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Dad was in hospital and was released with several appointments with kidney doctor, heart doctor and family doctor. Once he gets home she says he is fine and doesn't need those appointments and cancels them. We find out after the fact and have to reschedule. She still tries to rule the roost. Where do we go from here? We can't let her ruin his already declining health.

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Is your Mom the POA for your Dad? Has she been diagnosed with dementia? Does your Dad have any dementia? Does your Dad WANT to go to the doctor. I myself won't be, at 77, seeing any kidney doctors. I would not want to take dialysis. I am trying to figure out some reason here other than that you feel your Mom is sunk deep in denial and dementia. If this is true you would have to get guardianship and likely place Dad where his care can be managed. Has the rest of the family sat with Mom and explained that if she doesn't act for Dad in his best interest she might lose control of his care. Gently. Peacefully. Slowly.
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Both my MIL and stepFIL were rapidly moving into mental and physical incapacity at the same time when we finally realized it was happening. StepFIL had moderate Parkinsons (and probably some dementia, but not sure, LB Syndrome? etc.) MIL had pretty bad short-term memory loss. She was always the one to take care of him. I had a conversation with StepFIL that if they wanted to remain "independent" then he had to take care of her and make sure she ate and took her meds, etc. I thought he was capable of doing this. Didn't happen for whatever reason. They both went into NHs after that. I wish I had a different ending to this story, but I don't think your mom can care for your dad any longer (or maybe even herself?). Without a cognitive eval for her, it's unknown why she is doing what she's doing — but you DO know it's not working and now someone needs to intercede for your dad sooner rather than later.
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Difficult.

Technically, unless a diagnosis or formal assessment says different, the only person who can legitimately cancel your father's medical appointments is your father. His doctors ought to be liaising with him - unless your mother is his formal health care proxy, is she?

You also need to check that she isn't, after all, following his instructions. Suppose for example that he tells you he's going to be a good patient, of course dear, but in private moans to her that he can't see the point of all these tests and appointments, waste of good money, what's the use, etc. etc. and she takes her cue from that?

The pecking order in terms of decision-making, all other things being equal, goes:

your father
his formally appointed health care proxy or (the title varies) health POA
his wife (unless she's formally been found incompetent)
his adult children

All of whom can be overridden if there should ever be a guardianship application, from one of those parties (not your father, obviously) or the state, which a court decides it would be in his best interests to allow.

So there are things that can be done, but it's probably a bit too early on to bring out the big guns.

Step one: do you have any HIPAA related authority to see his medical information and liaise with his health care professionals? If not, you need it. You get it from him. He can authorise anyone he pleases to share his confidential information with you, but without his permission nobody should.

How actively involved and interested in decisions is your father at this point?
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Judysai422 Oct 2019
At least in AZ, when you establish care with a doctor, you complete a form for the doctor saying who the office can share info with. If wife is listed, then she can act fir husband. They care more about that form than a legal POA. This may be what's in play here.
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You need to communicate with every, EVERY office and they will flag their chart that you are next of kin and get some paperwork signed off on by dad granting you permission to be communicated with. THEN they are to note that NO APPTS ARE TO BE CANCELLED unless it is by YOU. ALso you can discreetly make clear oh gee, that the phone number has been changed...TO YOURS. So reminder calls giving your mom the opportunity to cancel will be alleviated. Also change the mailing address to a PO BOX or to your own with their name in c/o yours. You must also take possession of all the pills and just fill a box for the week. But keep them all with you.
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In my experience, spouse is next of kin and I have never seen anyone ask a spouse if they have a POA.

Should they exist? Absolutely, but no assumptions should be made that she can't do things without one. That doesn't tend to be the case. Most people, rightly or wrongly, assume that the patient trusts their spouse and they would be the ones that know the most and have the best intentions for their spouse.

Try and get both your parents to assign you as health care POA, this will help you be involved with authority. You can't override their choices and decisions but you can fight for better care for dad and maybe get doctors to stop accepting mom's verbal orders.

It is a tough situation to be in. Sometimes there isn't anything that you can do until there is an incident that lands someone in the hospital. At that point with HCPOA you can get testing and diagnosis to give you more power.
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Your mother be stopped, obviously. If your father is one of those who has always let his wife manage things, impress upon him that those days are over.
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I would let all doc offices know not to cancel dad's appointments.

Does she have an official diagnosis of dementia? If so, tell your dad's docs. If not, get her evaluated.
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Get her a doctor's appointment to get an official diagnosis. Hopefully, somebody in the family has POAs - and needs to start using them. Notify doctors that mom can not manage her spouse's health care anymore because of her own diagnosis and they should contact the person with POA. Side note, if mom has dementia and dad's care was managed by mom - it may no longer be safe for them to live alone.
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Unless you are living with your parents, it sounds like they are on a fast track to needing in home care or AL. When my dad, who was fully capable mentally, could not get my mom with dementia to take her meds correctly, I spoke to her doctor. The doctor said point blank, "If your dad cannot ensure your mom takes her meds correctly, he can no longer be responsible for administering them." That was the impetus we needed to move them from IL to AL. Dad still blames me, but at least mom gets her meds correctly. Dad still administers his own, but he just "supervises " hers. As his health has declined, he can do less and less for her and it's a godsend that they have help.
As someone else suggested, get the phone numbers for your dad's doctors changed to yours. As your mom declines, she won't be able to understand messages and it will cause a world of work for you. Be proactive. If your dad is cognitively capable, have a private conversation with him and explain what you are doing. He will probably be relieved you are willing to help.
Good luck.
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Set up an appt. for your mom to be evaluated. You may be looking at a POA/Guardianship status for BOTH parents.
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My mom was diagnosed with AZ a few months after my dad came out of the hospital with lots of specialist appointments. We convinced my mother that she should not drive anymore. The appointments were easier then. I drive them, so I make the appointments to fit in my schedule.
She remembers what it was like with her mother, so we set up everything early. I’m on the list at the doctors’ offices, and I have their POA, will, and advanced directive. I’m also on their bank account. I don’t think it would have happened without the diagnosis. As their needs progress, we have many things already prepared to make transitions as smooth as possible.
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Don't tell her about the appointments. Put someone else in charge of making appointments - do them in the afternoon so you whoever will take him to the appt will have time to go there, get him bathed/cleaned up and ready for the appt and go.
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20 years ago my father was diagnosed with bone cancer. He went to the doctors because his hip was bothering him and the X-ray showed he had cancer. The doctor told both my mother and father and they were in denial about it. The doctor urged them to tell me. I am the daughter. They refused to tell me. Do you know what the doctor did? After they left he went against everything he was taught to do and he called me. He knew they wouldn’t say anything so he called me. Eventually we did discuss it as a family. But when I called his doctor to ask him something my father REFUSED permission for me to talk to his doctor. You can’t just take over unless it is in writing and your parents AGREE to it. That’s the hard part!! They have to AGREE to it!!
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She doesn't get to decide his health issues since her brain is failing her.
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Talk to all dr's offices & tell them that they are just to say 'I'll take care of that right away' then call you to verify any cancelations - unless she is doing the driving [heaven forbid!] then tell her all changes are done by the person who will drive him to his apt as there is sometimes special driving instructions given -

She may be doing the ostrich act to avoid recognizing he is fragile & could die thus leaving her alone!
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I guess I was fortunate that when Mom got sick she deferred everything to me. Dad had been gone 9 years and I was an only child. I lived in another state about 90 minutes away. Once I started attending appointments with her the schedulers got used to working help me to arrange her PCP and Cardiologist on the same day. Her PCP was in her village and the Cardiologist or Oncologist another hour away. It always made for a long day especially if it was mid-week and I had to travel both ways the same day. During the week her sister would come and stay so if the Drs. office called to change anything she would tell "Oh you need to call her daughter" and give them my number.
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