Any advice when financial and medical POA are not the same person?

Uncle Peter stated in his POA that as his POA that myself and my sister could make decisions Jointly or Severely for financial decisions and health care . However we always made decisions by firstly talking to Uncle Peter he could understand well we explained what we were proposing to do then made the decisions together as the 3 of us.

I agree that any and all parties need to read and understand their roles and responsibilities. However, I disagree that it's a good idea to have a separate POA and Medical POA. My family was in this situation.  I was the MPOA, and I got along with the POA for a couple of years.  But when we disagreed on mom's care, my mom was stuck.  I had the power to make health care decisions, but I did not have the power to direct resources to pay for that care.  My sister, the POA, had the power to pay for mom's care but did not have the power to make health care decisions on mom's behalf.  The POA kept mom at her house because she didn't want mom to go into a skilled nursing facility.  After more than two years, mom's care became too much for her; and it started to affect  her health, marriage, and career.  My mother has Alzheimers and diabetes, is blind in one eye, and is going deaf.  She is a sweet, calm person, but she needs 24/7 care.  All my other siblings believe mom should be in a skilled nursing facility.  They live out of state and help as best they can.  She's staying with me now.  I have POA, but it was a long miserable process.  In return, I've promised to keep mom at my home for a few months before making any further decisions and that I'd talk with all siblings before taking any action.  Mom has comprehensive medicaid long term care benefits, but she's up all night humming, singing or talking to herself and walking around her little basement "apartment."    

If you MUST use this "checks and balance" approach, write in some mechanism for solving disputes between the POA and MPOA (i.e., a respected third party, other siblings, or a named elder care mediator).

It works out great for our situation. I live in FL and am the health care surrogate for my mom with Alzheimers. My sister is the financial POA. We live in separate cites but fairly easy commute. I highly advocate this arrangement for two main reasons. One, my expertise is medical, hers is financial. We are drawing on our combined skill sets for the best decisions and care for our mother. I can for see when she does become worse , it will be easier to focus one one task instead of two; esp as emotions can blur clear decisions. Also highly agree with previous comments regarding checks and balances. Good luck and thank you for a great question.

Looks like I'm going to be the dissenting voice here.
I completely disagree with giving 2 different people the different POAs. For the sake of sanity, give medical and financial POA to one competent person.
With the duties split, you get into situations where the medical POA is trying to do what's best for the person medically, be it a surgery or going into an assisted living or nursing home. Maybe you need a scooter chair to give you some more mobility and have the money to buy one.  Ooops! They can't do that because the financial POA thinks it costs too much!
So the medical POA spreads themselves thin trying to take care of their loved one themselves, while the financial POA counts beans. That's often what happens. It may not start out that way, but it ends up like that. Think carefully, if you trust someone enough with your health and they make a decision they think is in your best interest, do you want it vetoed because the person you trusted with your money (who may understand little about how to care for sick people) says no? It's so frustrating for your 2 POAs, expending energy trying to communicate, or fight, or whatever, with each other - instead of caring for you and your interests.
There's also the situation where the financial POA thinks or knows they are in the will, and this colors their decisions on how much your medical POA is allowed to spend. Sure, you try to pick someone you can trust, but they may not even realize a little greed is creeping in there, causing them to veto things your medical POA thinks will improve your life. After all, since they're not your medical POA they can't see first-hand how much this expenditure can improve your comfort.  
I'm POA for my loved one, and I'm forever grateful that I don't have to ask anyone else if I can do for him what I believe is best!
When I get on in years this is a lesson I hope I never forget.

It is a better option for 2 different people- one to have MPOA and the other to have financial POA.

Louisesteel , that is horrible. Some humans are sub- human. Im youngest daughter an " designated daughter " as I live in same town as both parents. I am Durable POA for both. MEDPOA is my Mother or Father then goes to me if spouse canot or will not do it. If Dad is mental incompetent the DPOA id void an the MPOA comes in. I just found this out in Dec. Im the executor of will also. My older sister lives in another state an doesnt really like my parents anyway. She may love them but cant stand to care for them. So Im doing it. I love my parent's. Iv been caregiver for 5 yrs now. Im 49. Ive had to sign for both at appts. Procedures etc since Im DPOA. But if Dad is declared incompetent MEDPOA comes in. He has mild dementia. Im not recieving any compensation for doing this an would never do so cause its my parent's. They have paid for my gas running everyday for them. But no pay. I quit my job in 2009 for my sons but in 2012 Dad got sick an slowly it has consumed my life. Im a very caring person. Iv been in med field since 18. But haven't been able to work due to parents. Appts, groceries, rx's, loading pill boxes, arguing with nurses at dr offices an ER an in the hospital when admitted. Sister is only 1hr an 30 min away. She does not understand the stress. I now have depression an anxiety an hate my life (thats depression talking). I have NO life. I use to be very social. All friends have disappeared from the depression an anxiety an time it takes to care for parents an my own husband an 2 sons now 15 an 20. An my house! Laundry. I do parents to. They live in a horrible retirement community. Smoking is aloud in rooms so it reaks of smoke. Rooms suppose to get cleaned weekly an DON'T ! On an on. They pay 3,500$ a month for 3 meals a day ( sometimes cant eat it if nasty food or if to many carbs or rice etc) werkly light cleaning (if its even done), fall call button, activities. But Dad does nothing but lay in bed all day an up for nurses an to eat. He is now on Hospice due to heart. He has tons of health probs. Mom is not 100%. Prob 65%. She does everything else I dont do. I cant be there 24/7. Its starting to become burnout. Dad is rude. Non-compliant. Rude to Mom. His way or highway. We get into arguments. We dont have a good relationship. He does still know what he is doing. He has severe sleep deprivation which mimics dementia. But I still cried when I signed papers for Hospice. He is still my Daddy. An I will have severe guilt after. It is not eady what we all do on this dight. An ones who dont do it have no clue the toll on the caregiver, their family, their marriage (almost divorced), their social life, mentality. Im on medication #12.
Goodluck. I dont see how it would work if POA an MEDPOA not in same state or in same city. I guess in Texas its diff. All our papers were drew up by lawyer.

Louisesteele, I hope where the lawsuit was filed allowed you to counter file against your aunt, winning against her charges will only cost you money, a counter suit will get you reimbursed for your expenses, if what you say is true you will win and she should be punished financially for what she is doing, it sets precedence and helps others in the future. If the greedy ones only get to cost others money and never have to pay for the trauma their actions cause, why not they have nothing to lose. Talk to your attorney if you have not counter sued and get that started so it can be addressed at the same time, it shows her that you did nothing wrong and are not going to be bullied and defamed by a cruel uncaring greedy relation.

Best of luck and let us know.

(Not trying to hijack this post, sorry)

Do not do it, I and my sister were our uncles POA and to date after he passed 16 months ago we have been taken to court by his sister as she is stating that we spent to much of his money. 

The mistake that my precious uncle made is that he made her sole executor of his will, he should have made myself and my sister the executors. So far it has cost myself and my sister over 10 k uk pounds in fighting her. Our lawyer told us that she only did this cause she has the money to do it, “ using our precious uncles money against the people who cared for him” we took expenses quite rightly so, our uncle clearly stated on his POA that we were to be paid a professional salary for being  his POA, he stated we could make gifts to his family, give loans etc with no restriction as to amounts etc. We could by sell his property we had full control of everything his care health and well-being and this is now what’s happening to us. 

I even have an email from my aunt in America who is the executor to say to me spend spend spend its my brother money and I want him to have the best”  Now look what greed has done to innocent people, we have handed over everything all receipts for ever purchase, but she is still not happy with how we spent his money. 

She inherited a house 300k painting and antiques £110 k and cash value 200k and that still wasn’t enough. Had we know what she was going to do to us we would have spent more, and probely sold our uncles house and placed him into a better house with a garden for him to go outside easier. We have no money we were not mentioned in his will, we knew we were getting nothing out of it when we took on the role of POA “ we did it beacause we loved and adored him, she has distroyed and still is destroying what little faith myself and my sister have in humanity, she is the most evil greedy person ever. May she burn in hell. 

My aunt is a 73 year old woman who is and was very wealth prior to my uncles death. I’ve already had to sell my home here in Scotland to pay my legal cost. Our mother our uncles other sister was also excluded from the will, which we all found very strange, Mum lived directly across the road from uncle peter. Our mother is appalled With her actions towards myself and my sister. Our aunt visited our uncle once in 21months she lives in America, she never see anything we did we visited our uncle every single day traveling 1:15 hours a day to take his shopping and give the live in carers ther 2 hours daily break 7 days a week 365 days a year for over 2 years. 
Do cleaning washing overseeing everything, cutting uncles finger and toe nails taking him out for the day, visits to the theater art gallery’s swimming, lunch coffee etc. 

So all I can say is do do not do it if you do not want your life distroyed.

This is the preferred way, and adds a sort of "checks and balance" like government. It prevents one person from having all the power. It's a good idea. For guardianship and conservatorship the courts prefer this. It is not the most convienent and would be easier to have both positions. My brother and I have this set up though, and I think it's good and we make it work. It also prevents an emotional response, or foolish response from one to go unchecked by another. Be a team and do your reading on responsibilities.

Please keep in mind if your uncle is "asking" then he is in his right mind and has chosen with competence who has which role. The POAs do not become active until your uncle is no longer in his right mind. At that point as far as compensation is concerned, one must consider the financial needs of your uncle to make sure that isn't
"drained" due to compensation. Must be why your uncle has made his "choices" over who handles financial and who handles medical. I believe in honesty. Sorry. Best of Luck.

I won't speak to my concerns about the split role but I will speak about the concern of being in a different sate, especially the medical POA. Would your cousin be able to go and stay if he were to become seriously ill? I can't imagine making life or death medical decisions without being able to talk directly with the medical team and the person, if possible. 

If you really don't have to, don't.

If things are changing then I definitely agree to take a step back because it would only be the beginning of a very rocky and uncertain road ahead

Thank you all - great advice. I am not sure at this point if I am even going to accept. A few months ago he asked me to be his sole POA, but has for some reason changed his mind. Things have been complicated and are getting mores so, and if we can't get a clear picture of what he expects of us now, it is only going to get worse. Stay tuned...

Be sure that the POAs are valid in the states you and cousin are in, in my state of AZ a Durable POA is what is needed. A general POA becomes invalid if he loses mental competence, ie has a stroke or brain bleed, just when you really need it you find out it is the wrong form. Just a heads up, have uncle ask the Atty to make sure that the forms would be valid for whatever state.

Have you and cousin talked about what it would mean to both of you and how you would want to deal with things, this could head off a lot of future strife having some upfront ideas of what to expect from one another.

Many people opt to have different people serve as POA and MPOA. The MOST important aspect of this is that the two people have to be able to work together and make compromises when dissent occurs (and it will).

My two younger brothers hold POA and MPOA, but really? since mother is in sound enough mind, it doesn't even matter, she can do what she wants. POA ONLY kicks in after the person is declared incompetent to take care of themselves.

You won't "have control" over your uncle, this is good pre-planning, really. He is asking two people he trusts to look after him and finances when/if he becomes incapable of doing so. You don't need to move him nearer to you, unless you want to and he wants to. My brothers take no compensation for their work in mother's behalf--it has been limited to a once a year financial review.

HOWEVER, once she passes, one brother is the executor and he WILL be paid for the time he takes in working out the trust. When someone passes, POA's become null and void.

If you and your cousin have a good relationship I don't see why this can't work. However, while you may have a good relationship now it would be prudent to work to maintain that relationship once the documents are signed and everything is in place. When there's an elderly family member at the center family relationships have been known to deteriorate. One person feels that they have more power than the other person or one person acts unilaterally without discussing decisions with other family members. A million things can do wrong. But if two mature, stable adults work together in the best interests of their elderly family member and keep the lines of communication open it can be a positive experience for all involved.