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Rebeccaal Asked November 2020

What if my brother and sister have POA but I don’t think are advocating and asking questions of the doctors on my mom’s behalf?

I have very strained relationships with my siblings. They weren’t stepping up so for about 8 months I’ve been managing my mom’s care. My mom typically gives the verbal OK for doctors and such to talk with me. Recently my sister made a comment and I started to fear that I don’t actually have the legal protection of POA. I decided I’m not managing my moms care anymore and those with POA should. Both my brother and sister have POA. I told my siblings that I’m not managing moms care anymore because I don’t have the legal framework of POA but I also said I would help if they wanted or needed- I will provide any info to help the transition from me to them to manage her care. They have not responded to me.


My mom is in the hospital right now and I can see her CT scan via a patient portal- I have questions and shared them with my siblings- requesting they ask and follow up with the docs. They have not addressed my concerns. Throughout the last 8 months when I’ve been managing my moms care I created a google doc and put all the info there- updated in nearly real time - and I always asked them for questions and relayed them to the docs. They are not doing this- but I don’t think they are asking the docs the questions either.


My mom is in the hospital for a kidney infection but I can see they did an ECG and it shows a prolonged QT and was noted abnormal- do I just let it go and trust that the docs have everything handled? I’ve asked my siblings about it.


Anytime I suggest to my mom that my siblings should ask a specific question she fiercely defends my siblings - she knows we don’t get along and she thinks she doesn’t need anyone to do anything - she doesn’t know or realize what I’ve been doing and now stopped. She is the most clear that she’s been over the last eight months but she is still 78 and so many of the details are just too much for her to manage.


I don’t want to turn my back on my mom but I also can’t keep managing her care without feeling protected. My sister is very vindictive and passive aggressive. She was recently in a lawsuit with a step daughter of my aunts and I wouldn’t put it par my sister to try to destroy me in some way.


Any recommendations for how to proceed? Ignore my concerns for my mom - everything will be fine? Or ignore my sister and brother and advocate for my mom with doctors and so forth? It’s painful the siblings aren’t doing anything and there is so much to be done-they aren’t even aware of every detail- my mom calls me to order things for her and to ask for help. I am a hyper communicator and I have very consistent regular communication with the house caregivers where she lives and with the house NP- and actually all the docs and even family friends. None of us live nearby- all out of state but I’m actually the farthest away. Incidentally- we have these same issues with my dad but I actually have durable POA for my dad (but so. does my brother).


There is no inheritance and hence I’m witnessing no strong incentive to help with the many laborious details. In fact there will likely be a financial need to support them at some point so the siblings are distancing themselves from the details of managing their care- my brother didn’t even sign the POA paperwork (parents don’t know he never signed). It’s all so sad but I started to feel the need to pull away from managing it all and feel a little too vulnerable especially as my mom defends them.


Thank you for sharing your thoughts and experiences

thingsarecrazy8 Nov 2020
From what I gather from the situation, it seems that your mom is able to speak for herself. She can put you as her healthcare proxy with the hospital as long as she has not been diagnosed as incompetent. A POA does not give anyone the authority to take the right of the patient unless they are unable to speak for themselves either due to being unconscious or lacking the mental abilities to do so otherwise. While many people who are authorized as a POA believe that this gives them total control over the situations, it does not. If it were guardianship, yes, it does give authority, however, there are even greater rules that need to be followed such as keeping records of expenses or treatments. Someone with a POA does not have to share any information with their siblings or other family members, but they should be doing what is best for the one they hold POA.
Best wishes,

NeedHelpWithMom Nov 2020
Good luck to you in sorting this situation out. Sounds very frustrating. Many of us have siblings that aren’t going to cooperate or be considerate.

So sorry that you are struggling with this.

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worriedinCali Nov 2020
If your mom is of sound mind she can make you her health care proxy, the hospital has the forms and can take care of that. That will allow her doctors to speak with you. You don’t need an actual POA, she can designate you as health care proxy and fill out HIPAA release forms so you can speak to her health care proxy providers.
AlvaDeer Nov 2020
Sounds like the perfect way forward, actually, and the easiest, if Mom wishes to do it. If Mom doesn't, step away.
AlvaDeer Nov 2020
Mom gave POA to the siblings.
From what you say, that is where she wishes the POA to remain. It is her choice. Doctors will now discuss things directly with Mom or with the POA for Health care if Mom is not competent in making decisions. Offer your siblings your help should they ever wish to have it.
You said that you "used to" do the health care end of things with Mom giving permission but for some reason you decided to no longer do that. You cannot have it both ways. You gave this up for your own good. Step away now. Your Mother can ask you to step in if she wishes. Your siblings can ask you to step in. It is unlikely the doctors would discuss a prolonged QT with anyone. They would look at the meds, she if she is taking anything that causes this (some meds DO) and consider whether they should eliminate it or not. That is a medical decision in which they would merely say "Irma, we think you shouldn't take such- and -such anymore; we see some rhythm changes it could be causing". No need to discuss every single little thing with everyone.
If you are noticing such things as prolongs QTs I am assuming you are in the medical profession somewhere. I understand it is difficult then to not be the POA for Health Care. However your Mom doesn't want that. And your siblings seem happy enough. Perhaps consider taking this burden off yourself. The outcome for Mom's health will be what it is, by her choice.
And you know, if you are sitting right there there's no reason you cannot say to the monitoring nurse "Wow, that's a heck of a long QT there, isn't it???"
Look at it this way. There are 100s of thousands of elders in hospitals now living well into 80s and 90s with no children at all. Goes a long way in stopping sibling problems.

sjplegacy Nov 2020
If you feel you still want to offer your 2 cents go right ahead. A POA offers you no legal protection, in fact it could be a liability to the agent if not properly exercized, that is acted in the best interests of the grantor. You already have a good rapport with the staff so keep advocating for mom.

Grandma1954 Nov 2020
If your mom is competent she can change POA if she wishes.
Taking the "nice" way would be to follow the advice of gladimhere.
If you want to take the not so nice way you could contact the Attorney that drew up the papers and discuss your concerns. At that point you could ask what would be the next step. It might be getting mom declared incompetent and you taking Guardianship. This is NOT a nice or easy way to do things.
The other way would be to continue to express your concerns to the doctor and let them take it from there.
Has your mom expressed her wishes as to what type of medical intervention she wants if any?
It might be possible that she wants minimal treatment and you want to go all out. This might be why she chose a sibling as POA and not you.
Rebeccaal Nov 2020
Thank you- I will talk to our attorney friend and my mom together in the future- that’s good advice.

oddly I think the opposite of what you suggested is true- I would never go all out- I would always choose minimal- my sister wants CPR and to go all out. Both parents have selected DNR.

my issue is that I’m extremely thorough- I call doctors daily and ask a TON of questions- I read results and I ask away. My siblings don’t even request to talk to the doctor- they talk to my mom and get reports from her- but she’s not fully capable- she thinks she is but there’s just so much that’s happened to her in the last 8 months- I wld never expect her to be aware of and track details.
Geaton777 Nov 2020
You mentioned twice about you having PoA for your protection. To clarify, this is not the point of her PoA, it's an authorization by your mom for someone to act in her best interests. You don't need a PoA to help your mom manage her medical stuff, she can assign you as her Medical Representative by writing you in on the HIPAA forms for her doctors. Doesn't require a notary or anything. Your mom doesn't have dementia so she is still in charge of her own medical and financial decisions. Not being the PoA does NOT make you "vulnerable"...what would you be vulnerable to?

Also, since your mom doesn't have dementia she can create a whole new PoA or add you as a PoA if she wished.

Does she have a Living Will on file with her doctors? If not you should encourage her to create one (with input from her doctors) so that she can remain in control of her medical choices in the event she can no longer speak for herself. This is actually a very important document and the medical community is extremely happy to have the guidances it provides for each patient. If there's no Living Will doctors are pretty much required to administer "heroic" levels of effort to preserve life. She can create a doc that is more detailed than a DNR.

Also, you said your brother didn't sign the PoA from your dad. If this is true and it's not notarized and you don't have an original notarized copy, this is not a functioning legal document.

Finally, "...there will likely be a financial need to support them at some point..." No. Just, no. This will break everyone's bank in short order. Please read the thousands of posts on this forum bemoaning the avalanche of problems when people try to take it on. None of you children are obligated to pay for her care. I strongly advise you take her to see an elder law attorney who will explain what lies ahead and how to prepare financially for it. One must be extremely careful to not co-mingle their funds with hers, or make what "appears" as financial gifting of money, assets, property. Even if there will be no inheritance, her ability to qualify for Medicaid at a critical time can be ruined by well-meaning but uninformed children wanting to "help" her. Please go into this with your eyes wide open so that all her options remain protected.
Rebeccaal Nov 2020
my sister has been very vindictive and doesn’t talk to me- when she does she has said she doesn’t trust me and she thinks me and the facility are abusing my Parents - my parents would definitely disagree so it’s really a non issue but at some point my parents won’t be here - I get the blame when anything goes wrong and I anticipate trouble from her.

my parents have a living will and I’ve actually already navigated and applied for Medicaid- my parents were both slated to get the MI Choice waiver (a Medicaid program in MI state) but I pulled out the partially finished application recently because we have a couple more months that we can afford at the facility and my mom may actually get better and go home eventually- a few things are being played out monthly but I’m very aware of the Medicaid process- I’m being strategic because I’ve got both parents in need but it’s to our advantage to apply for just one. Once they get Medicaid and if they do use the waiver- they will still have some expenses- but indeed they will fall on the family- and that’s ok. I understand your concerns but I’m pretty far into this process- can barely explain all the details her but thanks for your reply. It helps to hear people reply and have a plan e to share my thoughts.
gladimhere Nov 2020
First, relax. You are in a tough situation. Mom gave POA to sibs. If you think they are not doing the duty, then ask Area Agency on Aging to do an assessment.

You mention "the home" is mom in a facility of some kind? You can always raise concerns with them. Then let them deal with it.

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