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Questions as POA & Caregiving Options
Posted: Tuesday, December 3, 2019 10:54 PM
Joined: 12/3/2019
Posts: 8

As the POA for my father, I realize I may need to contact an elder law attorney. But I'm hopeful someone here may provide some insight.

He has been to the hospital 6 times in the past 3 months. He has also been in a skilled nursing facility twice during that time. The doctors tell me if he goes back to the hospital, I can expect him not to come out. Several doctors have written notes indicating my dad needs 24/7 care. Adult Protective Services is involved and have said in no uncertain terms that he will NOT be allowed to go back home.

The reason for this is because his wife (my mother) refuses to allow caregivers into the home for more than 16-hours/week and often threatens to take that away. Even if they are there, she will do all she can to make sure they are miserable (accusing a caregiver of sleeping with my impotent father who wears diapers, for instance). 

My mother has long been verbally abusive to my dad. As his cognitive abilities quickly decline, this has become even more apparent. When he suggests he needs care, she calls him lazy and stupid, and then tells him she can take care of him herself. He has been diagnosed with severe malnutrition among other things; she cannot care for him... 

Yet, he wants to go back to her. He feels obligated, says it's his duty as her husband to be there, even knowing that he will literally die going back to that house. Her children are claiming this is a "tragic love story" and that I'm trying to prevent two people in love from being together.

As the POA, do I have any right to get him healthcare at an assisted living facility? Do I have an obligation? Do I just sit back and let him wilt away sooner rather than later?

This is draining everything from me mentally and physically and I need some guidance. Please help.

Mobile AL
Posted: Tuesday, December 3, 2019 11:42 PM
Joined: 7/21/2018
Posts: 44

This is strictly my observation because the ultimate decision is up to you.

If you have POA over your father, it is your duty to consider what he would do if he had a choice in the matter but it is also your duty to do what is best for him if he can't make the choice. That is why a POA is needed. You have the support from the doctor saying it is best that he not go home. To me, that would be my response to the rest of the family. If the doctor says no, then you need to do what the doctor suggests.

Posted: Wednesday, December 4, 2019 7:16 AM
Joined: 3/6/2017
Posts: 2265

You need to consult with a certified elder law attorney asap.

I'm not a lawyer, but my understanding is that your dad chose you as POA over your mom for a reason and that obligates you to act for his health and welfare now that he is incapable of acting on his own behalf. I don't know if you can ethically ignore medical advice for a care placement.

It sounds as if this is a blended family situation which complicates things vis a vis their assets and paying for his care. "Her" children from another relationship may not be as invested in your dad's well being and may be OK with her neglect/abuse if it preserves assets which might presumably come to them in the form of an inheritance. 

Given your dad's progression, I would work with a CELA to look at their assets to find a way to place your dad in a good quality facility. The financial piece of this will be complicated, especially if assets are jointly held. You may need to do Medicaid planning with mom as a community spouse. 

The other piece to consider is your mom's cognition. She should also be evaluated. Sometimes when a person has a long standing history of a challenging personality it is easy to ascribe cognitive impairment as personality. 

Eric L
Posted: Wednesday, December 4, 2019 10:53 AM
Joined: 12/5/2014
Posts: 1291

As HB already said, it might be time to start worrying about your Mom's mental status as well. Most caregivers tend to welcome extra care.
Posted: Wednesday, December 4, 2019 2:19 PM
Joined: 12/4/2011
Posts: 18733

If it is not a Durable POA your questions are not relevant. Please check the document.
Posted: Wednesday, December 4, 2019 9:43 PM
Joined: 12/3/2019
Posts: 8

It is Durable POA.
Posted: Wednesday, December 4, 2019 9:45 PM
Joined: 12/3/2019
Posts: 8

I completely agree... Unfortunately, my mom does not want to acknowledge that she is anything other than 100% with the "minor" exception of end-stage COPD. And two of her daughters (my sisters) keep reinforcing this false narrative so she won't go to the doctor for anything related to cognition.

As I read through these posts, I realize that she fits every marker mentioned. I can't believe I didn't catch this earlier. Yet, I don't think there's anything I can do because she's convinced I'm embezzling money.

Posted: Thursday, December 5, 2019 9:42 AM
Joined: 2/6/2018
Posts: 324

What a tough situation you are in, Sylvia. If the POA you have for your Dad includes healthcare decisions and not just financial then you could possibly have him admitted to an assisted living facility. Usually there are 2 different POAs, one financial and one for healthcare. The healthcare POA may state that you only have power if a doctor says that Dad is unable to make healthcare decisions himself and you lose power when he has mental capacity again. How does APS say they are going to enforce their “He can’t go home” directive? And also, can you use his doctor’s insistence that “he needs better care to avoid another hospitalization that he won’t survive” in order to get him in assisted living somehow? If you haven’t already, I would explore these two avenues as well as the healthcare POA to get your Dad admitted somewhere he can stay long term. You can tell him and the sisters that it’s temporary until a safe caregiving situation can be arranged at home, which very well might be true. And also add that it is not just your right but also your responsibility as healthcare POA, because this is true. Your Dad asked you to look out for him when he needed it when he gave you the POA and that’s what you’re doing now (tell them this.) And you may also be able to place some “blame” on APS and doctor’s orders.  Dealing with your Mom is a whole other situation. After getting your Dad settled in a new living situation, maybe you can tell her that in order for APS and your Dad’s doctor to allow him to come home and be under her care again, she needs to undergo a medical evaluation to determine if she is fit? Then continue the fiblets to get her a full eval to diagnose any dementia. Either your sisters will need to go along with this fib, if she shares it with them, or maybe you can tell them that it’s YOUR requirement as daughter and POA looking out for Dad.
Dave Cahail
Posted: Thursday, December 5, 2019 7:56 PM
Joined: 6/24/2018
Posts: 41

Make sure you are clear on what the durable power of attorney covers - financial, medical or both. Also, you will have to have it activated in order to effectively take charge of the situation. Hopefully you know your parent' attorney as they can usually file this with the courts on your behalf. Provide that attorney with any information you have from financial and medical experts that state the need for you to step in and help in this situation. 

Once the POA is in effective, make sure you provide copies of it to all necessary entities (e.g. banks, financial planners, doctors, etc.) that can help you deal with this situation. 

I am sorry you have to go through this but know that many of us have already gone through this and can provide advice and guidance to help you. But most of all, take care of yourself. It is also easy to get caught up in the day to day problems so keep the big picture of knowing you are doing the best you can. Reach out when you need help.