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My sister comes to town once or twice every couple years. She doesn't know all about my dad's health like I do and after a week she tells the caretakers at the group home to give him all the morphine he wants the nurse took him off of it because he was taken other pain meds for arthritis neuropathy I really too many drugs can do you in she can't just come here take over nurse has to go by my medical poa not what my sister thinks ?

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Give him all the morphine he wants?? That sounds a bit dark.
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I agree with ferris1. Yes, it would be really nice in a fantasy world if we could all play nice and work well together, BUT, if one person has the POA and it is on file at the facility, the facility is actually breaking the law if they do not adhere to that POA. The sister has absolutely NO RIGHTS to do anything other than visit and you can even stop that if it becomes a problem.
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I guess I'm lucky, my brothers like that I'm handling it all.
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Gotta love those siblings that come to "visit" every couple YEARS and think they know WTF is going on better than the sib that is with mom every DAY. And I know it's rude to put things in all CAPS and say "wtf" because I hate it when young people do that. But in some really bad scenarios even I will let it fly. And those sibs like yours (and mine) are it. Nothing worse than those who pop in after Many Moons and try to be helpful (to.assuage their guilt, I guess). I mean, why do they even bother with the visit. I'm pretty sure if mom's could go for a few YEARS without changing their kids diaper it would be child abuse.....OK now I know that's not quite a fair comparison. But.seriously. the out of town kids will always find their distance to their advantage, in avoiding a "visit." If there were a tax write off for visiting ones elderly parents, it might help a tiny bit. The local involved ones are always doing much, much more, and they Know What's Going On. Period.
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I am sorry for the typos. I just cannot find them and I am horrible on this device.
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I will say this, and this could be regulated by state, her drs iffice told me that info goes to anyone deemed to be in her charge or as her caregiver as far as their purposes. I did NOT like that. At all. And aksi hipaa is a joke, as they are regulating and fining institutions and do not give two whits about the patients. They can hand out your med records, leave them by the side of the road and be hit with a huge fine, but you cannot sue them unless you gave a state provision that allows it. The fines are collected to keep them in business.

But with that said, if directive is given by the poa, then that should be different. When I read the med POA we have on file it seemed to me to only be valid when she cannot make decisions herself, and until then the durable trumps all. Does this seem right? On the medical we, my sis and I, are jt period.
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ferris 1 is so right about this! You are the legal decision maker. I am surprised at the group home workers for not ascertaining who has right to give orders! ( Also what about the ordering MD? Does he/she not have to approve changes?)
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First of all, the caretakers at the home should have a copy of your Medical Power of Attorney. Next, if orders are changed contrary to your orders by anyone else, you can sue them. Tell your sister if she tries to change the orders again, you will get a restraining order barring her from seeing your father without you being present. I would give this group home a severe scolding, and tell them if they ever change anything again without your permission, you will find your father another group home.
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I have the POA, financial and medical, because I'm the one who still lived near my Mom. No one at any facility should be taking orders or giving out information to anyone who your parent or you haven't listed that it's Ok to do so. This is a Hipaa regulation (The Health Insurance Portability and Accountability Act). No one should be changing meds at any facility WITHOUT a doctors order. I would assume this facility had already asked for the Medical POA when your parent was admitted. It is very important that you get POAs written up while parents can make decisions. Under Hipaa, doctors/nurses are under no obligation to explain your parents health concerns unless you are on the list OK'd by the parent. This goes for husbands and wives too. If a parent is not able to communicate someone has to speak for them and without a Medical POA, you can't by Hipaa. regulations. My daughter is secondary but only if I'm not available. The nurses spoke with her when I wasn't there and she was able to sign paperwork.
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It is about guilt, as the other person said. My sister and I no longer soeak due to the POA, as I am primary and she is secondary, allowing that she is to step in in my abscence. She sees POA as an expression of our moms love or a popularity contest when it is actually a burden of running two households, one for a blind, angry, quarrelsome, sick woman who is very demanding and unappreciative. She sees the caregiver I hired as her bestie (blah blah just loves me! She makes sure I am wearing clean clothes and holds my arm when we walk! My neice just loves me, she takes me to church) while missing the fact that the cg is PAID to do this and my cousin, while wonderful to pick her up twice a mo for church, only does that. I am run ragged and she never says one kind wird, and my sister looked at me and said eff you, you wanted the POA, YOU do it all. WHAT? I did not. The attorneys chose me because I am disabled and home, she still works. But while she refuses to take mom to the hosp if called first, which she was twice, she will jump up to sign a document or answer a medical question. Huh? She has not spoken to a Dr about mom or filled a medicine or communicated about her in two years. Infuriating. My take is we should be sharing all medical info because I am sick and if she will not help, and if she does not want to be at appts because this is her mom also, she should know what the doc said. I could die, then what? She has cussed me like a dog. I told her to go away. I have offered her the Poa, she will not take it. This is tragic.
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Even though you may have the power the law doesn't back this up very well. It is always good to document every activity that has happened. I have had several run ins and the police or attorneys are of little help. Even under a verbal court advisement my sister did as she pleased in interfering with the task at hand., which is mom's care and best interest.
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We've also found that showing that we are ready to include my wife's sibling's input into any major decisions, despite that we have guardianship, makes a difference.

We've also found that NHs, etc, don't have the tightest controls on who can provide direction. It depends on what's being asked and how defensive they feel they need to be!

However, even if your mom is not competent, her requests about who can receive information, provide direction, etc, can make a difference in terms of whether or not they get carried out. If your mom is competent, then she can override anything in writing regarding the medical POA.
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It's all about guilt. People who don't come often want to do it all in the short time they are there. Best to say yah, yah to them. Good advice to tell the staff to go through you. Also, ask the doctor if the person is right--just this time. Encourage more visits from people. And always expect advice. Listen to them and look at their point of view.
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If you have the healthcare POA directive as well as the financial one, you are the only person who can provide orders on behalf of the family. If the facility has those documents on file, there should be no question and they should refer all information back to you. I have all POA's and my siblings know I am doing more than a full time job, just taking care of mom. I report to them on a regular basis about what is going on for mom, mostly big important things, but sometimes the mundane as well. They have a very good sense of how much work I am doing. Do you communicate with your sister on a regular basis? You do not have to be best friends, but when someone gets filled, they feel like part of the process and that takes some of the animosity or power grab intentions away.
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My brother has the same long-distance, visit now and then, try-to-tell-me-how-to-manage-our-parents relationship to them. I have all the POAs as well. He calls tem once a week. I have been able to diffuse the situation pretty much by sending my brother regular updates by e-mail, and calling now and then on specific issues. Because he feels more included, he has backed off to a large extent. My parents' caregivers at their facility as well as management know that if he demands some change, they are to contact me. As txcamper suggests, make sure that management and caregivers (if they are separate entities) each have a copy of the POA.

Hope you can work out a similar relationship with your sister. The regular communications have certainly improved my relationship with my brother.
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Have a business talk with the owner/manager of the group home. Has the medical poa proxy been activated? If I understand POA's they give the representative attorney in fact specific authorization as to what the POA can do at your dad's direction. If your dad is competent he can allow your sister to speak for him unless the health care proxy gives you full control. Seek legal advice from a elder affairs attorney if needed. I would be sad to see you have to get a restraining order.

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Give the nurse a copy of your Power of Attorney and ask her not to make changes to Dad's medications without conferring with you. Tell her that no one else has authority, that you don't share POA with anyone.
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