Elderly / Power of Attorney Abuse
October 23, 2012 11:35 AM   Subscribe

What can I do to protect my elderly mom from my abusive and greedy sister?

My sister, who has power of attorney over all of our 85 year old mother's affairs, verbally abuses her on an almost daily basis and takes her sweet time getting her the medical care she needs when she's sick, and now that mom is in hospital, she is telling the doctors that mom wants limited care because she has "lived too long" and wants to "die naturally." She even told a nurse "mom doesn't need that" - referring to an antibiotic injection. Oh and mom's house has somehow gone up for sale while mom is in hospital.

Based on her actions and what visitors to the hospital have overheard, I believe with every fiber of my being that my sister is abusing her power of attorney and doing her best to withhold treatment that could prolong mom's life, while not doing anything illegal to shorten it - if that makes sense. For example, she told the doctors mom doesn't want treatment when in reality mom doesn't want to be put on life support if that's the only option left which is VERY different from mom doesn't want an antibiotic to cure an infection. Do you get what I'm saying?

But my hands are tied because mom has given my sister all the legal power, so how do I prove that she is not only abusing her power of attorney but also trying to hasten mom's death by misrepresenting my mom's wishes to the doctors?

I do not have the means to hire a lawyer or anything like that because I'm on disability for Post-Traumatic Stress, Panic Disorder and Agoraphobia, which, in itself, makes me look like the "crazy paranoid sister" who is just imagining things.

I did contact the hospital to voice my concerns and begged them not to listen to my sister but to do everything within their power to treat mom aggressively for everything that CAN be treated, no matter how old she is or how sick she is. They assured me that their first priority is always patient care BUT because mom can't communicate her wishes herself, they have to do what the power of attorney (my sister) decides.

How do I protect my mother? How do I get anyone to listen and do something before it's too late?

We're all in Ontario Canada, if that matters.
posted by iNurtureTheOdd to Law & Government (25 answers total) 3 users marked this as a favorite
Traditionally, you'd gather evidence and hire and lawyer and get a judge to throw out her power of attorney. You may be able to get some help if you have a local/provincial Elderly Support agency, but you'd have a better idea of that than I would.

I have to ask though, are you sure? If your mother is 85 and unable to communicate, maybe your sister is right in that she wouldn't want to live like this.
posted by Oktober at 11:44 AM on October 23, 2012 [2 favorites]

Do you have a copy of your mother's current health care proxy and living will? Does the hospital have this? If your sister is the proxy, this plus the POA is very powerful indeed, and should be, if it is the way your mother set it up.

I think it is worth considering that this may be something your mother and sister had worked out; not everyone wants to live once quality of life is in steep decline. It can be hard to deal with this when you were not part of the conversation, though.
posted by Riverine at 11:55 AM on October 23, 2012 [2 favorites]

Not to twist the knife or anything, but I just went through something very similar with my 85-year-old grandmother (I was her only living relative and in charge of her healthcare.) We started cleaning out her rented apartment before she died because she wasn't coming back to it; selling a house is ten times as hard and I wouldn't blame someone for wanting to start ASAP. Had I not told the hospital that I wanted the equivalent of limited care (well, I signed a DNR,) they would have kept reviving her even though she was totally noncommunicative and immobile and had no chance of actually leaving the hospital. They didn't actually listen, and she ended up dying in a hospice a month later.

The hospital isn't going to just not give people antibiotics because someone says so. Your sister is not a doctor, she is not your mother's doctor and the healthcare proxy/power of attorney person doesn't have the power to prescribe treatment. There's really very little outside of signing an DNR that your sister can do to change the course of these things outside of saying "yes" and "no" to lifesaving operations which, at age 85, aren't going to extend her life very long if they're necessary and that's also assuming she doesn't pass during surgery. Believe me, I went through a good month of "can you just let her die peacefully?" with the hospital and, no, they can't.

What has the hospital told you about her prognosis? Can she go back home and care for herself? Will she have a home-health aid? Does she need to go to a nursing home or hospice?
posted by griphus at 11:57 AM on October 23, 2012 [2 favorites]

Also, as you have agoraphobia, when is the last time you saw your mother? My aunt threatened me with violence over the phone when she found out my grandmother was going to a nursing home. When she actually visited my grandmother (who had had several strokes and full-blown dementia) she apologized and told me that I did the right thing. If you haven't seen your mother in a while, you may be shocked as to what horrible state the human body can end up in and not die.
posted by griphus at 12:01 PM on October 23, 2012 [11 favorites]

I believe in Ontario you need to call the Office of the Public Guardian and Trustee, specifically the Guardianship Investigations Unit (scroll down). Here is a PDF about the unit.
posted by Eyebrows McGee at 12:10 PM on October 23, 2012 [2 favorites]

You might try contacting Ontario's Elder Abuse Victim Support Line at 1-888-579-2888 or 416-314-2447. What you're describing would absolutely be illegal elder abuse (financial, neglect) in the U.S.; it sounds like the people staffing the elder abuse line can at least refer you to resources that can help.
posted by jaguar at 12:15 PM on October 23, 2012

My sister, who has power of attorney over all of our 85 year old mother's affairs, verbally abuses her on an almost daily basis and takes her sweet time getting her the medical care she needs when she's sick, and now that mom is in hospital, she is telling the doctors that mom wants limited care because she has "lived too long" and wants to "die naturally." She even told a nurse "mom doesn't need that" - referring to an antibiotic injection. Oh and mom's house has somehow gone up for sale while mom is in hospital.

How do you know this? Have you witnessed it yourself? This will be important when you call social services.
posted by endless_forms at 12:26 PM on October 23, 2012 [1 favorite]

there might be a lawyer willing to handle this pro bono.
posted by brujita at 12:26 PM on October 23, 2012

I appreciate all the replies, thank you. While I am agoraphobic, I have made a point to push myself and see my mom at least once a month and I talk to her by phone at least once a day. I should have clarified, my mom isn't senile, she does not speak english at all and so her interpreter is my sister.

I am very sure that my sister's motives are not honourable. She has been telling anyone who will listen, for several years now, that mom is such a pain and she's so fed up with her, etc etc. She and her husband have also been trying to get mom (and dad when he was alive) to give them the house instead of leaving it and all other possessions/monies to all the kids and grandkids equally.

There is no misunderstanding here.

Last year my mom fell and broke her ribs. My sister did not take her to the hospital or the doctor until a week and a half later after my mom had been "driving her nuts" (according to my sister) because she was in pain. The doctor ordered an xray and the technician was so alarmed at what he saw that he told the doctor he suspected this woman was being abused. The doctor dismissed it because she always sees my sister - and only my sister - with my mom all the time. My sister didn't tell my mom her ribs were broken, she told her back was a little bruised, so my mom forced herself to do physical things that perhaps she shouldn't have. We (me and extended family) were told the same lie. We found out a year later when it "slipped" because liars can't keep track of their lies. When I confronted my sister about the lie, she said, "well nothing can be done for broken ribs so no point telling anyone."

The doctor told me that barring something sudden like a heart attack (because she IS 85) with proper treatment they expect her to be able to go home and, with some help, carry on as usual.

I have never seen a copy of the will or anything else, nor has anyone else except my sister because she convinced my parents a long time ago that these things should be kept "secret". So I don't know for sure what is in the will BUT I do know for sure that my mom wants to be kept alive unless and until living would mean being hooked up to a life support machine... she has told me that repeatedly. It's my sister who has decided that at 85 she has lived long enough and she should just "die peacefully".
posted by iNurtureTheOdd at 12:31 PM on October 23, 2012

My sweety is a co-conservator for her developmentally disabled brother. At least once a year, a court appointed investigator calls her and the other conservators, along with case-workers and program managers, to make sure that they're behaving properly in their conservator role.

If your sister is a court appointed conservator (rather than just someone who has a sheet of paper your mother signed designating her power of attorney), then you could call the court that made that appointment and ask them to review the situation based on the information you wish to bring to the process.

I am not a lawyer, I am just someone who's seen part of the conservatorship process as a third party.
posted by straw at 12:37 PM on October 23, 2012

Unfortunately my sister just has a sheet of paper my mother signed. No court was involved.
posted by iNurtureTheOdd at 12:40 PM on October 23, 2012

You may want to find a sympathetic relative who can take over as POA/health care proxy (or whatever the Canadian equivalent is called.) Trying to get it for yourself may not work because you're on mental health disability and may not be considered suitable to direct your mother's care. However, if there's someone you can point to who can say "I'll take over" that will help your case a lot. From what I understand of these things, the system would rather have a relative do a half-assed job of directing care rather than take on the role themselves and risk getting sued. You want to make this process as easy as you can on the hospital, because their resources to maintain status quo are a lot bigger than your resources to get anything changed.
posted by griphus at 12:41 PM on October 23, 2012 [1 favorite]

If nothing else, I think you could ask the hospital to provide an independent interpreter to your mother to assess the situation.
posted by zizzle at 12:43 PM on October 23, 2012 [6 favorites]

(Also, on a more personal level, I have mild anxiety, and directing care was absolutely brutal. In your condition, you may not want to become the proxy yourself as there's a lot of work involved, and a lot of hanging around at the hospital and talking on the phone with doctors and nurses and just all sorts of stuff that is just not conducive to having an anxiety condition.)
posted by griphus at 12:44 PM on October 23, 2012

Unfortunately my sister just has a sheet of paper my mother signed. No court was involved.

That sounds like a PERFECT case where you can have her "power of attorney" challenged, no? Ask the Elder Support Hotlines it looks like you're going to call; honestly, it can't hurt to ask exactly how legally binding such a "power of attorney" statement could be since there was no court involved. At the very least, they can explain what your rights and your sister's rights and your mother's rights are in this very specific situation, and help you sort through what can and can't be changed, and how much things can be changed.
posted by EmpressCallipygos at 12:44 PM on October 23, 2012 [3 favorites]

Do you feel comfortable telling us what languages your mother speaks? Is she hospitalized in or near a major city? Does she speak French? Is there an immigrant community which she is or was a part of?

Again, this is something to go over with elder care -- your mother should have access to another translator.
posted by endless_forms at 1:09 PM on October 23, 2012 [2 favorites]

Yeah, social services. In addition to the hotline mentioned above, hospitals and nursing homes often have their own social worker. I was required to speak with one about a family member's home situation before taking him out of the hospital. If not a social worker there may be an administrator or patient liaison with a similar role. Right now my father is in a nursing home, and my family situation is a little weird-- continuity and communication are not ideal because no one lives nearby-- and the administrator of the whole place was very forthcoming with me.
posted by BibiRose at 1:20 PM on October 23, 2012

Also, I like griphus's idea that you bring another family member on board. It sounds like everyone is already a little suspicious about your sister, so that may be fairly easy.
posted by BibiRose at 1:30 PM on October 23, 2012

I would ask the nurse to put you in touch with a case manager or social worker to discuss your mom's plan for after discharge from the hospital. I live in the US, so I don't know exactly how things work in the Canadian system, but there should be someone responsible for making sure she has a walker if she needs one, or placement in a rehab facility if she needs that or whatever. The people who do this have seen EVERYTHING. They also know how the system works. If you explain to them that you are concerned for your mom's safety they will be able to point you in the right direction.
posted by selfmedicating at 3:57 PM on October 23, 2012 [1 favorite]

I don't know how it works at this hospital, but at every hospital I have ever worked at, the healthcare proxy or power of attorney doesn't just get to make decisions for the patient automatically when they're in the hospital. The decision to activate that power comes when the patient is no longer capable (for whatever reason, whether permanently or temporarily) of making medical decisions for themselves. In some cases where it's debatable, we bring in the neuro and psych services to evaluate the patient for competency if we are at all in doubt about their faculties. So in my mind there are two things that could be going on. Either your sister is refusing things for your mom and the hospital is wrongly listening to her as an interpreter when they should be using a trained interpreter to make decisions with your mom, or your sister is verbally powertripping you and the hospital is going about their business as usual in caring for your mom while trying to appease her bossy daughter. Either way, if you are at all concerned about your mom in general, please call Elder Services, explain the situation and perhaps don't go in depth on your own medical issues, because, lets face it, it's none of their business and just because your mom is 85 doesn't mean she is ready to die. I've met a whole spectrum of 85 year olds in my career and to make that generalization about every 85 yo that ends up in the hospital is ridiculous.

I don't know anyone in the situation, but it might be good to have an objective voice (like elder services) in play here, especially given the language barrier, the non-notarized signed paper proxy (in English, presumably? Does she even read English? Was there a witness at this signing who was not a family member?), and the presumption from what you have said that your mom is not, in fact, mentally incompetent to make her own decisions. Please call and voice your concerns. If nothing else, it will help clear your conscience that you have spoken to someone about it.
posted by takoukla at 6:15 AM on October 24, 2012

If your mother isn't senile and can communicate to you clearly, why don't you just talk with her about your concerns, and if she's unhappy with the way she's being treated, simply ask her to revoke the power of attorney she granted to your sister?
posted by Static Vagabond at 7:42 AM on October 24, 2012 [2 favorites]

Thank you everyone for the additional comments. They are all helpful and appreciated.

Update - So the hospital took my concerns very seriously and looked into the matter. Mom now has a social worker and an independent interpreter and my sister now knows we are all on to her (my family and my brother's family), and that we are all keeping a close eye on things.

I did speak with my mom about it but the woman is so intimidated by my sister's ongoing threats to put her in a nursing home (sister does this to keep her "in line"), that mom covers for her. For example, mom said she (mom) is the one who told the doctor she wants to die, which is not possible because mom does not speak a word of english and the doctor doesn't speak a word of Italian which is all my mom speaks, and people heard my sister say it! So then I asked, "So you WANT to die? Should we stop treatment?" to which she replied, "No no, as long as I respond to treatment, I want it." And she started crying when she talked about dying.

The new concern now is this. When the hospital discharges mom, she is going to move in with my sister. Ugh. My sister insists mom goes with her, and told her in front of us that mom HAS TO give my sister and her husband her pension otherwise she's going to send mom to a nursing home, even though my brother's family told mom she is welcome to live with them. Mom has agreed to this because, again, she's so terrified of being put in a home. Mom believes EVERYTHING my sister tells her and also believes that because she has Power of Attorney over all her affairs, she has sole unquestionable power and that no one, including mom, can do anything about it. It doesn't matter how much we've told her otherwise (that the POA can be changed etc.). So, mom does everything she feels she needs to, to keep my sister happy.

I am going to speak with the hospital social worker to see if something can be put in place where a social worker checks in on my mom and what my sister may or may not be doing, on a regular basis. Of course, the family will keep an eye on things as much as possible too, but if my sister continues to scare my mom, we won't necessarily know everything that's going on.

What a mess!!!
posted by iNurtureTheOdd at 4:37 AM on October 25, 2012 [1 favorite]

Very encouraging report! You've made a lot of progress, and you will continue to make progress!

Now please, make sure you take care of yourself. I got back recently from visiting my father, who has been in and out of nursing homes and rehabs. (And we don't have anyone acting jerkish in my family, just a lack of continuity from everyone being geographically scattered.) Honestly, I needed a couple of days in bed after that last visit. These things are incredibly draining. You're always going to feel there is something more you can do. But this is the long haul so you have to keep yourself healthy. Rest, drink a lot of water, get outside and expose yourself to daylight.
posted by BibiRose at 6:51 AM on October 25, 2012

It doesn't matter how much we've told her otherwise (that the POA can be changed etc.). So, mom does everything she feels she needs to, to keep my sister happy.

Would she be more likely to believe someone else?

The image I'm building up of your mother is of a woman who fears and/or trusts Authority. Italian-Canadians are pretty dense on the ground in Ontario; she might believe, say, a gray-haired male Doctor who speaks Italian, if the hospital has one. Does she have other ties to the Italian-speaking community? Does she, or did she, go to church? Even if she hasn't gone for a long time, even if the clergy have turned over, if she used to be a member of a local congregation, you can probably get a priest to talk to her. Actually, even if she wasn't, if a priest is someone she'll listen to. And there's a good bet you can find one who speaks Italian. If you don't know where to start, you can ask the hospital chaplain (you might get lucky), or call the local Diocese.

Basically, pull away from making this she-said/she-said between you and your sister about the POA.

even though my brother's family told mom she is welcome to live with them.

When and how often has your brother reiterated this offer? It might have more force if he called her again and started talking about it as a concrete plan, i.e. "Hi, Mom, we're still eager to have you when you're well enough to leave the hospital. We've got it all worked out -- you'll have Anna's room, and she'll have a bunk bed with Marta (ANNA! Get on the phone and say him to your grandmother!) That's for the best, because it's the only bedroom on the ground floor. Please don't worry, the social worker tells us we can get help in for 5 hours a day while you get settled, and Mary is home a lot of the time, too. . ."

The point is, with enough practical details, it starts to sound like a real plan, not like him just saying stuff, and it becomes harder for your sister to claim Authority. Especially if he does talk to the social worker about what kind of resources would be available to him and his family in taking in his mother.

It also might work to challenge your sister in front of your mother about what "home" she's supposed to be going to. I haven't really thought that strategy through, but you might start raising issues like, "Gee, Mom seems weirdly reluctant to go to Greg's afterwards, what kind of care facilities have you researched? There's Golden Acres and Happy Pastures nearby, they both have really nice reputations -- my friend Daisy's aunt is in Golden Acres, she visits every week and her aunt's comfortable there, plays backgammon every day, and I think she has a boyfriend!. . . " blah blah blah. The idea would be to demystify "the home" as a threat your sister can hold over your mother.
posted by endless_forms at 9:45 AM on October 25, 2012

Talk to the social work and ask if there is an equivalent of Adult Protective Services in Canada - in the states it's the equivalent of Child Protective Services for the elderly. This is horrible to read.
posted by namesarehard at 4:43 PM on October 27, 2012

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