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Thinking of obtaining guardianship for my mom. She is in a nursing home. Wondering what the drawbacks could be to that? Will the doctors leave her out of conversation about her medical care? Will the nurses ignore some of my mom's requests? Such as occasionally letting her sleep in if she requests? What would they do if my mom refused a medication? If some meds are scheduled PRN, and my mom requests a pain pill, will they refuse her because someone has guardianship over her (she was deemed incompetent).

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I think your fears are largely unfounded. Her medical caregivers will continue treating her as her condition warrants. It's not like they have to check with her legal guardian for every little thing. But you will become responsible for end of life and DNR decisions in the event she has not put this to paper in the past.

Guardianship would help you take care of her affairs. It can be a hassle to get but it certainly is nothing to be afraid of.
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Does anyone have poa?
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Is this because she doesn't have a POA? There shouldn't be any drawbacks if this is the only reason. It's expensive, so be sure that there isn't another way. I never had to do this, so read the opinion of others before you decide. You would need to check with an elder law attorney, too.
Take care,
Carol
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If you are her DPOA and her financial POA you should be covered and not need the expensive and time consuming path to gardianship. Having the two documents mentioned give you the power over medical and financial matters. If you decide to go for guardinship please share your exp it would be helpful to others to know the steps you took.
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I have medical & financial POA for my mom. She gave me permission and signed for me while she was still able. Guardianship seems to be for when the person is incompetent & has not given permission and is harder to get I believe because a dr. has to deem the person incompetent first. POA has allowed me to do everything needed to handle her medical and financial affairs including selling her house.
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I am currently applying and going to court for guardianship of my mother because she never gave anybody POA. She has Alzheimer's and will get steadily worse and somebody needs to be able to take care of her. POA is so much easier if there is still time for you to get that and a lot cheaper
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Once guardianship is established, the person's wishes no longer have to be considered as the guardian essentially stands in for the person, decision-wise. But, as others have said, if you are her Power of Attorney for financial and medical decisions, you already can make decisions for her. Seeking guardianship is very expensive as you have to have her declared incapacitated and that involves going before a judge and you need an attorney. Only do that if your mom is too demented to sign over Power of Attorney to you. But, even with a guardian it doesn't mean your mom's voice won't be heard at the facility. They may just check in with the guardian before they do what she asks. If you are seeking an independent guardian, one word - DON'T. We had one and I ended up writing an entire book about the devastation of the whole thing. (Tales From The Family Crypt is on Amazon. It's a cautionary tale.)
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I am G/C for my mother. We had POA and DPOA for healthcare, but Mom was fighting every decision. She was refusing AL placement, refusing to move from her condo, developing wild financial plans she wanted to control (a remodel of her condo, a trip to Italy, a new Lexus) and things got bad enough that we had to have that extra power to control where she lived and control her use of assets.
The disadvantages of guardianship are several. The process requires a petition to the court filed by an attorney, back up documentation from doctors, may involve a full neuropsych exam, may be contested, and in the end a scheduled hearing in probate court has to be scheduled and attended with the ward and potential guardian. The cost of this is I think at least $4-5,000. It can be more when there is family infighting or the ward fights. In the end all legal bills are paid back by the ward. There is annual reporting required to the state, and if you are conservator there will be a bond required which costs money every year (to give you an idea, $200,000 in assets requires an annual bond fee of $1000.
One thing it does not do is take away the wards ability to speak for themselves, and you are supposed to take their needs and wants into consideration in all your decisions, so your mom would not lose the ability to choose the things you mention, although they may phone to ask about it more often.
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Who deemed her incompetent? The doctor? Is there no one designated - on paper - right now to make healthcare and financial decisions for her? If she can coherently express to legal council that she wants you to be her Power of Attorney and that she wants you to make all of her medical and financial decisions - then go this route. The biggest hang-up to guardianship is the court costs. Another reason why people may seek guardianship is that the POA is not doing a good job or is taking advantage of the person, etc. If no one is on file to make these decisions - she's considered FULL CODE. Do you know this means? The doctors will do everything necessary to save her life - even if their intervention may be leave her in absolute physical misery. What if she gets cancer? She doesn't have to have treatment if she has so many other declining health issues - but the paperwork will need to be in place before this event so you can discuss with the doctor what is best for your mother's quality of life and you can ultimately decide not to do the cancer treatment - otherwise doctors will begin cancer treatment. You need to meet with an elder attorney to discuss your situation. It's great that you're seeking advice here on the AC community but your state may have a different set of rules versus where I live in.
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cothrangirl3 - yes, I do have medical and financial POA for my mom.
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debbyc - what do you mean by an "independent guardian"?
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tw1129

With you having both types of POA for your mom, why is guardianship an interest or concern? Guardianship will tie up some of your time with regular reports. It will involve taking your mother to court, a trial, two doctors testifying that she is incompetent and why, plus family members are informed of the trial and its date. Do you really want to go through and take you mom and family through all of that, plus it's costly?
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I did not have POA for my wife who has Alzheimer's. We moved to CO to unite the family (2 married daughters). I could not sell our condo in NJ or obtain a mortgage in CO using joint assets. I found a good elder attorney and she handled all aspects of the petition for G&C for $3,500. She also filed a waiver so my wife did not have to appear at the hearing. Everything went smoothly and took under 2 months. There was no bond requirement here. The main drawback is you need to keep detailed records and file guardian and conservator reports annually. You may also need to maintain separate accounts, ours are inextricably intertwined! Hopefully this won't be a problem.
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TW, guardians who are "independent" aren't related to the family, are appointed by the court and report to the court. You'll generally lose control of most aspects of care, including management of finances.

I feel especially negative about court appointed guardians after seeing very unsettling abuses while working for an estate planning and elder law attorney. It wasn't him who was committing the abuses, but it was a court appointed guardian from a mid sized law firm. The accounting he filed reflected he was liberally and generously using up the funds of the woman for whom he was supposed to be providing care.

Granted, this and the other instances I saw were in fact few, but the risk for abuse when guardianship is granted to an outside party with no family interest does in fact exist.
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We were told it would cost us a minimum of $6000 to obtain guardianship. My husband has POA for both medical and financial, and it doesn't make sense to me why he also needs guardianship? If so, what was the purpose of the POA?
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Ephesians6vs2,

You are right. Your husband has all he needs with both POAs. I looked at guardianship for my mother but the lawyer told me that I had all that I needed with my two POAs.

BTW, interesting name, Ephesians6vs2. I've seen that verse applied in very healthy ways and I've seen it applied in very spiritually and emotionally abusive ways. I assume the better for you.
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Avoid guardianship at all cost. Get a POA. Guardianship is very expensive and time consuming. In and out of court, attorney fees. Annual final accounting and reports need to be done and presented in court (more fees and accountants involved). It's like managing a separate business. Quite a bit when your hands are already full.
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Kathy,
That is an excellent description of the realities associated with this. As a hospital social worker I've seen this process both misused and absolutely necessary to safely secure discharge. Families responses to these situations can be so unpredictable . Id advise concerned responsible caregivers to decide quickly about this if they suspect others may take advantage of an increasingly more vulnerable parent.
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Cmagnum my name is meant in the healthiest of meanings. It's my way of reminding myself that through it all, I will have no regrets on the other side.
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Ephesians6vs2,

Good to hear!
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If you have both forms of POA, you don't need to go through any of the heartache and expense of guardianship.That's really only needed when you weren't made POA and then your parent is too demented to do so. You should, as POA be able to do what you need for your mom and also take her wishes into consideration while she can make good choices. Good luck. This is not an easy time and I wish you the best and peace for all of you.
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POA should be all you need, I had POA for my uncle and never had an ounce of problems with that. I sure wish my mother would have trusted people and put all of this into place before this time.
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I have G/C for my Mom. In our case, the expense was minimal because I did not hire an attorney. My mom was in agreement, which simplified the process. Each state may be different, but in Maine I went to the probate court and purchased a G/C packet. I forget the fee, but it was around $200.00. You will need to have her doctor sign forms stating that your mom has dementia and is unable to make decisions in her own best interest. There was an initial court date where I went in front of the judge, and he asked some pertinent questions and made his decision as to whether or not this petition was warranted. In the 2nd faze, You must list all interested parties, and notify them. In my case, I went to my brother, and uncle and they happily signed off. This means they are not disputing my application. The court assigns a "Visitor" who will come and sit and visit your mom. He or she will explain to your mom what is happening, and be very clear to her what it will mean for her. Then he or she will file a report of her findings to the court. There was a total of 3 visits, total fee of just under $400.00. Once all the paperwork is submitted, and visitor's report filed, a final court date was scheduled. Mom declined to go, which was good because she is not ambulatory. I think the whole thing would have been too much for her. I went alone, and was granted G/C. I am required to file a financial report each year, as well as a guardianship report. For us, it was the right choice. For most, I would agree that a POA is all that is needed.
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My brother and I are co-guardians and co-conservators for my 88-yr-old mother as of last year. The cost was around $6000+ for attorney and court filings. In GA it also requires a surety bond that is a percentage of her estate paid annually, in this case $2140/year, to protect her estate from fraudulent use by us….it's the law, not a statement about our own personal character, I hope. It was unpleasant because her dementia prevents her from seeing the necessity and she's angry. She had been served the papers by a court rep which set her off. Her appearance at the hearing was not waived because of an incompetent attorney assigned her by the court. Fortunately she did not get as hostile in that setting as she can be. It required an evaluation by a psychologist and her Primary doctor signing off on it. Now my brother and I are tasked with filing inventories, financial plans, and audits of her income and expenses each year around the anniversary of the court's decision.
It is all a hassle but a necessary one because though I had POAs, I could not keep her from getting scammed or make sure she took her meds and she would not agree to live anywhere but where she was. She's appears very lucid and logical to anyone who spends less than 2 hours with her. Please notice I said "appears." We continue to handle the bulk of her physical care at her home with outside, paid caregivers in 2 days a week. She is still in excellent physical condition; she just can't remember what happened 2 minutes ago.
The point is this: since you have the POAs you are in good shape unless she is making bad (read dangerous, harmful, or unhealthy) decisions for herself and stubbornly refuses to change those or not do them, as was our case. As with other posters, I don't believe minor decisions made by her facility would require contact with a guardian any more than with a POA. Just the major ones. I personally do not recommend the guardianship route if you have an agreeable parent and family members who can ensure she's protected and well cared-for as well as trust your judgment. As from others, I've also heard having an outsider guardian is more often than not a nightmare.
With all that said, prayers and best wishes to you in these uncharted waters in which we all find ourselves.
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