Over the past year I have joined my mother in her doctor visits because her memory is declining and she doesn't fully relate any issues or medical care but, does rely on me to help her with it at home. She fully and agreeably relies on my judgement to help. Her doctor is extremely dismissive of me in person. On the first visit, I handed her the FULL DPOA and she immediately told us that means nothing unless mom is incapacitated. I thought that was a regular "springing" POA that worked like that. The last two times she asked mom about her affairs being in order and she was told (by mom) that I am her primary home care and take care of everything for them...bill paying, house cleaning, shopping, cooking, appointments. The second time when mom told her that, she got closer to mom and looked pointedly at her and asked "and the rest of your children know this". I kept silent but was a bit put off. My family is tight and they all support me and are grateful I am able to be there as I am. I have one brother who comes to assist when my father is more incapacitated as his health is in much greater decline. There was a recent episode and mom had a bad morning with dad's care before her visit so she was visibly shaken. The doctor made comments like "How nice of your son to come and stay with you and your daughter is able to "bop in". WTH - I more than "BOP IN". They live next door and I am there 2-3 times each day. I never leave my property without taking them for a ride. I cook for them, clean, yard work, EVERYTHING. I wanted to set her straight but, mom has had her as her doctor for 20 years and she's almost 89. How do I inform this doctor she is overstepping her bounds and that as DPOA that I DO indeed have a say in what goes down. I wished she had just tended to moms' health. Instead she spent the whole visit talking about my fathers and his impending death and what was mom going to do. We have that covered and she has been told that 3 times now. I am a professional who owns my own business and has assigned staff to handle it while I spend my time caring. I do not rely on any income or inheritance from my parents and seek nothing but to help them in their elder years but, this doc is really rubbing me the wrong way.
It sounds like you would like better recognition of your caring role from her doctor. I don't blame you, but it really doesn't seem to me to matter to the care Mom gets from that doctor. That doctor and your mom have known each other for a couple of decades and their relationship is well established. Unless your mother wants to change doctors, try to respect that relationship and don't be bothered by the relationship between you and the doctor.
If it ever arises that you want the doctor to do something or refrain from doing something that is different than what your mother tells the doctor then you may need to get a lawyer involved. But as long as you are just giving your mother advice and she states her decisions to the doctor, where is the problem?
BTW it sounds to me like you are an extremely valuable and loving care partner to your mother. You deserve a lot of credit for what you do. I wish the doctor would express that, too.
It's okay though as mom and I have decided together on a course of action to speak with her about my role. Coming once more from mom...then we'll see about the next step.
I suspect the primary hurdle for the doctor is that she does not consider your mother incapacitated. It does not sound like your mother is incapacitated. Memory loss and incapacity are a long way apart on the scale of how impaired someone's thinking is. Your mother may not be able to remember what the doctor said, but she is certainly capable of expressing her wishes in regard to her care. It's a common mistake to believe that someone who can't manage on their own automatically activates a POA.
The language in most POA documents is clear that the individual has to be unable to make decisions before the POA can step in. It's a gray area to say if someone is unable to understand their decisions and their consequences versus not agreeing with the opinions of others.
I once had a client with vascular dementia who "fell in love" with a caregiver and began to give the aide large amounts of money (thousands). The family knew he was being suckered, his doctor knew it, Adult Protective Services knew it, and law enforcement knew it. The fact that the person had documented dementia did not mean anyone could step in and put an end to the scam. The reason was that while he was making bad choices, no doctor considered him incapacitated.
That's an extreme example, but it shows why a doctor might disregard a POA document when the patient is still able to converse and make decisions. As for your mother's doctor, she may be off the hook for wanting to deal directly with your mother rather than going through you, she is NOT practicing in a way that a compassionate physician would.
One thing I know with all my heart after 20 years of caring for dementia patients is that the caregiver MUST have a trusted ally in the physician directing their loved one's care. Dementia caregiving is a long, often solitary road. Having a good doctor backing you up versus someone who makes life more difficult is the difference between peace of mind versus one more source of stress.
My loved one would have to be dead set on staying with a doctor even knowing how miserable I was before I would stick with someone who wasn't an ally. Doctors are a dime a dozen depending on where you live. There are areas of the country where it's a take-it-or-leave-it shortage of doctors. If that's not the case where you are, I'd be doctor shopping pronto. Good luck.
THIS is the point many are missing, esp those telling OP she's off base, whiny, seeking approval and that she just needs to suck it up, grin and bear it! As long as mom gives verbal okay for OP to be there, then that's ALL that's needed from OP's side. Doc is the one who needs to put up or shut up. If that's not enough for this prissy doc, then have staff bring that nice form that is expressly used to allow others to be privy to your medical needs/care, instead of being a rude SOB.
I feel the same way about doctors for myself, for my kids (when they was little), for my cats and while overseeing things for her, my mother too. If the doctor dismisses me, ignores me, can't be bothered to talk WITH me, then adios. I've done it multiple times. Either work with me or we are done. I HAVE to advocate for the kids when they are little, the cats, who can't talk, and my mother who had dementia (I also went and/or arranged medical/dental for mom before the dementia and went with her to all the appts.)
If verbal approval isn't enough for the doc, every doc office I've been to has forms for the patient to fill out if they want someone to be privy to their medical information/care.
Also, instead of referring to yourself as the POA, refer to yourself as the "caregiver". Explain to the doctor that since you live next door, your parents and your siblings agree that you should be the caregiver. Explain this in front of mom during a visit, or better yet, ask mom to explain the situation to the doctor. Allow the doctor to have private time with mom to discuss personal arrangements, in order to validate to the doctor that this is what mom wants.
Doctors and nurses are very cautious about abuse/neglect/exploitation of vulnerable adults. Unfortunately, this is rampant, and the overwhelming majority of exploitation is done by adult children of the eldertly/disabled. The reason I became a caregiver was because of a situation like this in my own family, which resulted in legal charges against the exploiter, and has been financially and emotionally devastating to my exploited family member, along with the rest of my family.
As offensive as these questions may be, understand that the doctor is simply looking out for your mom. You both have the same goal: for mom to be safe and get excellent care.
I understand how you feel, and I think the doctor could have explained her stance more diplomatically. I also agree that maybe this doctor gets off track with personal conversations at times, which is annoying. That said, even though your parents do indeed rely on you to make decisions, does not mean the doctor cannot discuss their medical issues and maintain a relationship with them directly.
I went with my Mom to her primary every single time from when she was competent to the times she was no longer mentally "present" and each time the doctor spoke to her directly. It's makes the patient feel safe and relevant. After he spoke with my Mom, I would fill in the blanks she left out or ask questions if there were any. I never presented my DPOA - it's just not necessary.
My advice is to step back a little. I think you're a take charge person determined to be a great caretaker for your parents. I think your feelings are hurt because the doctor seems to be refusing to acknowledge that. But look at it from a different angle. Ultimately the doctor is putting his client (your Mom) first, making her feel secure and maintaining a relationship of trust & care. Stay in the background, and ask your questions and fill in the blanks once their exchange is done.
Juse keep showing up with mom for her appointments and your mom can keep answering the questions.
Onice mom can't answer the question herself. Answer them
Don't let it bother you what the Dr asks and says.
You and your mom know what's going on.
The only grin this doc would get from me is when I was waving bye-bye after getting mom to agree to change docs. When there is a true medical issue, or emergency, you NEED this doc in your camp. She isn't in the camp and doesn't seem interested in being in it, so find someone who IS - dad's doc sounds like the perfect alternative.
Time for a new Dr!! ASAP!!
the one I have is called "durable power of attorney" at the top BUT it can only be enacted if 2 doctors declare that dad is unable to make decisions for himself.
Medical POA and or directives will also be ignored by doctors that don’t want the family whom want looped in “as a team approach” in caring for your loved one. Bob
Only seeing your mom 2x a year, this "doctor' probably doesn't even recognized your mom when she comes in.
She isn't addressing the situation that brings your mom in and she is not respecting your mom's caregiving daughter, HUGE WAVING RED FLAGS! If she isn't helping your mom with her medical conditions, she could very well be harming her. Perfect timing for a second opinion and a smooth transition.
I understand not wanting to push for change but, this "doctor" has ignored her 3 times already (I believe in the 3 strikes and you are out rule.) and God forbid that something happens to your mom, this is the Yahoo that you would need to have confidence in to provide records and/or medical care. Not something that I would want to deal with in a time of crisis. Your alarm bells are telling you how wrong this person is for a reason, trust yourself.
She is blessed to have you looking after her and advocating for her well being.
Since you already have a relationship with dad's doctor, either switch mom's care to him/her OR ask that doctor for a reference, if he/she can't take on mom as a patient.
Designating someone to be a Medical Advocate.is usually covered by documents like an Advance Directive or a Declaration of Medical Advocacy or Surrogacy. Documents differ somewhat from state to state.
You may be both of these things for your mothet, but it is not the DPOA that controls the Medical decisions.
No one ever questioned the DPOA I presented for managing mom's finances. I didn't have any letters or any "proof" of mom's incompetence. She was with me at both the bank (to close the account and make managing it all easier) and the CU, which was her primary account. She never said a word, no one asked her anything. She just stood there rifling through her wallet and purse, in both places.
I did try to get her doctor to issue a letter regarding what the federal pension required to become representative (DPOAs don't apply to ANY federal entities.) He agreed to do it while we were there for exam (a copy of the DPOA, the letter from the pension people AND the list requiring what was needed was sent to the office BEFORE we had the appointment.) Nine months later, despite repeatedly contacting them, I never got anything from them other than a request for the DPOA (replied that I sent it to them, but here's another copy via the portal) and some time later a request for what was needed (replied that was ALSO sent to them, but here's another copy via the portal.) Most of the time I had to resort to the portal as I could never get through by phone to a person. NINE months and nothing! We had to find a new doc anyway, as she refused to let aides into her condo, so Plan B had to be done, move to MC. The one chosen was closer to where I live, for easier access to oversee, provides necessities and visit. The new doc tried once, and it was rejected. The second one succeeded.
IF I didn't need to change address, the pension and SS would have been left alone - direct deposit and two of us were on her account, along with the DPOA. HOWEVER, SS does not approve of this. Legally the only way to manage someone's SS funds is to sign up as rep payee. Same for the federal pension. I did both, which allowed me to change the mailing and residential address.
Doctors aren't always the most responsive when needed. So many say have doc contact DMV about revoking license - HAH! Many don't want to get involved. They are docs, not legal experts and many try to avoid getting in the middle! WE have to advocate and see to it our LO gets what they need. Never mind advocates for others, I've had to change docs myself when my issues are dismissed - I don't have many, but when I did, I was getting nowhere fast with many of them! Same with pediatricians when my kids were young AND with some vets. I have some brain cells and can think, plus my kids are too young and the cats can't talk, so WORK with me or I will go elsewhere.
The POA wasn't even involved in that matter.
I was the sole successor of a family trust. Even when my MOM became incapacitated it was very difficult to get 2 doctors signatures stating that she was in that state of being as required by the trust documents. It was very difficult to pay for my Mom's financials without having access to the trust funds. I was finally successful in doing so with one of her financial institutions a day before she passed away. She was deemed incapacitated but she was in an skilled nursing facility (SNF) and only one psychiatrist had seen her. (This was also during the peak of Covid 2020-2021) Being incapacitated meant that she couldn't sign over the trustee position to me and I was unable to get a second doctor to sign off. She had contracted Covid in Dec. 2020 in the facility.
Please ask the doctor if they have a form that your Mom could sign that would allow you to conduct all functionary medical needs for her. Take care of any legal / financial matters while your Mom has capacity, if possible.
doctors, as my father who was a Faculty Member of a Medical School would say, have an arrogance the younger they are, until they are blessed with a little humility. I have experienced this personally, to the point where the SNF called in the Geriatrician MD that my father used for his Alzheimer Disease, whom demanded I not be in the room, nor my paid caregivers, ‘for the patients privacy rights. The doctor came out and blasted me and my caregivers for attempting to dope my mother up on more Haldol as during the 26 day stay in the hospital, the one nurse also agreed that my mother needed a very small dose added around 2pm, and the orders were given as needed. The Geriatrician MD told me this was false and I was lying. I suggested the Geriatrician go to her little computer and pull the in-patient chart of medications for her last ten days at the hospital. A week later a certified letter was received at our home informing my mother that the Geriatrician resigned as one of my mothers doctors. I suspect the doctor went and read Mom’s in-patient chart and found she crossed the line accusing me of lying.
I hate to say it but these doctors also break the law by practicing legal interpretations of the law on the fly. You will never win this battle, as the doctors will eventually tell you flat out “at the moment we discussed and examed your mother ‘today’ that she appeared to be competent. Bob
I wish the best for you and your parents.
What you suggested mom should do/say is something I would likely do myself! Mom sounds a bit too dignified to stoop to that level, but it WOULD be priceless if she could do it! Yes, I am here 2 times/year for 10-15 minutes to get my checkup, so shut up and do the checkup already!!!
I wish the best for you both during this very challenging time.
I would look for another doctor ...seriously who wants one that talks about death all the time. Find one that talks about life and ways to make her life happier. I know my life if happier when I am with my children who love me and care about what happens to me.
DPOA does not expire unless it is specified. I doubt the one in this discussion has an expiration date.
It's best to provide the DPOA BEFORE it is needed, so it's on file. NO harm in doing that.
As for needing it during visits/exams, OP's mother can give VERBAL okay. If that isn't enough for this doc, then doc can ask mom to fill in the form ALL doc offices have, which would allow OP to be privy to mom's exams, care, etc ALL the time, without mom having to grant permission every time.
OP doesn't need legal advice to move forward. What she does need is some good reasons to give to mom to have her change to the doc who is treating dad, her husband, who sounds like the best doc!
Contact an elder care attorney. The POA for health, finances, and appointment of health care representative on behalf of my brother were all drawn up by an elder care attorney so the wording was correct. I presented these documents to an assisted living facility, doctors, hospitals, hospice, insurance companies and even the utility company. I never had a problem. It was open sesame.
I have to say at the first first appointment with my brother’s oncologist I mentioned I was POA and he brushed it off a little. Maybe he was trying to draw out my brother’s opinion—not that my brother could comprehend much with his brain cancer. I guess he was waiting for my brother to speak up. We didn’t have the problem next time.
But your situation is in a whole other league. I would look for another doctor. Your mom probably won’t be happy about it but it’s becoming impossible to work with this doctor. The doctor needs to include you in the conversation with your mom and it sounds like your mom would probably understand your explanation. I don’t know how your mom would react if you simply stated to her doctor that your family is very close and fully support and appreciate all that you do—in other words respond directly to the doctor when these comments come up. Caregiving is difficult enough without dealing with disrespectful doctors. She has her own agenda going on and it’s interfering with your mom’s care. Good luck.
When I needed to step in because mom was in early stages of dementia, I had to set her up with a new dentist (she hadn't been to one in a while.) Then because she refused to let aides in, next stop was MC, which was closer to where I live allowing me to oversee and visit - this required a change in docs. Mom didn't bat an eyelash. During an episode of pain, I was not happy with over-prescribing OTCs instead of trying to determine what the cause was (I pursued that further on my own with orthopedist.) I changed docs again. Mom didn't bat the other eyelashes.
"Work with this doctor."
How do you work with someone who makes snide comments and spends the exam time discussing anything but the exam? OP's description of her dad's doc sounds like a better fit and that doc can treat the family as a WHOLE, instead of implying mom is being taken for a ride.
Yes, it still is mom's choice, but I would suggest the change and let her decide. Personally this doc sounds like a real piece of work and I would want mom to find another. I've had to change docs for myself, for my kids, for my cats. Until I find the ones who work WITH me instead of against me, then I will always keep open the option to find another. It isn't about getting the doc to pat my back, it's about having a GOOD relationship with someone competent, someone who LISTENS as well as TALKS, someone who should know the dynamics of the family, esp after 20 FN years.
The more we stand up for our rights. The easier it is for the next person down the road.
My God Father/ Uncle takes my Grandma to Kaiser. There are no issues like this.
Why do you need the doctor (or anyone else’s) approval? It shouldn’t matter whether you get the “credit.” What you are doing to help is between you and your Mom. (Or between you and your mom and God, if you’re religious). No one else’s opinion matters. No one else may appreciate you anyway.
I don't think it was inappropriate for the OP to bring the POA to the doctor's office; we gave all of that kind of paperwork to my mother's doctors AND to the hospital every time she was admitted - POA, health care proxy, living will, etc. My attitude was better to bring it right from the beginning, before there are any issues or emergencies, and then I'm scrambling to get it to the people that need it.
If the issue the doctor had was the daughter filling out a HIPPA, that should have been explained to the OP "I'm sorry, even though you're here with your mom's permission, we still need you to fill out the HIPPA, according to federal law". That's a reasonable request from the medical staff, to protect them down the line. I doubt the OP would have had a problem with that. It seems to me her bigger issue is the way the doctor spoke to her mom, as if the OP was the "enemy" here and mom should be wary of her involvement. I would be put off too, if I felt that was the message the doctor was trying to convey.