My wife recently had a devastating illness. she is now suffering cognative issues, I have no "POA" or healthcare directive. I need help

You will need to apply to the court to become her legal guardian.  You will need two doctors to sign certifications that she cannot make her own decisions, and file a complaint with the court.  It will take a few weeks to accomplish but is not very difficult.  Place contact my office as I am very familiar with this issues.