Is it legal for health care advocate/DPOA to refuse appropriate care to save money?
Mother is diagnosed with dementia. Her AL wants her to go to a NH because she has stopped walking. Her grandson who is POA & Healthcare agent wants to bring her to his home to save money. Can he do this although it is not in her best interest?
Sylvie, As others have said, you are a good daughter to try to get the best care for your mother.
A difference between "dysfunctional" and "normal" families is learning to see everything as a crisis. Another is difficulty in making compromises. Each family member thinks they know best. If someone disagrees, it can be seen as a betrayal.
In a "normal" family, if there is any such thing, people are interested when someone has a different idea. "Why do you think that? What if X, Y or Z happens?" Calm discussions. People are more comfortable with not knowing for sure what is the best thing to do. At least that's what my therapist tells me.
Religious people sometimes feel comfortable leaving some decisions in God's hands. They trust that the path will become clearer over time.
If GS moves your Mom into his home, it will go well, or it will go badly. If it goes well, you can relax. If it goes badly, you can help people decide on the next step. This will work well if you can remain somewhat calm, and take a "wait and see" attitude. If you tell GS that his greed is hurting your Mom, he will not listen to a word you say.
For your own sanity, practice deep breathing and acceptance of your limited power. This is a marathon, not a sprint. Save your strength for later.
By the way, I think it is quite admirable that you are trying to look out for your mother's welfare in the circumstances. Do the best you can. Do not beat yourself up or feel guilty if you can't correct the consequences of the dysfunctionality of your family at this late date.
Being diagnosed with dementia is not enough to make someone ineligible to make decisions about DPOA. A person with early dementia may be able to understand the concepts involved for weeks or months or years after the diagnosis.
To try to answer everyone's questions, my family is dysfunctional. My mother and I have been estranged on and off my entire life. Still, I have no wish to see her not receive the best care especially since she has the money to pay for it. I have no "case" or wish to gain any advantage over my son. I am second DPOA, but have no wish to serve. . .only to protect.
The DPOA, health care advocate appointments took place in FL. GS and GM reside in NY. I live in a 3rd state across the country. I have stated that GM has been diagnosed with dementia by an MD. I believe this prevents her from engaging in legal decisions.
Thanks everyone for your interest. At this point, I hope the social worker and medical personnel involved will prevail with good sense.
So where is she now? If she's still in one of these less than ideal ALFs, maybe the thing to do is cosy up to her key worker/case worker and get some supervision started there? The AL may be desperate to get rid of her, but probably not to the extent that they would neglect their duty of care to her (in ensuring that she moves to a suitable environment, that is) if they were aware that someone is watching closely.
When did the transfer of POA take place? If, as it sounds, it was only a year or so ago, you might be able to challenge the validity of the GS's POA on the grounds that your mother was not competent to grant it. But you're getting into mighty muddy waters here.
Besides, if I can ask this in a non-accusatory way, who is going to take over POA: you? Where do you fit in? Why is your nephew (?) the sole heir? And when your mother was being robbed, where were you?
I would add that I shouldn't be too quick to ascribe the GS's behaviour to purely mercenary motives unless you've got awfully good evidence of them. It is also, isn't it? - quite possible that he is outraged by the fees an NH would charge and/or dissatisfied with what he knows about local provision. And if he thinks that having grandma at home would mean a cushy life for him and big financial savings he is in for a disagreeable surprise.
I can understand your concern about your mother, I don't doubt that it's genuinely about her best interests, but you do rather send out the impression of a person who is more concerned still about preventing the grandson's gaining an unfair/unlawful financial advantage. It doesn't help your case when it comes to objecting to the grandson's plans.
Hmm ... I thought you said GM appointed her grandson at that time, under pressure? I am kind of confused about who actually has authority to make decisions for GM.
Do you want to take over decision-making? Is GM "competent" in the legal sense? If so, she can simply revoke all prior POAs and name you. If she is incompetent, I believe that you would have to seek guardianship to be able to make the decisions.
Having GM live with them before did not work out. I wonder how GS thinks it will be different this time? Especially with his wife objecting it doesn't sound like it is in anyone's best interest. I take it you have no influence with the grandson. How about with your mother?
I am very sorry that you and your mother are in this situation.
Here are the details: GM appointed GS DPOA because her lifelong friend who was DPOA had been stealing from her. This was verified by legal authorities. $20,000 in jewelry has never been recovered. So, this appointment happened quickly and under pressure. The current DPOA is not from a state where GM or GS live.
GM lived with GS and his wife plus 2 children under 10 and 2 dogs for 3 months. It was a disaster for all and GM went to AL. In the past year she has been in 3 AL's and in the hospital, then Rehab 5 times. This is due to chronic, seemingly uncontrollable UTI infections. When this happens, she cannot walk.
She has pins in her hip and is diagnosed with dementia.
GS is heir to any monies left after her death. He is in his 30's and trying to take advantage of the Family Leave Act by claiming GM helped raise him. This is a total fabrication. He doesn't want to work at his job, but wants to stay home and care for GM who is 90. From his point of view, he thinks she'll die soon, he will not have to work at his job and will receive the greatest amount possible after her death. He has no caregiver skills. His wife objects. This all seems highly inappropriate and not in GM's best interest, do you think? Who might influence or supervise these circumstances?
It is actually more expensive to care for someone at home if they need a not of services. Nursing homes have some economy of scale. That is why Medicaid (for example) will do a lot to keep clients in their own homes, but not up to the point of needing 24 care ... then it is more cost-effective to use a care center. If it is grandson's intention to save money, he is either going to have to put in a lot of hours himself and/or pay for a lot of in-home help. If Mother is neglected, he will be in trouble.
But in general, where it is possible, dementia patients do well in a private home setting. It often isn't possible to provide this right up until the end because it is so expensive to provide all the care they need and/or the care just isn't feasible at home. So if Grandson is able to give your mother a period of comfort in his home, that may be a very generous thing. (And he may find it is more than he bargained for.)
From what you've said, Sylvie, we have no way of knowing whether this is in her best interests or not.
Mother chose this person to act on her behalf. It is legal for him to make decisions for her -- that is what he was appointed to do. If it turns out the decision is not in her best interest, that would be the time to try to influence some changes.
How do we get from A) the grandson wanting to bring her to his home to the conclusions B.1) that his motive is to save money; and B.2) that it is not in her best interest?
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A difference between "dysfunctional" and "normal" families is learning to see everything as a crisis. Another is difficulty in making compromises. Each family member thinks they know best. If someone disagrees, it can be seen as a betrayal.
In a "normal" family, if there is any such thing, people are interested when someone has a different idea. "Why do you think that? What if X, Y or Z happens?" Calm discussions. People are more comfortable with not knowing for sure what is the best thing to do. At least that's what my therapist tells me.
Religious people sometimes feel comfortable leaving some decisions in God's hands. They trust that the path will become clearer over time.
If GS moves your Mom into his home, it will go well, or it will go badly. If it goes well, you can relax. If it goes badly, you can help people decide on the next step. This will work well if you can remain somewhat calm, and take a "wait and see" attitude. If you tell GS that his greed is hurting your Mom, he will not listen to a word you say.
For your own sanity, practice deep breathing and acceptance of your limited power. This is a marathon, not a sprint. Save your strength for later.
This is VERY hard for you. God bless you.
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The DPOA, health care advocate appointments took place in FL. GS and GM reside in NY. I live in a 3rd state across the country. I have stated that GM has been diagnosed with dementia by an MD. I believe this prevents her from engaging in legal decisions.
Thanks everyone for your interest. At this point, I hope the social worker and medical personnel involved will prevail with good sense.
When did the transfer of POA take place? If, as it sounds, it was only a year or so ago, you might be able to challenge the validity of the GS's POA on the grounds that your mother was not competent to grant it. But you're getting into mighty muddy waters here.
Besides, if I can ask this in a non-accusatory way, who is going to take over POA: you? Where do you fit in? Why is your nephew (?) the sole heir? And when your mother was being robbed, where were you?
I would add that I shouldn't be too quick to ascribe the GS's behaviour to purely mercenary motives unless you've got awfully good evidence of them. It is also, isn't it? - quite possible that he is outraged by the fees an NH would charge and/or dissatisfied with what he knows about local provision. And if he thinks that having grandma at home would mean a cushy life for him and big financial savings he is in for a disagreeable surprise.
I can understand your concern about your mother, I don't doubt that it's genuinely about her best interests, but you do rather send out the impression of a person who is more concerned still about preventing the grandson's gaining an unfair/unlawful financial advantage. It doesn't help your case when it comes to objecting to the grandson's plans.
Do you want to take over decision-making? Is GM "competent" in the legal sense? If so, she can simply revoke all prior POAs and name you. If she is incompetent, I believe that you would have to seek guardianship to be able to make the decisions.
Having GM live with them before did not work out. I wonder how GS thinks it will be different this time? Especially with his wife objecting it doesn't sound like it is in anyone's best interest. I take it you have no influence with the grandson. How about with your mother?
I am very sorry that you and your mother are in this situation.
GM lived with GS and his wife plus 2 children under 10 and 2 dogs for 3 months. It was a disaster for all and GM went to AL. In the past year she has been in 3 AL's and in the hospital, then Rehab 5 times. This is due to chronic, seemingly uncontrollable UTI infections. When this happens, she cannot walk.
She has pins in her hip and is diagnosed with dementia.
GS is heir to any monies left after her death. He is in his 30's and trying to take
advantage of the Family Leave Act by claiming GM helped raise him. This is a total fabrication. He doesn't want to work at his job, but wants to stay home and care for GM who is 90. From his point of view, he thinks she'll die soon, he will not have to work at his job and will receive the greatest amount possible after her death. He has no caregiver skills. His wife objects. This all seems highly inappropriate and not in GM's best interest, do you think?
Who might influence or supervise these circumstances?
But in general, where it is possible, dementia patients do well in a private home setting. It often isn't possible to provide this right up until the end because it is so expensive to provide all the care they need and/or the care just isn't feasible at home. So if Grandson is able to give your mother a period of comfort in his home, that may be a very generous thing. (And he may find it is more than he bargained for.)
From what you've said, Sylvie, we have no way of knowing whether this is in her best interests or not.
Mother chose this person to act on her behalf. It is legal for him to make decisions for her -- that is what he was appointed to do. If it turns out the decision is not in her best interest, that would be the time to try to influence some changes.