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therealdaughter Asked September 2013

Dad, 86 had 3 strokes, non-verbal, in a nursing home. POA, his girlfriend of 25 years, is having surgery. What happens to POA?

He has POA#2, my mentally unstable step-sister, and POA#3 my step-brother who lives 6 hours away. My brother and I, the bio kids, are in complete agreement with my dad's care as POA #1 has been handling things. We have great concern if #2 becomes POA, while POA #1 is in the hospital for a week. #2 can change access, care, etc.
I live 1000 miles away, my brother lives nearby my dad. Property has recently been transferred to me and my brother as per my dad's wishes. I am more concerned with his care and the fact that even though he doesn't want any type of life support, POA#2 is determined to prolong his life and, therefore, misery any way she can. She doesn't see the situation for what it is-0% quality of life, and no chance for recovery.
Is there anything I can do to prevent POA#2 from making changes during POA#1's incapacitation?

PinkLA Sep 2013
The durable power of attorney is different then the Medical Directive that states his DNR request. POA#2 would have to have that changed in order for his medical wishes to be changed and that would require that your father sign those papers. It doesn't sound like he is capable of doing that any longer. Make sure the nursing home is aware of that (which is sounds like you have). And, if the NH does make any changes based upon POA#2 stating them, concerning his medical end of life care, then tell the NH that you will sue them. That always opens their eyes.

POA#2 could certainly make financial changes but I would think that POA#1 is only out of the loop as long as she is under anesthesia (just like the President). They only lose their authority during the time of the surgery. Even if POA#1 is in the hospital POA#2 should not be able to make any financial changes.

Madeaa Sep 2013
Oh man the agony that we go through. I was thinking that when the POA was drawn up there were three people chosen. Could it have been his thought that he would want debate over important issues such as this? If all are reasonable could they not sit down together and talk it through without insult, assigning guilt and shame, without recrimination? Maybe if you can put yourself on hold and be open a resolution can be reached that everyone agrees to without hating each other in the end. I don't know, I know how hard it is to do this when your feelings and emotions are super charged, but for dad's sake can it be done? I hope so.

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alwayslearning Sep 2013
It sounds like the main trouble you have with POA#2's choices is her belief in Doing Everything That Can Be Done, and you disagree over how much is too much. She's showing up all the time, and putting in a lot of time, and she advocates for more and more treatment, and she thinks it's elder abuse to back off on any of that. Ok, you see control issues, but -- just for the sake of strategy in the big picture -- imagine just for a second what SHE might be thinking about that: she might well see herself as the one who cares the most and tries hardest. I say she "might" because you don't actually know what's going on in her head, and it's dangerous to build a narrative based on a speculation about someone's motives, because then you react not just to what they do but also to the motives you've decided they have, and that's what makes conflict so difficult to resolve. For example, you say "she wants to prolong his life -- and therefore misery -- any way she can." If we administered magical truth serum to both you she might say "Yes, I want to prolong his life any way I can," and you might say "I don't want to prolong his misery even if that means letting him go sooner" but it's unlikely she'd say "I want to prolong his misery any way I can." You've got a profound and important difference of opinion over a profound and important set of decisions - a set of decisions that most families have to struggle with. You want her to step back and look at the bigger picture of your dad's life and impending death. You'll be better able to collaborate with her if you step back and look at the bigger picture of the conflict you have with her. If she were in it for his assets she wouldn't be trying to keep him alive; and she might well respond to your last sentence with "it would be just fine 'if dad knew what his step kids were up to' because he'd see how hard I'm using all my skills on his behalf." From your point of view she's a bully with control issues while you're being sensible and strong, and she may well be behaving in ways that make things difficult, but the bottom line is you each want things to go your way, and you're both insistent about it. I'm not taking her side over yours -- I'm saying, you're two adults who are both trying to do what you each think the right thing is (nobody gets up in the morning and says "I'm going to do the WRONG thing today") and you disagree on what the right thing is. It's a challenge when not everyone agrees, isn't it! It's hard to deal with that challenge; in the context of that challenge it's easy to think there's a good guy and a bad guy; and thinking there's a good guy and a bad guy makes the challenge harder.

ferris1 Sep 2013
Before the girlfriend goes in for surgery, have her make a codicil to her POA, stating nothing will change until she is able to continue her duties as primary POA. If she dies on the operating table, all bets are off. Then POA #2 will become activated. If your father has made a Will and Living Trust (which I recommend everyone have), then his wishes for DNR (do not resuscitate) will be honored by the facility. Don't worry #2 will do anything in one week. Glad your dad left you bio children something...

Madeaa Sep 2013
I think, maybe I am wrong, there are a lot of people who know better, but I would assume next in line is POA2, unless you go to great time expense and lengths to change this. Maybe it is best to just allow the POA 1 to have her surgery, are we talking about a brief time of being under. I think I would let it be and just wait for her to be out of surgery and ready to speak on his behalf if needed. With all the best, perhaps nothing will happen and it will resolve itself in your favour.

therealdaughter Sep 2013
Thanks. yes, the NH knows there is a DNR in place. From what I've since read, I think POA#1 stops only when under anesthesia like you suggest.
I think the Health Care proxy is the POA too, then my brother, then me. This assumes the Health Care proxy is different from POA#2?? That's been the challenge you see. POA#2 has been asked to make health decisions by doctors and nurses because she is present constantly. We had to straighten everyone out as to who to get approval from, which is POA#1. POA#2 gets herself in there, befriending the dr.'s and nurses, asking for care and treatments, etc., as much and in any way she can get away with it. She has a obsessive need to be in control of his well being at all times. She's a bull dog alpha-type who can turn on the charm when she wants to get something done.
Look out when she doesn't get her way, and worse, POA#1 is very intimidated by her. POA#2 threatens to sue us for elder abuse when we disagree about my dad having extra caregivers and PT, that is not only painful to him, but not at all helpful.
And get this, we are also paying two caregivers to be there 12 hours a day! They are being paid out of his estate that will go to me and my brother if there's anything left. We believe she, POA#2, would like nothing more to liquidate any money coming our way. What a crazy mess....
I'd appreciate any and all suggestions to the above. I wish I was down there-I'm not intimidated by POA#2, and there would be a lot more sensibility about the whole thing. I have a family to take care of at home, and I get down there as much as I can. I'll be there for the week during POA#1's surgery, just to keep an eye on things.
My dad would be beside himself if he knew what his step kids were up too.....

pamstegma Sep 2013
Who is the Health Care proxy? The Nursing home should have a list of primary and alternate proxies.

Jinx4740 Sep 2013
I honestly don't know. Just pray that nothing goes wrong. You can make sure that the NH knows if he is DNR, if he is.

Does the primary POA stop being POA? Can't they talk to her except when she's actually on anaesthesia?

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