At Support For Home Health Care, we have a lot of experience with the concept and realities of power of attorney (POA) status. When used properly, it can truly be a life saver for the person who cannot manage their own care. When abused, it can be a terrible thing for the person being controlled. When not obtained at the right time, by the right means, it can tear families apart. I have written about this issue before in the postings here and here, for example.
Let’s explore these situations. First, the problem we see too many times is the case of the family that does not make provisions, via trust documents and advance health care directives, for conditions in which a family member cannot make decisions – due to injury or illness (including forms of dementia). I absolutely understand folks’ reluctance to deal with these tough issues, but there is no excuse for not doing so, in my view. The consequences are far too grave.
So, what happens when individuals do not make their wishes known when they are competent to do so? Usually it is one of two bad things. One is that no one steps forward: “Dad will be okay. We do not want to take his independence away. We do not want to hurt his feelings.” So, Dad continues to drive and hurts himself or someone else. Or Dad continues to live by himself, with no caregiver support, and develops pneumonia, or completely loses control of his Diabetes, or suffers a stroke and is found far too late for medical intervention to make a positive difference, or …
The other bad thing that may happen is that an adult daughter or son decides, during a crisis, that power of attorney must be established, to protect the parent. That can be devastating if resisted by the parent (as frequently happens) or when multiple adult children disagree with the decision (as way too frequently happens!). The child seeking power of attorney will normally have to go to court, often fighting parents, siblings and other family members, to obtain the court’s appointment; and it will not get prettier after that, in most cases.
So, the message to all mature adults — do not let this happen to yourself or your family. Deal with the need to plan for the aging process by making decisions about power of attorney well in advance of any need. You will benefit from it and so will your loved ones.
In making that plan, however, make sure you choose wisely. Another major issue that we see, too frequently, is a bad choice as to who is given that power of attorney. There are, frankly, people who abuse that power. We see it, at Support For Home Health Care, more than we would like.
Sometimes the abuse is unintentional. Because the person with POA has significant authority, they can lose sight of the boundaries. In most states, the person whose care is being managed still has the right to make decisions up to his or her ability to do so. We have seen this ignored too many times.
A case that comes to mind is a senior with traumatic brain injury who still has cognitive ability to rightfully play a significant decision-making role in his care. For someone to abuse the POA by excluding him from that decision making is unethical and probably illegal.
Bottom line, power of attorney can be a tremendously important tool in ensuring that individuals who need help get it. However, going through the right process to obtain the POA and then being extremely careful about abusing it is of critical importance.
Best wishes. Bert