How can a Power of Attorney help keep you out of a nursing home?
A Power of Attorney is more powerful that you think and a document that is not given much thought. To clarify, a power of attorney is a document that you sign to name a person of your choice, who you wish to appoint as your surrogate to act on your behalf should you be unable to act on your own behalf. This may be because you are out of town or are physically or mentally incapacitated to a point that you cannot attend to your own affairs.
Think about how you and I decide who to name as our surrogates. We simply choose the people we love and trust the most without giving much thought to the types of decisions they will have to make. In reality the most difficult decision our surrogates will make is to step in when they see us slowing down in life.
We say to them that if you see that we cannot manage our own affairs, we trust you that you will make all the right decisions, including the decision about our housing needs. And when our surrogates find us not being able to address our own needs independently they will turn to the medical community for help. And our medical community views nursing homes and assisted living facilities like the rest of us view McDonalds. Cheap, convenient and available. Little attention is given to the effects and quality of the food. Same way, the doctors and medical providers generally do not explore the issue in any detail because institutional care is an easy fix.
This is the reason why many of us end up in nursing homes though we could well be able to stay at home. So, what you want your power of attorney to do is not just to give responsibility to your surrogate, but also to direct that your surrogate use the resources in your estate to seek out the assistance of a qualified geriatric care manager who can provide your surrogate options that should be considered about your care needs. Including whether you could stay at home and if so what services would be needed to accomplish the objective; if you could not stay at home what alternatives exist between home and nursing home and associated costs.
With this information your surrogate could make the final determination, but at least it will be based on a thorough review of the facts by an objective independent professional. In the end, you are not a burden on your surrogate and your quality of life is much improved because of this directive. Not to mention the analysis of whether Medicare or Medicaid could cover some of the costs.