BIL refuses contact with us. when she declines and I am unable to continue her care, how do we arrange nursing home care. she can pay out of pocket but he holds her finances. can he deny her care at a facility? does he need to be informed or approve? very frustrated
If she still has enough "capacity" and (which an attorney will determine through a private interview with her) and does not have a medical diagnosis of cognitive impairment in her records, then she still may be able to change her PoA (if you want it to be you). Capacity has more to do with comprehension than retention, so even if she has poor short-term memory but has mild cognitive decline, the attorney may judge she can reassign her PoA.
Otherwise your only other real options are what AlvaDeer laid out.
This is why those caring for someone should also be the POA. Your BIL is trying to save his inheritance while you do all the work, as said, time for an elder lawyer who can demand that POA contact him with financial information. Also informing POA that he has responsibility to his mother. He should at least be sending you her SS each month. You should not be spending any of ur own money on her if she has her own. A complaint to SS that he is not giving her her SS could be done.
The elder law attorney will give you your options.
If all else fails you are down to an attempt at ER dump which means you refer the hospital to the POA and you refuse to take MIL back saying you are physically and mentally unable to care for her and he will not speak to you. This will however be complicated at this point as you have made YOUR HOME her home now. She lives there and is considered at HOME there, a tenant whether she pays rent or not.
See an attorney today. Have billings sent to the POA if he handles the finances.