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92 y/o spouse dx'd w/dementia did not even appoint me for a medical POA; he put his sister on the form at the VA hospital and she was astounded when I told her this because she and he do not get along at all. I have been advised that I need a DPOA and an elder lawyer and I have no clue about where/how to do this..

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You can't! The must be willing and competent to do so. The only remaining route is to file for guardianship which is expensive and time consuming.
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Go see an Elder Law attorney. Take any and all paperwork with you. You may want to make a list of talking points to make sure you do not forget something you wanted to share. He/she can provide you with a list of options and steps which may be available to you. Laws vary from state to state so you need someone familiar with the ones in your state. His sister may be able to refuse to serve as the medical POA. Your state may give some legal standing to a spouse in situations such as this.
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Your sister-in-law can relax - she can't be appointed medical POA without her consent to it, either.

To find a reliable lawyer, see if the hospital or perhaps friends with experience of dementia can recommend one with a good track record. Do NOT rely on advertising or glossy claims! Word of mouth from people you trust is the best recommendation.

What do you need medical DPOA for? Generally, it is useful but not essential unless you are having to cope with people who might dispute your authority to act on your husband's behalf. As his wife, you are next-of-kin and would routinely be consulted when decisions need to be made; so before you go about formalising your position on that score, do check that you need to.

You should consult a lawyer anyway, though, because there will be all sorts of administrative tasks to be undertaken on your husband's account and if you haven't already looked into these then you will need expert advice.

But don't panic: nothing terrible will happen to your husband in the meanwhile just because you haven't got DPOA. You have time to get things straight. Best of luck, please update.
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Start by getting documentation from your spouse's doctors. It usually takes two, but may vary from state to state. You will probably need them to conclude your spouse is no longer able to handle his own affairs. I think once you have that, an estate attorney should be able to help you.
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I did not have a DPOA but when needed to speak with VA, SS, etc. I would explain my dad was hard of hearing, they would ask to put him on the phone to confirm his personal info, then ask if it was ok to speak to me. This worked for me. I don't know if your husband can or will do it but it may be worth a shot for the moment. When I was at a doctors appointments With dad i also asked that they write in his chart that is was ok to talk to me if I called. Things may have changed but it can't hurt to ask.
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First of all, no one can be made POA without their knowledge and agreement because a form has to be filled out and signed before a notary by all parties. If his sis has not done that, she is NOT his POA. He may have listed her as an emergency contact person or the VA may have asked him to fill out a HIPPA form which gives permission to discuss health care with someone else. On the HIPPA forms, many people can be listed and that's the route you can go for medical care, discussions, offering input to the docs. Without that form, his doctors and other medical staff may LISTEN to you about his care, but they may not share anything with you, or come to you for decision making. When they get him on the phone and ask if they can talk to you, that is essentially a verbal HIPPA form. Anyone can ask for one to be filled out, at any office or treatment place or hospital, clinic etc. No notary needed or anything. I also recommend you see an elder care attorney and either have him/her discuss with your husband there, the importance of POA as you get older, because of his dementia diagnosis because as time goes on, there is no doubt that you will have to make many decisions on his behalf. You should also consider one for yourself....and review all other types of protections needed like a will, living trust etc. to protect your assets as you walk the road of the elderly!
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Where your name is on the assets with his, that shouldn't be an issue. For other areas, I've had the same experience as Patrice.

If your husband is in the early stages of dementia, he might still be capable of signing a DPOA if he chooses. I hope you don't need to go to the extent of applying for guardianship.

Has he always been this arbitrary?
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In my own case, here in TN, the only reason that I needed POA and guardianship was when I was trying to get a Medicare part D supplement policy by phone. In all other cases I am the next-of-kin and there was no question.
When my wife suffered a sudden dementia I found an attorney, who got me an emergency, 60 day POA with doctors statements and an attorney ad litem for my wife and then after the 60 days I was given a permanent guardianship and yes there is expense, in the nature of $6000+.
I hope this helps
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Willyj, a nice clear account like yours of a directly comparable experience is always helpful. I'm just taken aback to infer that Medicare runs a supplemental scheme that is only accessible with the aid of an expensive legal formality. Is that not a little eyebrow-raising?
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There is an online service called AVIVO rates attorneys. I found an excellent elder care attorney with the help of this site. The lawyer saved me many hours of frustration. Make sure you get a free consultstion . Here in NYC lawyers are charging for consultations. I paid $250 and the advice was awful. My new attorney spent quiteva lot of time with me on the phone before I had even retained her.
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As a spouse, you have rights. More than any other family member or person in your husband's life. My husband has been in the hospital several times and I've found that they give you a health care proxy form along with the paperwork about your rights as a patient. What we did was fill it out right there in the ER, grabbed a busy nurse and a transport guy to sign as witnesses and that's all we needed. It's legal, binding, and 3 years later, we still use it. If you're with your husband in the hospital, you might just want to do that. Ask admissions for the health care proxy form or double check your paperwork. Grab anyone you've developed a relationship with at the hospital, like an aide or the person who cleans the room, to sign as your witnesses, and you're done. You should not have a problem with this unless someone specifically chooses to give you a problem, but I can't imagine anyone giving grief to a wife trying to care for her husband. If and when you do this, I would avoid involving anyone too high up at the hospital, or anyone in the administration. Often, in my experience, they've become part of the "machine."
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This may sound sinister, but if you're desperate, you can take your husband to the ER for some minor issue (nothing cognitive and DON'T let them know he has dementia--use a different hospital system if you have to, one that won't have his records). Make sure you get the health care proxy form them upon check-in. Ask the admissions person for one if you don't see it. Then, because the issue you report will be minor, you'll have 5-10 hours to fill out the form and get some busy person to sign it. This would probably work best at a busy, overcrowded, "public" or "county" hospital where you get the sense that they cam't quite keep track of everyone. Then once you have the form signed, wait a little while and report that he "feels better and doesn't want to wait, so you're going to follow up with his regular physician tomorrow," then walk right out the door. You don't want him admitted. Hospitals are apt to do that to patients who have a medical history or are over 65 (guaranteed Medicare money). Be pleasant and keep moving! Mission accomplished. It's so sad that sometimes it seems that there's an "us against them" mentality among the people who are supposed to care for our loved ones. It's a matter or survival and we have to do what we have to do. GOOD LUCK!!
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I agree with Christine73 about this. Just get 'er done. I'd draw up a DPOA and have it ready (you can get one on line). The situation you're in was driven by his impulsivity. One of the things dementia does to a person is give them wild swings in mood. That's probably how he assigned his sister to begin with - it was a fleeting thought that crossed his mind.

When your husband is in a good mood, and being agreeable, bring up the topic calmly and mention that his doctors, etc, have said that's it's best that his wife be his DPOA so there's no delay in care waiting to contact his sister (or whatever reason you think may most appeal to him).
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Good luck trying to get this changed from his sister as since he is diagnosed with dementia, his signature will be invalid. If his sister refuses to act, then you can file in Court to appoint you, otherwise the Court will appoint someone else.
At 92 yrs. with dementia, it may become moot since this diagnosis is terminal.
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Joannes is incorrect. The person named as POA does not have to sign the document, at least in the several states I am familiar with. If a person was named and cannot or will not serve as POA, they just decline to do so.
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Folks do not give illegal advice. His signature on any new document will be invalid and his wife could be prosecuted. What were you thinking?
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Ferris, who are you responding to?
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His wife won't be prosecuted unless someone wants to prosecute. The sister won't fight the new document because she doesn't want the job given to her by the old document. Yes, it's better to do without a signature obtained from a demented person, but also yes his dementia may come and go and he could be entirely in his right mind when he signs, and also yes there are times when you have to figure out how to work with the system.
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I am thinking, best if wife can somehow get Dpoa, Or Guardianship, BUT, if she is anywhere near his age 92, there needs to also be a successor DPOA (and do tbey also appoint succesor Guardians?). I mean, what if the Lord should send His angels and take the wife to her Heavenly Home tonight, where would the husband be in that not too unlikely situation? Best to have all the bases covered. Maybe bring that question up with their kids (if there are some) or grandkids.
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Country mouse: Eyebrow-raising at least. Dismaying and disheartening too. Of course the intent is to make sure that it's not too easy to get at somebody who has unscrupulous relatives, but Lord help, I went through all that and had another elder lawyer lined up for a conference and now that the wife is in hospice It all turns out to be a total waste!!!I never did get the Part D supplement that she needed and all the conservatorship account and everything else is now moot.
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Vegaslady, in NYS the POA has to sign to acknowledge reading and accepting the responsibilities. NYS has also tightened up its POA form due to increasing number of situations where fraud occurs.
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Ferris, please reconsider your answer. A person with dementia CAN and often DOES sign a DPOA and or a Medical POA. Having dementia does not automatically make you incompetent to handle that act. In our case, the lawyer simply had to be assured my husband understood what it meant to allow someone else to act on his behalf. Fortunately the attorney came to our house while he was having a good day and he could explain to her what he was signing. If he hadn't been, she was willing to come another day when he was doing better cognitively.

IT IS NOT ILLEGAL for a dementia patient who has not been declared incompetent by a court to appoint DPOA and mecial POA.

Please read the Aging Care Legal expert on this topic, here https://www.agingcare.com/articles/elder-cant-sign-will-trust-power-of-attorney-153521.htm
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Sometimes a person picks a POA because they don't want their spouse to be the one who decides to pull the plug. They want someone who will be cool under fire and able make a rational decision.
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i THINK YOU SHOULD RESPECT YOUR SPOUSES WISHES AND NOT PUSH THE ISSUE !
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But what to do when the proposed POA person refuses the job?
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rovana, pick someone else
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