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My nephew had a stroke and while in the hospital he had two more strokes his sisters and brothers gave up their rights since he was here. in new York with me the decision making was past down to me, now the hospital want to send him 100 miles away from the family to a nursing home instead of one here in town, he can't talk or see now, but that's another story can they send him away without the family consent. Also

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Can I just say mildly that I think that what 1RareFind was getting at is that there are now infinitely more and better forms of assistive technology for people with all kinds of disabilities, and that there is no reason why a life with disability, all things being equal, should not be as rounded as any other. I'm sure she recognises as well as anyone that it will, still, depend on the severity of a given disability and/or injury; and I'm absolutely sure that she won't have meant to imply even tangentially that a person not leading a 'normal' life is just being lazy or self-pitying.

They are working on voice recognition apps, btw. Reference "In Touch" programme on BBC Radio 4. And stem cell techniques - is that what I mean? I do get terms muddled in my old age - to grow transplantable spinal cord cells, there has been some success with that I believe.

Long way to go; but things have come a long way too.
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1RareFind----I hate to be rude but your comments made me laugh. ""there's no excuse these days to be unable to live a normal life apart from disability when there's so much out there to offer people and free them from what holds them back"----please tell me you're kidding with this statement. You really should read the entire post first before blurting out comments that have no relevance to the original post.

Clearly, you have no idea how the brain or nervous system works. When a part of the brain is deprived of oxygen for a period of time, whether due to a clot or a bleed, that part of the brain dies & is no longer functional. This is called a "hypoxic" or "anoxic" brain infarct. The area of the brain that was deprived of oxygen & the size of that area that has sustained the infarct is what determines the amount of damage & residual effects of the stroke. Some people have strokes where there is minimal damage because the clot was small & only a small part of the brain was affected. Other people have massive brain damage that puts them on a ventilator & unable to move at all. Other people lose their vision or part of their visual field. Other people do not lose the ability to move their limbs, but suffer from aphasia---the inability to communicate verbally. The damage done to the brain in this manner is totally different than a child born without the ability to see.

There are many others causes of paralysis---ALS, transverse myelitis, polyneuropathies, other autoimmune disorders. The cause of the paralysis is very important. There is no cure for ALS or any of its "sister" disorders, nor for transverse myelitis or polyneuropathies or other autoimmune disorders.

It is rather impossible for someone that is blind to surf for apps on their cell phone, by the way.

Many paraplegics and quadriplegics have permanent damage to their spinal cord---the amount of motor function is determined by the level in the spine that the damage occurred. If the spinal cord is severed or damaged to the point that it cannot be repaired, very little can be done to change that, and no amount of "technology" is going to repair a severed or irreversible spinal cord injury. If a person loses a limb, prosthetics are often used for their mobility. Assuming that "technology" can make every paraplegic & quadriplegic walk again is rather absurd. Furthermore, this "technology" you speak of costs hundreds of thousands, if not millions, of dollars.

Your post about an app converting audio to text is rather ridiculous----the OP's nephew is blind. He can't read text.

You were adamant about speech therapy---the OP said he is unable to talk.

Making a comment about disabled individuals having "no excuse" for not living a normal life is an ignorant one. Even if you remain blind & depend on audio assistance to live, you're still blind----you will never be able to drive a car or do other things that sight requires. That is NOT living a "normal" life.

"Special technology" for quadriplegics & paraplegics to "move on their own" does not mean that the spinal cord is healed or other nerve issues are resolved----technology that helps them "move on their own" include things like exoskeletons (which cost about $65,000), which are made of metal & do not enable normal range of motion do not enable a person to "live a normal life". Also, quadriplegics sometimes require a ventilator to breathe on their own. Assuming that these people "can live normal lives" is short sighted, callous & ignorant. Granted, there is much more that is available today to help those with brain & spinal cord injuries and autoimmune nerve disorders---but, there is still no technology that repairs nerves that have been deprived of oxygen or repairs serious spinal cord injuries. Despite what you think, this "technology" you speak of is not "rapidly improving"---it has taken decades to develop many of these things that help the disabled. Steven Hawking is ventilator-dependent, unable to move at all, is wheelchair-bound yet retains his cognitive abilities. The only muscles he is able to move are his eyes.
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POA's cannot transfer their authority to someone else. That is the law.
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Pam she states the longdistance POAs have transfered POA to her. Evidently as eyes on. A needed reasonable and necessary since trying to move him 100 mi away. And she is close by. Since she is still family. Possible she can assume POA but have to check with state jurisdiction in the matter. If she has transfer in writing noterized appointing her as POA surogate to serve as communication assistance since this is largest barrier at this point to his needs. What I told to do will work for placing him.she will be able to place him in facility best needs met. DCF Authorized Represenative. She can get noterized letter from siblings appointing her this also. This makes her DCF payee and access to HIPPA protected info. When she applies on line for LTC Nursinghome for him on the benefits application website she lists herself as contact. Because Siblings designated her as Health care POA. @nd what I said to do will make her DCF payee and his ADVOCATE.And ADA advocate She need only say Quality standards of care then look up community standards of care.Also applies to hospitals and nursing homes.add in Quality standards of care for dehabilitating and life threatening(obamacare) illness injury or disease. All under pt rights. Then say ADA 505 reasonable accomodations does apply. Then contact state ADAAdvocates should be in state capitol or call state procecutor or elder affairs usually have website can file grievance on. Even if the POA not quite correct now. As DCF A. Rep she can be his pt voice another organization to join. And she will have already acted on his behalf as DCF self Appointed Auth. Rep. And local representation for the POA. She just needs to adjust her wording unless or untill POA changed uncontestably to her. She does what I said, they won't be able to move him and she will have say in where he is. No where did she said POA signed off . She said transfered to her. As I always advise leave an option for appointment incase a disaster and unable to follow through. Yes everone close not nec. Best because natural disasters can happen. That being said wish her well. She has taken on an honerable mission.
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pamstegma is correct.
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If he can answer simple questions by a finger movement yes or no or blink or eyes up and down hand squeeze etc ... He can make his wishes known. Let his Dr and Soc worker know you are willing to assume assignment as GPOA DPOA and HCSurrogate you can get DCF appointment as Authorized Represenative self appointment if he cannt sign. Have poa and letter of intent for passing care to closer relative for quality standards of care for disabled person and person with critical or lifethreatening illness. reassignment noterized by previous poa. This will allow you to place as his DCF Authorized Represenative If he can make a mark even thumb print on this paper then he can appoint you. It is in application for foodstamps and longterm care fill out as selfappointed authorized represenative and apply for longterm care for him. The Hospital will have to acknowledge this esp if you can get his mark on it after you apply for longterm care and list yourself as contact as DCF Authorized Represenative. You can represent him at ACHA as advocate and Authorized Represenative for his medicaid and medicare. Trust me Ive had to us this TRUMP on the establishment and to advocate for needs denied by a facility etc pulling HIPA this authouizes you past what dr can see even court without susponea then they habe to know what to ask for you only approx dates to advocate this is what he immediately needs is an advocate today then gather the rest.
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1RareFind while your experience, whatever personal capacity that is, may be where your words come from, not everyone has had it in such a way that you describe where all you have to do is get some therapy and find an adaptive device or even app and the person over some time with effort thrives in the world again. Sometimes there is just too much damage to repair all cognition or physical challenges. My mother had the WORST brain aneurysm that completely blew out the ENTIRE right frontal lobe. The night after her coiling surgery it re ruptured and a clot traveled to her left frontal lobe where they had to clip the aneurysm and perform a lobectomy. With this surgery her LEFT frontal lobe and part of the left temporal lobe was removed from her head. She has no frontal lobes! She was comatose for 6 weeks. Within 3 weeks her waking, she was walking again MIRACULOUSLY but she doesn't remember the day or month or year and if I leave to get her a glass of water she may or may not recall that. Can she read, yes. Can she sign her name, yes. That doesn't mean she is competent to assign POA. I have just skipped years of unfathomably harsh details such as 30+ infections, sepsis 4 times, osteomyelitis, MRSA amongst other joys that for time constraint I will refrain from. My point is, not everyone recovers in the same manner. I'm just content to have my mommy today so we can enjoy each other. Today she celebrates her 73rd birthday! WOOHOO!!!
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I agree with attorney Ralph Robbins. If he has the capacity to understand what is happening to him and can make a mark that is notarized, then he could designate you as his MPOA. Not knowing his prognosis, it is hard to say how long he would live and seeking guardianship might take longer than he has. I am so sorry his siblings have abandoned him, but 100 miles doesn't seem that far since I am now living in CA, and one can zip up the coast in no time. Best wishes!
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Pardon the typos, the phone just rang. I was trying to say that with rapidly improving technology there's no excuse these days to be unable to live a normal life apart from disability when there's so much out there to offer people and free them from what holds them back
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I also forgot to mention that I've been seeing a little bit about a device that's coming out. Bionics are starting to be used to reverse vision loss and restore sight to the blind. It's big and bulky, but at least it works. I've been seeing a little bit about it on social media where blind children are seeing their parents for the first time, but it's not restricted to just children, anyone who needs them can use them. With the way things are now with improving technology, there is no longer an excuse for blindness being why people can't live normal lives. I saw another thing about paraplegics also using special technology to regain motor function and walk. Yes, technology has come along way when they can make paraplegics and even quadriplegics to be able to move on their own and eventually graduate from needing the assistive equipment and onto being able to move on their own so they no longer need any more assistive equipment. I've been seeing some things online where technology can now help us move mountains to the point there's no longer excuses to not be unable to live a normal life
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In the scenario described it appears there is an existing Power of Attorney in place? If so, read it carefully as to "Successor Agent" provisions.

Absent an existing document or successor agent provisions, the question is not whether your nephew can speak or write but, rather, does he have the capacity to make decisions regarding his personal matters both health care related and otherwise. If he can understand what is presented to him (by whatever means) and can communicate that fact (by whatever means) then it can be determined that he has the capacity to grant Power of Attorney to another. It is not necessary for him to sign his name; as long as he can make his mark, and it is witnessed and notarized in accordance with his state's requirements the POA will be valid.

Otherwise, the only option is to obtain guardianship.
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You could become his Guardian.
Not an easy task and it does involve paperwork and some court time.
You would then have more say in his placement as well as other details that involve him.
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OK, I didn't realize he was also blind. This is another obstacle that can also be overcome and I'll explain why:

A friend of mine is also blind and there's specific software for devices to help blind people, some of them being audio where you can speak and it converts audio to text. Look into your App store for your device and investigate all of the apps and you'll see there's plenty of software for the blind. Not all of them are free though, so be prepared to pay for some of them if you decide to get them
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Presumably the hospital has not selected the distant Nursing Home purely to distress and obstruct the family. What is the reason for their preference?
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1RareFind, not a lot of people who can't see can use a notepad.
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Can your nephew communicate another way such as writing or through typing? With technology the way it is now, all you have to do is pull up a notepad and type as another form of communication. This would definitely be worth looking into and if he can communicate, find out what his wishes are. One thing I can't help but ask is has he had any form of speech therapy? If so, how is he progressing? If not, why not? If he's never been in speech therapy, why not? These days there are multiple therapies available for stroke victims, I know one and she had multiple strokes and she took speech and physical therapy. She's doing very well and you would never know she ever had even one stroke
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Since the next of kin have signed off, he then becomes a Ward of the State of NY. You would need a lawyer and petition for Guardianship. Too late for a POA at this point.
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