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My friend was in End Stage Renal. He was like a big brother to me but when he became sick, he pushed wife and myself away. He would only contact me in case of an emergency. When we were able to, we would go out to dinner every other month.


Then his health declined, so we offered help (ASL, he rejected). He threw information into the trash right in front of us. Diaslysis center close to home? Refused. Meal on wheels? Refused. PillPack to oraganize meds? Refused. Help get finances in order? Refused.


He stated that I may be trying to take their money. He would take his wife to pay bills and go to back, and he made me turn my back while she wrote out checks. He would only call when we had to take him to hosptial. After a while, he didn't even do that and was mad when we found out.


4 months ago his dr advised him to get his afairs in order and he contacted me to be power of attorney. He did not tell me about what the dr said and nothing happened. Last week he crashed at home and then at the hospital. The outlook is grim. They have no children and his wife cannot care for herself. She can make her own choices. They had home healthcare that she depended on. Now calling for help in power of attorney for her. She has no one else. She is non compliant in any kind of advice and is in total denial on her husband's health. Refuses DNR bracelit, hospice etc.
What would you do?

Refer them to the Social Services for help with appointing a Fiduciary as Guardian.
You call this person a "friend". But you are giving advice they do not want and have not taken. If they friends, then visit, bring sympathy and flowers, and no advice other than recommendations for Fiduciary.
While hospitalizated they will have access to Social Services to help them. Eventually it is likely they will require State Guardianship and a Court Appointed Guardian and Fiduciary. YOU meanwhile can remain a friend.
If they are not hospitalized then give them numbers for "Fiduciaries" licensed in your State to render this care for them.
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elsinorejim Sep 28, 2020
Thank you very much. This helps. I hope the social worker at the hospital is going to go this route. It kind of sounded like it. She gave me an open door for the metting and I declined. It is my opion that the wife needs more professional help than I can give and social worker can take it from there.
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Call the social worker at the facility where he is right now and ask her to step in to assist wife with decisions to be made. Or, before doing that, ask her if she wants a ride to an elder attorney to get things in order to protect herself.
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Reply to my2cents
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Please let the courts appoint a legal guardian for her/him/them. Since both have been noncompliant with their own care, you do not need to make decisions about their care. Continue being the good friends and neighbors you always are.
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Would not be POA, that's for sure!
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I am 71 and I would not get involved. He has already shown that he has not taken any help you have offered. He is still "with it" so a POA for him in futile. He can do a living will at this time and DNR. With her, its better the State take over her care. Do you really want to get involved in their finances and make decisions for her. SS does not recognise POA. The State guardian will be able to get the resources together that they both need and quicker than you can. Personally, I wouldn't want the responsibility and the headaches that come with it.
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disgustedtoo Oct 5, 2020
While I also suggested it might be best to steer clear of this mess, explaining a bit what POA does and does not imply, he could still get the ball rolling by explaining to the hospital SW. Let them keep the ball rolling! But, for your statement:
"He is still "with it" so a POA for him in futile."

This isn't true. POAs can be set up in such a way that they only take effect if A, B and/or C conditions are met, such as being deemed incompetent, or being comatose, etc. HOWEVER, POAs can also be set up to take effect (in some ways, as soon as some are signed they are "in effect") at any point, even verbally. Some may revert back, if one regains consciousness or capability.

There are also temporary POAs, such as the one I used to allow my atty to sign the closing documents for a house I sold without me having to drive 2+ hours each way to sign a couple of papers! Specific task and limited time/scope.

But, there are too many red flags in this situation. Do the best you can to get help for them, but then back off and stay out of this mess!
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"I will not be attending. My heart is really heavy."

It is probably best to stay out of this. I'm sure you feel bad, as they were good friends at one time, but you were pushed away, suspected even, so much that even if you thought you could perform the duties of a POA, it is probably better to not accept it.

You have done what you can by discussing this with the SW and being frank about everything. It will be up to them now to work things out for him and her. They will be better equipped to address all these issues.

Just to clarify, now that I've gotten to your better description of the wife's "needs", being POA does NOT mean you would take on her care, in essence take over for him. POAs would allow you to oversee finances and medical care, arranging these as if you were them, sign documents for them and even oversee the care she receives, but you would NOT be caring for her yourself.

In any case, I think you made the best decision. Pass the baton to those who CAN get the help they need and step back. You can still be a friend, and help out in friendly ways, visiting, bringing gifts or supplies if they are in serious need, but that's about it.

Taking on POA for family members is hard enough. Sometimes it can be just as difficult as these who are requesting your help, but they are family. Even so, some will decline to take on this role, if those family members act like your friends, so you aren't the only one to ever be in this quandary. If they had been more agreeable and could have set up things and made arrangements before the situation became so dire, maybe, just maybe. Trying to do this when he isn't always lucid and she is so difficult, nope.

Also, should you ever accept being appointed POA for anyone, you DO have the right to revoke that appointment (as does the appointee.) It needs to be done in writing, probably best to notarize, and provide it to the appointee, the atty who drew it up or replacewment atty, and any other "interested" party. Typically that would be those who were given a copy of the POA to facilitate things, such as doctors, hospitals, banks, etc - that way they won't contact you (hopefully!)
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Reply to disgustedtoo
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Wow...just wow

I am exhausted just reading your post! Can’t imagine living with it.

It’s clear that they both need help. Can you force them to receive it? I don’t think so.

Did you accept POA for your friend? Do you have access to med records? Are you able to discuss details with the doctor?

Would you be willing to contact a social worker to step in? I think that is what I would do. Contact someone such as a social worker that can lead you in a direction to help.
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elsinorejim Sep 28, 2020
I forgot to add that in. The social worker at the hospital where my friend is did call me this afternoon. That what brought me to this. I discussed with her the whole replationship and it was a very frank discussion. She asked if I was willing for the POA. I advised her that I have been beeting my head against the wall for the past five years trying to help. I do not know if I could do it. The social worker agreed with me and is going to have a meeting with dr. and wife to go over husband condition and her. I will not be attending. My heart is really heavy.
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Just guessing, but I'm wondering if the terminal diagnosis was just so unexpected, and the man was so unprepared that he took his fear and disappointment that his life was ending out on anyone who wasn't facing similar threats.  

Now it sounds as if he's being more rational, reaching out for help.    Facing the end of one's life certainly can be horrifying, and some people are just unable to deal with that threat.   I don't know how I'd act, but perhaps I'd act in a similar fashion.

What to do?   I would just offer to help in any way I could, but don't push it.   If they need assistance with meals or something of that nature, offer it, or just bring over meals.    With a noncompliant wife, I think it won't be long before they'll both need more help than they can comprehend now, but you may have to wait until they're able to recognize that plateau for themselves. 

Is the wife dealing with physical complications of her own?   I'm not sure how to interpret that she "cannot care for herself" but can "make her own choice", or is it that she can't make her own choice?  That's not criticism, just an attempt at clarification.  

Do you know any of their relatives, friends, or perhaps religious acquaintances who could talk to them?  If not, all you can do is be prepared for when the panic hits.  

I would try to identify ways in which they'll need help, such as transportation, groceries and supplies, hospice, home care, etc.  and either be prepared (if you're willing) to help, or identify sources that can help.

You might research online to see if you can find an organization dealing with end stage renal failure, and try to determine what the next stages will bring, and how much assistance they'll need.

I'm sorry to learn about this unsettling situation.  And it may be that your support, friendship, and comfort might be the most important aspect for them in  going forward.
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elsinorejim Sep 28, 2020
Thank you for the response. As to his wife. He took care of everything. Even before he became ill, he did the cookiing and cleaning. She does not know how to cook and always had someone do everything for her. Her health was fine until three years ago. Age related problems. Gait., Falling. She will wait in bed for the home health care to come to get herself ready for the day. She can do that but wants someone else to do everything for her.
As for my friend, he is in and out of being lucid. He is in the ICU. The dr meeting tomorrow to discuss end of life issues. She still thinks he will be comming home. He knew the this would be comming and I have no clue and on what he prepared. She has a sister but they do not get along at all. She has a sister in law. Samething.
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It sounds like husband is hoping to nominate you to replace him in caring for his wife. This is far, far beyond POA - and keep in mind he can give you POA for himself, but not for her. She decides for herself who, if anyone, to give POA to. And POA he gives you ends at his death. Sounds like he does not really understand how to proceed. Social worker is his best resource. Does his wife want you to be HER POA? Remember, her POA is up to her, not him. And if she is non compliant, how would that work for you? Again, POA acts on behalf of the person granting POA, not the same at all as the guardian/conservator. I'd really suggest your friend work with the social worker to see what can be set up long term. You could well find yourself having to try to "fix" situations without having the power to do so.
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I suggest talking to an attorney so you can understand exactly what being POA is about.

I hold POA for my mother and am responsible for handling her finances and paying bills. Mom is no longer able to do this for herself. Prior to her dementia I would preview her bills with her, help her write checks, and made sure all her mail was read and dealt with.

I keep careful records so if there are any questions I have all the paperwork. I also am a co-signer on her checking account and can write checks.

POA downs not give me any rights with her medical care, that needed a separate Medical POA in Ohio.

Also, any POA is revoked when that person dies. The executor is then responsible for paying debts and settling the estate.

And the Federal government does not recognize a POA so if your friend has any kind of government or military pension that is a whole other level of paperwork.
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disgustedtoo Oct 5, 2020
Ditto.

People often don't understand what POAs are for. They allow you to make financial decisions as if you were the person, aka in accordance with what they would have done, pay bills, manage finances, sign most documents, etc. Medical POA allows you the same only for medical issues. ANYONE can be appointed as a POA by someone IF that someone is deemed competent. It doesn't have to be accepted accepted by the designated POA and can be revoked by either party. It also ends at time of death, so there should be a will with an executor appointed.

What POAs do NOT require of you is ANY kind of care-giving. Should the person need to be placed in a facility, you have the power to sign documents, but NOT to make the person move against their wishes. THAT would require guardianship.

Please ALL note what Frances73 says about federal entities! NONE of them accept ANY POA. Each entity has it's own rules and forms. These include:
VA
IRS
Federal Pensions (probably state as well)
Social Security
Medicare

There may be others, these are the ones I have personally had dealings with.
IF you have POA, you can most likely (people write about banks rejecting legal POAs all the time!) manage the bank account, BUT, if there is SS funds and/or other pension funds deposited, you will need to address these. For a while I was unaware of the SS rules, but because of selling mom's condo, the mailing address had to change. Since mom had dementia, the only way to do that was sign up as Rep Payee. Their documentation specifically addresses this issue, stating clearly that NO ONE has the right to "manage" any other person's SS funds and they REQUIRE you sign up as Rep Payee. This was one of the easiest tasks I had to accomplish! Local SS office. One appt. Set up special bank account. Keep records on how funds are spent/saved and report yearly as requested (can be done online.) That pretty much took care of Medicare as well.

The federal pension took almost TWO years to get the right documentation, but thankfully once it was done, they allowed the funds to continue going to her regular account, and to date have never asked for a "reckoning"!

The VA had several forms that were needed, just to talk to them!
I gave up on the IRS - I use an Enrolled Agent to do her taxes, he submits electronic and I sign the checks, if any payments are made, as DPOA. So far no issues...

That said, your question is about what we would do. Given what you have said about her:
"...wife cannot care for herself. She can make her own choices. They had home healthcare that she depended on. Now calling for help in power of attorney for her. She has no one else. She is non compliant in any kind of advice and is in total denial on her husband's health. Refuses DNR bracelit, hospice etc."
...it sounds like she is of "sound mind", but needs physical help. If she is "non-compliant" for advice and is refusing assistance, what can you do? She would have to agree to see an EC atty and stipulate what the POAs would allow. Who is the DNR and hospice for, the husband or the wife? If it is for him, she's refusing and he is still competent, someone at the hospital should be able to arrange for DNR documents, notarized, and hospice. IF he isn't competent, perhaps you could contact the SW at the hospital and explain the situation, esp that she isn't cooperating, and that you have no power - you are just a caring friend who is trying to help.

The best situation, eps where there are no family members, is to have the state step in and assume guardianship. Even without the "hands-on" care, it can be time-consuming, and in this particular case, very frustrating and they are not even family! If you contact that SW, explain the rest of the situation and leave it to them to sort out. Much as it is nice to be able to help friends out, you were more or less accused before of wanting to "take their money" and wife isn't really cooperative. I'd steer clear of them, other than setting them up with SW.
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