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Our Elder brother who has POA of our Mother, can't handle caring for his mother who has Alzheimer's, and turned over her car to the two daughters, across the state from him but he retains POA. My wife does not want to put her in a home yet, but feel limited in her care by not having more of the control of her medical care. This has gotten very ugly and it"s tearing the family further apart than it already was.

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Do all you can to resolve this WITHOUT going to attorney--try a Family Meeting, your clergyperson, your workplace Employee Assistance, even a paid Negotiator. There is nothing more profitable to a law firm than several siblings strewn across the state, each with their own idea of how to care for mom. You will spend thousands of dollars. Take the initiative to tell all your siblings, Look, we can go spend thousands of dollars into the lawyers pocket, or we can preserve that for Mom, the choice is ours, and let's get together and decide to work together, for Mom. Write a short & sweet letter, encourage some idea sharing and most of all, support the current POA in whatever they have done. If the POA needs (and can) be changed then make sure everyone understand the rational reason for change. Again, lawyers hage broad grin behind your arguing backs -- there is nothing better for their paycheck than a fighting family. Keep telling the siblings "do you want the lawyers getting rich on this?" and try your best to steer this rocky boat towards some type of agreeable resolution. Your mom is most important here.
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The only one who can change the POA assignment is Mom. Is she mentally competent to understand the concept of allowing someone else to act on her behalf? Having dementia does not automatically disqualify someone from naming or changing a POA of MPOA. Dementia covers a huge range of competency. Where is your mother within this range?
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The person who does the bulk of the caregiving should be the one who has POA. It's only logical.
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If you are not satisfied that things are not being handled properly, then I would consult with an attorney in the state your mom resides. Generally, the POA should live in the same state as the person who appointed them POA.

I would discuss my options with the attorney. If you file for guardianship of the person you can ask to be in charge of the health care, the finances or both. HOWEVER, in order to avoid going to court and it getting messy and expensive, I would see if you can retain the attorney to sent them a letter, addressing the concerns and asking for a peaceful agreement on how things might be handled to address the proper care of your mom. If it can be arranged that's great, And if not, then the gentle reminder that court action can be instigated might help convince them to see things more clearly.
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POA (Power of Attorney) and MPA (Medical Power of Attorney) are two different things. POA is for financial and MPA is for medical. The "durable" distinction means it does not become invalid if the patient becomes incapacitated. Since that's when you need it the most, you want to be sure he has DPOA anyway. Since she already has Alzheimer's, she cannot name someone else to be POA. She has to be of sound mind to do so. It cannot be traded around willy nilly.

At least this is the way I understand it. You may be able to apply for guardianship, consult an Elder Care Attorney.
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Which POA does he have or does he have both durable and medical POA?

I think there is a legal route where you can charge him with not fulfilling his duties as POA for his mother. I don't know how that works, but I know someone who didn't think their brother was doing right by their mom, had evidence of it, went to a lawyer and everything was changed.

The other and costly route is to take your wife's mother to court and file for guardianship because her alzheimer's makes her incompetent to handle her affairs in a business like manner which must be testified to by two doctors who have examined her. This costs around $5,000 and would probably complete the tearing apart of the family based on it already being torn apart.

I don't think he really had any business turning his mom's car over to the two daughters. It should have been sold and the money used for her care.

Having said all of that, in what way is your wife's elder brother not handled her mother's care?

I see that you are caring for her at home. How bad is her Alzheimer's and how are ya'll doing in providing for her care?

Do either of you work outside of the home or do you both work?

What exactly would she want her brother to pay for to keep taking care of her at home?

Where does her doctor think she should live given the condition of her Alzheimer's?

Is her brother heading in the direction of having her mother placed in a nursing home which has a unit for people with Alzheimer's?

Are ya'll possibly looking at this whole situation form completely different perspectives?

Is the brother thinking more in terms of the long term care that mom will need as her Alzheimer's gets worse and worse which is does and some like my dad can decline very rapidly and suddenly you can find yourself in over your head while trying to find somewhere for mom to go that is equipped for people with her medical problem?

I don't know if this is true, thus I'm raising this as a question and not as support for his view.

On the other hand, is your wife looking at this from the perspective of the short term situation and how nice it is to have mom at home and still be able to care for her there which is a valid point and can be done up to a point.

Again, I don't know if that is how she is looking at things, and that is why I'm raising this issue and a question and not in support of her view either.

I am trying to see if there is any possibility that there are two different perspectives going on here. In other words, I'm trying to do conflict management. If you are talking about two different perspectives and not merely a personalized power struggle for control, then there is a possibility of negotiating a plan in which each party hears and understands the other's perspective and then comes up with a plan that each can agree upon as a plan for now and for the future.

You write that this concern has gotten very ugly and is tearing her family apart.. Are there more siblings beyond your wife and her elder brother involved in this? If so, that makes conflict resolution a little more difficult. I don't know how ugly this has gotten, how deep the wounds are or how entrenched everyone is in this, but it is really, really bad then one or maybe all are beyond the point of listening to where each other is coming from and people are talking past each other, but no one is really listening. If it has become that dysfunctional and toxic, then there is not a lot of hope for resolution for there are probably even deeper issues really going on here that are actually at the heart of things that go back to family of origin issues from childhood. Digging into that right now will not help really help anything.

I wish you well and hope something that I've said helps.
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