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DPOA -- Medical versus Financial
McCott
Posted: Monday, September 9, 2019 1:40 AM
Joined: 8/22/2017
Posts: 371


No doubt this question is for Crushed, and I hope I don't get a stinging lecture : )
I am one of the people Crushed has chastised for not wanting to face up to things -- in fact my preferred approach to life is the proverbial head in the sand. Once you look up, too many things hit you in the face.

Two years ago we did a Medical DPOA, which at the time was what I thought I needed. I do have signing power on his IRA, the bank account is in both our names, as is our house (although I know I could change that easily, and maybe I will).  No other assets  --
I really don't worry about our 20 year old car -- de minimis non curat lex, if I recall.

My question is -- do I also need a separate Financial DPOA when we have such a simple financial situation -- his IRA (on which I have signing power), a joint bank account (which has to stay joint receive his SS payments) and the house. My retirement account is separate and in my name only.

I went to an Elder Lawyer last year but was so upset by having to pay her $1400 for a one hour visit and a report, that after a year I still have not opened that expensive report.  In our meeting, she told me two things: cut off my mentally ill siblings (which I cannot do) and put the house in my name only.  I have done neither.  She also said I needed a DPOA, but since I already have the medical one, I  actually don't know if I need a separate financial one, and didn't think to ask about that at the time.  I had given her a copy of the Medical DPOA, a multi-page form from Compassion and Choices.  If I call to ask any questions, she will charge by the minute, at $400/hour.  I cannot imagine my ever calling her -- I feel paralyzed by the fees and the whole structure of the situation.

I had such a creepy feeling at that meeting in her high rise Seattle office -- I felt that I was just there to pay her expensive rent -- I still feel ill thinking about going there, and that is part of why I haven't opened or read her 'report' a year later.

OK, confessional session over.  

Question: do I actually need a separate Financial DPOA when I already have a Medical DPOA, notarized two years ago?  

Thanks in advance for not mocking or lecturing me.


elainechem
Posted: Monday, September 9, 2019 4:41 AM
Joined: 7/30/2013
Posts: 5886


I would say yes you do. Medical POA is only for medical stuff. I used the financial POA to do things like cancel all credit cards that hubby could use, close our joint bank account, close the safety deposit box, and have the deed to the house put in my name only. After I got all that done, I haven't had to drag it out and dust it off in several years. I could have used it last spring when hubby turned 65 and his term life insurance policy from work expired. I had to open a new policy for reduced coverage that was offered under their portability provisions. I could have signed the documents myself  but I didn't feel like arguing with them, so I had hubby scribble his name. Naturally, he had no idea what he was signing. I need that life insurance because I have no retirement funds since I've been a stay at home mom since the early 90s.
PaulsWife
Posted: Monday, September 9, 2019 6:37 AM
Joined: 3/1/2017
Posts: 57


My DH was an attorney and though he can’t do this work anymore I can tell you what his advice was to others in this situation and what he was happy about having another attorney do for us almost 3 years ago. You MUST get a financial DPOA and ideally do it while your spouse is still competent. If your spouse isn’t competent there will have to be court involvement which will cost you more money. 

One example of what you cannot do if you don’t have a financial DPOA is place your LO in MC. There will be other issues as well.


Ed1937
Posted: Monday, September 9, 2019 8:32 AM
Joined: 4/2/2018
Posts: 1527


Absolutely look at whatever you now have from the attorney! I will only add that financial institutions, such as banks, have their own rules on POAs. Once you get the financial POA, you might want to take it to your bank to see if they will honor it as it is written. Also, if you want to sell real estate property, they go over everything with a microscope. Lack of a middle initial, for instance, might force you to have it written again. This happened to me.
Paul&Me
Posted: Monday, September 9, 2019 9:21 AM
Joined: 1/21/2017
Posts: 123


Look at the report you have, then if you need to, look for a different elder law attorney. I'm surprised you didn't get the first consultation free, which most (if not all) around here advertise. Call around until you find one. Crushed has said before that your husband would be legally competent if he can verbalize what assets there are and whether he knows what is happening. It's possible there are attorneys who donate time to answer questions for free. Call any senior centers or legal aid to find out.
LadyTexan
Posted: Monday, September 9, 2019 9:31 AM
Joined: 12/21/2018
Posts: 206


Greetings McCott.

I understand how overwhelming this is. There is no judgment from me. As you know, this is a difficult task for many reasons. For me it was difficult because:

  • it was so far out of my knowledge wheel house, 
  • significant expense was involved, 
  • I wanted it to be accurate and appropriate for our circumstances and 
  • it meant I had to face the reality of our future (or lack there of).

DH and I had the wills, Medical POA, Stautory DPOA, and HIPAA release for each of us prepared when he had a heart attack several years ago. This was done by a small town lawyer.

When DH received the EOAD dx, I saw a CELA to review our situation and documents. Based on his guidance, I decided to leave DH's documents as is. He recommended I revise my documents based on the change in circumstances. 

The elder law attorney I hired recommended these documents for me

  1. will
  2. Statutory Durable POA
  3. Certification of DPOA
  4. Medical POA and Directive to Physicians
  5. Declaration of Guardian
  6. Appointment of Agent for Disposition of Remains
  7. Patient Authorization (HIPAA Release)
I can't speak to what you need legally. But I can tell you what I paid in Austin Texas. 

  • Initial consultation (2 hours) $400 flat fee
  • Deliverables at $350 per hour that I have estimated as follows:
    • Report of recommended action based on my circumstances $900,
    • Preparation of will and documents 2 through 7 indicated above, three conferences and multiple phone discussions $1,300. 

So my total INVESTMENT so far is $2,600. I call it an investment because the paperwork is done, I am better prepared for what is to come, and I have established a relationship with an attorney I trust.

I would expect legal expenses in Seattle to be higher than Austin because of the high rent there. When it comes down to the nuts and bolts of the documents, I expect there could be variable expenses based on the complexities and family dynamics. I think our situation was fairly straightforward for the CELA because we had prior documents to use as a baseline. DH and I had already had critical conversations when he had his heart attack. We have no dependents.

A dynamic in our situation was DH's recurrent threat of divorcing me. DH's statements about divorce lead to discussions about divorce, guardianship and other what ifs. These things were important to consider and discuss. As a result of DH's statement, the CELA represented me and NOT DH.

McCott I applaud you for taking action on this. You have my support. No judgment here.


Jo C.
Posted: Monday, September 9, 2019 10:17 AM
Joined: 12/9/2011
Posts: 10073


Ostrich syndrome!   I am not the only one!  Our dear McCott, place hands on ground beside your buried head and then pull hard, get head out of ground and read that report you paid so much for. Then . . . . you can go full-on ostrich again as much as you please.

All kidding aside, the cost of your attorney was quite a hit.  Most Elder Law Attorneys will provide first meeting at no cost and then charge time for documents. 

I am a person who wants to cover all eventualities so I decided for both the DPOA for Medical and DPOA for Financial; as a, "just in case" sort of thing.  Opposite of my ostrich bent; this is my, "deer in the headlights," persona.  (My Brunhilde identity only comes into play for my LOs care issues.)  I did not know if anything would come up that would necessitate a Financial DPOA, I just did it to save any unanticipated grief in the future.  Also, the general HIPAA Waiver we did without an attorney; doesn't need one.  That HIPPA Waiver was so used in so many ways so often,.  I can't figure out why hospitals and doctor's offices lose their copy over and over again.

Hate to say, but the cost of our lengthy DPOA for Finance was, $225 from an Elder Law Attorney.  I know; hard to tell who is going to charge what.  As it is, attorneys have a boilerplate document on their computers and just insert the personal information in the areas needing the specifics unless the estate is highly complex.  

It would be interesting to hear what your attorney included in her document . . . . sure hope it wasn't a refund of some of the fee if you sent back a signed certificate by a certain date . . . . teasing, just teasing McCott!

Let us know what was in the document if you decide to open it and I am sure Herr Zerquetschen will catch up to you soon.

J.


Bob Sacamano
Posted: Tuesday, September 10, 2019 7:33 AM
Joined: 1/31/2012
Posts: 473


Yes, a financial DPOA is very necessary. Unexpected things do come up. Such as, in my case, being able to redeem my mom's savings bonds at maturity or the ability to contest fraudulent charges that showed up on her credit card. Ultimately, I was able to get the card canceled. 

In both cases, the entities would not speak with me if I did not have a financial DPOA.


jdmg1
Posted: Tuesday, September 10, 2019 7:53 AM
Joined: 4/23/2019
Posts: 54


This is what was explained to me.  The reason for getting the house in your name is in case your loved one has to enter memory care facility or nursing facility, the institutions can't stake claim to your house.  Medical POA ends with the passing of your loved  and the DPOA extends beyond your loved one's passing and enables you to make all the necessary financial decisions.
Donr
Posted: Tuesday, September 10, 2019 8:08 AM
Joined: 4/6/2014
Posts: 337


When I took the DPOA to the bank they sent it to their lawyer to accept it. Its is now on file with them. Same with our doctors.
jfkoc
Posted: Tuesday, September 10, 2019 8:34 AM
Joined: 12/4/2011
Posts: 17318


"If the principal dies, the durable power of authority automatically expires. The agent no longer legally represents the principal and must relinquish all powers of authority. Upon the principal's death, the executor of his estate handles his personal and financial matters according to his last will and testament."


Rick4407
Posted: Tuesday, September 10, 2019 8:43 AM
Joined: 4/4/2018
Posts: 111


This is a quick response off the top of my head.  If your college, where you teach, has a lawyer on staff.  They may be able to do a traditional DPOA.  If no lawyer on staff, just about any lawyer can do a DPOA.  A CELA  is a specialty and like most specialties, they are going to charge more.  Lastly, start calling around and just asking costs for DPOA.  You could even call your original lawyer as perhaps now that you've paid the price of admission her fees may be lower.   Rick
Crushed
Posted: Tuesday, September 10, 2019 11:03 AM
Joined: 2/2/2014
Posts: 4675


OK

The two are totally separate items and both are needed. 

IM on a thin edge internet so here is a fair description of three separate functions on the health care side https://www.czepigalaw.com/blog/hipaa-health-care-directive-poa-whats-difference/

http://www.marylandattorneygeneral.gov/Pages/HealthPolicy/AdvanceDirectives.aspx

 

 Financial DPOA  are separate documents with separate authentication requirements.

MAryland has quite a good statutory DPOA on line 

http://www.marylandattorneygeneral.gov/Courts%20Documents/17-202.pdf

 

 


Crushed
Posted: Tuesday, September 10, 2019 11:06 AM
Joined: 2/2/2014
Posts: 4675


Competence to execute powers of attorney varies by state.  The mere fact a person has alzheimers does not make them incompetent. As a practical matter Spouses in current intact marriages who hold a power of attorney that they are clearly using to benefit the ill person are rarely found to have extracted it form an incompetent. The issues always come up in blended familys wher ethe power is used for someone elses benefit.
Gig Harbor
Posted: Tuesday, September 10, 2019 12:13 PM
Joined: 3/10/2016
Posts: 573


I paid $1300 for an elder care attorney in Tacoma. It included a meeting with him to discuss what would be needed ( I met with him alone) and then my husband and I met with him to sign papers. He did a will for each of is as well as medical and financial POAs and HIPPA forms. It may be cheaper to get it done in Tacoma versus Seattle.
Crushed
Posted: Wednesday, September 11, 2019 3:21 AM
Joined: 2/2/2014
Posts: 4675


Victoria2020 wrote:
jfkoc wrote:
"If the principal dies, the durable power of authority automatically expires. The agent no longer legally represents the principal and must relinquish all powers of authority. Upon the principal's death, the executor of his estate handles his personal and financial matters according to his last will and testament."
Or if assets in a living trust the surviving trustee can carry on without a snag. We did both- trust and DPOA.
 
 
Just to add Certain properties pass at death by action of law without going through the probate estate. 
Jointly owned accounts, life insurance, Accounts payable at death IRAs to beneficiaries. etc.
 
 


McCott
Posted: Friday, September 13, 2019 5:52 AM
Joined: 8/22/2017
Posts: 371


Thank you all, especially Lady Texan for that nice list, more comprehensive than the report, for which it turns out I paid $1500, not $1400.  I did finally read the report, and felt more or less justified for not having read it for the past year.  It was 6.5 pages long: page 1, summary of information I had submitted,  pp. 2-6 elaborate schemes for qualifying for Medicaid (which I don't expect will happen), and a short paragraph about what to do next, such as getting a DPOA, re-doing my will for some reason (don't remember what she said about this and she didn't explain it in the report), cutting off my siblings etc. 

But I will go ahead and pay her the $150 she wants to do a DPOA for my husband, if and when I can get him downtown to her office. I have to call and ask if that is a requirement.   It turns out the DPOA only has to be notarized, no witnesses needed, unlike the Medical DPOA we did two years ago. 

Meanwhile, my husband has had a recurrence of severe lower back pain, which we went through in winter of 2018.  The MRI showed arthritis and a pinched nerve -- situation resolved for over a year and a half by a spinal epidural cortisone injection.  So I took him back to the same doctors and he is scheduled for a repeat shot next week.  He is on a low dose of hydrocodone 5 mg (Norco) which is not very effective pain-wise, but has made him even more spaced out than before, plus the inevitable bowel problems.

The difficult part is that over the last two days he has been losing strength in his legs and cannot do the stairs unaided.  Until earlier this summer, he was still walking up to two miles a day, although gradually backing off the hills. (He had been a life-long runner since cross country in high school.) The idea of him becoming unable to walk is probably the scariest thing since his diagnosis 5 ½ years ago.    I will have to set up a bed in the extra room on our main floor (my erstwhile study) and put up our old child gate to block access to the stairs.

These alarming recent developments demonstrate why I should have done this last year if not sooner.  I put it off for many of the reasons that Lady Texan mentioned, feeling out of my depth (which I’m not used to and don’t like) and having an allergic reaction to the high rise law scene.  In retrospect I realize she reminded me too much of the ‘women in charge’ from my past life –having been in Catholic schools until age 20 (when I finally managed to transfer out), I find that female authority figures tend to remind me of nuns I didn’t like.  I should have gone to a greying male Elder Lawyer, although the high rise office might have been even fancier.

Thank you all for your kind replies and for the specific examples of why this is needed.  I was more or less lulling myself with the idea that our finances were so simple…  but as each of you know, nothing is ever simple, especially not with ALZ.

 


Caring4two
Posted: Friday, September 13, 2019 7:23 AM
Joined: 7/6/2014
Posts: 644


McCott wrote:

 pp. 2-6 elaborate schemes for qualifying for Medicare (which I don't expect will happen)

Your DH needs to qualify for Medicaid (not Medicare). The programs are often misunderstood.

The link below is the 2019 info for the state of Washington. When my husband (now deceased) was first diagnosed, the first thing we did was see a CELA to start the process of long term care planning. We didn’t have much, owned a home, I had small soc sec income and my DH had a pension, no investments. But, getting the proper paperwork, wills, DPOAs, guardianship for son, and avoiding probate, made my life much easier after his death. I have a 38 yr old autistic son that lives with me and I had to preserve what assets I could for HIS and MY future care. 

We fear what we don’t know. Medicaid is complicated but it is the only safety net we have right now as our loved ones require more and more expensive care. Understanding how it works (in your state) and working with a knowledgeable lawyer, can help alleviate some of those fears. As Crushed has often said, we become “instantly poor” once that diagnosis is made. That’s why Medicaid planning exists and is so vital. 

https://www.medicaidplanningassistance.org/medicaid-eligibility-washington/

 


Crushed
Posted: Friday, September 13, 2019 9:20 AM
Joined: 2/2/2014
Posts: 4675


McCott wrote:

The idea of him becoming unable to walk is probably the scariest thing since his diagnosis 5 ½ years ago.    I will have to set up a bed in the extra room on our main floor (my erstwhile study) and put up our old child gate to block access to the stairs.

 


slightly off the main topic but might be a help. We had a working group a few years ago on access to ordinary bathrooms with minimal modification.  One good idea was to assume  a narrow "airplane" wheelchair .  In many bathrooms you can put access bars around the toilet and tub that allow transfer to the toilet and to a permanent seated area in the tub. often you "back" the wheelchair into the space between the toilet and tub and work from there.

 


Gig Harbor
Posted: Friday, September 13, 2019 11:13 AM
Joined: 3/10/2016
Posts: 573


Another referral that has had some good recommendations is Compassionate Legal Care in Seattle. Not sure if they do a free consultation hour.
McCott
Posted: Friday, September 13, 2019 11:43 AM
Joined: 8/22/2017
Posts: 371


Caring4two wrote:

McCott wrote:  pp. 2-6 elaborate schemes for qualifying for Medicare (which I don't expect will happen)

Your DH needs to qualify for Medicaid (not Medicare). The programs are often misunderstood.

https://www.medicaidplanningassistance.org/medicaid-eligibility-washington/

 

*************************************************************************

This was a typo (in a post written around 3am) which I have corrected -- obviously I was referring to Medicaid.


McCott
Posted: Friday, September 13, 2019 11:59 AM
Joined: 8/22/2017
Posts: 371


Gig Harbor wrote:
Another referral that has had some good recommendations is Compassionate Legal Care in Seattle. Not sure if they do a free consultation hour.

*******************************************************************

Thanks for this referral -- they are close to where we live and sound a lot friendlier than the downtown high rise legal scene.