At the end of my rope. If I cut off access to medical information does the DPOA have any recourse?

That doctor scheduling a 6 hour grind, including a "fitness" test sounds like an idiot! If this is about dementia, that is ridiculous.

Unclear what your LO has, or what the prognosis is, but I wouldn't want to sit through any 6 hour grind myself and I am relatively healthy! It's none of our business what the medical issues are, but if you are overseeing the care that LO would have wanted, then it is NO ONE else's business either, family or not.

As noted before, it is okay to share some information, and if a family is close knit, I would even share more details. If they start questioning every decision I made, then I would tell them this is what I was assigned to do and I'm doing it, and would provide little to no additional information. If they started to pester me, I wouldn't take their calls or respond to email or texts.

My OB was never assigned any POA capability (YB and I were, OB isn't local, so was not here to sign documents, and we certainly don't need another *stupid* opinion.) In our case, mom is living in MC, and I manage everything for her. YB doesn't lift a finger or even listen, so I generally don't bother with consulting him. I basically cut ties with OB for different reasons and haven't had ANY contact in over 2.5 years.

That said, just recently mom had a stroke. She refused transport, so they turned to me. I gave them okay to attempt transport and testing, but only IF they could get her to agree, and specified no hospitalization. I did phone consult with YB and reported back that he was in agreement with me. She's "managing" ok (we were DENIED hospice!! At 97, with dementia, no real hearing, wheelchair only, right side weakness due to stroke, takes 2 people to transfer her now, etc.), Funny that after she was doing a little better (found slumped over, drooling, slurring words and unable to do much with her right side), she asked the nurse who called EMS. When the nurse said she did, mom got angry at her and tried to kick her!

I know she previously had indicated no extensive care, so it's time to let this run it's course. Anyway, I felt it was only right to inform OB, so I sent email with high level info and included links to more information. Took 15 hrs to get a reply "Thanks for update". No questions about her status, just that. I'd bet during that 15 hrs he was likely checking to see how much is left in the trust (we all 3 are trustees, so he can see the balances, etc.) Last time he was here, over 2.5 yrs ago, he wouldn't even visit her a second time, after a very short morning visit, saying he "doesn't know what to do with her." She wasn't that bad back then - just a lot of repetition, which you can get around!

Anyway, you do what you feel is right and let those others think what they want. It's not likely you're going to convince them of anything, so why bother? As for the DPOA and finances, that person should be paying the bills and ONLY question if a bill is legit. Otherwise, ignore the rest and try not to stress over anything they say.

That's so sad, Frazzled. Wishing you and your family well!

Thanks for the update, Frazzled. 6 hours?! Was this a comprehensive dementia workup?

Do your sisters not believe the dementia dx that your parent has?

This sort of assessment WAS useful for us as a baseline for my mom AND in getting the rest of family on board with the fact that there was something wrong with mom's brain, not just her having emotional meltdowns.

I would seek to ascertain if they would continue 6 hours of testing if it was clear that your parent was being harmed by the process.

Many medical care decisions have financial implications. Some may have implications for care imputs from family members. It would not be sensible to make medical care decisions without consulting to financial POA to see if they are affordable. Of course the very best gold star facility would be great, but is it affordable? Or the best medical decisions might be home care in shifts from all family members – but they might not be willing or able to do it.

It is pain in the neck if the family is trying to butt in inappropriately, but not reasonable to cut them out completely. Could you get together with the financial POA to work out a joint strategy? Yes, it has been left up to you two, but most caring family members would be understandably annoyed if they were simply told to mind their own business.

Many medical care decisions have financial implications. Some may have implications for care inputs from family members. It would not be sensible to make medical care decisions without consulting financial POA to see if they are affordable. Of course the very best gold star facility would be great, but is it affordable? Or the best medical decisions might be home care in shifts from all family members – but are they willing or able to do it?

It is pain in the neck if the family is trying to butt in inappropriately, but not reasonable to cut them out completely. Could you get together with the financial POA to work out a joint strategy? Yes, it has been left up to you two, but most caring family members would be understandably annoyed if they were simply told to mind their own business. Work out what the two of you can say, and just don't respond to the inappropriate queries.

"I have also re-routed prescription bills to me so they can be put on auto pay and have begun giving email updates only."

Hopefully you are not paying for their medication yourself (aka your own funds.) If it is your parents' funds, how is it you have access to them? That is DPOA's bailiwick.

As for the others, the only thing I would share with them is very high level status, and given their "issues", it should be email or letter only, not by phone. It is unfortunate that you caved on the appt and hopefully it won't be taxing to the parents - maybe telehealth only? The only thing DPOA might ask is whether a bill/charge is legit before paying it, otherwise it is none of that person's biz. Their "job" is to manage the finances as best they can in the manner that your parents would want (of course not giving in to parents wanting to blow it all on something silly!) As to what the medication is and what it's for, that's YOUR job,

It is best if families can work together, understand the roles we are given and not cause problems. In your case, as much as they are being a pain in the butt, it at least sounds like they want to help, although it isn't what your parents wanted. The ones who butt in and cause issues because they want to preserve what's left to get a bigger piece of the "pie" are the real scum of the earth.

Hoping that this silly doc appt will appease them - then again they could say the doc is in your pocket and demand a second opinion... The answer to that is a resounding NO!

Even if they are going to be doing the overnight "care", hopefully you will be there too. I wouldn't leave them alone with these family members.

Just keep sharing the info. If they question what you are doing, the answer can be quite simply - I am following the advice of his doctor/medical team.

And please don't be quick to discount a suggestion made by others. Sometimes you may find it is worth asking about if you just keep an open mind. In fact, ask a few of the questions posed to you by other family members to the doctor(s) you see. And provide feedback to family so they know you have actually considered their input.

Imho, as MPOA you have the final say. Prayers sent.

HI frazzled, I empathize with your situation. I was the POA for both my mother and my step-mother. My mom had a stroke which left her paralyzed on her right side, and unable to speak. I started informing my sisters what was going on in the beginning, but after being told what I should have done and why what I did was wrong, I simply quit updating them. If they asked me, I told them she was doing as well as expected. In Dec 2012, mom quit eating so I called them and told them she was declining and they had better get down here soon. Both sisters and mom's grandkids and their spouses all came to see her before Christmas. She passed away on Jan 7, 2012

With my stepmother, I let her tell them whatever she wanted. I didn't talk to them at all about her status. I did however let them know that she was rapidly declining and if they wanted to see her they had better get down here quickly. She passed away in her sleep on Dec 31 2018.

Neither sister ever offered to help me with any of the multitude of details it takes to handle someone's affairs.

My advice is to just tell them your dad is doing as well as expected, then change the subject

I think it is fair, perhaps important, to share medical information and decisions with direct family at some level...and different opinions are normal, sometimes solicited by the MPOA...but the POA is the POA, not everyone. So once the decision is made, the interaction should be limited to understanding what it is and why it was made, not an opportunity to question it. These are difficult decisions, involving treatment (or not), surgery (or not), medications and effects, and the patient's wishes. Everyone wants the best result, but in dealing with biology and medicine - and especially aged - there are uncertainties and risks in these choices. Hopefully, your siblings will understand this and not blame.

I think your posts show that it is increasingly more difficult for you to stand your ground. I am uncertain why. Is this your OWN uncertainty? Or is this that you feel they are challenging you?
It is, we discussed under other threads, not always good to have two DPOA, one for health and one for financial, but that is the way it is.
I think your problem, quite honestly, is that you are not MAKING BOUNDARIES and sticking to them.
I would not become adversarial, and withdrawing any info IS adversarial. That could force someone on the "other side" to go for guardianship through the courts so that YOU are removed. You cannot allow that to happen because, as you fully discussed before, you are responsible to one person here, YOUR ELDER who told you exactly what" they wanted done, and you are doing it.
Do not allow questions. And TELL THEM YOU WILL NOT. Tell ONE PERSON, as I said before, a daily update. "ie Dad is comfortable. This is progressing as is expected. His blood pressure is lower. There are no treatments other than comfort. He is comfortable". THE END and FULL STOP. No discussion. In fact tell them "I am not discussing details. Dad is now dying. The expected outcome is death and that is what we are moving toward. Please pass on the update." This may go on and on and on and on because in all truth, the doctors will tell you "No dialysis and he will die" but the truth often is that the body adapts and he may not die quickly at all.
You must set limits. If you are unable to set limits and stick to them (and ONE argument or discussion ruins everything) or this stew is going to roil on the burner forever until everything is gone.
Set strick limits. Tell them what you are doing.
1. I will speak with one person daily. Form a phone tree now.
2. The expected outcome is death. That is what is to be expected. Without dialysis Dad will die. Either more or less quickly. I cannot know that. Nor does the doctor. I will not say this twice.
3. I will NOT brook any interference in the task I have taken on. I will not argue. I will not discuss.
GOODBYE. Take a walk. Take good care of yourself. This is very hard for all of us.

If you feel you cannot handle this, if you want to set this dreadful group onto the doctors, and prolong your Dad's life against his wishes, and submit him to the torture that all that is, then step back and let others assume this duty of end of life. It IS end of life care, whether there is dialysis or not, in all truth. But it appears you are being tortured not by the demise of someone you love, but by your own family.
GET HELP either for yourself, or the whole family. Ask the social services you are working with at hospice to make a recommend for you.
Sorry this continues to go so badly, but until you put your foot down this will not change.
IF YOU ARE NOT BEING LISTENED TO THEN STOP TALKING.

It is very hard to be responsible for life or death decisions for someone else. Nonetheless, your parent trusted YOU to make the decisions and you will do the right thing. It is a courtesy to keep the rest of the immediate family informed. I did it in case something happened to me and I wanted them to be able to pick up the slack without much confusion. Also I didn't want anyone to accuse me of keeping them in the dark. I put everything in email so they could reference it - medications, doctors, etc. In the end, they were glad I made all the decisions so they didn't have to.

You will not be responsible for bills. The DPOA person is responsible to pay bills from LO's accounts. It would be best if you and the DPOA person can have an understanding about the direction of care for LO. Usually DPOA person is concerned about preserving finances so they last for the LO's lifespan - so that is the usual reasoning for all the questions. The MPOA person's focus is to maintain a quality of life and health care congruent with LO's stated wishes. The goals of both POA persons should be "what is best for LO." Please consider asking DPOA to have a meeting with you and LO's primary care provider to discuss health care goals for LO. Hopefully, the DPOA will be more willing to work with you when they hear the same information you provide coming from the primary care provider. If there is a continuing problem, please remind DPOA that LO asked you to decide medical care.

Can you speak with your attorney to find out what your options are, from a legal perspective. Or some community organizations offer free legal advice. However, it's more than just a legal issue. You may also want to talk to a social worker or counselor to get advice on how to handle the family issues. My good friend got into a situation like this and ended up not talking to her sister until the day she died. It was very sad. If your mother has a living will with clear guidance, hopefully that should be guiding you on what she wishes for her medical care.

I am both mpoa and dpoa. All i care about is making sure mom is cared for. I keep my family in the loop because that's what mom wanted. Mom has dementia and lives with my siblings. Her wishes.
The only interference i get is from an inlaw. She wants to be in control. That's not happening any time soon.
Poa is a difficult sometimes thankless job but i get peace of mind knowing i am doing the right thing for mom. That's all that matters. Good luck to you.

As POA it is YOU who gets medical information. Who else is getting it and who is giving it, as this is a violation of the law unless the senior him or herself OKs the sharing of information. Stop sharing information. I believe you told us this is failing kidneys and your parent refusal to do dialysis, to enter into hospice instead?
Why would a "care bill" (sorry, don't know what that is) not be paid?
My advice was to meet with family and explain your parent's wishes. You have done that. So that is now OVER.
Now you will simply update them on the daily progress as your parent moves toward the hopefully peaceful demise chosen.
Again, thanks for honoring the wishes of your parents. No one else's wishes or opinions matter. Continue to give updates to ONE person and have them form a PHONE TREE to communicate with all others. Do let them know that you aren't interested in and have no time for their opinions, that you are busy honoring your parents wishes. Keep on keeping on. Unlikely that they will stop. Unlike that they will be satisfied. So don't even try.

As MPOA, you have the final say. They can opine all they want. You do what you think is right.

"I hear what you are suggesting; after consulting with the medical professionals and with mom, I don't believe it's the right course of action".

I’m sorry you are having difficulties with your sisters. IMO it’s difficult enough to be POA without having unwelcome interference. Since I’ve only been financial And medical POA, I’ve never had to be concerned with a bill not being paid etc. I have had the weight of scrutiny which isn’t pleasant but probably made me a better advocate for my loved ones.
I believe I would read over the medical POA very carefully. I might even call the attorney and ask a few questions. It could be that a meeting with both POAs and the attorney would be beneficial. One can have a legal right and still not reach the objective. These are legal documents but for a loved one. The family being in discord is not helpful to the agent. It’s truly good that they care about their parents care and feed back from someone who cares should be considered but you are still the decision maker and not free to discuss more than the agent would choose. It’s a tough spot to be in. Being a POA is not a fun job. It’s a gift you are giving to the agent as well as to your siblings who don’t have the legal responsibility but still may feel a moral obligation to look out for their parent, the agent. I agree with stopping the meetings as they didn’t work. Regardless of what medical treatment you choose, your parent will one day die. Read the book “Being Mortal, Medicine and What Matters in the End” by Atul Gawande. It helps with the stress of caring for a loved one and may give you peace with your difficult decisions.

I am assuming here that the agent is beyond the ability to revoke either of the POAs and assign one person to handle both? Let us know how this plays out. We learn from one another.

You’re not under any obligation-moral or legal- to share information unless the person you are medical POA. Unless the person you hold POA for has asked you keep certain people information, you shouldn’t be doing it. And if that’s the case, if you’ve been asked the principle to keep others information, you can politely inform them that it’s creating an unnecessary burden and you will no longer be doing it. If the DPOA pays the bills, all you need to do is explain what a bill is for when asked.

As MPOA you really shouldn't be sharing info. You are a representative for the person who assigned you. You job is to follow their wishes and make informed decisions on their behalf. The person assigned you because they felt you would do the job.

Does the financial POA tell everyone how the person stands financially because they shouldn't. That info s/b kept confidential.

Stop the Pow Wows. You can explain what I said that you researched and found as POA you shouldn't and you are not obigated to give private info out.