Power of attorney vs. healthcare advocate?

If you are not the medical or financial PoA and you are providing all your grandmother's care for free, AND you are paying for her care...this is unsustainable. Grandmother's financial PoA should be paying you out of her funds and there should be an employment contract. I understand you love your grandma and want to protect her but as the others have suggested, this may be a criminal matter so you need to make a decision. I'm not sure that APS gets in the middle of financial abuse but you can call your county's social services (at the Dept of Health and Human Services) and ask, or contact your area's Agency on Aging for resources. I wish you all the best and peace in your heart knowing you did all you were able to!

There is a POA for health care and a POA for financial. Both are appointed by the person asking another to serve in this capacity. If the grandmother is suffering from dementia then she cannot confer POA on anyone in the family; it is too late for that. A POA works for the person, at their direction, to pay bills, invest assets, keep records and etc. if working on financial things; and most POA language from lawyer confers their ability to work in this capacity even AFTER the person has some dementia, continuing to work in their best interests. If the grandmother gave POA and the grandson now caring for her suspects that the POA is being abused by the family to pay their own bills then the Adult Protective Services should be called to open a file in order to protect grandmother's assets. If the grandson is acting in behalf of a grandmother with dementia, in his home, then he can ask the court for guardianship of her, and control of her accounts, being a representative payee for Social Security. This is two actions. None of this is easy. All of this costs money from lawyers and requires meticulous record keeping. This grandson should NOT be spending his own money to care for grandmother. It were better she is placed in care; he needs his own money for his own life ongoing. The simple case here is that if he is living with and caring for his grandmother it is time for him to collect everything he knows into a coherent bundle and see an elder law attorney. A social worker at any hospital, most doctor office are able to help with health care directives if grandma is coherent and able to confer this as well and make her wishes know. Otherwise her next of kin is likely to be the one contacted to make decisions.

Your friend is his grandmother's healthcare advocate? She formally gave him this authority?

And who has Power of Attorney for her?

How it should work, is that decisions about where and how grandmother is to be cared for are made by the healthcare advocate. The expenses are then paid using grandmother's funds by the POA.

If the POA disputes the healthcare advocate's decision - for example, perhaps because the grandmother does not have sufficient funds to pay for the services the healthcare advocate recommends, or because the wider family has concerns about the quality of care being provided - then the two need to discuss what options are possible.

Do you have a reasonably clear idea of what the source of conflict is? You say your friend's family has turned against him so that they can use grandmother's money to pay all their (own) bills; but objectively speaking, it's very improbable that they would see it like that; and it's important to remember that grandmother gave the person she chose the authority to act for her - it happens, but again it's unlikely she would have picked someone who was going to keep all the money and refuse her the care she needs.

What's much more common is a disagreement about where grandmother should be cared for. If, for example, the POA does not agree that grandmother is best looked after in your friend's home, it will go against the grain to support what the POA sees as a bad decision by co-operating with it (s/he should, but there's no point in being surprised that s/he's obstructive). So: what are the issues, and how might they be resolved? The answer should certainly not be for your friend to be paying for support out of his own pocket.