however I trust no one.

I think you need a better lawyer or you need for him to fix this. Shaking his head and leaving you high and dry is not acceptable.

 

[auntie]

If she is on Medicare for insurance ask her doctor if this current hospital stay would qualify her for her 100 day stay at a nursing home. If so, get her transferred from the hospital to the nursing home--DO NOT let her go home in between or Medicare won't pay. That will at least give you some time to get things worked out with the bank.

If she has the money in her bank accounts is pretty much irrelevant at this point, either she does and you use that or you start the paperwork for Medicaid. You probably want to start the paperwork for Medicaid anyway because you will most likely need it anyway and that will start your look back period.

Contact the local senior ombudsman, now, and find out how to get started with this. She will have a social worker assigned to her case and will be able to help you through all the guardianship issues too.

I agree..it doesn't matter whether she has the money or not. She's likely not going to have enough to cover her for years of assisted living. At some point she'll likely go on Medicaid anyway. Start the application process. I'm sure the social worker at whatever facility you choose can guide you along these lines. They will find out whether or not your mom has the funds. They will use any eligible funds she has. Also..I forgot ..but that's right what the previous poster has written about the first 100 days of the nursing home through Medicare. So this gives you some time to get things worked out.

 

[happily single]

Request that your lawyer specifically draft a Court Order listing your mother's name, social security number and date of birth as well as account numbers, if known. Ask the judge to sign it.

Then Present that Order to the Bank along with a Subponea Duces Tecum for the Keeper of the Records of hte Bank to appear at the Court hearing (which is in three weeks) to provide ALL BANK RECORDS for the past 4-5 years.

GOod luck

 

[uconndz]

If your mother spent 3 nights in the hospital (was admitted and in the hospital for 3 midnights) and has Medicare Part A she may be entitled to up to 100 days at a rehab / long term facility. It is not a guarenteed 100 days. She needs to have a skilled need. Skilled need is something that a licensed therepist or licensed nurse needs to provide daily. If a person needs custodial care only (help with day to day activities / supervision) Medicare will not pay for the stay.

 

[walden]

A Guardianship in most states is both a legal and medical issue. While Doctors like to give advice they often forget the permutations of this legal stuff. It really is not that simple!

Please consult both elder services and an Elder Law Attorney in your state if your family attorney is not skilled in this area.

You will need an order from a judge to attain Guardianship and access bank accounts, especially if your mother is resisting. If she resists big time, she can have her time in court.

Good luck.

 

[buckler]

If your mother spent 3 nights in the hospital (was admitted and in the hospital for 3 midnights) and has Medicare Part A she may be entitled to up to 100 days at a rehab / long term facility. It is not a guarenteed 100 days. She needs to have a skilled need. Skilled need is something that a licensed therepist or licensed nurse needs to provide daily. If a person needs custodial care only (help with day to day activities / supervision) Medicare will not pay for the stay.

This is good advice. A typical assisted living facility with a locked Alzheimer's unit does not have skilled nursing staff and wouldn't qualify for Medicare. Your mother would have to be in a skilled nursing facility and require skilled nursing care (intravenous injections, wound care, physical therapy or something that requires a specially trained person to perform). It isn't enough that she can't bathe herself, dress herself, feed herself or is a wandering risk. Those are typically custodial care needs and don't qualify for Medicare.

Also, Medicare doesn't pay 100% for 100 days in a skilled nursing facility. They pay 100% for the first 20 days. Then a copay is required for days 21-100. If she has supplemental coverage, that might cover the copay. Otherwise you have to pay out of pocket and it is up to $128 per day (as of 2008, may be more now).

Do the doctors at the hospital say she needs to be in a facility where a doctor can monitor her on a daily basis for the drug addiction? Needing daily monitoring by a doctor might move it into a Medicare situation.

 

[kesha]

This is good advice. A typical assisted living facility with a locked Alzheimer's unit does not have skilled nursing staff and wouldn't qualify for Medicare. Your mother would have to be in a skilled nursing facility and require skilled nursing care (intravenous injections, wound care, physical therapy or something that requires a specially trained person to perform). It isn't enough that she can't bathe herself, dress herself, feed herself or is a wandering risk. Those are typically custodial care needs and don't qualify for Medicare.

Also, Medicare doesn't pay 100% for 100 days in a skilled nursing facility. They pay 100% for the first 20 days. Then a copay is required for days 21-100. If she has supplemental coverage, that might cover the copay. Otherwise you have to pay out of pocket and it is up to $128 per day (as of 2008, may be more now).

I had this same situation with my mother and they did pay for 30 days in a nursing home with her being in the Alzheimers unit but that was back in 2004. Not sure if anything has changed since then. My thoughts are with you. We dealt with my mom for 2 years after my father had a stroke. I'm glad they lived in a small town, we never had any problems with the bank. Something sure doesn't sound right. Your lawyer needs to get this taken care of. If not get someone else right away.

 

[luvavacation]

Sorry for the delay in response, but yesterday had me running all over taking care of stuff for mom.

My mom has Medicare part D. The assisted living does not take any insurance. The only places that take Medicaid (went to see two of them, so I know for the future) will not allow her cat (if he is still alive then) and oh my gosh, they smell so bad!

Plus, my mom's social security check amount is over the Medicaid limit, anyway, and as far as what I think I know of her accounts, she has too much saved, and would not qualify for many years.

I did find a very nice facility not far from me, with a two-bedroom (because my sibling, the one that the sun rises and sets upon, needs a room too for those few days a year that a visit fits into his schedule ), and it will take her cat.

The lawyer called me again yesterday afternoon, he had spoken with the branch manager at Harris Bank and also the judge that granted guardianship. Harris said that the bank must be specifically listed, but they still won't grant me access to the accounts if I am temporary guardian, even with a judge's order. So the judge was called, the lawyer said that the judge was also amazed at what Harris Bank said, and the judge is writing up something new, I don't remember what it is, as my emotions were interfering with my understanding of legal terms. However, it might be what a previous poster mentioned.

This new order is supposed to be faxed over to Harris Bank this morning, and I think I am supposed to pick up the original later this morning. I will be calling later today to be sure it is done. More running around for me.

The assisted living facility will take my mom on a respite care rate for now, we will move her in on Saturday. They will bill me at the end of the month, and by then I should have full guardianship and Harris Bank should honour that. It stinks not knowing for sure if my mom has the money, though I believe she does, but who knows. She is an easy victim to scammers, and she is so secretive that I would never know.

However, she is also conniving! I tried to look at bank statements from the last few months that she should have in her files, but could not find anything beyond 2008! She loves to shred things, it is possible she shredded everything. Pretty sure she shredded the original Power of Attorney for her finances, too, though I do have the Power of Attorney for Healthcare in my possession (didn't make it to the shredder yet, I suppose!).

The fun continues. Thank you all so much for your advice. It is a great help in how I proceed, and your previous advice guided me in finding this attorney I have now, as he does do elder care. I think yesterday we were all just flabbergasted at Harris Bank, but while I was running around, he was trying to do something, so I am grateful. Of course, this means that $1,000 retainer is being used up quickly, but oh well, if my mom is protected, it is worth it. She may still view me as the Devil's spawn, but I know I am not. God sure has been hearing a lot more prayers from me for patience and understanding, though!

 

[Disney Doll]

Whatever $$ your mom has will need to be spent down in order for her to qualify for Medicaid. If the terminology you are using is correct, neither Medicare nor Medicaid pay for assisted living. That is usually priavte pay. Medicare pays for skilled nursing care in an ursing home, as PP described above. The patient then usually "spends down" their money to reach the Medicaid income limits and then Medicaid will pay for custodial nursing home care.

I would caution you to be very cognizant of your mother's abilities. Assisted living offers assistance...the person must still be able to somewhat manage themselves. As far as being set up for a wandering resident, many assisted living facilities are not, because many of the residents are semi-independent and able to come and go. From your description of your mother, assisted living may not be the right level of care for her...you may need to consider a nursing home with a unit specifically designed for people with demnetia.

Good luck with sorting all this out...I know it can be a pain.

 

[The Mystery Machine]

Agree with DD. Your mother does not right for assisted living. I do not understand why you are going that route?

Sounds like she needs nursing home with lock down.

Your mother may really lose it when she does not go back home. I hope you understand what I mean. I am not trying to attack you, it just sounds like you are not being realistic to me from the descriptions you have given with your mom.

Make sure that you know all the rules before you move her into the place.

Good Luck!

 

[luvavacation]

The assisted living that my mom is being moved into is for patients with dementia and other similar illnesses. They have different levels of care, and after speaking with her doctors and having them fill out patient evaluations, they determined what level of care she will need. The facility is a lock-down type, must be let in and out by the staff. I made sure of that!

They have a separate wing for patients that need more care, but in the same facility. No worries there about my mom having to adjust to another new environment, at least.

The facility is very, very nice. You would never know it is filled with people that have memory issues, everyone of the residents there looked clean, happy, friendly, and many of them had dogs and cats, too! Only 55 residents live in this facility, including the ones in the wing for patients that need more care.

My mom needs to be watched 24 hours, she is a flight risk, she does have memory problems, but she is still able to care for her self and her cat, as long as she is not under the influence of narcotic prescription meds. She will have another resident there as her "buddy" for the first two weeks, to introduce her to the other residents and help her get acclimated. She will not be allowed to stay in her room all day, staring at the walls, crying and medicating herself. She will have activities every day that are geared towards her individual needs to help her memory stay focused to the best of its ability.

I figured that if I was willing to stay in this place, then it was good enough for my mom, too! Everyone there is trained in interactions with dementia patients, included the staff preparing the meals. The place looks like a mansion from the outside, and was built less than a year ago. The inside looks like a house with lots of rooms off the main entrance. Truly a nice place, and I am confident that my mom will be well taken care of, with better care than I would be able to give her in my own home.

And hey, when it comes to money, this is why my mom and dad worked all those years and saved, so provide for themselves in their old age. Even if my mom's money ran out and Medicaid took over, I would be oh so hesitant about placing her in any of the facilities that take Medicaid, at least around here. But, that is in the future, and I will face that when the time comes. At least for now, I know she is going into a nice place, just have to make sure I have access to funds to pay for it! All in due time, I suppose.

 

[The Mystery Machine]

Oh good. That sounds like an integrated system. Most assisted living places around me are not that way.

Sounds like you are getting a handle on the money as well. I will think good thoughts for you.

 

[NotUrsula]

I'm glad everything is working out for you.

On the topic of flight risks, there is a lot of research being done now on ways to discourage elopement without physical restraint. One of them, amazingly enough, involves painting a large black oval on the floor in front of the doors. With their typical poor vision coupled with memory loss, it has been found that Alzheimer's patients typically will not cross the oval unassisted -- they think that it is a large hole in the floor.

 

[lpereira]

I think you are going the right route for your mother for now. She will eventually need a skilled nursing facility. There are nicer ones around but you will have to search high and low for them. When you find one get on the medicaid list asap. It is a sad fact that medicaid beds in skilled nursing facilities open up because patient's die. And in some cases that can be years- during which time the list of people needing that bed grows.
Also a number of churches run non profit nursing homes. If your mother is a member of a church you can look into that. We have a super nice facility in the area I live in. It looks like a resort inside and out with high staffing levels. It does not take medicare or medicaid so it appears on none of the state lists. It does admit Episcopalians on a sliding scale and as long as there is room you won't be turned away.

 

[barkley]

just a hint to find any bank account and other financial information-try to locate her tax returns or contact whoever did her taxes. that way you will at least know which banks reported interest. go to a local credit reporting agency and you should be able to use the court paperwork to get credit reports (you can determine any credit cards AND credit/debit cards that could identify checking accounts at banks previously unknown to you).

we had to administer a family member's estate when she passed-she went on shredding binges periodicaly during her final months leaving us with only clues as to what was where her cpa and those credit reports were of great help.

ALSO-put in a change of address to a PO BOX that you have the key to, then when she gets settled you can notify those you wish to of her new physical mailing address while the important items will keep coming where you can get access to them (PO BOX is MUCH better than your personal address-that way you don't get all her junk mail, and it just keeps things more streamlined. a great investment for less than $50 a year).