Mom keeps cancelling appointments and refuses referral to neurologist. She also refuses to sign HIPAA form so we can discuss details with her physician. Dad is already in hospice.

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The answer to your question is no. You can’t legally mandate.

However…. If she is cancelling appointments because the doctors office is calling her to confirm the appointment then change the phone number from hers to yours.

Are you the person who takes her to doctor appointments etc? If so, then you need to do that anyway.

An oncologist office called my in-laws office to ask MIL to come back in. They (in-laws) never told SIL who took them to their doctor appointments. She never followed up. The oncologist committed suicide. Several months later, SIL was on a routine appointment with her mom and the doctor said, I was sorry to hear about your moms diagnosis. Turns out she had cancer…from which she died. Not the out of control diabetes no one was helping her manage, not the dementia but the cancer she got no treatment for. Partially because a person who had dementia was still receiving phone calls from the doctors offices. I guarantee you MIL would have said no, she didn’t need the appointment but she would have never picked up the phone and called to say she wanted to cancel. Way beyond her ability.

It’s another thing to refuse to go in once you drive up. would she refuse to get out of the car, to go in? What if she thought the appointment had something to do with your dad? Would she be more likely to go in then?

You can manipulate in a positive way (see Mountain Moose’s post) to get them the help they need. In some cases, perhaps like Katiepaints, the diagnosis is a complete shock, not just “ordinary” dementia, and an early diagnosis may be helpful.
In other cases, it is just confirmation that there is a problem that must be managed. One you are most likely already dealing with. Or, you need it in order to activate the POA? You will need to read your POA to see what powers were given to you and when they become effective.

I am sorry about your dad.
Helpful Answer (1)
Reply to 97yroldmom

I am my brother’s medical POA and health representative with my 22 year old niece and another brother as backup. We went to an elder law attorney who also added a HIPPA form. He had significant memory problems and needed a diagnosis. I live 1500 miles away from him but I found a neurologist on the internet, contacted the office and explained the situation. I filled out the patient forms and faxed copies of the POA, etc to the doctor.

I also wrote a letter describing very specific examples of his memory problems and sleep changes. My niece lives near him and took him to the doctor but I wanted the doctor to know what exactly was happening—I’ve wanted to keep the information and medical load off her as much as possible. My brother wouldn’t have been able to answer any of the doctor’s questions. The doctor spent ten minutes with him and ordered an MRI. It revealed a massive tumor which morphed into glioblastoma.

The POA is so important—it’s open sesame to doctors, hospitals and nursing facilities. Ultimately, after consulting with my niece, I made the decision to place him in hospice. She signed all the paperwork—including a DNR—while I was on speakerphone. Don’t waffle, hesitate or debate getting it. An elder law attorney can be very helpful in putting this together. Our attorney was also used to cancellations when the LO suddenly wasn’t cooperative.
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Reply to katepaints
97yroldmom Jun 13, 2021
We lost a dear friend last year a month before he turned 65 with the same problem. Huge shock. we knew something was wrong. Thought it was dementia. It happened very quickly. He is blessed to have things in order and all the layers of care.
Wishing him and all of you peace and comfort.
I wss in your situation. I had to go the guardianship route
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Reply to MACinCT

My mom was having back issues along with really weird mental stuff that our family doctor picked up on. I also dropped a note off at the doctor's office with dates of things my mom said or did strange things. Obviously a family doctor can't help serious back pain, so we got a referral to another doctor. Oops, the referral was for a geriatric center that specialized in dementia (either ruling it out or diagnosing). I asked God a hundred times to forgive me for lying to my mom so she would go to that center! She was diagnosed with Lewy Body Dementia. For the record, we did take her to a doctor for her back a few weeks later.
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Reply to mollymoose

I was my dads DMPOA and I did not have to have a signed HIPAA release to act on his behalf. The Durable Medical POA was sufficient, even long distance.
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Reply to Isthisrealyreal

My situation is different, but maybe this will help you?

I couldn't talk to my relative's Doctor (as patient not there, won't go, doesn't see problem, & won't sign for me to have permission to discuss yada yada).

So I talked to MY Doctor, who COULD discuss MY problem: Having a relative I was concened about.

She said with these sorts of situations; resistance, lack of insight or denial, it was often a waiting game. Three things she said really stood out that have helped me;

1. Many things are outside of my control. Let them go.

2. People deemed competent (ie everybody not deemed incompetent) have the right to make their own decisions: Good or Bad. She called this *The right to rot*.

3. Sometimes it takes a crises to effect change. No-one can predict the future, but having a plan to speak up when a fall or other event happens may be the chance for change.
Helpful Answer (12)
Reply to Beatty

Depending on the DPOA you may or may not be able to act for your mother. My DPOA (both financial & medical) was effective upon my parents signature. However being POA doesn't make you her guardian - you are her agent and until she is determined incompetent she can countermand your decisions.

I promised my parents that as long as they were competent I wouldn't make any major decisions without going over it with them. Even as dad declined I continued to tell him what I thought was in his best interest until he ended up in SN where he died.

I continue to go over things with mom - Soon I hope to have her in a new facility - I took her to the 2 top picks for her to see. She told me I could have done it without her - but I felt she may want to have a voice in which facility she thought would be best for her. Mom is still competent and can at anytime revoke the current DPOA and appoint someone else her agent.

As far as her docs, I provided most of my parents medical providers with copies of the POAs and was able to call or ask for information. But then I also would accompany them to their appointments (pre-COVID) - because any time I'd ask what the doc told them, I'd get an "I think s/he said ..." So make sure the med providers have a copy.

I doubt this answer helps all that much.
Helpful Answer (3)
Reply to cweissp

No, because your Medical POA is not in effect until Mom is found incompetent. So its a Catch 22. Your Mom probably has Dementia and you need to discuss this with her doctor but you can't discuss it with her doctor until your POA is in effect.

You are going to need to wait until something happens. Seems she is pretty with it if she can cancel appts and know what signing a HIPPA paperworks means. All you can do is keep her Doctor informed of any changes.
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Reply to JoAnn29
Beatty Jun 10, 2021
Yep. In the *awaiting a crises* club I'm afraid.
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A POA document needs to be written that includes HIPPA privacy documentation in order to access records.

So, I am going for guardianship of an individual and am in the same boat. My lawyer hired a neurologist and two phsychiatrists to stay at my home several days to determine competence. That is the backdoor method for evaluations.
Helpful Answer (5)
Reply to Stacy0122
bluejasmine Jun 10, 2021
So this is how to go about getting an evaluation of dementia? Do I ask the lawyer or make a neurologist appointment? My dad was able to make appointments for himself and pay his bills and go grocery shopping. But since his last fall and UTI, he seems a bit bonkers to me. He used to love my hubby more than me and now he hates him?
I hope things work out in your favor for guardianship. Yes, I never had HIPPA. Just DPOA and guardianship & health care surrogate.
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As her legal POA you don't require HIPAA, I don't believe, but you should check the law for your state. I don't think that you can legally mandate she get examined. Were you to be her conservator or her guardian you could. But until she is diagnosed as having dementia your Mom remains legally competent. That means she is ALSO competent to remove your POA, as she conferred that upon you b y her own choice.
Eventually your Mother's condition will come to a head. You may need to make a wellness check request to APS; they may send your Mom to hospital by Ambulance and help you arrange Social Worker to get you a temporary guardianship which amounts for her or him a simple call to a judge. However, if your Mom is examined and found to be competent in her own care, you will not receive letters to enable you to act in any way contrary to her wishes with your POA.
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Reply to AlvaDeer

Jklangston, absent incapacitation, POA agents can only do what POA grantors continue to let them do. Given that your mom is cancelling appointments, it doesn't sound like she's incapacitated and thus it's pretty unlikely that her POA agent can mandate anything. In fact, your mom can even revoke the POA or sign a new POA naming a different agent or one with new limitations. So, you can continue to try reasoning with her to get her to agree to an evaluation, maybe by not specifically calling it a "dementia evaluation" or perhaps by promising her a really nice lunch or dinner after that appointment. Here's a link to an excellent article about guardianship and the limitations of POAs:
Helpful Answer (0)
Reply to bicycler

Read the POA document to determine what authority the agent has, and under what circumstances the agent can act.
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Reply to sjplegacy

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