POA for Health Care for my mother and terrified. How do I prepare and work through this...

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My mother has end-stage COPD. She lives at home, has oxygen, breathless and weak with exertion. She has lost a lot of weight and not caring for herself. Can still make it to the bathroom, but not more showers or anything. My father lives nearby and cares for her daily; I'm 2 hours away and see her on weekends and will be taking more time off now to be with her. I'm her POA for health care and will meet with the doctor next week with my mom and dad to activate the POA and discuss next steps. I'm terrified of the responsibility. Can I name a joint person, like my sister, though she lives a few states away...or does my mom need to do that while or if she can. I don't like having the sole responsibility and feel that I will just not be able to handle it. What are some practical steps to take and which professionals do I go to to for an explanation of how to approach this, get through this, make informed decisions, and still function. I really don't want the sole responsibility of making an end of life decision--but am also wary of sharing the responsibility or giving it to someone else--and having someone decide something I don't agree with. Does this sound familiar or just indecisive or weak-spined of me. (question mark not working).


It is a terrifying responsibility. You should be honored that your mother trusts you with it, but that doesn't mean it feels comfortable!

It would not be up to you to bring in another person as POA -- only your mother can designate someone in that role. You may certainly get input from your sister and listen closely to her ideas. You are the one the hospital must listen to, but you can talk decisions over with anyone you want to.

Remember that your role is to make decisions for your mother as you feel she would make them for herself if she were able to. What is spelled out in her advanced health care directive? For example, does it specify whether she would want to be resuccitated if she has a heart attack? What do you know about her wishes and beliefs? Is she alert and with it enough for you to discuss such issues with her when you visit?

In general, I don't think shared Health POA responsibility is a good idea. What if the two POAs disagree? What if a decision must be made now, and the other person can't be reached?

Does your mother now qualify for Hospice? That would be a wonderful service to arrange, and the staff will be very helpful to you and the rest of the family, as well as to Mother. Discuss hospice when you see the doctor next week.

Best wishes to you as you travel the last leg of life's journey with your dear mother.

Jeannegibbs--Thanks for your helpful and kind reply. I think that palliative care most likely will be set up, and I suppose hospice will come up during the doctor's visit also. Though my mother specified her preferences in the POA a few years ago, our family has never discussed broader or more detailed end of life issues--which makes this all the harder. My mother is alert, though she sleeps most of the day, but either due to vascular dementia, breathlessness, depression (all of which doctors have been trying to sort out for a while now and have addressed as well as they have been able to) or just being tired, she is not good at conversations. She'll answer a question with "yes" or "no" or say "I want to go to bed" or "to the bathroom." We'll look at pictures together and smile or comment, and she watches TV, but no real conversations lately. I have a hard time "reading" her and she doesn't express much emotion. It's hard for me because it's been a very long time since we've had "heart to heart" conversations and she's very private; so bringing up hard topics like wishes for end of life is very awkward and sad for me---and I don't know how she feels by her outward response and I don't want to make her sad or cause her distress, and not be able to discuss it or keep talking about it. I know it has to be done and that I sound childish---the situation is just highly emotional and my family isn't good with emotion. Any more thoughts or advice on approaching discussing end of life matters would be much appreciated. kn
My mom added me to her DPOA and medical POA before her dementia worsened. Hopefully, your sister will agree to be added and willing to help you, but keep in mind that sometimes working together doesn't work out. My brother is joint with me, and he refused to help do anything, so it could still be your decision when the time comes. I hope it works out for you.:)
KN, I suggest you begin by reading (and re-reading) the medical instructions your Mom signed when she gave you the authority to make decisions. They may be very clear in which case, you are only reiterating her directions to any medical providers. In reality, there is only a limited amount of discretion for you, if the directive is substantial. Within the past year, the person I am responsible for, required surgery. The doctors had the advanced directive but required me to state (and sign) if CPR should be given should her heart stop during the surgery! I signed for NO CPR -- this is what she requested on the directive signed 25 years earlier. I couldn't imagine that the person would want it now, in her advanced stage of health. I felt comfortable with the decision, I was just reiterating the directive! She made it through surgery and continues living as I type this note.

It sounds to me like your Mom can't participate in offering you further insight. Hospice (which I heartily endorse, will remove all decisions. Their goal is to provide palliative care only. All my best . . .

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