the client can do a new power of attorney that revokes the old power of attorney. the client can appoint whoever she wants in the new document. As long as the client understands what she is doing, she can make a new power of attorney, even with the dementia diagnosis.

It's hard to know what steps to take right now without knowing more about your situation. Probably one thing to do is to visit with an elder law attorney to get specific advice. You can find an elder law attorney by going to the National Academy of Elder Law Attorneys website, naela.org. There's a "Find An Attorney" button on the very first page. Educating yourself about your loved one's diagnosis and what to expect as time goes on is beneficial also. A care manager can help immensely as care giving gets more difficult; you can find one at the Aging Life Care Association website, aginglifecare.org.

I'm not familiar with a medical loan, but I think the first thing I would look at is whether she could qualify for Medicaid to help pay for assisted living. Medicaid is a government program that helps people pay for long term care if they can't afford the cost of care themselves. There are income, resource, and health requirements to the program and sometimes there are waiting lists for some kinds of care.

The best protection for your mother and the family is to use a reputable company that provides care giving services. The company will have a contract for your review; make sure you understand its terms. Using a reputable company means that the caregivers will be well-screened to begin with and, if a caregiver is not a good fit for your mother, the company's management can provide a different caregiver who suits her better. I do not recommend trying to find an individual caregiver yourself. However, if you become aware of someone who seems like a good option and who makes it through criminal and credit background checks, then yes, it makes sense to have a contract with that person. Keep in mind that it's unlikely you'll be able to sue an individual caregiver in case of a bad result because that person probably won't have any money and will not be insured.

Usually the cost of personal assistance services are based on the number of hours the caregiver spends with the care receiver. So, for example, you might have someone come in for four hours a day, three days a week, for a total of 12 hours a week. Hourly rates vary depending on the company you use. I recommend that you use a personal assistance services (PAS) company to hire a caregiver, rather than hiring off the street. Reputable companies screen their employees on many levels and can also fill in with another caregiver if your regular caregiver calls in sick. Admin Ryan McGuire can chime in here with more information.

The most important thing for the care receiver to do is give someone power of attorney for financial and medical decision-making. By doing this, the care receiver allows a trusted family member or friend to be able to handle finances or medical decision-making if the care receiver becomes unable to do so. Powers of attorney are legal documents (in Texas we use two, one for finances and one for medical) that give the person appointed, called the "agent," authority to act on behalf of the care receiver.

That's a good question. According to the National Academy of Elder Law Attorneys, "Elder law and special needs planning includes ... planning for incapacity and long-term care, Medicaid and Medicare coverage (including coverage of nursing home and home care), health and long-term care insurance, and health care decision-making. It also includes drafting of special needs and other trusts, the selection of long-term care providers, home care and nursing home problem solving, retiree health and income benefits, retirement housing, and fiduciary services or representation." Anyone facing those issues should seek an elder law attorney. However, an elder law attorney can also help an aging person without those immediate issues, because she can point out potential pitfalls in the future.