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She only has a few days left, and for years she has groomed everyone, including her DPOA, to let her die at home. Now the DPOA (non-family member) has chosen to keep her in a hospital against her expressed (and very coherent) desire to die at home with family. This is very heartbreaking. Her DPOA isn't even in state anymore, yet is forcing the family to watch her waste away in a hospital bed without the dignity she insisted on. None of us want her to die. But her DPOA is making it worse for her and everyone in the family.

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Gerry's girl:

Please contact an elder care attorney, pronto.

Almost all give a free initial 1 hour consultation.

If she can communicate coherently with eye blinks and indicates she wants to go home, the person with MPOA has not right to stop her. Nor does the hospital.

Also, she can blink to indicate she wants to remove her Medical POA or DPOA.
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Emergency guardianship and lawyer.
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DPOA CAN be both, but not necessarily. They can each be done separately, as my mother did in her Living Will. I am her Executrix, POA for financial and POA for healthcare/medical. All three are separate documents.
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DPOA means durable power of attorney, meaning this person is has power to act on both medical and legal decisions
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I had Financial and Medical POA. Once Mom was diagnoised with Dementia I made all her medical decisions. Her Medical POA read like a Living Will. She had a DNR in place.

I too wonder why the POA cares where she passes. If family is willing to be there 24/7. If she can respond to questions than she is cognitive. Just because she can't talk doesn't mean she cannot make her own decisions. Can you call Medicare and tell them what is going on. The hospital is telling them something to keep her there.
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Are you still dealing with this? I'd consult with an attorney in the jurisdiction of the hospital. I'd inquire if they can call or send letter to their director or legal counsel. I've never heard of a DPOA having any authority over healthcare decisions. Who would honor that is beyond me.

I'd get a copy of the document to review with the attorney. They can review and advise you of the legal authority or lack thereof.
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Am i allowed to share the name of the book that my son and i wrote when he came to the house of my husband and i when he was dying with aids.

It is called conversations with my son by terryann fisher and troy michaels.

There is no medical advice only a diary of our last three months together.

Looking back ... and even at the time ... i would never have allowed him to die in a facility.

It was the most fulfilling time in our life together and i am so grateful that we could have it.
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If you can show that your grandmother is able to communicate her wishes that should legally override any decisions by a POA. Unless a judge has determined she needs a guardian she can also designate a new POA at any time. I would contact the ethics board for the hospital and have new POA forms drawn up with Grandma's approval. If the hospital is refusing to follow her wishes I would involve an elder law attorney.
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Many patients can go home with the assistance of hospice. Hospice nurse comes out to make sure they are being kept comfortable. Have you spoken with the hospital’s case worker or a doctor about hospice? I have a friend whose mother was taken home and they kept her comfortable and it was easy on the family. My Dad was at the hospice facility though because he needed round the care attention if he got in distress. He was there one week.
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I have DPOA for both Financial and Health for my stepfather, and it is my responsibility to oversee his care and honor his wishes. As defined in his Trust documents, the DPOA givs me the authority to make all healthcare decisions. My own father passed recently and his wife behaved despicably in all areas of his passing. My resolution came in these three words: “He chose her.” And though I and my sisters believe she was responsible for his ultimate passing, I was reminded if these three words: “He chose her.” It is unfortunate seeing someone violating your mother’s last wishes and you may be legally able to challenge them. This being said and having relocated my stepfather several times, I also understand the stress, angst, costs - emotional and financial, to move a loved one. I am sorry you’re having to go through this. The solace might be found in surrounding you dear mother with your presence, love, and prayers to make her transition as peaceful as possible under the circumstances. I wish you comfort throughout.
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Having same issue with the exception my grandma is in assisted living. She needs pt/ot advised by facility. DPOA says”oh, she’s old, nothings going to help her, she does not need those services”. DPOA, (sole heir expected to receive a very large inheritabc) doesn’t want to see Grandma receive “quality of life care”. It’s already paid for; included in her living facility.

Its a shame when DPOA isn’t concerned with quality of life for her person, but only sees $$$$ signs. (May not relate to this topic but I had to make this statement). I apologize.
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Does the grandmother have her wishes written down somewhere?
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According to the OP:

the grandmother has made her wishes clear to all concerned
the hospital social worker is convinced
the family is united in wanting to take grandmother home

Only the distant DPOA is opposed, for reasons which have been not explained.

I do not know what information is missing from the account but evidently it is of overriding significance.

I hope the elderly lady's passing is peaceful, wherever it takes place.
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Gerrysgirl, you say your Grandmother is unable to speak, but can she write. Because coherency is a factor. But as Countrymouse mentioned the reason and ability for the DPOA to prove this reason to keep her in the hospital, would be good to know. I am sorry you are dealing with this at such a difficult time.
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Shad your cynicism is misplaced this time - the hospital's own hospice social worker, we are told, has agreed the lady would be more comfortable at home.

I'm still wondering what the DPOA's reasoning is.
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My post vanished. So I'll repost.

Jeanne makes an excellent point. Medical decision making is typically not included in a financial/legal DPOA. And the hospital should NOT be relying on, accepting decisions, discussing or providing HIPAA covered information to someone not authorized.

The person named as proxy in the DPOA should NOT be making medical decisions. Contact the hospital, go directly to the Administrator if you have to, and make it clear that decisions are being made without proper authority. Raise the HIPAA breach; that should get someone's attention very quickly.

But legitimate authority also addresses the other issue Jeanne raised. Has anyone in fact been appointed to handle medical decisions? You stated that the "the original hospital she went to overrode my grandmother's DNR in the first place". What happened in this situation, and did it contribute to the existing situation? Was the DNR integrated or combined into a health care proxy (Living Will, e.g.)?

You and the family will need to quickly mobilize to address this situation and get the DPOA proxy out of the picture. If you have to, on Monday start calling elder law attorneys in your area (I assume you're close to the hospital geographically?) and ask about immediate intervention. You'll need someone skilled in this area, with litigation or injunctive relief experience.

But contact the hospital Administrator today.
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Hospital may have suggested DPOA keep her where she is, less of a liability risk for them plus the option to use their hospice services.
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It is NOT the DPOA who is authorized to make medical decisions. Who is the medical POA? Often this person is named in the advance healthcare directive.
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Gerrysgirl, you say the DPOA is "taking advantage" of the difficulties other family members have in getting your grandmother's case across.

But that word "advantage" is exactly what puzzles me.

The DPOA knows your grandmother's wishes. The means to get her home and cared for are all in place. The hospital social worker is on board.

What possible advantage is there to the DPOA in going against what *everybody* else wants? What reason is s/he giving for refusing to okay the move home?
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If she is in the hospital there should be an ethics committee, if she is competent and able to make her choices known that must be taken into consideration.
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Talk to the social worker who can advise on emergency guardianship, and a lawyer. It depends upon how the dpoa is written.
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@BarbBrooklyn, thank you for your questions and advice.
We set up in-home hospice care for her that was to start this coming Monday. My step-mother, who has been her caretaker for the past three years, is still here, and I am here. So she would have around the clock care for her duration.
The DPOA knows this, even had the hospital hospice social worker confirm that she'd be more comfortable at home, yet the DPOA still insists.
Also, the original hospital she went to overrode my grandmother's DNR in the first place. I'm thinking that should be cause to dismiss any documents they had on file concerning her death?
Grandma can't speak, but she communicates with head nods and eye rolls. Doesn't her coherency override a DPOA?
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Who would be available to care for grandma around the clock, at home?

If you think that you'd like to be in charge of arranging for grandma to die at home, approach the social work department at the hospital and tell them that you would like to arrange for emergency guardianship. Make sure this is what grandma really wants, because it's going to cost her thousands and thousands of dollars, for guardianship, medical transport and in home health services.

Make sure you arrange for a home health agency to have 24/7 aides at her home . You probably want to set up hospice services as well.
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I should also mention that my grandmother's original DPOA died a few years back, and he loved her more than his own life. So she thought she found one that would be like him and honor her.
Also, the DPOA is taking advantage of most of the remaining family being mentally challenged just enough to not be taken seriously by outsiders. But there are three of us who are n not afflicted by such challenges.
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