My grandmother is currently in a nursing home after being placed there by a daughter who did not wish to care for her any longer. The daughter is both the Power of Attorney and medical proxy. Due to a family rift, the POA is not in communication with my grandmother's remaining children (who would have gladly taken on my grandmother's care, but were denied the opportunity because of the POA's not wanting her to live with them). She does not communicate any information related to my grnadmother's health, forcing the rest of the family to have to go through the hospital or the home to get updates. Twice when my grandmother was hospitalized the POA instructed hospital staff to not give out information to family members calling to check on my grandmother. Now she has also given the same instructions to the nursing home. There is no justifiable reason for her actions other than her own pettiness. And there is no base to her instructions- my family only want what is best for her, and up until now, the nursing home never had any issue with us calling and visiting. Is there any recourse?
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Whether your grandmother is competent or cognitive is really something that needs to determined by medical and legal professionals.This will be expensive to do. Until that happens and she can change her situation the POA is in charge. Whether her care is best served at home or at a NH is ultimately the decision of the POA. The POA has decided it is in NH - a skilled nursing facility. Keep in mind that if you challenge it, you'd have to prove that the NH isn't the best place for the level of care that she needs and that you can do and provide for all that the NH has. For example, I imagine that most registered physical therapists will, under oath, state that PT is best done in a rehab setting and not at home. So unless you are a RPT your opinion on whether PT can be done at home doesn't carry much weight. Realize those are the type of issues that will come up if you challenge the POA. If gran lived with you and there were problems that happened while gran was under your roof (you said she lived with you and there were some sort of Rx adverse issues), then you aren't in a good position to become her caregiver because all that will come up if there is a guardianship hearing. Can get ugly.
Nursing homes really are skilled nursing facilities and have changed dramatically and what a NH was in your greatgrandfather's day is not what they are today. There are some that are terrible and some that are almost ideallic. But because of regulations, you can't get into a NH without it being medically needed. Go an visit your gran at the NH and make the most of your time with her and put the whole POA issue behind you if you can.
And while you are correct that legally my aunt has no obligation to impart any medical information to the rest of the family, from a moral perspective to not inform my grandmother's five other children of how she is doing is rather pathetic and sad.
There is a reason why daughter # 1 was chosen by mom as POA over the others when mom was still competent and cognitive. If you had issues with it, you should have challenged it then. That was mom's wishes then and Daughter # 1 acted for mom's best interests and I would imagine mom's needs changed to the point that a NH was needed. Admission into a NH is something that is not done easily and mom had to meet a certain level of medical necessity in order to be there and stay there. The POA has no responsibility to let you know what the reasons were and HIPPA laws have to be enforced by the NH and all of mom's health providers.
To get mom to change POA that could stand up in court now would be highly unlikely as mom likely has moved into decline significant enough that she is now in a NH and not competent or cognitive. I've been executrix twice and spend more hours in probate court than I could have ever imagined, and probate court is also most often where they hear guardianship requests and it's all open court so you get to hear all kinds of things. I will say in the time I sat around waiting for our docket to come up, changing an existing POA to a guardianship once the person is in a NH and the POA has seemed to do everything according to the norm, just does not happen. The judge is going to view the POA as valid and is not likely to be changed as the elders competency and judgement is impaired. Guardianship is not likely to be granted if the POA can show that proper care is being provided which being in a licensed NH does. The only ones who make out by this are the attorneys who get paid. Keep in mind, that if the elder has any $ the POA can use that $ to get an attorney to fight your challenge to the POA. You have to spend your own $ to do this. Costs do add up. Also my experience is that if the family is not all kum-ba-ya on mom's care, the judge will appoint an outsider to be the guardian - it will be an attorney, and the judges have a short list of those that are ready to do this asap - and once that happens the family can pretty well kiss goodbye becoming guardian or conservator for the elder for at least 6 months.
Guardianship isn't automatic and the judge can require all sorts of background checks, bonding, etc. for one to become guardian. After all this, the original POA could get appointed guardian anyway, too.
I'd like to give my aunt the benefit of the doubt and say she won't block people from seeing her, but personal history tells me she's capable of anything. This latest instance is in retaliation of one of my cousins going to visit my grandmother in the hospital and ignoring my aunt's advice that it wasn't a good idea. This cousin works in the medical field and understands precautions and would never jeopardize my grandmother's health. She had also driven 3 hours just to see her and would not be deterred. The very next day when she called the nursing home to see that she was doing ok was when we found out about my aunt's instruction to the nursing home.
As far as trying to remove her from the home....quite frankly yes, I do not want her to be there. At least not now. Do I think there's going to be a time when she will need that level of care? Absolutely. But right now she is not so far gone.
Unfortunately I likely cannot afford to do anything legally, but I do appreciate the advice. Thanks for listening.
xo
-SS
There are aspects to this that may never be fully understood. In any case, go about your purpose of giving this poor woman some peace in her remaining years. Keep the family squabbles (or wars) away from her. Visit her where she is and bring a ray of sunshine when you come. I understand why phone calls aren't possible. Cards and visits still are possible, right? Aunt POA might keep the medical details from you, but surely she has no authority to say who visits when, does she? Especially if your grandmother can express her own desires.
It sounds like what you would want to have happen is to remove Grandmother from the NH. Right? An attorney who specializes in Elder Law can give you advice about what actions are available to you, what they will cost, and how likely they are to be successful.
If there is no feasible legal recourse for that first wish, do everything in your power to let Grandmother feel your love where she is right now. Give her the peace she deserves.
I am truly sorry that your family is having this experience.
When she first got to the home, the nursing home told us that anyone could call as well as no limitations on visitors. Now we can no longer get any information when we call and my aunt is not particularly forthcoming with information. Calling to speak to my grandmother directly is not an option as she cannot hear well on the phone. We do visit regularly but it's difficult as we still feel she does not belong there. Keep in mind, prior to her going to the home, she was mobile (with supervision), and her other faculties were intact (when her meds are properly adjusted). Now she spends her day in a wheelchair and gets winded with the slightest exertion. Her meds are now under control so her mental faculties are still intact. And even those visits the POA is trying to control, trying to dictate who goes and when.
This in absolutely no way about money. It's about trying to give my grandmother some peace in her remaining years. My grandmother grew up with an abusive, controlling father; married an abusive, controlling man. And now has an equally controlling child who is using her as a pawn to lash out at her family.
That pretty much sums it up if money isn't the issue.
Esne76 - are we helping you at all? Is there more we can know?
xo
-SS
Oh my goodness. This statement by terrimerritts literally brought tears to my eyes. I had to go on to other things for a while before I could address this.
I belong to a support group for caregivers of persons with Lewy Body Dementia. One of the hardest facts of our lives is that in all probability our loved ones' needs will outstrip our ability to satisfy at home. I have seen husbands, wives, sons, and daughters absolutely agonize over and become physically sick at the recognition that they can no longer provide the best physical care for their loved ones and I've watched them go through the transition from being 24/7 hands-on caregiver to being advocate, oversight providers, and once again loving spouse or child.
I have had very painful discussions with my husband in his more lucid periods, assuring him that I will never ever abandon him and that I will always see that he has the best care possible and that I'll be there for him always. We both acknowledge that the day may come when the best care is in a professional setting.
If (when) the time comes and I determine that a long term care setting is where my husband will get the best care for the stage he is in, I will to everything in my power to see that it happens. I would fight relentlessly anyone who thought they were more qualified than I to make the final decision, or that they could provide better care in their home than I could provide in mine. I want to do WHAT IS BEST FOR MY LOVED ONE. To have the angonizing, heart-breaking decision to place a loved one in a care facility described as "dumping" someone for "glory with none of the work," literally makes me cry.
I suppose that there are really instances of "dumping" out there. But to automatically assume that that is always what is going on when someone is placed in long term care is heartless and misinformed.
As my husband declines, I dread creeping closer and closer to the point where I may have to give up primary caregiver position, for his own good. Fortunately all of our family have been involved enough in his care that I don't expect any opposition to any decisions I make. But knowing that there are many people out there willing (and apparently eager) to judgementally declare that I've "dumped" him adds to the burden that already feels overwhelming.
I assume that your Aunt was the fulltime caregiver when she "did not wish to care for her any longer." Is that correct? As the POA and Medical Proxy, Aunt had the legal authority and the moral obligation to decide what level of care would be in Grandmother's best interest. As the caregiver she also had the most intimate knowledge of the situation. Aunt's responsibility was to determine what was best for Grandmother, not to hand out opportunities to other family members. Sometimes care in a private home is NOT the best option, no matter how many well-meaning relatives are willing to provide it.
So maybe Aunt is a selfish, spiteful person who just wants to antagonize other family members for her own reasons and she placed Grandmother in a NH as part of that agenda. And maybe she made an excruitatingly difficult decisions based on her close knowledge in the best interests of her mother. We on this board certainly don't have enough information to judge that. Maybe you do. But maybe your judgment is clouded a bit by the filter of the "family rift."
You say that "up until now, the nursing home never had any issue with us calling and visiting." Do you mean that out of the blue, with no provocation or incident or reason, Aunt just suddenly decided to pull rank out of pettiness? That seems a little unlikely to me, but I suppose it is possible. You say that "my family only want what is best for" Grandmother, and I have no reason to doubt that. But I also know that in a family of 6, there can be 7 opinions of what is "best." One person, and one person alone, has the final responsibility for deciding and acting upon what is "best." Your Aunt does not need to take a survey or a vote or listen to other people's opinions. She must decide. In families where there is not a "rift." the POA will often listen to the ideas of other family members. But when it comes down to making a decision, even in the most loving and functional families, the POA is in the same position as Harry Truman was when he said, "The buck stops here."
If this is about money, or there really is evidence-based concern that Aunt is not acting in Grandmother's best interest, get a lawyer.
If this is about sadness over the rift in the family, show Grandmother your love by visiting, sending cards, calling her directly (not the NH staff), and maintaining the best relationship you can in spite of family obstacles. You can't make any decisions about her treatment, so does it really matter that the NH won't tell you if she has a uti or is declining rapidly or has an improved appetite? Unlike your Aunt, you have the luxury of treating this oldest family member only as your beloved Grandmother, and not as a patient or a dependent. You don't need the medical detail to continue to show your love, and to receive the love Grandmother can offer.
Grandmother's life is in the home stretch. Use the time left to share cherished memories and to build some new ones. There will be time enough for all the acrimony and family strife after she is gone.
And can you just go see her in the home? I think, if the grandmother is that important to you, you'd want to see with your own eyes how she is doing. I don't think the NH can refuse for you to see her. Just get in the car or get on a plane and go!
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