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When my mother asked me to be her health care proxy in the 1990s, she described it as simply ensuring her end-of-life wishes were carried out if she was ever in a coma. I did not realize back then how complicated hcp is.


She is now older and showing mild signs of dementia amongst a broken family of adult siblings. Staff at places like orthropaedic rehabilitation ask me to do things like scheduled family meetings (when I worked in health care years ago the social worker set up these meetings not the hcp, sign admission papers, etc.)


This is much more complicated than what I originally agreed to do verbally. I live over 500 miles away and am expected to travel with work often in locations with poor phone access and with working schedules making it hard to return phone calls. I also was diagnosed with cancer about three years ago so am dealing with this.


It does not help that I have no relationship with the alternative. We have been estranged for years. There is a history of abuse and bullying from her while growing up which makes any potential interaction hard. When I have asked her to cover for me as HCP in the past, she has not responded to any emails and per an admission clerk told the admission clerk she was not comfortable making health care decisions for my mother (why did my sister agree in the past to be the alternative then if she supposedly states to the admission clerk she does not want to do it).


Any advice or support? Have others had similar experience with the alternative.

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When your mom can no longer make medical decisions then a doctor may call you to determine if you agree on certain treatment such as surgery consent or hospice. Health proxy is not much more. Unless you are a guardian or POA, you can tell a discharge planner or social worker that you are not obligated to provide housing or pay for whatever care she needs to live in a safe environment. Once you pass that info along, they will assist in getting her help. You can decide on when and where you want to visit or not.
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https://www.agingcare.com/questions/how-does-one-end-being-health-care-proxy-or-take-a-break-from-it-482765.htm

You have duplicated your question. Just letting others know.

How does Moms MPOA read? My Moms read that I only made decisions, based on Moms wishes in the MPOA, when a doctor declared her incompetent to do so.

You are too far away to deal with Moms health. You need to explain when you are called that you are 500 miles away with a job you are not always available. That your the only one who agreed to take on the roll when Mom asked. All you can really do is if a decision has to be made about her health (like a feeding tube put in or Hospice brought in) then they need to call you. But, there is no way that you are going to be able to get a family meeting together from 500 miles away. And if your siblings are not on Moms HIPPA paperwork, I don't think they are privy to Moms heath info anyway. You are the only one.

So its not you who "needs to do", its them who needs to be flexible. If Mom has Dementia, there is no reason for her to attend a family meeting. So, all they need to do is contact you. (My care meetings were 15 min. Mostly what they are doing, no time for any questions) You tell them its the best you can do. Make sure the MPOA is on file with them so they know Moms wishes. Its what it is, they work around you, not you them. They can email, they can text "Please contact us at your earliest convenience".

Does Mom have a POA for financial.
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Bottom line is that healthcare proxy means you have the final say, it doesn't obligate you to micromanage every little problem or possibility. Care plan meetings are standard, you are not obligated to attend and in this day and age it's a simple matter to ask for a zoom call or to be kept informed by phone or email. Some facilities go overboard in this aspect, discuss a policy of when you would like to be informed/consulted and what you expect the facility to handle without your input. It's up to you to set boundaries - nothing short of life or death requires your immediate response.
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dnajaras Aug 2023
thanks this really helps. Certain family members have expections that I am my mother's nurse and expect me to find placement for my mother. I have told them again and again I cannot serve the role of my mother's nurse (it is a violation of medical ethics per my attorney). Setting boundaries with family members may be what is needed. Also, making the family meetings simple not complicated. Because I live far away I invite my siblings who live close by to help with education over the matter and keep them informed.
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