Getting The POA Enacted

Mike515

Hi, I just wanted to know if anyone has had the POA enacted and what that process looks like if you're already the POA. My grandmother is getting worse, but she might not want to go to a care facility at the end of this year. I let her doctor know I'm the POA and I'd like to get it enacted in case we have to put her in a care facility against her will later this year. The doctor first told me that it would have to go through the courts, since it would be against her will, which would be institutionalizing her, but then I contacted HHS and they said that if I'm already the POA, all I need is a doctor's letter of incompetence. I let the doctor know this, then she said we will need to see a psychiatrist. I'm not sure her regular doctor knows how to handle the situation. Has anybody in Iowa had a similar experience? How bad do they have to be in order to get the letter of incompetence? Thanks.

BassetHoundAnn

I'm really surprised the doctor isn't familiar with these things, and has given you so much wrong information. You should have two POAs—the durable POA, which is for financial matters, and the medical POA which is for healthcare. In order to activate these you need a Statement of Mental Incapacity from a doctor. It doesn't need to be from a psychiatrist. For my mother's statement two GPs from the same practice talked to her briefly, administering the Mini-Mental State Exam (MMSE). The MMSE is a very brief test that consists of 11 questions to determine the state of different facets of mental acuity. The two doctors signed the Statement of Mental Incapacity and that was it. I carried a copy of the Statement of Mental Incapacity along with the two POAs whenever I handled her medical or financial issues. I carried them whenever I took her to a medical appointment.

harshedbuzz

It's best to consult an attorney to understand this POA. There are all kinds— general boilerplate documents off the internet, springing POAs that need one or more physicians to sign off, POAs that become invalid when a person loses their capacity and durable POAs. The rights and obligations in these can be different as well. The CELA who wrote dad's understood that I would be selling property and handling money/assets on their behalf, so it was written to satisfy those needs as well as more general needs.

H1235

The DPOA my mom signed took effect right away. Her neurologist suggested we would need a letter of incompetence to activate the medical POA. I didn’t get that impression from the lawyer when the papers were signed, but the doctor was willing to write the letter. She sent a copy to the pcp as the second signature. I figured it’s better to have it and not need it than need it and not have it. She had been seeing both regularly so there was no evaluation. Good luck.

Mike515

https://alzconnected.org/discussion/comment/209130#Comment_209130

Yeah, I figured her doctor didn't know what she was talking about. This is the same doctor that misdiagnosed her with depression 4 years ago when I thought it was early signs of dementia (it was). I might just take her to another doctor. Thanks for the info.

Quilting brings calm

My Mom’s POA was effective immediately upon signing and will be in effect until her death. That didn’t preclude her from doing things on her own( but she’s happy for me to do it instead). My MIL’s POA was the springing POA. My BIL just needed to get a letter of incompetence from her doctor for it to become effective.

My parent’s medical POA is marked as effective upon incapacity. However not one medical person has questioned my authority to make decisions upon their behalf at all times. Even when they are sitting right next to me in the exam room. You will find out that the doctors can figure out when you should be the one to talk to. My step-dad has passed away, so now I’m only making decisions for my Mom.

Mike515

Thanks. Do you know what is considered 'Legal Incompetence?"

towhee

I believe that the terminology is in the process of changing. I think that now most doctors avoid the term legally incompetent, as this is something declared by the courts and pretty much takes away all of your rights. I think the term doctors use now is "lacks the capacity to make medical decisions" That should be all you need for a medical power of attorney.

Mike515

https://alzconnected.org/discussion/comment/209181#Comment_209181

Thanks for the info. I need it enacted for both medical and financial.

Hope5757

My experience with POA is similar to @Quilting brings calm . All doctors, including specialists, have never questioned me. I think it’s because I’ve always taken MIL to her appointments. On rare occasions, a doctor has asked “is it ok if I talk to your DIL?” I’m not her POA but my spouse is.

Only the ER has been different. When they ask about full code, they’re very careful to address her and if her responses are evasive and muddled, they assume she wants full code. Which she does.

CaliforniaGirl-1

There is a lot of excellent advice in this forum. But remember that every state is different. Consult an elder care attorney in your state. The doctor is concerned about not getting sued.

If you have DPOA you should not have to go to court but if the LO protests that they are competent and you have to prove they are incompetent then it is more complicated.