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I might also add, it could be devastating to Mom to move her away from her friends and support group. If she is remaining in the area where she had lived a lifetime, then you should support that also. My MIL did that and it has been very successful. It really depends on her condition.
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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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There are reporting requirements for Durable Power of Attorney, but elders often waive them.("That's too much trouble for my daughter/for my son. They're busy.") That can be a big mistake, as this article for the New York City Elder Abuse Center points out -- nyceac/elder-justice-dispatch-durable-power-of-attorney-dont-overlook-the-oversight/.
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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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jimm, you would have to petition for Guardianship through the Surrogate's Court. The court would evaluate mom for competency. If she is competent, she can appoint whomever SHE wants as POA. If she is INcompetent, and the family disagrees about who should be POA, the Judge simply appoints an impartial third party, generally an attorney selected by the Judge. Usually both sides are very unhappy with an independent conservator/guardian and the fees they collect from the estate.
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Ignore all of the previous answers. In most states, the POA must retain all records of all transactions, and if an interested party requests it, the POA must furnish that info to the. interested party. If the POA isn't cooperative, a judge can make the. POA provide the info. Interested part can be a child, other family member, etc. of the person who's receiving care. The law doesn't care about where siblings. have been. The law exists to protect the person getting care. If you're mad. because someone's questioning your authority as. holder of a POA, you shouldn't be holding POA.
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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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"http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/"
Summary of the HIPAA Privacy Rule
You need a HIPAA release signed by mother
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Agree 100% with Garden Artist.
I have 5 siblings, only 2 of whom (my sisters) help me out at all with mum and dad.
My 3 brothers just leave us to it (2 of whom live 5/10 mins from mum)

Unless you have evidence of ill treatment, then if your SIL has cared for your mum and now decides this is the appropriate care, then you may just need to respect that, unless, as the above poster asks, you are prepared to have her live with you or fund a more local option?

We are at the point of having to put mum in a nursing facility, and my pompous brother now deciding (too late) to throw his opinion into the ring is frankly making this harder.
Sometimes you should trust the person closest.
If you have no complaints over you SIL's historical care of her mum, then maybe you should trust her judgment now?

Seems a little odd that she'd put her in a place 1000 miles from anyone (her included?) though?
Have you calmly asked her what the reasoning was for that? Can't imagine it is without good reason?
(We are really struggling with waiting lists... can't get mum into the places we like, so being forced to cast the net wider. Won't make it easy for dad to see her regularly. Very sad, but unavoidable!)
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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 can't tell is this is the correct place for this follow up question, but if we disagree with the level of care the POA holder is providing is our only recourse the courts?
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Does your wife stay in contact with her Mother, sending cards, calling weekly and checking with Sister to see if there is anything she needs help with? Open communications and concern go along way.

Sibling relationships can sometimes go south when it comes time to take care of elderly parents. A little late now, but a family meeting to discuss future plans and how "everyone" intends to still be a part of Mom's life and care might help clear the air. Good luck!
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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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