Aaargh!!

[davidgillon]

One of the things we did while I was up in Durham was set up lasting Power of Attorney for my sister WRT my mother, with me as reserve. The forms were much longer than we expected, about 42 pages of print-out in the end, which caused a problem as my sister's ancient inkjet laboured to get that printed, with the end result I had to make certain everything got signed in the the right place and the right order before breakfast on the morning I was catching the train down to Kent.

That's now come back to haunt us slightly as, while the financial one was fine, they're saying there was a missing signature on the medical one, which means that primary decision making will rest with the doctors rather than us if my mother is unable to make decisions. Now if we missed a signature I'm damned if I know where it was, I caught two that weren't covered in the notes on what to sign, but there's not a lot we can do to argue about it. So £84 down the drain.

Apparently if we move quickly (the next couple of days) we can get the problem resolved (for a bargain price of only £42), but my mother has slightly thrown the cat among the pigeons by declaring tht if it came down to it she wouldn't want resuscitation anyway, which is the most likely scenario for needing medical PoA rights (to object to an unwanted DNR), and my brother-in-law has pointed out that even without a medical PoA in place for his mother the doctors always ran everything past him anyway. 

So given that, and needing to respect my mother's expressed wishes, my sister wants me to figure out if there's actually any point in chasing after the medical PoA. Which would be easier if I hadn't had a sinus headache for the last three days. Can anyone think of a scenario where we might need medical Power of Attorney outside of objecting to a DNR?

Comments

[skygiants]

A situation where it was really helpful to have POA arose recently with my grandfather -- someone needed to be able to weigh in on risky but potentially beneficial investigative medical procedures while he was having a cognitive decline and was unable to reasonably consent or advocate for himself. My mom pushed, they did a lumbar puncture and a biopsy to figure out what was going on, and were able to reverse it. That's a relatively unusual example, but we were certainly glad to have POA then.

[davidgillon]

Thanks, we've actually had similar stuff with respect to my dad - which makes me realise we can use him as an example.

[redbird]

I don't know much about your mother's health, but other possibilities where a medical POA might apply, at least in the US:

Sometimes the question is whether to maximize pain relief, at the cost of awareness and possibly shortening the patient's life. If that applies, would your mother's preferences be the same as the doctors'?

Without a power of attorney, doctors/hospitals/etc. may feel obliged, or be legally required, to give patients feeding tubes, which your mother might not want.

Sometimes a long-shot cancer treatment might be difficult to tolerate, and might be "this could give her another three weeks" rather than "another year" or "possible cure."

These are things where I'm not sure what my own answers would be: but if I'm not conscious, or not competent, I would rather have the decisions made by someone who knows me and loves me, rather than someone who (we hope) is doing what is considered best for a typical patient in my condition.

[lilysea]

Also: sometimes patients who WANT feeding tubes have to fight Drs really hard in order to get them: this would be another reason to have a POA.

I know of a case where a patient wanted a feeding tube (because otherwise she'd die) and the Drs kept saying "but have you considered NOT getting the feeding tube?" even though they knew she'd die without it.

She ended up having to do a massive internet campaign to pressure the hospital into giving her her feeding tube...

[davidgillon]

We've discussed them wrt my dad and may have to again, so it's a good point.

[davidgillon]

Good points. We've actually been through one or two of these with my dad, so things to consider.

[alatefeline]

I'm sorry, but yes, I can. Blood transfusion, psychiatric medication, additional procedures needed under anaesthesia, even pain relief ... and anything unexpected and medical. You don't want to discover that people AREN'T being helpful and cooperative on this one.

... I need to be about doing some paperwork soon myself.

[davidgillon]

Thanks!

[slashmarks]

If she changes her mind about the DNR, it's going to be a lot easier to tell a family member with POA that than to ensure that the doctors respect that without the paperwork.

Also seconding everything everyone above me has said about cognitive incapacity - either actual or merely theoretical on the basis of a condition that could cause it - and things doctors often object to because of stigma like feeding tubes, etc.

[davidgillon]

That's a particularly good point. And reminds me that a friend had to resist 'palliative care only' for her son from pretty much the moment he got his terminal cancer diagnosis.

[davidgillon]

Thanks for the comments everyone. My mother has now decided that we aren't going ahead with the medical power of attorney, so it's somewhat moot. But I'll pass everything on to my sister in the event she manages to talk her back around. We really wanted it for the financial one, and largely just did the medical as it was there, so the process hasn't been a total loss.

WRT her health, she'll see us all into our graves! She's 78 in a few days, and unstoppable. Which is not necessarily a good thing - 'Mother, you can afford to get a taxi back from Dad's care home when it's dark', 'No, I'll walk, it's not a problem'...