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So...just for the sake of argument - Doctor's orders - as NYDIL stated - are for nurses. For patients, the term "doctor's orders" is a colloquialism for lack of a better word. People often feel that doctors have some level of presumed authority over their patients so their recommendations carry weight as orders. But unless the patient is in a setting where they are unable to leave and under a restraint type of situation (think psychiatric hospitals - and even then patients have rights) - doctors don't have that level of control over their patients.
I'll give you an example. My FIL was the most medical treatment loving man I have ever met. His idea of a vacation was a trip to the hospital. During COVID we had to sit on him to keep him home for literally the silliest things - because he positively loved being in the hospital and would not believe that he wouldn't get the same fawning attention during COVID.
But once you got this man home - you couldn't get him to follow "doctor's orders" to literally save his life. Diabetic - ate wildly and pumped extra insulin in to counteract, took his meds willy-nilly, would refuse to do PT, doctor shopped until he could schedule ill-advised surgeries but wouldn't do the smallest thing to help himself NOT need the surgery,
So...doctor's orders are genuinely subjective. Are we talking about needing to be on oxygen and the POA is literally ripping the oxygen mask off of BF's father's face so that he CAN'T follow what his doctor has advised - preventing HIM from choosing to do what his doctor has asked? Hiding his medications so HE can't opt to take them? Feeding him a terrible diet when he can't feed himself?
But wait - how can the POA not follow doctor's orders when the POA doesn't live there and you do? I'm confused?
And I will say something controversial. Doctor's aren't always right {GASP}
Well before my father was actually at his worst - when he was diagnosed with cancer later - this was early on when he was just mildly sick and they were trying to find out why - when he was only maybe 10 years older than I am RIGHT NOW - his original primary care physician - a wet behind the ears, fresh from med school doctor wrote my dad off. He said that my dad was "too old to waste his time on"
For the record my dad was not even 65 yet. He didn't even take the time to find out what was wrong with my father. He just decided he was too old to waste his time with. Not even retirement age yet.
Not all doctors orders are equal.
Exactly WHAT doctor's orders is the POA NOT following?
"Doctor's orders" apply in the hospital. "Doctor's orders" are for nurses. People who go see their PCP or specialist get medical recommendations and neither they nor their legal representatives are under any obligation to follow those recommendations.
OP has no authority. She is not a family member. She quit a job to take care of an old man and that was a BIG MISTAKE. Her BF has no authority either. He should talk to his sister about their father and that conversation should be between the two of them.
Interesting discussion with a lot of side points raised, and questions asked.I am interested in the discussion about how the POA in conjunction with the LO could elect to decline some medical advice . Now at this point I think we need to hear from the OP for answers to the questions raised..... what did the doctors orders say? what are the aspects that are not being followed?
As with so many OPs. An elaborate question is asked, and there is no return to the discussion again. Sadly. Along with you I always look for participation in the Forum when questions are asked.
So what ARE the Doctor's orders? (Being picky but I would rephase 'orders' as recommendations)
Is it for this man to have more supervision & assistance?
Is it for this man to no longer live alone?
Personally, I would tread very very carefully here.
Stepping away from your job, stepping in as caregiver for family (or as as good as) can be treacherous.
Like leaving a water-tight boat in a familiar river & stepping into an untested, leaky looking boat & setting off down a side river. You don't have the oars, your BF's Sister appears to have those so your BF is going to need really good skills to navigation skills.
If you team up with the Sister you have a hope. If you decide she is the 'bad guy' you could sink very fast.
Make sure you have a life-vest! ie get an exit plan.
Really, the short answer to "who can help" in this instance is "only an attorney". And if the POA doesn't wish to share his or her document and discuss with you, they need not. So that the attorney asking the court to investigate all this? Read expensive!
If this is about POA deciding elder may live at home then that is their decision to make. The POA, usually, if well written by an attorney will allow the POA to make all decisions for the elder according either to the elder's wishes or to what the elder said he/she wanted done. Ie. "I want to stay at home; even if you think it unsafe, I want to stay at home as long as you think it is safe". If the elder expresses that then the POA can allow the elder to stay at home even if YOU and MD think it not necessarily safe for the elder.
Now, if you see signs of it being unsafe, do call in and report to APS. APS will examine the elder's mentation, safety, home environment, how checked on and how often, nutrition, hygiene and will, if unsafe, discuss with POA.
Do know, only way YOU can intervene is with an attorney. Expensive. Start at 10,000 to try to wrest control, and go up to 50,000 pretty quick in a guardianship issue. And if the elder is at ALL able to say "I want to stay home" then few judges will take his rights as a citizen from him to force him not to stay at home.
Sometimes things that endanger us are our own choices to make. And the POA when we cannot, but have expressed said choices to him or her. Quantity of life doesn't always win over quality. Some wish to stay at home even if that choice kills them.
I so agree you cannot have an elder wandering from home out in to traffic lost. That would be negligent. But pretty much anything up and unto that point is the elder's choice, and that of his POA in his stead with a well written document.
The POA that my brother and I did with his attorney pretty much gave me the right, as the attorney teased him, to pull the gold from my brother's teeth (yes, it's a joke). POA, according to how written can be very very powerful. And they do trump a doctor's opinion usually, unless that doctor is willing to pull in higher authorities through social workers to intervene with the law.
Are you sure that sister is the POA? Have you seen the document? I ask because sometimes Admin sumarise for simplicity, and also some people ‘say’ that they are in charge because that’s just the way they ‘feel’.
If sister really does have the Power of Attorney, she is in charge of money and legal decisions, but not necessarily care decisions (depending on the wording). She can sell the house. She can try to evict you, but if it has to go to court she might have trouble unless she is putting forward an alternative care option.
You as GF have no right to move in, do the care, expect free room and board, and perhaps expect to be paid. You are doing yourself no favors by quitting your job. The best option by far is for BF, BF’s sister and BF’s father to work out a plan that suits them all.
"Sister outside of home, likes to be in control in charge of everything, wants the father to live alone, which is not in his best interest, cognitive decline, white matter documented, anxiety, depression, memory loss!"
Seems the POA thinks Dad can live alone and he can't. If POA wants them out so the house can be sold for his care in a facility, sister has that right. But her responsibility is to keep her Dad safe and having someone with Dementia living alone is not safe. Your BF should ask her, if he moves out what are Sisters plans for Dad because he cannot live alone. Its documented and I would think her POA is in effect because he has been declared incompetent to make informed decisions? Unless a FPOA is immediate, a doctor/s have to sign off Dad is incompetent for the POA to be invoked. So, if sisters POA has not been invoked, she has no say IMO.
In the end, you may need a lawyer. Or call APS and see what rights you have.
Your concern (per your profile info) doesn't seem to indicate that this is a medical/health issue, its a housing issue.
Do you (or BF) pay rent to live there? Is there a signed lease?
Maybe the PoA (who may also have the financial PoA) wants you out so that the house can be sold to pay for a different type of care for this man?
Are you being paid to care for him right now? If not, why not?
Are you going to the doc appointments with him? If not, how do you know what the doc is telling him/the PoA? Like others have correctly stated, the PoA has the final -- and legal -- say and not the docs. They just diagnose and give treatment guidance and that's it.
If I were you I'd read the writing on the wall and move out. This is a power struggle between your BF and his sister, and it usually doesn't go well. At the very least, you and BF have no power in this situation. TIme to leave because it may legally come to that anyway. If she's the man's FPoA she might have the authority to legally evict you and BF.
In almost any instance a POA TRUMPS the doctor. The doctor is there to run tests and suggest treatments. He is not there to make decisions for the patient. The patient makes his own decisions for his own health with the ADVICE of a doctor. If the patient is incompetent, then a POA makes the decisions for the elder when the elder cannot make his/her own decisions. If the POA believes that the senior would not take these medications suggested by the MD then in most instances the POA can refuse these medications suggested by a doctor. The POA can also refuse tests and procedures on behalf of an incompetent senior, whether the doctor suggested them or NOT. The doctor is not in charge of your health care. He is there to suggest treatments and tests. It is up to YOU whether you take them or not. If you are incompetent and have appointed a POA then your POA will make the decisions to the best of his or her judgement as to what YOU would have wished.
Exact details would help, but in most cases, with an incompetent patient who appointed a POA the POA RULES!
I agree, either there are more details to it, or else it is not making sense If you are doing the hands on care, many hours of work, why is your sister the POA?
I would suggest having a discussion with her. She should either listen to your opinion, or transfer the POA to you , assuming you want that. If she wont, then I would not be the caregiver to do work that you don't believe is right or have a POA dictating things you don't agree with.
It's her boyfriend's father the OP says she's caring for. OP isn't even related to this gentleman, per her profile. Sounds as though she and the bf moved into the father's home, ?to care for him? The boyfriend should be the one to speak to his sister, not the OP. If the Dr has suggested the father shouldn't live alone, the solution isn't necessarily to have family move in to care for him. Perhaps the sister/POA has some other ideas.
"Caring 24/7 for my bf father. We live in his his now. Sister outside of home, likes to be in control in charge of everything, wants the father to live alone, which is not in his best interest, cognitive decline, white matter documented, anxiety, depression, memory loss! Wants us to move out. I just don't no where to start. I quit my job to care for him. I just need help. "
Your boyfriend's sister is her father's POA. She IS in charge.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
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APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
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APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
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If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
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This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I'll give you an example. My FIL was the most medical treatment loving man I have ever met. His idea of a vacation was a trip to the hospital. During COVID we had to sit on him to keep him home for literally the silliest things - because he positively loved being in the hospital and would not believe that he wouldn't get the same fawning attention during COVID.
But once you got this man home - you couldn't get him to follow "doctor's orders" to literally save his life. Diabetic - ate wildly and pumped extra insulin in to counteract, took his meds willy-nilly, would refuse to do PT, doctor shopped until he could schedule ill-advised surgeries but wouldn't do the smallest thing to help himself NOT need the surgery,
So...doctor's orders are genuinely subjective. Are we talking about needing to be on oxygen and the POA is literally ripping the oxygen mask off of BF's father's face so that he CAN'T follow what his doctor has advised - preventing HIM from choosing to do what his doctor has asked? Hiding his medications so HE can't opt to take them? Feeding him a terrible diet when he can't feed himself?
But wait - how can the POA not follow doctor's orders when the POA doesn't live there and you do? I'm confused?
And I will say something controversial. Doctor's aren't always right {GASP}
Well before my father was actually at his worst - when he was diagnosed with cancer later - this was early on when he was just mildly sick and they were trying to find out why - when he was only maybe 10 years older than I am RIGHT NOW - his original primary care physician - a wet behind the ears, fresh from med school doctor wrote my dad off. He said that my dad was "too old to waste his time on"
For the record my dad was not even 65 yet. He didn't even take the time to find out what was wrong with my father. He just decided he was too old to waste his time with. Not even retirement age yet.
Not all doctors orders are equal.
Exactly WHAT doctor's orders is the POA NOT following?
OP has no authority. She is not a family member. She quit a job to take care of an old man and that was a BIG MISTAKE. Her BF has no authority either. He should talk to his sister about their father and that conversation should be between the two of them.
Now at this point I think we need to hear from the OP for answers to the questions raised.....
what did the doctors orders say?
what are the aspects that are not being followed?
Is it for this man to have more supervision & assistance?
Is it for this man to no longer live alone?
Personally, I would tread very very carefully here.
Stepping away from your job, stepping in as caregiver for family (or as as good as) can be treacherous.
Like leaving a water-tight boat in a familiar river & stepping into an untested, leaky looking boat & setting off down a side river. You don't have the oars, your BF's Sister appears to have those so your BF is going to need really good skills to navigation skills.
If you team up with the Sister you have a hope. If you decide she is the 'bad guy' you could sink very fast.
Make sure you have a life-vest!
ie get an exit plan.
Read expensive!
If this is about POA deciding elder may live at home then that is their decision to make. The POA, usually, if well written by an attorney will allow the POA to make all decisions for the elder according either to the elder's wishes or to what the elder said he/she wanted done. Ie. "I want to stay at home; even if you think it unsafe, I want to stay at home as long as you think it is safe". If the elder expresses that then the POA can allow the elder to stay at home even if YOU and MD think it not necessarily safe for the elder.
Now, if you see signs of it being unsafe, do call in and report to APS. APS will examine the elder's mentation, safety, home environment, how checked on and how often, nutrition, hygiene and will, if unsafe, discuss with POA.
Do know, only way YOU can intervene is with an attorney.
Expensive. Start at 10,000 to try to wrest control, and go up to 50,000 pretty quick in a guardianship issue. And if the elder is at ALL able to say "I want to stay home" then few judges will take his rights as a citizen from him to force him not to stay at home.
Sometimes things that endanger us are our own choices to make. And the POA when we cannot, but have expressed said choices to him or her. Quantity of life doesn't always win over quality. Some wish to stay at home even if that choice kills them.
I so agree you cannot have an elder wandering from home out in to traffic lost. That would be negligent. But pretty much anything up and unto that point is the elder's choice, and that of his POA in his stead with a well written document.
The POA that my brother and I did with his attorney pretty much gave me the right, as the attorney teased him, to pull the gold from my brother's teeth (yes, it's a joke). POA, according to how written can be very very powerful. And they do trump a doctor's opinion usually, unless that doctor is willing to pull in higher authorities through social workers to intervene with the law.
If sister really does have the Power of Attorney, she is in charge of money and legal decisions, but not necessarily care decisions (depending on the wording). She can sell the house. She can try to evict you, but if it has to go to court she might have trouble unless she is putting forward an alternative care option.
You as GF have no right to move in, do the care, expect free room and board, and perhaps expect to be paid. You are doing yourself no favors by quitting your job. The best option by far is for BF, BF’s sister and BF’s father to work out a plan that suits them all.
Seems the POA thinks Dad can live alone and he can't. If POA wants them out so the house can be sold for his care in a facility, sister has that right. But her responsibility is to keep her Dad safe and having someone with Dementia living alone is not safe. Your BF should ask her, if he moves out what are Sisters plans for Dad because he cannot live alone. Its documented and I would think her POA is in effect because he has been declared incompetent to make informed decisions? Unless a FPOA is immediate, a doctor/s have to sign off Dad is incompetent for the POA to be invoked. So, if sisters POA has not been invoked, she has no say IMO.
In the end, you may need a lawyer. Or call APS and see what rights you have.
Do you (or BF) pay rent to live there? Is there a signed lease?
Maybe the PoA (who may also have the financial PoA) wants you out so that the house can be sold to pay for a different type of care for this man?
Are you being paid to care for him right now? If not, why not?
Are you going to the doc appointments with him? If not, how do you know what the doc is telling him/the PoA? Like others have correctly stated, the PoA has the final -- and legal -- say and not the docs. They just diagnose and give treatment guidance and that's it.
If I were you I'd read the writing on the wall and move out. This is a power struggle between your BF and his sister, and it usually doesn't go well. At the very least, you and BF have no power in this situation. TIme to leave because it may legally come to that anyway. If she's the man's FPoA she might have the authority to legally evict you and BF.
If the patient is incompetent, then a POA makes the decisions for the elder when the elder cannot make his/her own decisions.
If the POA believes that the senior would not take these medications suggested by the MD then in most instances the POA can refuse these medications suggested by a doctor.
The POA can also refuse tests and procedures on behalf of an incompetent senior, whether the doctor suggested them or NOT.
The doctor is not in charge of your health care.
He is there to suggest treatments and tests.
It is up to YOU whether you take them or not.
If you are incompetent and have appointed a POA then your POA will make the decisions to the best of his or her judgement as to what YOU would have wished.
Exact details would help, but in most cases, with an incompetent patient who appointed a POA the POA RULES!
If you are doing the hands on care, many hours of work, why is your sister the POA?
I would suggest having a discussion with her. She should either listen to your opinion, or transfer the POA to you , assuming you want that. If she wont, then I would not be the caregiver to do work that you don't believe is right or have a POA dictating things you don't agree with.
"Caring 24/7 for my bf father. We live in his his now. Sister outside of home, likes to be in control in charge of everything, wants the father to live alone, which is not in his best interest, cognitive decline, white matter documented, anxiety, depression, memory loss! Wants us to move out. I just don't no where to start. I quit my job to care for him. I just need help. "
Your boyfriend's sister is her father's POA. She IS in charge.
Leave, and get a job.