As primary health care proxy, which is invoked, can I fire my mother's pcm?

DNA, mom is living with brother in the family home, correct? And you are at a distance, and frequently unable to be reached, I recall. And I believe you were hesitant about what your powers were as POA, but you DID have a visit with an attorney.

Is brother the one taking her to appointments?

Remeron is frequently used for seniors. It is, among other things, an appetite stimulant. My mom took it for many years. It helped her mood and quelled her anxiety.

This is an ongoing situation you have written to us about before, if I recall?
I really don't have time to go through and post links to your questions in the past but this issue with sister is not new here on AC.

I think there is ongoing dissention between yourself and a Sister who holds GENERAL POA.
Often the person holding general POA takes precedence in a situation.
I do believe we have suggested before that you and sister attend an elder care attorney to work out who makes what decisions, because you currently have too many Chefs spoiling the stew.

Sure do wish you the best ongoing, D.

Sure, you can say “You’re fired.” But to what point? Just to antagonize? Your wording implies a desire to control rather than cooperate. Or perhaps misplaced, fear-induced arrogance (you want the doctor to seek your permission to prescribe meds or You’re fired!) To quote Westley in The Princess Bride, “Prepare to be disappointed.”

Sorry if that sounds harsh, but you led with “You’re fired.”

I’d ask:
1) Is the doctor’s office convenient?
2) Does mom like and trust the new doctor?
3) Is the doctor prescribing the right meds after all or willing to adjust based on your concerns?

If no, find a new doctor.

If yes, solve the problem at hand.
Ask mom to hold off with Remeron because you’re concerned about potential side effects. Use doctor’s office online portal to follow visits and explain your concerns about Remeron and ask about alternatives.

I have been following your posts. Your problem is why both POAs should be handled by one person. That way Doctors and staff have one person they deal with. Don't you live some distance from Mom? One reason you should not be the healthcare proxy, Doctors do not have the time to deal with family squabbles. Someone goes with Mom to the Doctor. If they accompany Mom to the visit, then the doctor assumes Mom has OKd that person to hear what the doctor says. He does not ask "are you her healthcare proxy, if not you need to leave" If you are so concerned, then you need to be with Mom at every doctor's visit and hospital and Rehab stay. Your proxy should be filed at every facility she enters.

I would not "fire" this doctor, he did nothing wrong. Just call the office and ask that you be notified of any change in Moms medication.

What we have here is one person who is health care proxy and one person who is general and financial POA. If you research this online it says that it is CRUCIAL that the two agree, because anything else will mean constant battles in court between those two. And all attorneys therefore advise that the same person be appointed to both positions.

So this OP has a choice. GO TO COURT with an elder law attorney and take each issue to court OR get along with the Financial POA. Often in court the general financial POA trumps the health care proxy in decision making by a ruling of the judge.

This issue has been going on for some time for our op. Another member says they looked up some twenty postings about these issues and the disagreements and dysfuntion between our OP and another family member regarding care.

I doubt very much that the Forum can do much for our OP here regarding this. Our OP needs an attorney rather than the advise of a Forum full of people. I can't see how, not knowing what is going on in this apparent dysfunction, anything can be contributed by us that doesn't simply add to the confusion.

Your profile says your Mom is living at home (your home? hers?) Where do you live (with her, near her, distantly?) and who is taking her to these appointments that you aren't present during the exam? If you say the proxy is active, is it durable or springing? More info would help...

Who accompanies mom to these appointments?

This is Remeron's Black Box warning. Please note that it is aimed younger people; it is not a drug that is considered problematic for elders any more than any other antidepressant.

"FDA warning: Suicide risk
This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
Mirtazapine may cause an increase in suicidal thoughts or actions. This risk is higher in children, teenagers, and young adults. It’s also higher within the first few months of treatment and during dosage changes. You and your family members, caregivers, and doctor should watch for any new or sudden changes in your mood, behaviors, thoughts, or feelings. Call your doctor right away if you notice any of these changes."

Your sibling(s) take your mom to the clinic; do you communicate with them about what is prescribed or talked about?

Frankly, if you and your siblings can't cooperate, and if you are far away from each other and can't communicate to the benefit of your mom, then perhaps you should give up the HCP.

Definitely confer with an Elder Law Attorney for a best practice review of the health care proxy document and, recommendations going forward. Is your mother still making decisions for herself? Or has the document assigning you as POA for health care proxy been involved?
Your mother or whoever is speaking on her behalf should certainly be able to request a different doctor or change medical PCP or other caregivers. "Patient rights" should always be honored; for best practice and full understanding of the particular document (s) your mother has , please do yourself a favor and confer with an attorney, preferably an Elder Law Attorney.

I am confused, one of your posts asks how to resign HCP and then says it's done. So, that's not true?

Power of Attorney DOES NOT give you special authority to make people jump through hoops and chase you down to get permission to treat your mom.

You need to decide what level of involvement you really want from what 500 miles away.

You are trying to make this as hard as possible for everyone involved. Your brother has been with mom for 10 years, he deals with her face to face daily, it would serve mom well if you let go of the power trip. Sorry, sounds harsh but, I would blow a fuse if you were my interfering, absent sibling making things as hard as possible for everyone involved.