My Aunt is 89 years old and never been married and doesn't have children. She started to get dementia and could no longer take care of a home that she lived in all her life. We brought her to PA so she could be closer to family. The place she went to was an apartment in an independent facility that has personal care in it. My Aunt lived in the independent side and then her dementia got a little worse and she went to personal side where she has her own apartment with her cat. My one sister who lives in another country handles her finances. My wife did medical and I collected the bills to fax to my sister plus I do all the running around and I clean after the cat. I have a sister who all of a sudden wanted to be POA for my Aunt. Around Easter she came up from TX and decided to become my Aunt's medical POA legally and now my other sister is POA financially. The one sister told my wife and I to keep doing the same things as before. We thought no problem. My Aunt went in the hospital because of elevated blood sugar. We thought she would be in a couple of days then go back to her apartment. The Dr. at the hospital asked if my Aunt had a medical POA and I said my sister and gave the Dr. her info. plus they said about a POLST paper which I never heard of. My sister at that moment decided to make all medical decisions for our Aunt. She wanted my Aunt to go to a rehab place to get stronger and the Dr. said ok. My Aunt wasn't any weaker than her normal self. My Aunt went there and she became "combative" and complained her knees hurt a lot. Come to find out they were giving her intense physical therapy(per my sister's ok) and she has severe osteoarthritis in both knees(my sister didn't know that). Then she wouldn't get up and walk so they started using a lift on her. Then they gave her 3 norco a day and she really became confused. I talked with a nurse and told her that my Aunt would walk sit and throw her legs up on her walker and go again. She was walking all around where she was living and she got more care at her apartment than she is now. And I told the nurse my Aunt's old pain management which was tolerable for my Aunt. So the nurse I guess talked with the doctor there to cut back her norco to half a pill 2 times a day. Which her major dementia calmed down but my Aunt still wouldn't listen to walk. Now insurance will no longer approve her staying there but my sister wants her admitted there as a resident. My Aunt is unhappy, she has a tiny room, she isn't allowed to get up on her own even if she would walk for them and she is more incontinent because she isn't allowed to get up to go to the bathroom and they don't come in time. So what's going on now is the person that evaluates and is head person at my Aunts apartment building, went in to my Aunt. My Aunt's eyes lit up and said am I going home now? Then that person asked my Aunt if she could describe her apartment and the name of the apartment and she had no problems answering those questions. Now, this rehab said my Aunt is a 2 man lift. The person that came to evaluate she took a table away from in front of my Aunt and put her walker there then asked her to get up and walk my Aunt had no problem. So the representative an I went to talk with the social worker and said my Aunt is no different than she was 3 weeks ago. She just suggested if I would stay with her for a couple days until she gets used to the old schedule. We had a conference call with my sister and she doesn't want her to leave the place. Can my Aunt or I over ride my sister who is the POA. My Aunt even got her hair cut today thinking she was going home this weekend. I also asked her today if she would rather stay there(skilled care) or go home to her apartment. She said home to her friends and her cat. Is there anything I can do?
good policy , respecting the wisdom of the elder and im all for it .
There are two possible things to attend to:
1. The sister who is all gung-ho about rehab but didn't know about the osteoarthritis needs to be brought fully up to speed, so that she has a better understanding of your aunt's wellbeing overall and can concentrate on what really matters to your aunt. I can't advise on this - my own experience of trying to get an interfering family member to pay attention holistically went badly wrong, so I'm the last person I'd ask how to do it. But you know your sister: who will she listen to? The social worker, maybe? The caregivers and managers at her ALF? You? Your aunt, even?
"All behaviour has a positive good intention." Your medical POA sister's positive good intention is that your aunt - hey presto! - will be transformed by the rehab/boot camp experience and live a newly fulfilling life. I.e. she's not doing it to be mean. She just needs to understand the reality of your aunt's physical state, the limitations of what is achievable, and the comparative merits of intensive therapy vs. aunt being comfy in her familiar environment.
2. Meanwhile, discuss the issue of capacity with your aunt's supervising physician and social worker and see what they say. If aunt is deemed competent, there is no problem: aunt decides, and the only remaining difficulty will be explaining this non-confrontationally to POA sister. Try not to let this become a battle of wills, because that is good for nobody.