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My husband’s mother has dementia and is considered no longer able to make decisions for herself. She has 3 children: my husband, his older sister, and younger sister. Their father is still living, in a nursing home, but of sound mind.


The younger sister has Medical POA for their mother. She has conflict with the older sister, and they have never trusted each other. My husband has been able to maintain mostly good relationships with them both, but because of that, his younger sister is very suspicious of him too sometimes.


Their mother was recently hospitalized, and at first the younger sister and my husband were both on the list to have permission to talk to nurses/doctors. Older sister asked their mother if she would give permission for her to talk to them, and she said yes, so she was added to the list.


Then a doctor called older sister instead of younger sister to talk about their mother. Older sister told the doctor he needed to call younger sister, which he did. Now, younger sister thinks we are conspiring to take away medical POA from her behind her back somehow because of one misplaced call from a doctor.


Now, everyone is off of the list, except for younger sister, and when my husband and older sister call the hospital, they are told they can’t get any info and have to talk to younger sister. But now, younger sister also won’t answer anybody’s texts or calls.


If my husband’s father called the hospital, would they also deny him any information? When it comes to Medical POA in general, does a spouse have rights that are equal to or supercede it if another family member has it?


We’re trying not to involve him if we absolutely don’t have to, because we don’t want to stress him out, but we may need to if younger sister continues to shut us out.


Thanks in advance for your help!

Given today's HIPPA laws medical information can only be given to the person with the Medical POA. The spouse's wishes cannot over ride this unless the other spouse signs some HIPPA document giving them permission to have access. Family dynamics aside, which sound very dysfunctional, that's it.
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Reply to cmagnum
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You wrote that your husband's mother has dementia and is no longer considered competent. Has a doctor deemed her incompetent? Often times people say someone is unable to make decision but it is not based on a doctor's order then they do not have the authority to speak for the individual. For a POA to spring into action one of three things must happen;

1. One doctor must declared the individual incompetent,
2. Two doctors must declare the individual incompetent or
3. Sometimes the DPOA is immediate - not as common.

Look at the Medical Power of Attorney and usually in the first paragraph it will tell you what it takes to spring the document into effect.

Once a POA has been activated then the person listed as the 1st Agent will be the one making decisions for the individual. If the 1st Agent is not able or available to make decision then the decision will go to the 2nd Agent and then the 3rd Agent (if there is one.)

Although the Medical Power of Attorney can prevent you from getting information they can NOT prevent you from visiting your loved one. I have often been involved in working with family members who have been told by the POA that they can not visit their loved one. A POA, both medical or financial does not have the authority to prevent someone from visiting. A Guardian can sometimes have that authority if it is written into the guardianship.

In order to stop someone from visiting the hospital/long term care facility would have to be able to show that the individual's visit with the person/resident/patient was having a negative effect of the individual. Only then can the visit be stopped.

Final thought: I would remind the POA that you are not trying to take over, in fact when you got the call you immediately told them to call her. This should show her that you respect her position and that you are not trying to take over.

Good luck!
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Reply to cjwilson
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Younger sis was appointed the agent. Perhaps best to get an elder law attorney involved.
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Reply to Llamalover47
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I reread this. If Mom put everyone on her HIPPA paperwork, the POA does not have the right to remove them. Mom overrides POA. The POA is in place for sister to carry out Moms wishes when she is not able to.
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Reply to JoAnn29
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Respect the POA.

Would you like it if your mother in law tried to change yours?
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DrowningDIL May 26, 2019
Just to clarify, we aren’t trying to change anything, or claim rights to make any decisions. We just wanted information because younger sister witholds it from us.
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I am going to go out on a limb here and suggest that perhaps nothing nefarious is happening. I think it's just an "over time" compilation of who can get info from the hospital, and most likely nobody knows who is on those HIPPA forms.

Bottom Line: The charge nurse and the floor nurse do not have time to talk to and give updates to more than one "relative" or "authorized representative."

I have only one sister, and I am the POA and the Health Care Proxy for my mother (father passed away many years' ago), but I always put my sister's name down on the HIPPA form as being able to get info.

I'm the one who manages the healthcare. I cannot tell you how many times my sister has not told me that she called the hospital and talked with the Nurse, or called the nursing home and talked wth the floor nurse......did not tell me....and then I called....and then I ended up talking with someone who was busy and trying to accommodate me but not thrilled about having to repeat the same information twice.

I did try to manage this. The nursing home knows that I am primary contact, POA and Health Care Proxy. The nursing home knows that my sister and I do not communicate well together. They know that they are never supposed to call my sister first. But, that cannot stop my sister from calling to ask for info and then not letting me know.

It is a common situation, but what's most important is that the person who has the legal authority to make medical decisions has to make sure that the the hospital knows NOT to give medical info unless they have tried and cannot contact that primary person.
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Reply to anonymous903302
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Wow, your SIL is obviously not a good MPOA. But it is what it is.

She should be careful considering that she may need help from the family sooner then later and she is creating a situation that no one will want to be of any assistance to her. She will be reaping what she has sown and that will be very said for her.
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DrowningDIL May 26, 2019
Thanks, Isthisrealyreal. The sad thing is, we used to have a very good relationship with younger sister. We drove her to specialist doctors across multiple states for a decade so she could get the best treatment. We paid for all the hotels, and transportation, and food, and bought her electronics, and had genuine friendships with each other. Then she got mad when her mother gave us financial POA, and everything went downhill from there. We still love her very much, and my husband especiallly wants her to know that her brother is there for her. Still, I feel a bit like her love is conditional and her kindness transactional. We remind ourselves that she has neurological conditions, but my husband said she has been like this her whole life. He still feels responsible for looking out for her.
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A medical POA and a DPOA are two distinct different POA's A medical POA gives permission to make medical decisions for the person if they are unable to make that decision for themselves, such as being unconscious or suffering from dementia. But I was unaware of the hospital refusing to give progress reports to the next of kin. As long as only one person makes medical decisions. I assume the daughter was given this document because her father was unavailable. I think you need to speak to an attorney and find out what the POA is and how it is being administrated. If my mother was in the hospital I would certainly want to know what was going on and I think I would have that right. As to making decisions that is something else entirely.
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DrowningDIL May 26, 2019
Thanks, Mary. It seems like the hospital wanted to have just one family member receive the detailed progress reports, which we understood. We would just call to check to see if she was ok because she couldn’t use the phone herself. We had permission, and then we were cut off all of a sudden. Turns out, younger sister was having her moved to a new nursing home (she was in te last one for 5 years) without letting anybody else know. We had no idea she was even considering it.

We have respected her role as medical proxy. We just wish she would still keep us informed, especially about major decisions. It’s very frustrating and hurtful.
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In spite of the good info here, I think I'd still check in with a certified elder law attorney. It strikes me as a bit unusual...unless one was considering long into the future and a spouse being incompetent potentially or a marriage not being strong, that someone would appoint a child as POA over a spouse/next of kin. It sounds like you at least know where this new nursing home is...if you didn't you'd be potentially even kept from visiting. I share your concern about an environmental change. Any change like that is a major challenge for someone especially someone with dementia.
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DrowningDIL May 26, 2019
Thanks, gdaughter. Her husband had a stroke, and has recovered a good amount, but handling her medical details is still too difficult for him.

We’re crossing our fingers that things work out for the best with the move. All we want if for her to be well cared for and for her to find some semblance of comfort in her final days.
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Talk to younger sister that you know the fact that mom has been diagnosed with dementia then your husband, older sister & husband can't change the medical POA BECAUSE ONLY THE PERSON WHO WROTE IT CAN CHANGE IT - none of her papers can be changed so POA, will, etc are basically in stone now because MIL is incompetent - the only exception is if you can prove [prove not guess, think] financial issues/stealing then the financial POA can be revoked by the court = $$$$$ or possibly if younger sister is herself diagnosed with dementia & again = $$$$$ with the court

Ask her to talk to a lawyer to see her rights in your area but this could also be seen on line in some places maybe then she will relax a bit - if she won't answer your calls then hubby may have to write her a letter
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DrowningDIL May 26, 2019
Thanks, moecam. That is a very reasonable answer. Unfortunately, younger sister doesn’t seem to be comforted by all of our attempts to reason with and assure her that we have no ulterior motives. Once her mother gave my husband and I financial POA when she wanted it, she decided she couldn’t trust us anymore, and everything else has flowed from there.
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You said younger Sis has MEDICAL POA. Who has financial? If someone else, all they have to do is tell the facilities if they want to be paid, they need access to the Mother. They are responsible for costs involving Mom, not Sis.
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Reply to katiekat2009
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worriedinCali May 26, 2019
Sounds good but won’t work but no facility will violate HIPAA.
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Some medical POAs are only valid if 2 drs declare her incompetent. My mother’s does. Some also have secondary POAs listed. If you haven’t, get a copy.
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Mary1934 May 26, 2019
A medical POA has NOTHING to do with competency. It has to do with whether or not a person is able to make medical decisions. If they are unconscious due to accident or heart attack, a perfectly competent person would not be able to make a medical decision. As I stated earlier A DPOA is for mental incompetence, a medical one is what we all need whether or not we are old or young, it covers ONLY health issues.
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Someone breached a protocol and now there is conflict. Something similar happened to my husband and MIL. There are 4 siblings. My husband's assigned job is on the financial end and another BIL has medical. My husband was called first and he made a decision contrary to the other brother. Can you see the problem? It was set up previously because BIL was the most sensitive about the medical care. Your SIL has every legal right to shut everyone out. She is legally assigned. The reason may be due to the affected persons knowledge that someone may not carry out their wishes. In your case it may still mean that SIL was assigned previously. She accepted this position. The spouse can give an opinion but has no legal standing. Only the wife can make that designation.
I suggest in the future and after this medical crisis that you all sit down and talk about assigned roles. Medical professionals do it frequently after an incident happens. It is called a huddle. The purpose is to tighten controls so that everyone is of clear mind and so this does not happen again.
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DrowningDIL May 26, 2019
Yes, she has a legal right to shut everyone out, but I find it incredibly unkind and immoral. I understand why it is necessary to have only one person getting the detailed information and making the decisions, and I respect mother’s choice to have it be younger sister. However, with that responsibility should also come the responsibility to keep the other siblings informed in a reasonable way. I understand what goes into being medical POA, because I have been one for my own mother and grandmother. I have 4 siblings, and I always kept them informed. We never had any of these problems.

There is no huddling up with younger sister. She will only use it as a chance to berate all of us and make us listen to her lecture on why we are all bad people, which we are not.
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Read your reply to my post. I guess you r just going to have to wait it out. Be there when sister realizes what all is involved. If Mom is on Medicaid, changing counties is a big thing. Your Medicaid comes from the county the NH is in. She is going to have to fill out yearly paperwork. Make sure PNA doesn't take Mom over what Medicaid allows in her bank acct.

When she complains, surprise, surprise! That's what is involved in being a POA.

My SIL was POA for her Mom. Early signs of Dementia and spending money she didn't have on stuff she would never use, like trips. SIL got it all straightened out. Sold Moms house, got her in a good Independent living with meals, transportation and activities.

Then comes along younger sister. She wants to know how much of the sale of Moms house was she getting, now. Then, like ur SIL, took Mom and had SIL dropped as POA and her assigned and then...she did nothing. Bills were not getting paid, etc. SIL was able to get it switched back to her. Not sure what her sister thought POA meant. SIL took Moms phone away because "mom" was keeping in touch with the scammers that were taking her money. Little sis turned around and got Mom another one. SIL did set it up so Mom can only call certain people and only certain people can call her. Its just all the aggravation.

So, I do know where ur coming from.
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Reply to JoAnn29
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If mother is unable to make choices and a POA was legally established before that happened then even if your father calls they are not supposed to release the information. Younger sister can be asked to share access to medical information but if she refuses there's not a lot I know of that you can do outside of a lawsuit.
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Reply to faeriefiles
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As the spouse, they may talk to him. But final decisions fall on the POA.

I think the younger sister is being childish. The doctor made a mistake and the older sister corrected it. If OS has not done it yet, she needs to give a copy of the POA to the Hospital.

I was POA and I don't think when Mom assigned me it was with the idea of keeping her other children out of the loop. It was because I still lived in the same town. POA would have been given to whichever child was the closest. When it came to my Moms health, my brothers were told how she was. I felt they had a right to know how there Mom was doing. Now finances, my Mom was never secretive about her money. My brothers never outright asked but said if she needed anything call them. I guess I was lucky that they trusted me. We all new we would not inherit. We all told Mom to spend it.
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DrowningDIL May 23, 2019
Oh, JoAnn, if I told you all of the crazy making and paranoia that younger sister engages in, you probably wouldn’t believe me.

Their mother actually made me and my husband financial POA, and warned us that younger sister was going to have a problem with it but it was definitely what she wanted. She was right, and younger sister went behind our backs and tricked their mother into signing financial POA over to her last year. The good thing was that mother was already in a nursing home and I got her qualified for Medicaid, and I had already handled all of the business to settle her assets (there few to start with and none left). If younger sister only realized how much of our own money we spent to make sure mother was taken care of.

I should have known something was up, though, when my husband was taken off the list yesterday. Older sister finally got in touch with younger sister, and it turns out she was moving mother to a different nursing home, a half hour further away from us, without even discussing it with anyone! We’re so concerned that the change at this stage of her dementia is going to be so disorienting for her.

Did I mention that younger sister is wheelchair bound, and poor, and requires assistance with all of her own activities of daily living? Lord, help us!
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The spouse has no rights that trump a POA.

Are you local to the hospital? If your husband can visit his mother in the hospital, I bet the staff would talk to him. We had a similar issue very recently—my FIL was hospitalized for an extended period and my BIL is in charge, he’s the POA and he’s the one that the hospital is authorized to talk to. One morning the hospital called my husband thinking they were calling his brother. When my husband said he was the other son, the man on the phone refused to tell him anything! Freaked us out honestly because for all we knew, he was calling to notify my BIL that FIL had died! Turns out FIL was fine but anyway........whenever we visited my FIL at the hospital, the staff always talked to my husband and told him what was going on. They even answered my questions.....so while they wouldn’t talk to anyone but my BIL over the phone, they had no problem talking to us when we were there in person.
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Reply to worriedinCali
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DrowningDIL May 23, 2019
Unfortunately, we’re not local to the hospital. Older sister and younger sister are, but we’re a couple of hours away (husband was smart and moved before we met 20 years ago to get some reasonable distance from his dysfunctional family.)

We’ve actually gotten an update from younger sister since my post yesterday. Turns out she blocked us all out because she was in the middle of transferring mother out of the hospital. However, instead of bringing her back to the nursing home she’s been in for the last 5 years, she decided on her own to move her to a new one, another half hour away from all of us and out in the middle of nowhere, because it has “nice scenery.”

Turns out she was just using the doctors misplaced phone call to deflect while she carried out her plan. Now, we’re really concerned that the move will be so disorientating for mother that it will cause her distress. It’s also harder for us to get there, which is I think what she really wanted. We were all together at the hospital last week when a doctor asked us if mother had dementia, and younger sister said no. She’s refused to accept it for a long time. (Mother has a prior mental illness history, and younger sister has always been in denial.) Well, she finally told us last night that mother’s recent MRI said she has mid to late progressive Alzheimer’s, which any fool who spent any time with her could have told you.

I wonder if the official diagnosis had something to do with her decision to move her to a new facility.
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POA trumps relatives. A Power of Attorney is a legally binding, signed document. When my husband is in the hospital, they always ask me if I have POA for him even though we are married In addition, if medical information is to be divulged to anyone, they need to be added to the HIPPA privacy act form which is also a signed document. I’m not certain whether MiL’s word on who is allowed to be told her medical information is all that binding, especially since she is considered not competent. The people must be listed on the form. As for sister’s fears that Medical POA can be taken away from her, only her mother can do that which also may not be possible now. Her brother and sister cannot do that. They would have to file for guardianship which is a long and costly process and not something someone does because they’ve had a minor tiff with someone else.
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DrowningDIL May 23, 2019
It’s a tough situation, that goes much deeper than I went into in my post. We really should have applied for guardianship a while ago. Younger sister has major medical issues, including her own neurological deficits. But, she’s extremely litigious (she keeps notes on every time we call and visit their mother to prove that she’s more involved than we are), and loves using lawyers to back people off. She makes us out to be horrible people who don’t care, while she keeps information from us and is extremely paranoid. We’re just regular people. My husband loves his mother.

Now we finally found out last night that she took it upon herself to have their mother transferred to another nursing home after being in the previous one for 5 years, because she think it has better scenery. We’re so concerned that it will be disorienting and distressing for mother. There’s nothing we can do now, but try to make the best of it. It’s such a sad situation.
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