How do power of attorney and health care proxy work if possible together, what different authorities do each of them have?

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How do power of attorney and health care proxy work if possible together, what different authorities do each of them have?

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My brother who is POA and myself (HCP) appear to be at odds. He wants my mother admitted to a nursing home; I and my sisters want her (she has only mild cognitive disorder) to stay in her home as long as possible with 24/7 care we have already set up.

I understand the HCP is the one who signs the admission papers to a potential nursing home (I am not comfortable doing this at this point); however, the POA has the authority to do a reverse home mortgage on her home or smaller home equity loans Thus, unless we find a way to pay out of pocket for her 24/7 care financing to extend it longer, it will end if my brother, the POA, does not secure more financing to pay for the 24/7 home care. If the 24/7 care ends, I am concerned about my mother's safety in the home.

My mother appears to have enough assets (car, home) to pay for more 24/7 care. My brother, the POA, is not supportive of this.

Has anyone else dealt with this situation and or conflict?

Elder Law Health Care Directives Paying for Care Power of Attorney (POA) Relationships

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With a person having a GENERAL full POA that usually trumps a MPOA in a lot of states. The general POA is often put in charge of ANYTHING that has a financial component to it.

This has been I think an ongoing problem for you?

The best way to settle things when there are two people with legal powers is to attend an attorney together and sort this out. We as members of a Forum, often from other states and other countries would be of very little help to you in instances where there is disagreement and legal papers in place for your both. Do see an attorney. It's my opinion that your brother, will general POA will prevail. But the only way to know is to check on it. Legal questions require expert advice.

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I think I may have said this before. I don't think u understand what your responsibilities are as Medical POA. I think both u and brother need to consult with an attorney to see what they are. This is why, both POAs should be held by the same person.

IMO brother holds the purse strings so he would be the one to admit Mom to a facility knowing her financials. Your responsibility is to speak with Moms doctors and make sure they are abiding by her wishes. If there is a decision to make concerning Moms health, then u make it based on what you know Mom would want. You also speak to the nurses at the facility concerning Moms health needs.

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THIS 👆 Healthcare POA can speak for mom when she cannot.

Mom is still allowed to speak on her own behalf - until if/when guardianship has been appointed by a judge.

So, what does mom want?

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Sarah3; you can't always decide what's in the patient's best interests while ignoring reality.

There are only certain choices that are going to be on offer here. Having brother remain in the home proving care on his own MIGHT be what mom wants and the OP might think it's best, but the brother isn't willing to provide his services any longer.

So the OP is going to have to make choices based on what the mom's financial resources will allow for

I have my family as an example of how we worked it out. It wasn't perfect nor can everyone do this.

There seems to be a lot of animosity on both sides that I think needs to get worked out.

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Note I have suggested mediation or a geriatric case manager which the social worker thinks is a great idea. My brother, the POA, is totally against this. I think he is burned out as he is the sibling closest to home. But he sends us nasty texts and emails. I understand burnout but nasty texts, emails, and degrading comments are tough to deal with.

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Go to an elder care lawyer to iron out the house/ money , POA , etc .

You DON’T “understand burnout“ because you are not doing the caregiving .
I suggest taking Mom to your home and giving your brother a break while this is ironed out . Then you can say you understand what it’s like to live with someone with dementia .
It’s a lot tougher to “ deal with” caregiving than reading “nasty texts, emails , and degrading comments “.

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Sounds like after 10 years your brother is burned out and can’t live with Mom anymore .

Knowing why he can’t live with her anymore and what his living plans are if Mom goes in a facility would be helpful to you . Start talking .

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My brother held financial POA and all 3 of us held HC POA.

My brother did all the heavy lifting as he lived closest to mom when she was at home, in IL and ultimately in a NH.

I deferred to him in decision making, since he knew her finances and he was the only one who had even the remotest possiblity of being able to house her.

It would not occur to me to try to decide that it was "best" for my mom to remain in her home with care coming in if I wasn't on the scene to supervise, step in in the case of a call out.

Since mom has been deemed incompetent to make medical decisions, it seems like it's up to the POAs (all of them ( to determine where mom is best housed and cared for.

I think you should talk to your brother about what sort of facility he has in mind and how it will be paid for.

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That was how you and your siblings decided to handle it, personally I see it from the perspective of the op who is tasked with making healthcare decisions in her mothers best interest

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Some of these documents carry different responsibilities and accountability based on wording and in different geographic areas. Hence, to get your most accurate answer, confer with an Elder Law Attorney, have the present documents assessed and, go forward with legal direction. This may well support and protect all parties including the patient best. The patient is vulnerable and fragile. Family dynamics are affected by many many different ways and circumstances and, can often get in the way .......

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Re the reverse mortgage - I was going to do that for my mother who was 94, but there is a clause in the mortgage something to the effect that the person signing for the reverse mortgage has to reside in the home, and if they do not live there for 30+ days, then the entire reverse mortgage amount is due (i.e., you have to sell the house) and payable to the lender. THAT stopped me from pursuing that because I wasn't sure at what point I would have to make arrangements for my mother to live in an alf or, if she was hospitalized/rehab for longer periods of time.

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I fail to see how a reverse mortgage is achievable if the homeowner is incacitated, particularly if there is a soon to be admittance into a facility.

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I read the post several times and don’t see where it says she’s incapacitated, the op said their mom has mild cognitive decline

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Do you know if he’s in debt himself? Do you have reason to believe his agenda could be to sell her home? A poa has to do what is in her best interest. If she only has mild cognitive decline and wishes to remain in her home ( which also enhances and helps one’s mental state- drastic changes such as being placed in a facility are correlated with increase in decline). Have you tried to discuss with him why he’s determined to have her move out to a facility? If he’s not making decisions in her best interest although not fast or simple he can be removed as trustee. I would ask him to show you the financials from 1-2 years ago along with the current financials.

How do power of attorney and health care proxy work if possible together, what different authorities do each of them have?

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