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My wife's sister, who holds the POA for their Mother, has elected to place her in an assisted care facility a thousand plus miles away from her and all of the siblings. Recovery from hip surgery from a fall and the onset of dementia is present. Basically the kids all have moved away and there is no one close to effectively manage care on any kind of regular basis.

Getting any kind of information of what the POA holder plans to do has been impossible.

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Quite the opposite. The POA holder has an obligation to keep the patient's information private and secured. There is no obligation to tell anyone anything.
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Speaking to first question, first thing to do is get a copy of the DPOA and see if there are any obligations to inform siblings, although I haven't seen this as a standard clause.

Second, I think it depends on the relationship within the family. Even without any documentation to require a caregiver to do so, some keep family members informed; others do not, and sometimes withhold information as a ploy and manipulative tactic.

Personally, I've kept my sibling up to date notwithstanding much of a response (only infrequent calls, etc.). I don't feel any obligation to provide details on anything else.

So think about the family dynamics. Are the siblings supportive? Notwithstanding the distance, do they visit and provide respite care, call the caregiver or your MIL or SIL, offer to help?

Have they contributed any financial support?

How long has your SIL been caring for your MIL?

Given that the adult children have moved away, what alternatives would you think would be appropriate? Are you and your wife willing to take care of your MIL, either in your home or at a facility close to you?

There are many unanswered questions here so it's hard to offer suggestions without knowing more about whether or not the extended family has participated in your MIL's care.


As to the second question, I would offer the same suggestion on family dynamics. Obviously there's some communication with the caregiver which has caused you to disagree with the level of care. What have you offered to supplment and/or replace the care? If you and your wife are only offering distance caregiving advice, you're not on scene and would be hard pressed to know what the caregiver is doing on a daily basis.

That's not a criticism; it's a fact. It's kind of a "walk a mile in my shoes" situation.

I think you should again examine what you and your wife have done or not done in the past to support care of your MIL, what you're offering now, and do a serious evaluation of the issues in contention before even considering a lawsuit.

If you have specific legitimate complaints, develop potential solutions and offer them to the caregiver. Make your next vacation plans include a visit to the caregiver and your MIL, whether she's with the caregiver or in an AL facility.

Basically, become very involved before judgment is levelled against a caregiver in a distant geographic locale. You don't know what she's facing on a daily basis.
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I am POA for finance and medical. I have 4 siblings ,one who visits once every 2 or 3 months out of guilt. When it comes time to make any decisions guess who is going to make them all?
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We are facing the reverse of this problem...informing sibling only to face more questions, demands, criticisms of plans but not much in the way of solutions. What are you willing to offer to assist in the care of your MIL? What are you willing to offer to assist the person with POA? Your MIL may be far from everyone at this point but it sounds like she is where she was living...everyone else moved away. Are you able to move closer? Is it realistic for her to moved due to her current health problems?
Believe me, the stress of having to make difficult decisions for ageing parents is only worse when siblings get involved only to criticize.
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I am a financial and medical POA and my brother is the secondary POA for my mother and father and I have three additional siblings. When my brother and I were in the trenches handling the most difficult part of caregiving the other three just stood by and didn't do anything. My mother got sick first and was hospitalized for some time then she came home where every day I would go to my parent's house and take care of my mother and father, cook their food, pick up his medications and made sure they took them during the day and would stay with them for hours upon hours. Within five months of coming home my mother requested than I find a place for her so I entered her into a nursing home near her house where she stayed for eight months. So now I would visit her and stay with her in the nursing home and pick up my father every day to go see her. I still cooked for him and helped him with his medications. After awhile it became too much and my brother who is the secondary POA had to help me with my father. It was a very difficult time for both of us. The other three stayed in the wings the who time with very limited visits to the nursing home and no visits to see my father at home. My mother was moved to another nursing home about a 45 minutes away. I still visited my mother and helped her to get to her dialysis appointments too. Still the other three were in the wings and did nothing to help the situation. My mother was in this new nursing home for three months and my father was then admitted about three months after her. No one had nothing to say about my decisions up to this point. I also hired an attorney to help me with my parent's house, but that's another story and no one offered to help with that. I alone made funeral arrangements and everything that goes along with that. My brother POA was privy to all financial and medication decisions I had made and he supported me 100%. Still at this point nothing from the other three and their visits were very few and far between.

Before my mother passed away seven months ago I found out that she had horrible bed soars, so I contacted an attorney to help me with this. At this time I did now know my mother would be alive only three more months.

Ever since this suit has been active, two of the other three siblings now think that I've been stealing money from my parents and think that I'm pursuing this suite for my own financial gain mainly because one month after my mother originally went into the hospital I bought a new car. Now I worked all my adult life and have a pension and 401K which I used to buy my car. She appointed me to take care of her's and my father's finances and anything else I had to take care of. So I did. I would also freely tell my sister some of the financial information. Since my integrity was in questions, I offered to she her and my other brother my bank statement which showed the amount I paid off my car and I had a copy of the check send to me from my pension plan which also showed my balance. I thought this would clear the air. I guess it did for a moment until the law suit came into play. My other brother made a comment that my mother should not have been put into a nursing home, but he did not lift one pinky to help -- not one, but he remains to be an accuser.

The only person now that I give any information to whether it be financial or medical is my POA brother. The other three don't really talk to me anymore.

I did every thing I could to help my mother live and continue to help my father live even though he is in the nursing home, and these three have the nerve to say that I am pursing this law suit for my own benefit. I thought my mother would be alive to reap the benefits herself, but that did happen.

My father depends on my a lot even though he is in the nursing home. I call him every day, sometimes twice a day and see him once a week, sometimes twice a week and that still more than they do. They hardly call him and sometimes weeks would go by before they even go see him.

My POA brother told me no matter how transparent you are people are going to think what they're going to think.

After all this I cannot believe to this day how those three think of me, but I will continue to keep doing what I have to do no matter what they say or think. I spoke to my father about this and he supports me 110%.

I feel that if they were active in the caregiving of my mother maybe they would not feel that they didn't deserve anything from the suit. That's how I feel about it.

If anyone is in anything remotely similar to this, I suggest you keep doing what you're doing with confidence and try not to be shaken by nay sayers -- family or not.
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I have six siblings two of which help once in a while. I asked this specific question to our lawyer when I signed POA for my mom because I knew how the other siblings might react. The answer I was advised was that I am under NO obligation to share any information what so ever and in fact should keep it private. I have chosen to share with those that help me or if there obviously a major concern where morally I would want to know. Again, though there are always two sides and in my experience I am met often with confrontation from folks who never help so personally for the most part have followed the advice of the lawyer.
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The inquirer here doesn't give enough information surrounding events within the family leading up to POA's decision to give a black and white answer to his query.

In families, there is often one adult child who sacrifices their life (every last ounce of it) to care for aging parents, and or grandparents. This is the adult child who cares about what happens to aging relatives who are loosing their ability to be self sufficient. Often because of illness, a fall, or an apparent mental decline, this is the adult child who is observant of the needs of others instead of being self absorbed as to remain oblivious the the decline that happens to every human being including them.

This population is often just as vulnerable as infants, young children, emerging adolescents, and are preyed up and abused at alarming rates if left alone. They need a close, and trusted person to have their best interests at heart. We don't leave our children alone, nor are we uninterested in what happens to them during the day while interacting with people outside the family domain. I've been horrified by the actions and or lack of action of often times minimum wage, and untrained employees in many managed care facilities. This would include hospital settings, with educated, well paid and trained professionals providing "care." When I asked a nurse for a bedpan for my father at HIS REQUEST to urinate, and when the nurse told me to, "tell him to wet himself because he had a diaper" I was shocked and furious by her reply! Really?!! There was absolutely nothing wrong with him other than being forced to stay in bed because he was a fall risk at the time, and I was not about to allow him to be stripped of his dignity any further. I immediately called on the Patient Advocate informing of the situation, and stating that this nurse was to have no further contact with my father! What would have happened if I had not been there? Is that how any of us want to be treated? Caring for elders is a full time, under appreciated, and often thankless occupation, that unless you choose to take on the burden you have no idea about the personal sacrifice involved. I consider it the "right thing to do" because I'm that way. I hope someday what I model for my child will keep me out of harms way. No one wants to become a burden, but we sometimes don't have that choice.

In my family there has been little concern from other family members until the caregiver has reached a point of sheer exhaustion, both physically, mentally and emotionally. The caregiver eventually reaches the heartbreaking decision to put the elder in an alternative living situation. Then the siblings who've been on the remote sidelines, except with their hands out for the obligatory card and check, all show up up "concerned" voicing their advise and opinions about "what's best." What all that often boils down to is concern about the financial loss of any possible inheritance they assume will be forthcoming.

From my experience the POA or caregiver may be so exhausted and defeated by the lack of involvement of other family members there is also resentment, and feelings of being abandoned by other capable siblings. Perhaps this could be the reason that getting information about the intentions of the POA is "impossible." People generally shut down communication if they feel ignored and left with the sole responsibility for providing care.
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GardenArtist gave some very good advice. One question, a thousand miles away from all the siblings, even the primary caregiver, or close to the primary caregiver but a thousand miles away from the other siblings that moved away?

It sounds as if the SIL knows that Mom cannot be alone and needs an advocate that is close by. If SIL with the Health POA can't move to be close to Mom, SIL is moving Mom close to her. That is perfectly logical and one of the only responsible things for your SIL to do. If all the siblings expect the SIL, by virtue of the Health POA, to travel a thousand miles to meet with every doctor and handle every crisis, rather than move Mom closer to one of you or her, then shame on the siblings.

From my experience with my Mom, a hip break requires rehab. The surgery required for a hip break often accelerates dementia/Alzheimer's to a frightening pace. In the very least, it can take weeks for a person with dementia to just bounce back from the general anesthesia and relocations from home, to the hospital, to the rehab facility, and then, if the patient is lucky and was in good health before the hip break, back home again. I also suspect that your SIL has been told that your MIL requires at the very least, 24/7 assistance.

One other word of caution. I have seen my Mom have perfectly lucid conversations with a distant sibling and then spend the next 24 hours asleep or out of her mind with dementia. Please don't be fooled by the lucidity of the occasional telephone call. Your MIL sounds like she is in a very tenuous situation that requires assistance 24/7. Your MIL is also probably not a good judge of her condition.

Should the siblings know what is going on? I think your SIL does have a moral, if not legal, obligation to let you know, but I can understand her frustration if she is only subject to armchair quarterbacking from a thousand miles away. SIL has to make some really, really, hard decisions and I would hope that the siblings would spend some time with Mom (not a daily phone call or a one hour visit, how about nothing less than a week full time) before they jump to any conclusions about the perceived lack of communication.

I am so thankful and grateful for my long distance siblings and the ones close by. We have all collaborated and they have been nothing but supportive with what was ultimately my decision (because of the Health POA) with Mom. I am sure that some of my decisions came across as edicts, but they understood that I needed their support as much as Mom needed their support. My local siblings spent a lot of time with Mom and Dad (without me present) and when we felt that Mom or Dad were having a crisis they would not fully recover from, the distant siblings came and spent time with both of them. I would say, "if it was me, I would come", and they listened. I know that I am very lucky. Just know what is really happening before passing judgment.
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Does your wife have an alternative proposal for her mother's care?

I infer from your post that communications between the sisters are not good. That is a pity, although I appreciate that it's not always something that can be put right. But unless your wife has a better idea, and assuming that her mother's whereabouts are not actually being kept from her - she's still able to call, write, even visit, is she? - then I cannot see what there is to be gained by an attempt to invoke the law.

Presumably the POA sister has selected this ALF on the grounds that it's in her mother's own home location, has she? It's not totally clear whether the POA sister is among the siblings who would be more than a thousand miles distant; but even if she would, she must have had reasons for her choice. What do you think they are? Do you in fact disagree with them?
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@GardenArtist--the wording on a poa gives the agent certain powers. Also as important are state laws concerning the responsibilities of the agent. Check you state code,--probably available online in entirety, to see what an interested party has the right to ask you for, and what your obligations are once someone asks you for the records. There are always two things to be concerned about as am agent--the powers granted by the document itself, AND state law designed to protect the grantor. In Virginia, for example, any interested party concerned with the welfare of the grantor can ask for all fincial records, and any changes made to other documents, so they can request proof of what you've done with the powers allowed you in the document. If you don't respond, a judge can order you to do so, and if you still don't cooperate , the judge may relieve you of your burdensome poa. I don't know the laws in all 50 states; you'll have to look them up.

The poa is not a document rewarding the person who does the most with power. The poa allows someone to act in certain ways for someone else, in the interest of the person granting the poa; Because there are dishonest people who use their poa to do things that interest them instead of the person giving the poa, the law allows the agent to be questioned by anyone else interested in the well-being of the person granting poa. So, rights must come with responsibilitiesand the laws don't care if the interested party has seen the person granting the poa for years or not.
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