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My grandmother and broke uncle live together. He takes care of her but for the last 2 years he has been too sick to do it alone and my mom is forced to drive there and help for too many hours a week. No one else is willing to help and they (uncle, grandma and relatives) want the status quo to stay where my mom is doing more work then she can handle. This includes my aunt, grandma's power of attorney who will not start the paperwork for Medicaid so she can go into a nursing home. What can I do? My uncle and grandma are living on grandma's social security but the work is just overwhelming.

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A case of *Mission creep*.
Mom stepped in to help, but the care needs are creeping past reasonable limits.

(When it happened to me, I named it the *slippery slope* : into a pit of neverending servitude).

It can be very very frustrating being in or watching a situation like, but it can change.

You can't really change all those other people... so I think your role may be to continue supporting your Mom. Sit & chat with her. Tell her you are concerned for her. Ask her how SHE feels about it all. This is key - as she may see it differently to you.

How much help does SHE feel is reasonable for HER to do?

Eg if that was one full day a week, or two mornings, so be it. Then you could help her to be more assertive in telling the rest of the family what her new limits are. She can give an end date, eg start of next month. The family must find other carers (family or paid aides etc) by that date.

Mom may not be able to stop the other family members trying to add guilt & heap obligation on her - but she can say "No, I won't' do that".
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Your mom (I'm curious why SHE isn't the one posting here) needs to be able to say " no" and stick to it.

If there is an "emergency" she needs to tell them to call 911 or non-emergency rescue number.

Grocery delivery, housekeeper and home health aides need to be gotten.

They can't afford that? "Well, then you'll have to make a different plan".

Why does she feel "forced" to do this?
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First question: has your grandmother ever had a medical diagnosis of cognitive impairment? If she is mentally mostly "there" (even if she has a little memory loss) she can create a new PoA and assign it to your mother. This can be done online through Legalzoom or Rocketlawyer. She does not need an attorney but would most likely need to complete the documents with witnesses and a notary (this requirement varies by state). Your uncle does not have any authority over her unless the conditions of the PoA are met. Whatever is in your grandmother's PoA document (like one or 2 doctors need to provide a diagnosis of incapacity) needs to be met before he can do anything as her legal rep. If not, then your grandmother is still in control of her decisions.

But if your grandmother is clearly mentally impaired, that requires another tack. In my state, anyone can be designated a representative to fill out a Medicaid application. But, your mom will need to have access so certain information to complete the form: SSN, birthday, bank statements, medical bills owed, investments/assets, etc. The PoA does not need to sign the app, just the designated representative. If your grandmother doesn't have a lot of assets or property or investments, then the app is pretty straightforward but it can be different by state. She can download the app from the Dept of Human Services for her mother's county (Social Services). She can print out 2, one for practice.

Hopefully her son the PoA has not been mismanaging her finances or doing anything that can be interpreted as "gifting" of money (either to him or from him) as this could disqualify or delay her qualification. Medicaid has a "look back" period which varies from state to state. In my state, (MN) it is 5 years. The shortest is 2.5 years but your mom will need to look on the website for this info. She does not need the PoA's permission to apply for her mom if she is mostly in her right mind.

Is the uncle in his right mind? Guardianship by family or the county would be the only other option.
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Of course they want the status quo, Moms doing the work. So Mom needs to step back. Making a list of what she is willing to do and what she isn't. She can call Office of Aging and see what resources are available and make a list. Giving it to Uncle to take advantage of the resources. Maybe grandma would fit the criteria for in home Medicaid. She maybe able to get an aide so many hours a day.

I hope you realize that if grandma is still with it, that its her decision to go to a NH or not. She cannot be forced. And Medicaid requires certain health criteria to be met before they pay for a NH. Also, that grandma's SS is used to offset the cost. So that leaves Uncle out in the cold. If grandma owns the house it is an exempt asset but if Uncle cannot keep it up if Grandma goes to a home then he will not be allowed to live in it. She cannot have more than 2k (depends on the State)in assets. (Like I said house is exempt at this point). You just don't fill out a Medicaid application. The State is paying for the care so they don't make things easy.

If grandma is od sound mind, the POA is not in effect. So, Mom getting assigned will not change the fact that grandmom can make her own decisions. So Mom needs to make her own. Maybe step back little by little. Believe me, someone will take up the slack. It has happened on this forum.
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If your Mother will not bow out of this there is really nothing that you can do other than seeing to it that you in no way enable her to do this. That means you tell her the honest truth, that she is enabling this behavior, that she will get no thanks for what she is doing and is endangering herself, and that you in no way will contribute to enabling her to continue.
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