Health care proxy has been invoked. What power does this give me?
April 25, 2016 5:21 PM   Subscribe

My elderly and mentally ill aunt appointed me as her health care proxy and it has been invoked. I'm specifically interested in what rights I now have in regards to her living situation.

This is a follow-up to my previous question

A lot has transpired since I asked that last question. Aunt Alice was involuntarily committed to a geri-psych unit in mid-March and after much tinkering with her medication she is now at her baseline. The psychiatrist there was fantastic - she got a new diagnosis of schizoaffective disorder due to consistent hypo manic symptoms, and they also did a full medical work up on her and found that she had colon cancer. This turned out to be a blessing in disguise; she finally agreed to sign a health care proxy (yay me!) and she agreed to have surgery to remove the tumor. She has since been released to a nursing home for rehab, but she will only need to be on the short-term unit until the end of this week because she really doesn't have a skilled need at this point.

Her psychiatrist invoked the healthcare proxy just before she was discharged to the nursing home. I signed her into the nursing home, and as far as I understand it, she cannot leave unless I discharge her.

So what power do I have as her Invoked Healthcare proxy (is that the term?) She can't live independently anymore but she doesn't believe that to be true. She insists she's going home next week and refuses to discuss going to a rest home (level of care that is in between assisted living and nursing home).

Am I correct in thinking that I can place her in a rest home? I've applied for her and submitted the letter from the psychiatrist along with the healthcare proxy and the social worker at the rest home said that this is how it works. However, the question remains if she will be accepted at the rest home. The best possible scenario is that Alice agrees to go so that I don't have to put her in a place she doesn't want to be. I don't think she will agree to it though, so I am torn about having to do this against her will.

How do I manage her apartment? I don't think I have the right to give a 30 day notice with a healthcare proxy. Do we just let the payments on the place lapse and allow her to lose the place? When do her disability payments start getting reduced now that she is in a nursing home?

Any help is appreciated - and I do know that you are not an attorney, not my attorney, nor does your response constitute legal advice. Thanks!
posted by Sal and Richard to Health & Fitness (4 answers total) 1 user marked this as a favorite
Best answer: Unfortunately I think you need a power of attorney rather than a health care proxy to do what you need to do (although I am a doctor and not a lawyer). Perhaps you could ask mods to reclassify this as a law and government question? Healthcare proxies are for making healthcare decisions in the patient's best interest, when they themselves are unable to do so. You can make decisions regarding her medical care including needing a nursing home or rest home, but nothing related to her property and assets.

A few other points to make on the medical front though. How much do you know about her cancer? Have you spoken to her oncologist? Do you know the prognosis? I ask because she could potentially qualify for hospice services which would be another option. Also, have you spoken to her primary care doctor about the status of her other health problems? Might she have a lot of other progressive or tenuously balanced other medical issues that would soon necessitate nursing home care anyway? (Is a rest home really different from a nursing home? Where I'm from I understand those terms to be interchangeable) It can be nice for her to be at a facility that has a lower level of care and a higher level of care so she could more seamlessly move from one to the next when she needs it without so much upheaval, since that tends to be very upsetting for people in her situation.
posted by treehorn+bunny at 6:07 PM on April 25, 2016 [1 favorite]

Best answer: Just a follow up - I should have read your previous question first but just did it now. Nothing much to add based on that except god bless you for doing all this for her. She is so lucky to have someone so kind and caring as her relative. So many people are in her situation (I deal with it a lot in my line of work) and do not have that kind of support system, and the outcomes are terrible.

I was also able to use your state location to determine what the local definition of rest home is there, and it seems like a good solution for your aunt (we call those group homes around here). Of course, she's not going to like that either, but as someone wisely said in your last question, sometimes you just have to settle for having your loved one be safe. Don't be torn, although you can understandably mourn her loss of independence. You're doing the right thing.
posted by treehorn+bunny at 6:20 PM on April 25, 2016 [3 favorites]

Best answer: Nothing much to add based on that except god bless you for doing all this for her.

Seconding this. My advice remains the same as it was in the last thread. Contact NAMI, consider talking to one of the law firms they suggest. Doing stuff to/with her apartment would require power of attorney as I understand it. There may be ways of getting you appointed her legal guardian (different from healthcare, very much) depending in specific circumstances. My partner very recently went to a NAMI workshop in Massachusetts about this sort of thing, guardianship for the mentally ill specifically, and might have suggestions for people to talk with. Feel free to email me if you'd like to be put in touch.
posted by jessamyn at 6:32 PM on April 25, 2016 [1 favorite]

Best answer: If she lacks capacity to appoint you as attorney-in-fact, you may need to become a court appointed Conservator of the Person and Estate, which gives you greater range of authority (and generally requires reporting to the court periodically). To avoid missteps, I think you would be best served by consulting an attorney. Generally trusts & estates attorneys can help you with this. But the DPOA for Healthcare really is only for healthcare and also requires that you comply with her wishes, if any, expressed in her advance directive. I join everyone in tipping my hat to you.
posted by janey47 at 8:32 PM on April 25, 2016 [1 favorite]

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