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Yes,every situation and state are different when it comes to elder care.In my case (Ohio) my parents were under the care of my sister who decided she needed to exit the situation because of personal 'problems' and my brother never wanted anything to do with it.In other words both chose to decline any responsibility in their care.They were adamant they wanted nothing to do with it despite both parents were middle/late stage dementia.I needed to go it alone and the first place I went was to a elder law attorney who has been in practice many years.She wanted to protect both my parents foremost and me from mistakes that down the road could effect Medicaid benefits or litigation with the siblings especially if our parents passed away before the money ran out.She told me flat out 90% of the time money is the issue not the care level with detached siblings.Our parents had no will or directives.She filed everything with the county probate court and I was assigned a case manager to oversee everything I was doing in regards to my folks total care.More filings went to social security where I had a case manager too.My father did not live long after I became guardian but my mother lived long past after their assets ran out.I did this for a total of seven years.My mom passed away this January and I'm still dealing with many issues with the attorney.It was a very difficult and slippery road but I felt our parents received the best care possible considering the sorry situation.I tried to keep both of them at home as long as possible but both ended up in a nursing home in the end.That was when the real headaches and heartaches began and I'm glad I had a attorney to help me through the nonstop distress.Medicaid and nursing homes are a nightmare.They were in a "five star" one and it was still hell on earth.I never denied anyone visitation or to oversee what I was doing in regards to their care.They rarely came so it became a moot point (visitation).I saw a lot of this in the nursing home and it broke my heart for my folks and a lot of the other residents.I usually spent 40 - 60 hours a week with them and hired private caregivers to be with them when I was working.In the end all their money was gone and so was most of my retirement fund.My siblings got away scott free.We live in a strange society where if you dump your child you end up in jail but if you dump your parents there is no penalty.I have no regrets because they were fantastic parents.I met quite a few devoted legal guardians during those seven years and most had a tale to tell that was quite similar to mine.There are still a lot of wonderful people out there who are doing the right thing despite a system that puts up a battle every step of the way.A good reason to hire a very experienced elder law attorney from the get go.