Between COVID, moving her in, changing Medicare to the new address and trying to get her Doctors records, I have not been able to get her to a neuroscientist for an actual diagnosis although it is clear she is declining. Can I make decisions on her behalf with only the POA or do I need an actual diagnosis?
I’ve been letting her think she’s making her own decisions on some things but I’ve actually been steering her in the right direction. I discuss things over and over so they stick in her head and she believes they’re her ideas. It’s been working so far. She’s declining quickly so I’ll have to start intervening soon. I’ll have to start setting her up with a neurologist to get an actual diagnosis I suppose.
That said - we NEVER pursued any testing or specialists. When I tried bringing in aides for 1 hr/day to check on her/see that she took her meds, they sent a nurse out to assess her (paid by Medicare) and SHE did a thorough dementia test (better than the one a doc office does) right in mom's place with us there, confirming what I already knew. It was good, because she gave us some suggestions and pointers. Her primary doctor must be aware on some level about her condition - if so, using the POA should be sufficient to get/transfer her records.
I used the POA to close one back account - mom was with me, but just stood there rifling through her wallet and purse. They didn't know me from Adam at the bank. I showed them POA and ID. I used the POA to deposit the check from the bank and take over her primary CU acct (YB and I were joint on it, but I changed address to my PO Box, etc.) Mom was with me there too, but same thing - rifling through her wallet, clueless to what we were doing! They didn't really know me (I have accts there too, but never used the primary office before.) POA and ID was enough.
That said, I've read plenty of posts from others who've had trouble using the POA at banks. Hopefully you won't. You mentioned changing her address for Medicare, but nothing about SS. The best (legally the only) thing to do is sign up as Rep Payee for her SS. Federal agencies do NOT honor any kind of POA. For me, I called MY local office, set up an appt and answered all the Qs they had (they never looked at anything I brought with me.) It took a while, but they sent notice to me and my mother regarding the application. Once approved, you'll be notified and the first Rep Payee payment will come as a check. Once approved, you can set up a special Rep Payee acct at the bank, which only you can access, and then set up electronic payment. Transfer any remaining funds to that acct. It requires reporting at the end of the year, but it can be done online and isn't difficult. Just keep records on how her payments are used. They lump a lot of items together, such as housing/food. You report how much of her yearly income was spent in each category, and how much, if any, was saved.
Other places I used POA was CVS/CareMark, for medication, her other medical insurance and a credit card (since closed.) When she was still living in her own condo, I temp forwarded her mail to get the bills, addresses and phone contact numbers so I could have the bills sent to me. I did NOT have to use the POA for ANY of these except the CC.
No one ever questioned the POA. We had NO paperwork or doctor letters, testing, etc to start using the POA. The only other exception was the federal pension (it was dad's, transferred to her when he passed.) THAT was a bear, because POA was useless and so was her PCP (promised a letter after exam, but 9 months and hounding them multiple times/month by phone and online portal yielded nothing! Since we were moving her far enough away, we had to change docs anyway, but it was still difficult to get just the right "words" in the doc letter - took almost 2 years to get that done!)
So, start with reading the doc and/or asking the atty what the criteria might be or what, if any, documentation you need. If you can produce it for those who ask about it and they accept it, why put her through all that testing? It might be stressful for her.
Do look into the Rep Payee for SS (it'll cover Medicare too.) It'll make changing her address again when you move easier. Call the local office, if possible (virus) as the main number is usually a long wait! Once you're approved, you can deal with changes easily over the phone.
Good that you are keeping her "in the loop." Do that as long as she still shows interest. If she doesn't, just do what needs to be done yourself.
I did have trouble with one bank where they stared at the POA papers like they’d never seen written language before, and seemed like they were trying to make up requirements that didn’t exist to refuse them. I called their customer service number, and that person apologized profusely and directed me through sending the POA in over email. I can’t speak for all banks, but maybe it depends on who you talk to or how you submit them.
If possible (she must be competent enough to sign) a Revocable Living Trust is the easiest way to handle both her needs financially, medically, etc. and eventually if any left to disburse remaining assets. With you (or whoever) as trustee if she becomes incompetent you as trustee can step in to manage her finances, etc.
I read on this site about a Medical Power of Attorney (MPA) and wonder if that is the same as a Health Care Proxy, which in my state allows someone to make medical decisions if the person is not able to do so. A Health Care Proxy does not allow someone to make financial decisions.
It might be a good idea to contact a lawyer. Elderly service organizations often have lawyers that are well-versed in what you need and work either pro bono or for a very low cost.