Rights and responsibilities of adult child vs. rights and responsibilities of sibling with medical POA.

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I have Medical and Durable POA for my younger sister. My mother is the primary and I am the secondary - my mom is not "fit" to act in this matter and has ceded that responsibility to me. I do get guidance from her as she used to be a darn good nurse. My niece vanished from her mother's (my sister's) life and decided to become a part of it when my sister became paralysed. I am very happy this happened. Slowly, I have given my niece more responsibility with my sister including getting her to various appointments. She missed some appts and upset some folks due to "I was sick - I was up all night sick, etc." In addition my ex-brother in law has started being the person that is talking to me about things instead of my adult niece speaking to me. They changed appointments for a monthly treatment and the facility allowed this. I realized that I had ceded too much responsibility to her when it was clear that I did not trust her enough for this. I have contacted the facilities involved to see if they have the Medical POA on file and will be sending it to them. I don't want this to go the way it is going, but I don't know what else to do. Some may say I am being controlling, but I am trying to keep my sister from missing any more of her appointments. She will loose the hippotherapy if she misses. I just don't know how to deal with this. My niece and her mother were estranged for many years. My niece and I were estranged for many years. My ex-brother in law pushed me on the phone as to "why" I am taking away the schedule change of them taking her to her monthly appointment and putting it back on the facility of whom I had previously arranged. He forced me to say "I don't completely trust her". I feel horrible. I don't know what to do from here.

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My brother came, interfered for a while. I basically told him that Mom could not and would not be giving him any money for his help. This took the wind out of his sails. He never said so, but that was surely what he was expecting. I never did count on him or his wife to actually do anything.

He left. Still tried to cause me trouble. The family lawyer set him straight. Haven't heard boo from him or his family since.

Here it is Christmas Eve. He sent her a card about a week back. That's it. I have a nice scarf and glove set for Mom..I put my brothers name on the gift.
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Thank you Hedgie and cwillie, I feel better. This morning I woke up and scanned everything and made sure everyone that does anything with my sister had it and gave specific instructions and permissions on how to reach me. Then I told them they were welcome to reach my mom as well and where she currently was (which the nursing home knows because that was where my mom was rehabbing!). Today I found that two checks that were reimbursements for a transport chair and clothing for my sister were cashed just a little a week after they were issued. I informed the ex-husband (of whose money that likely was) this information and haven't heard back. Obviously, my niece did something else with the close to $375. I have had warning bells from time to time, but have worked very hard to rebuild/gain trust in her over the last three years, even asking her to house sit and dog sit for us in our home. cwillie, I did comment to my niece a while ago that I was concerned for her when she started to miss things. I even called the dad and said I was concerned for her a few times. I am also using the facility transport reason and in fact that is why they called to holler at me in the first place. He insists that my sister hasn't missed more than one thing because of my niece. I have counted on her more than I realized, including many care plan meetings. Today I realized she may have attended one? I'm certain my brother in law will be going to the ombudsman regarding the nursing home for something they think is an issue (which isn't). I actually told the administrator that my niece said she was on a "self-sufficient" wing - that makes no sense because NO ONE is self-sufficient! And they are now complaining that they have started using a Hoyer lift with her. That is a GOOD thing, not a bad thing! It is safer for all concerned! Oy Vey! My mom is now aware of all this stuff, and she is behind me and has been saying she doesn't trust her either for a while. Why do these things happen at the holidays? I cannot tell you all how much better I feel after reading these two responses. If anyone has experience with this actually resolving, could you let me know? I'm interested if there is a way.
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You might have phrased it that you worried it was becoming too much for her/them as they had missed some appointments. In my opinion it is better to work through the facility transport even if niece's trustworthiness were not an issue, asking someone to schedule time off work for monthly appointments when there is an alternative available is just not necessary. Oh, and of course tell them they are welcome to meet your sister and stay with her during the appointment if they really want to.
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Trust your instincts. If you need reinforcement you might want to read "Emotional Blackmail" by Susan Forward. You can probably get the book through your local library. You shouldn't feel guilty as long as you are doing right for your sister. I'm always very cautious when I hear about estranged family members (and ex-family) suddenly reappearing. Sometimes---not always-they have an agenda that is not in the best interest of the person requiring care.
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