My brother-in-law has POA over his wife. He's talking about removing her from the nursing home and taking her home. Can he do that legally?

She also has dementia. Her husband yelled at her and called her crazy when she was still at home and we believe the same thing will occur again if she's taken home.

The nursing home has to put a safe discharge plan into place to let her go. Hopefully, your BIL will cooperate with that. However, he can remove her against medical advice(AMA). If he tries to do that, the nursing home will most likely contact Adult Protective Services to evaluate the situation.

If APS thinks she is unsafe at home, they can make decisions that will override his POA. I would make sure the nursing home is aware of the family's opinion that your sister is getting better care in the nursing home- in an email or a letter. Each concerned sibling should write.

If he just removes her AMA, he could find the insurance will not pay for some of her care going forward. He really shouldn't do that without checking to see what the consequences will be- especially if he is worried about the costs of her care. Make sure he is aware of that!

This certainly is a good case for “if you see something, say something.” All those years BIL was abusing her and letting her run off on her own, did anyone ever say something? Call the authorities? Call APS? If APS had ever opened an investigation, there would still be a record of it and it would be easier to prove that she’s not going to a safe environment. Hopefully, if BIL does bring her home, you will get across to him that now, he will be closely supervised and if there is even a hint of abuse or lack of care, you will be calling in APS.

Woah woah woah, can we go back a bit?

To begin at the beginning.

How old is your sister?

You say she "also" has dementia. Also, as well as what?

Was your BIL always the dominant/overbearing partner in the marriage, or has the mental abuse you're concerned about developed recently - i.e. possibly as a (sadly misguided and ignorant) reaction to your sister's illness?

You say your BIL is only concerned about the cost of her care. But the cost is no small issue, and it can be an extremely worrying one. Again, it could be that informed advice might be a better solution to this than challenging his status as your sister's husband with power of attorney for her.

How immediate is the threat that he might remove her from the nursing home without a satisfactory alternative in place? How much time do you think you have in hand?

When she was evaluated at the hospital they said she had dementia and a form of psychosis, but she's basically physically healthy. The verbal abuse has gone on for years and it was reported to Adult Protective Services. Unfortunately my brother-in-law is extremely clever. He can come across as a loving husband to outsiders. He's cut off all communication with her siblings because as he told us, "I'm in control and I'll make all the decisions about her care." We truly believe he has mental problems of his own and a policeman said as much. After she was evaluated at the local hospital someone from the hospital called him to tell him he could come and see her and he responded, "I can't come because I have to stay home with the dog." He's told neighbors her siblings are "spying on him" because he claims we're driving by his house constantly and sitting at the stop sign too long. That has not happened. He's threatening to take her home around Thanksgiving for a "trial run" and if all goes well he wants her home permanently by December. We simply don't trust him because of his past. As far as having a reasonable discussion with him he won't answer his phone when he recognizes our number or he hangs up on us so we basically have no contact with him. We only have the current information because one of his wife's siblings happened to be at the nursing home when he was visiting. I realize the money issue in no small problem, but it's more complicated than anyone knows. Since he's a compulsive liar he tells different stories to different people. He says he's destitute and he told one person that her Medicare funding was taken away since he was recently awarded money from the VA, but he's told others that all his money from the VA is going toward her care. His daughter is coming home for Thanksgiving (by the way he told her she couldn't stay at home because he won't have room now that he's bringing her mom home) to see exactly what's going on. Hopefully she will be able to see that her mother is cared for properly.

To repeat the question: how old is your sister?

Who reported verbal abuse to APS, and what led to this report? When did this happen?

I'm afraid that this will sound unsympathetic to you, but most of the conflict you describe seems to stem from implacable family hostility to your brother in law. Whether the hostility was originally well-founded or not I've no idea, but it certainly won't help your sister now.

He tells different stories to different people... he's a compulsive liar...

Well, be fair. You are picking up dog ends of information from all over the place and then blaming him when they don't tally.

What happened? Begin at the beginning.

Perhaps it doesn't matter, but the relationships are confusing. BIL is whose brother? or wife is whose sister? What is the actual brother or sister doing about this - where do they fit in? Who are 'wife's siblings' related to? And who are 'we'? Do all the other relations agree that BIL is the problem?

Thank you, I understand now.

I personally know well two husbands who have had to deal with their wives' long term mental health difficulties. One continues to do it in his own way, which is loving but counterproductive at times; and the other left his wife. Neither example very encouraging, I realise; but what I'm thinking is that facing the issues and dealing with them openly, educating oneself in the slightly airy-fairy school of psychology, and practising practical compassion - these things can be extremely challenging for your man's man type.

Sigh. Where's Captain when we need him to set an example? Sadly missed from the forum.

I think it is important to bear in mind at all times that your BIL believes that what he is doing is right, reasonable or the very least - for example when he has thrown his hands up and given up - justified.

All the same. It sounds as though the recent history shows that however willing and committed he would like to think he is, he hasn't a clue what he's doing and he has neither the skills nor the insight to care properly for a spouse with dementia.

Is there a psychiatrist you can bring on board to oppose her discharge home? What conditions are in the care plan?

If guardianship is going to be the only way, is that financially possible? He'd challenge it, no doubt - for the reasons above, plus personal pride.

Sorry, just to go back a bit.

This abortive APS visit - when was that, and following the failure to gain access has the report been taken further or what?

If the nursing home puts together a safe discharge plan for her and he can fulfill it, I don't think your family is going to have much power in this situation. It sounds like APS investigated, he failed to cooperate and what then? They just dropped the case?
If APS thinks her home situation is safe and a safe discharge plan is cooperated with, she's going to be discharged home. Maybe his children can convince him she's better off where she is. If they cannot, I don't think you have a lot of options. One of her children or siblings could file to be guardian (very pricey!) but you are going to need a lot more evidence of his abuse to get her away from him. I'm sorry. That sounds like it's really hard.