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My mother has appointed myself and my husband her MPOA’s, and I am also my father's MPOA. There is dissension in the family and the majority are making medical decisions without our knowledge. Ex: hiring caregivers, not giving prescription meds that Mom's Drs have prescribed. Being that they have also decided that my sister can move into the house and be there M-Fri they believe they have the right to do whatever they want and most of the time they do!! Mom falls, dad falls, they don’t tell me, but the caregiver does on her next shift. Now I’m wanting to try to help my parents with some alternative solutions per my mom's primary care physician but my brother, who is the FPOA, is ignoring my requests for this treatment and refusing to pay for it, or reimburse me if I pay for it. Can all of these things be done? I’ve searched the internet to find articles regarding the positions of the MPOA and FPOA but nothing that helps in these instances. Doesn’t the FPOA have to pay for any and all Medical care? Can he just ignore my requests and refuse? Can the family, because they are in the home, make medical decisions without consulting us, the MPOA’s? Any thoughts or suggestions?? Thank you!!

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Be, welcome to the forum.

Go to your states website and read what the law says about POA. This will help you understand what the POA actually means and what responsibility the POA holder has as a legal fiduciary.

Can your parents speak on their own behalf?
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Benice2me May 2022
I will check that out. I’ve just read that the MPOA has the right to make necessary decisions medically without other family members acknowledgments. I’ve tried so many times to discuss things but it sheets goes south. Just as in medication to help moms behavior, they then post that I am trying to kill my mom and keep her in a comatose state. It’s ridiculous and hurtful! My mother cannot at all, she steals but it dies not made sense, and my father, with his advancing dementia, many times does not live in reality. He does have a great sense of humor, but may not understand conversations or questions asked of him. Good days and then not so good. Fixation and confusion is a problem now. Ex: when are you taking me home? When he is at home? He might stick to this all day long. But both are physically doing good for 92 (dads diabetic) and 89 (mom suffering from lasting stroke issues) But could be better if the family would follow my suggestions and help them more with diet and medications.
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Firstly do know that if the principal is now unable to make any decisions, and there is a disagreement between MPOA and FPOA this can get very dicey indeed and can end in court with enormous costs involved or minor decisions.
That is worst case screnario and believe me you don't WANT THAT. For many reasons but most of all that you may be stripped of any powers at all, there's enormous costs involved and you may have to pay them if you lose having brought the issue, and that ALL disagreeing may be losing the power with the state assuming guardianship or temporary guardianship. That is to say in court it depends on the judge and the judge can do anything.
MPOA is there only to enforce the wishes of the person who assigned you and to carry out the medical advanced directive. They are not caregivers and do not make caregiver decisions, especially if those decisions involve costs. MPOA can refuse treatment if the person who assigned them is incapable of saying this is a treatment they did not want, as long as this is written in the advanced directive.
A Financial POA pays NOTHING. They manage the funds of the person who appointed them to act as financial power of attorney as they BELIEVE is best for the person who assigned them IF the person who assigned them is incapable of stating his or her own wishes.
Do know that the MPOA has almost no/very little power in anything but an EMERGENCY care situation in which the patient him/herself cannot give his opinion.
The FPOA handles all finances as he/she was directed to by the person assigning or as he believes best if the person cannot speak for him/herself, and he need not SHARE ANY INFORMATION WITH YOU or with anyone else.
You cannot get the FPOA to pay for or reimburse you on anything he or she did not pre- approve.
You are not understanding either MPOA or FPOA and I suggest you get the advice of an elder law attorney (this is on your OWN dime) to explain to you the powers in your state of a MPOA and of a FPOA and the powers as written in your own document as MPOA.
ITRR's advice to read what the powers of MPOA and FPOA are is a good one, but your misunderstanding of both documents seems to me so acute that I would much prefer you to see a Certified Elder Law Attorney to explain the documents and it would be well worth the 400.00 or so for that hour and would save hours of hassle and argument when there is an ill parent involved.
So sorry for the grief of the illness and sorry for the misunderstandings which make this all so much more difficult. But if you cannot work with the FPOA (who quite honestly has more power than you do) I fear for the outcome.
It is truly a sad thing that the person who conferred these duties did not give them to the same person. It would cause/could prevent, just this sort of dissension.
This is an interesting link from legalbeagle.
https://legalbeagle.com/12718365-what-happens-if-two-people-on-a-power-of-attorney-disagree.html
Good luck. I wish you all the best.
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Benice2me May 2022
I think your ideas on the MPOAs abilities are a little off. The MPOA is the one who has been designated by the Principal to have the right medically to choose the caregivers, treatments doctors and facilities that the principal would need to receive for the care and no one else has that right, and if there is money in the estate, which there is, then the FPOA is to pay for the needs of the principal. This is from an Attorney’s website in Los Angeles.
“What can a medical agent
decide? As long as the POA says so, (this is my Dilemma) it can give
authority to decide everything medical. Also states: Make healthcare decisions, including the ability to consent to giving, withholding, or stopping medical treatments, services, or diagnostic procedures. (Note: your
loved one can also make a separate
"health care power of attorney" to
give only this power to another
individual.)
Medical care such as hospital
care, surgery, home health care,
and psychiatric treatment
Choose care providers
Decide on assisted living
arrangements
The principal must be able to afford the arrangements.”
And my parents can afford this
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Sorry, hold on - you and your husband have medical POA for your mother, and you have it for your father; but your parents' primary caregiver, living in the home with your parents, is your sister?

And at one and the same time you are peeved that your (resident) sister hired caregivers, but relying on the caregiver to keep you informed?

And if you didn't like your sister moving in, who did you want on the premises providing them with care?

And your brother is in charge of the money.

Your parents might just as well have gone out and taken a baseball bat to a hornets' nest.

Is either parent able to express a preference on decisions at the current time?
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Benice2me May 2022
My mother is totally incapable of understanding and making decisions and dads abilities are not to good either with his dementia. And Yes. Why wouldn’t I be peeved when she moved in, and she and my brother won’t follow the medically given protocol for either of my parents and then hire caregivers without my direction. Ya I’m peeved. Wouldn’t you be if your diabetic father was not provided with the correct meals because they don’t feel it’s necessary? How about taking the locks of the gates because she doesn’t like it when mom gets angry and now both parents can leave and or get ran over or lost? We went back, out then on, only to be removed again and then the VA dr came over and let me one to formally give them a warning and if they didn’t comply then he with contact APS, so then they followed the direction. Then she and the FPOA hire unlicensed caregivers who follow her protocol not mine. When my mother was discharged from the hospital they stated she needed 24 hr care and so we hired licensed caregivers and sought out hospice help in the home until both entities quit because of the unruliness, safety issues and constant berating of these entities by my siblings. Constant interference, lies and deceit. We can’t physically be there 24/7 to take care of my parents and then they choose caregivers that follow their direction, not ours? And now my FPOA brother has joined the unruly club to allow my other siblings to do as they please because he doesn’t want the responsibility to care for them medically and it’s easier to have them do it for him. They Give him direction and withhold it from us as the MPOAs. Sure we can call APS, call the police and get a restraining order against my brother and sister, then what? We are constantly needing to get updates from the VA caregiver, who is paid for by VA and has worked with me before moms Stroke in caring for dad, who is competent and knows of the deceitful tactics of my siblings regarding my parents care. But the alternative is to get APS to deem the situation unsafe and take over there care. Do we want that, do we really want the state to take over, NO! but trying to get ones to cooperate is not working either. Why can’t adults act like adults and do what’s best for their parents. It’s very simplistic what is needed but I’m sure that is where we are heading.
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1. Read the POA document. See how specific or non-specific the terms are.
2. Realize that state laws can differ.
3. Is the MPOA durable?
4. Are your parents incompetent?
5. In general, if your mother is incompetent, you as the agent under a Medical Power of Attorney are authorized by her (the principal) to make any health care decisions she would if she has the capacity. You as agent may direct medical treatment according to the wishes your mother has expressed to your when she was competent.
6. In addition to having an MPOA on file, your mother's medical providers should also require a HIPAA form signed by your mother when she was competent. Medical providers should not be sharing your mother's medical information with anyone who does not have a HIPAA form.
7. Do you have a relationship with your mother's health care providers? They should know who you are and that you're your mother's agent.
8. As MPOA agent you should be in charge of your mother's medical care as she entrusted you to do this.
9. If you know that your mother is not getting her medications properly or that she's falling, you are responsible to take charge and make sure that her health is protected.
10. Don't wait to hear from your siblings about what's going on. Go see for yourself if you can.
11. If your siblings won't let you properly take care of your mother and you are worried for her physical safety, you can contact Adult Protective Services.
12. MOST IMPORTANTLY -- CONTACT AN ELDER ATTORNEY. Your parents' financial and medical interests appear to be at the mercy of their children's inability to get along. Time to bring in an expert who can try to set it right.
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Benice2me May 2022
Thank you for the frank advice. Attorney costs are a big hurdle but we have already contacted APS and Coast department in our City which is an entity that works with the Police Department. It’s sad that hatred is overshadowing the proper care for my parents.
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Bernice2me,
It seems to me from reading your responses that this has gone beyond sibling squabble to all out war.
I still maintain that in any court battle between a medical POA and a Financial POA, the latter will win, and in the case that latter is caring for the incompetent adult will win EASILY.
Basically you are down to someone will go for guardianship. In that case, should you win, you have it all. But I would stake a lot of odds you will not win. In which case your court costs will be your own, and the court costs of your sibling will be paid by the principal who appointed that sibling the FPOA.
It is indeed sad and I agree with the responder who observed that whomever appointed one sibling FPOA and another MPOA took a baseball bat to a beehive. Pure and simple. Everyone will end stung pretty badly.
I find that most MPOA are those rote documents that say almost nothing when push comes to shove legally. They have to be very well written to cover what you need to "win" here.
Sure wish you BOTH luck, and your parent, as well. It is always tragic when siblings go to war over a parent. It is honestly so destructive.
You may be down to going for guardianship. You are correct; in any war it will go to 10,000 at the starting gate, and whomever wins gets costs paid while the loser has a lot of debt.
Only lawyer win these wars.
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I think you need to get guardianship over your parents. It will be costly though. If you win, the judge may allow u to take the cost out of your parents money.

Your parents need a lot of care. As guardian you can pick where they will be placed. Then u know they will get the proper care.
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Benice2me May 2022
JoAnn. Thank you for your helpful insight into a very difficult situation 💜
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You may need to hospitalize your parents in order to have case management or social services place your parents into an environment where they can be safe and have their needs met. While in the hospital, tell them about your difficulty with the FPOA. It might come down to family members being charged with elder abuse to remove their ability to make decisions about your parents.
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Benice2me May 2022
Thank goodness VA is setting us up with a Social Worker. Thank you for your response.
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Be, I am just curious what the caregiver situation was for your parents before your sister moved in and hired a caregiver.

I ask because they obviously can not live alone and maybe the situation deteriorated quicker then you were acting. Please don't take that wrong. When we get old or have health issues, things can change in a minute, leaving us with crisis management that means decisions RIGHT NOW.

Have you thought about just letting some things go? Your parents don't have any quality of life, is it really important to do whatever it takes to keep them alive or is them having some enjoyment, like non diabetic meals and a daughter taking care of them a better option?

As hard as it is to understand, people do get to an age in life that they would rather not prolong their life and if they can't comprehend that, do you really want to prolong if for them?

Just a thought, because a war with your siblings doesn't benefit any of you. I agree with Country mouse, two separate POAs is like hitting a hornets nest, no good thing will come of it.
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Jane7686 May 2022
Isthisrealyreal, I understand and agree with your general sentiment here. BUT, with diabetes in particular, not following a proper diet will lead to severely diminished quality of life. Unlike heart disease (for example), a poor diet for a diabetic can mean loss of a)feeling, then b) use of digits, c)loss of digits, d)loss of limbs. It's a slow progression, made worse if the person in question also suffers from dementia and doesn't know enough to tell caregivers what is happening. Also, the MPOA is legally responsible for the safety of their charge(s). Allowing the siblings to remove gates and other safety features from the home would be criminal. And then the deciding factor is what is in the Advanced Directive? Do Mom & Dad want
"all means necessary", "no extreme measures", or something in between? In the end, OP is required to follow their wishes.
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Benice2me: A Power of Attorney does not use his or her financials on their principal's care.
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As was stated earlier, you really need to consult with a Certified Elder Care Attorney. It's impossible for any of us to give any other sound advice here, as we don't know what directives are in the MPOA or the FPOA.

I will say that while there may be conflict between you as MPOA and your brother as FPOA, NO ONE ELSE has any right to be making any decisions for your parents. They had the forethought to assign those roles to you and your brother (though they probably did not foresee your current issues), and the two of your are legally obligated to make those decisions, or hand the responsibility off. There should be language in the documents for that scenario as well.

I am currently both MPOA and FPOA for my father, with my sister as secondary "in the event that I cannot or will not" make decisions. I have a financial background and hers is medical, and we will probably work out most things together when the time comes that he is unable to make decisions for himself (sooner rather than later, I'm afraid). Our third sister will not be involved in any way. She can certainly care for herself and her son, but simply is not suited for the roll of caring for another adult. Thankfully Dad is pretty perceptive, and knew what he was doing when making these decisions. Baby sis is also fairly self aware, and would never have accepted either position. I do wish that more people would give this kind of consideration to whom they appoint for both M & F POA. I think that parents in particular think that splitting these responsibilities will be more "fair" to their kids, or provide a sort of "checks and balances" system. The reality is that this forum is packed with stories just like yours, and so much of it could be avoided if families were open and honest long before these documents ever need to be put to use.

Best of luck to you in getting your situation resolved, and getting Mom & Dad the care they need and deserve!
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Benice2me May 2022
Thank you very much for your thoughts!!
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I'm so glad to hear that a VA social worker will be on hand to help with this fraught situation.
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