POA Healthcare - How To Get Around It

 Moving Mom to Wisconsin was a great decision on her part as well as ours.  As we embarked on this journey, here is one thing that we learned when it comes to the POA for Healthcare.

All states have paperwork that you can access online in order to have a POA for Healthcare in place.  Most can be found via the State Dept. of Health Services websites.  A lot of people think that you have to have a lawyer draw them up.  In Illinois and Wisconsin, we found that not to be true.

The wrinkle in our scenario was that the Illinois one would not be honored in Wisconsin.  We found this out when Mom went to the hospital for the first time in Wisconsin.  After checking with the hospital legal department, we also found that there was a way to get around it.

We typed up a statement that said that even though Moms' POA for Healthcare was not enacted in Wisconsin, she wanted us to be a part of all decisions when it came to her healthcare as well as her nursing home care.  This included anything that was going to affect her monetarily, medically or therapy.  We had her sign it in the presence of a staff member, dated it and had it added to her file at the hospital as well as the nursing home.  It was a great step on our part in that as soon as it showed up in her file, we started getting phone calls when changes were made to her care.  

This also came in handy when we wanted the Wisconsin version of her POA for Healthcare to be enacted, but at the last minute, Mom decided that she 'just didn't want to give up all of that control'.  You will run into these situations from time to time with your Elder.  Try and put yourself in their place.  They have moved into a facility, left behind most of their treasures and now don't have any control on what they can and cannot do.  They want to have the ability to control something, so when someone asks them if they want the POA for Healthcare enacted and they say no, those that are taking care of things for them are really in a bad spot.  You will also run into some situations where the hospital or elder care facility does not want to enact the POA for Healthcare since this now means that someone that is competent will be able to make the decisions.  Thus, they run the risk of not being able to add more charges to the bills.  

It was interesting to see how so many doctors felt that she was no longer competent to make these decisions, yet, when they were asked to sign the enactment page of the POA, they found a reason not to.  You also need to watch other staff that have been designated as the decision person for competency.  We've seen how they do this.  There are about 5 questions that they ask the Elder.  What day is it?  What month is it?  Who's the President?  When is your Birthday?  How old are you?  This, when your Elder can't remember if they had lunch or not.  While Mom answered all of the questions correctly, if you spent 10 minutes with her, it was quite obvious that she was having problems making sense of things.  If you are going to evaluate the comptentcy of an Elder, you need more than a few questions in order to do it.

Another thing to be aware of once the POA for Healthcare is enacted is just what this really means for the decision makers.  There is a lot of fine print on some of these POA's.  In our case, it states that if there is any chance of a treatment making a person better, even if it means their quality of life will lessen, then the doctor can choose to do the treatment.  In other words, the decision makers can be left out of the process if the doctor decides he wants to go ahead and treat the problem.  

We all know that there are many new medications and treatments out there.  While most of them are good, some need to be looked at and the conditions discussed as to whether or not this really is in the best interest of the patient.  Many things can happen as more meds and treatments are added to your Elders' care.  We are now at the point where we have to pay very close attention to the medical side of things.  There are so many drugs involved with so many side effects.  Add in the fact that you have so many doctors seeing the Elder in the hospital setting and it boggles the mind on how many of them are prescribing drugs without taking the time to see what else is already being taken.  When you have the loss of your primary physician in the hospital setting along with a new 'Hospitalist' everyday, it's no wonder there is confusion.  

Luckily, for us, Mom decided to have the POA for Wisconsin enacted recently.  She talked to us about how she arrived at this decision and we listened.  Our promise to her has always been that we will be honest with her and tell her everything that we know when it comes to her care.

 Once she told 3 doctors that she wanted it enacted due to her not being able to understand everything that was going on, we were able to get the 2 Physician Signatures needed for the Enactment Form.  Now, we just have to pay attention to what happens at the next hospital stay since any doctor or even Mom can decide that the Enactment needs to be rescinded.  Yes, that's a possibility.  But, we feel that since we have the additional signed Statement on file, we will still be able to be a part of the decision making process.  

Seeing how all of this is playing out when it comes to the medical side of life for Mom has made us realize that we are going to have some tough decisions and family discussions down the road.  Being a POA is a much bigger job that we had envisioned.  Knowing that Mom is trusting us to make these decisions with her input is something that we did not have to think about in the past.  While our recurring theme during all of this has been, 'Best for Mom', we are working on keeping our emotions out of the decisions in order to continue our theme.  Somehow, we are going to have to figure out how to handle more negatives than positives.  Once we realized that we can't 'fix' this, we were able to grasp how we were going to 'handle' it.  A big step for all of us.  With, Mom leading the way.

Have a great week!