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So does POA for medical care give us ability to make decisions that my mom AGREES with, or can we make decisions that she DISAGREES with? My mom needs in-home care or a move - but she refuses- but with POA can we “force” anything?? We don’t have guardianship.
I did read the POA and ours does not require a doctor’s authorization, but “incapacity” is the question- who decides??

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POA is for when a person can’t make decisions or speak for themselves. Unless you’re very sure that time is now, your mom is free to make her own decisions, even bad ones. Many of us here know the frustration
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Your last sentence is confusing. You state your POA does not require a drs authorization, which would imply a durable POA that becomes effective at signing, and then you mention incapacity, which implies a springing POA which is not effective until certain conditions are met. If you have a durable POA and your mother disagrees with your wants, you cannot force her. Generally, if you have a springing POA, you can require home care or placement for her if she is judged incompetent or incapacitated as determined by two doctors. However, they may not agree. Incapacity and who determines it should be defined in your POA document. The only way you can force her to accept care is to have guardianship over her which is done thru the probate courts and is quite time consuming.
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I kept Moms POA papers. The financial seemed to be effective as soon as Mom signed it. There was an A and B. A was effective immediately and thats where Mom signed. B was for disability only.

For her Medical it only says that her PCP determines if she is incompetent. At that time the Medical comes into effect. I live in NJ, the POA is 10 yrs old now, 6 when I first placed her. I have never had problems with this POA.

I would read ur POA carefully. How does it read for when it is effective. I am surprised if there is not someplace it talks about not being able to make my own decisions.

If your Mom is capable of making her own decisions, I would say you don't have the ability to override her.

If Mom is showing signs of Dementia, and nothing is said in the POA, I would still want her evaluated and a letter saying she was incompetent of making informed decisions from the doctor. At that point, you can make decisions for Mom "in her best interest". So if she needs to be placed in an AL for her safety, then you have the authorization to do so. Yes, she may fight you, but she can no longer make that decision. She has assigned someone to make decisions for her when she is not capable to do so.
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You need to document incapacity, my mom's needed two doctor letters. Without having POA activated you can do nothing.
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The POA will describe (hopefully, if well written) exactly what decides the issue of "competency". Usually it is two MD, and a diagnosis of being unable to act in ones own interests in a competent manner.
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I agree that the key is making sure what the legal definition of incapacity is in the case of your durable PoA. I would contact the lawyer who helped create the documents and clarify it, even if it incurs a fee. At that point then you can work "in her best interests" whether she agrees with it or not, which may be temporary in-home care (if you want to be managing that for someone who is resistant) or a transition into a care community (which she won't like no matter but may be best in her case). May you have peace in your heart whatever the outcome.
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Basically incapacity can only be judged by MDs, as any court would tell you. If the patient doesn't have medical paperwork suggesting that he or she is not capable of safely making decisions in his or her own best interests, then you cannot force anything at all. So it is time now to get a diagnosis with neuro-psyc exam.
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In the State of Ga. even though I had 2 Drs saying Dad was not capable of making legal or medical decisions, it is a judge that makes the ruling for competency. So, even with Lewy Body Dementia Diagnosis, he changed his POA documents after with the other 2nd wife's children taking him to an attorney. Also, they took him to the bank and removed me as the agent and allowed him to removed 6 figures from his individual account, while I was the POA since he was principal even though Dr letter states he could not make those legal decisions. In Ga, the State will make the decisions and I had a durable POA and other documents.
I went to an eldercare attorney for information prior to my care of Dad and was told I had everything to protect him before these things happened so do your homework and check multiple sources. Also check the specific banks for their business rules within their company. They said lawyers don't mention that part. When I investigated the banking incident, I was told it was their policy to approve withdrawal based on senior laws.
Since we were advised we had nothing left to do but go to court to recover his money and protect being able to make sure his medical care was met -most
important to carry out what he wanted done before LBD was more pronounced.

Current---We have gone to court for Guardianship and Conservatorship and won. We found out other things. It was like going through a messy divorce to get the power to take care of my dad and find where his money went to provide for his medical expenses. I wouldn't wish this experience on anyone -but I couldn't let this go without trying to get my dad the safety and financial resources back for care that he earned. No regrets regardless. Now time to move forward and keep the marriage together and her children from doing any further damage. He is doing as well as can be expected with LBD 2nd year.
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This will depend on how your state views POAs. I would probably start by talking to your mom's doctor; he/she will be up to date on the legal ramifications for the state your mom lives in. Basically, POAs give you power to act in her name if she is mentally incapable of making those types of decisions for herself. You would be safer from a legal standpoint when she is declared "mentally incapacitated" by a health care professional. If she is deemed capable, she can make decisions for herself - even against her own best interests.
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The POA does not function like guardianship. Guardianship
actually gives you the authority to force her to receive care or relocate. But, legal guardianship can be very difficult and expensive to obtain. If she has dementia that's affecting her ability to make executive decisions, a neurology report indicating this fact will help. My mother's neurology report indicated that she needed 24/7 assistance. If you have valid concerns about her health and safety, I would contact the local Adult Protective Services (APS) for assistance and tell them your dilemma. An elder's self neglect is something that also needs to be reported. APS should be able to guide you in the right direction. The APS office in my town was very helpful for my family. They advised us to pursue the 24/7 assistance for my mother or they would get a court order to relocate her themselves. So, after trying video cameras and other recommended tactics to monitor her ultimately, we relocated her about 5 months ago. She wasn't very happy about it but at least we had the support of APS if anyone questions the decision.

Good Luck
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