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JCHERRY2010 Asked September 2018

Can the Healthcare POA be changed without the knowledge of the current Healthcare POA when the parent has mid-stage dementia?

Life long health care worker currently working in Emergency Department as a Senior Tech as well as Nursing student. 1 of 3 children (middle child). Living Will compiled and executed while both parents were living and of sound mind that appointed oldest sibling as POA and myself as Healthcare POA. Falling out with siblings during Fathers illness, Fathers passing and Mothers hospitalization in regards to medical POA. Father passed 3/27/2017 at which time Mother had moderately severe cognitive dementia referred to as mid stage dementia and this was in March 2017 which has progressed to the point where oldest sibling felt Mother needed to be placed into a secured memory care unit at an assisted living facility for 24 hour care. During this transition it was discovered that the Healthcare POA had been changed from middle sibling with medical experience to oldest sibling without the original Healthcare POA being informed, notified or provided the opportunity to respond and/or seek legal advice/representation to agree or dispute. Oldest sibling now refuses to provide copies of such documents willingly and has directed all inquiries to attorney who prepared the documents in question. Is this legal in the state of Pennsylvania?

TNtechie Sep 2018
So you had your father's HCPOA during his illness and your older brother who had the DPOA disagreed with some of your decisions? Got Mom to name him HCPOA after Dad's death? How did you discover the HCPOA had been changed? Is the lawyer who handled HCPOA change the same attorney who handled the original DPOA and HCPOA documents?

Since HCPOA determines where the principal lives, your brother needed HCPOA or your mother's consent for her MC placement. Most MCs are lock down units; many prefer an invoked HCPOA authorizing the secured placement.

If you have any interest in contesting the HCPOA then you need to see a elder care attorney for legal advice. Your brother could not want you to see the POA documents because he's concerned there is some weakness there - probably around your mother's competence at the time they were signed. As the previous HCPOA he may be concerned you have more information about your mother's mental state than the attorney did. Or he could be denying you a copy because of the previous family disagreement or because he didn't like the way you ?demanded? a copy.

Personally, I'm always skeptical of hidden actions; however, many men think avoiding an "emotional" confrontation is just taking the easier or "right" path. It's possible your brother found out he needed HCPOA after he decided to place your mother and decided it would be easier if he had complete authority. Other oldest sons think decision making is their God given right and younger siblings, particularly sisters, shouldn't be in decision making positions.

Whatever your brother's reasons, the decision you have to make at this point is do you want to spend the money and introduce more disharmony into your family by contesting the HCPOA. I encourage you to consider what you believe is your mother's best interests more than getting justice for your offended feelings from your brother's high handiness. You might consider offering to not contest the HCPOA if you can review the current document and confirm that other than the decision maker, none of the other language concerning end of life directives was changed.

gladimhere Sep 2018
Sibling fallout? Try to get past that and remember care of your mom is the most important. Don't make it a sibling rivalry issue. Yes the POA can be changed without your knowledge. Medical experience really has nothing to do with who is appointed. The majority of POA's have no medical background. Don't take it personally.

The attorney had to make the determination about mom's competence and ability to sign. Though you should have been notified of the change.

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cwillie Sep 2018
This is a public forum of caregivers who are not legal experts, if you want real legal advice hire a lawyer. My two cents will tell you that it is possible for someone with dementia to sign legal documents as long as the lawyer in charge determines that they are not unduly influenced and that at the time they are signing they agree and understand - since most documents prepared by a lawyer would involve the initial consultation and then signing the document at a later date that would be demonstrated on more than one occasion. Whether or not the previous POA needs to be informed of the changes is going to vary depending on where you live.

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