--- In [email protected], m2smart4u2000 <[EMAIL PROTECTED]> wrote:
 
> There seems to be two things needed, a "power of attorney" and 
> an "Advance Directive". The Power of Attorney gives rights to make 
> decisions on your behalf regarding your estate. This is notarized 
> and has a space for signature that says "acceptance by agent" 
> and "acceptance by alternative agent" The Advanced directive names a 
> health care representative and an alternate health care 
> representative and states your wishes should you become seriously 
> ill. It can be as specific as your like. 

Just some further things to consider for the Advance Directive (aka
Medical Power of Attorney in California I think). I spent three years
caring for my mother in advanced stages of Alzheimers. 

(Its ironic or nicely symetrical -- she passed away one year ago today
-- so i hve been thinking of her -- all blessings to her wherever she
may be.) 

She created an Advanced Directive Medical PoA) in 1990 or so and
placed my brother as number one and myself as number two. That all
made sense, he is the eldest, she and he ran the same business and saw
each other daily, he lived withing 30 minutes from her, and I was 500
miles away.  And the general Power of Attorney worked in a similar
fashion. My brother wasnamed #1 due to his proximaty and I was named
number two. My mother said if I had been closee by than my brother,
she would have named me #1. 

Later, in 1997 this was revised when a caregiver moved in to a fairly
self-contained suite upstairs in my mother's house to sort of help her
out with things -- at that point it was just checking in with her a
bit, helping with shopping, but we expected a gradual decline, thus
all supported the live-in caregiver idea. So the Advance Directive was
changed to have the caregiver #2 and me #3 since the caregiver was
"right there". 

The order is important as I came to learn. The Advance Directive, at
least in California, does not designate those appointed as co-equal
managers. It gives 100% power to the first, and if they are unable to
perform the responsibilities, 100% of authority falls to #2, etc. 

By 2001 my mother had declined quite a bit, so I decided to sell my
house and move the 500 miles so I could be there for her and be part
of the caregiver team (there was the live-in and another part time
"commuter" caregive". And my brother had move 700 miles away. Though
we talked  about changing the Directive, my mother could no longer
sign a document, or even if she could make some scrawl, she would not
really knowwhat she was signing. So the Advanced Directive was fixed.

A year later the live-in caregive moved out, 300 miles away. So the 24
hours care / watching over was then done by myself, living at the
house, and two part time commuting in caregivers. However, my bother,
700 miles way, and the original live-in caregiver, not family, and 300
miles way still had legal medical authority for my mom over me. And my
brother had 100% control of my mom's finaces, and since payment for
medical expenses and for the part-time caregivers was in his hands, he
wielded substantial power over how things were done. 

One would think that this would not be a problem among mature,
educated adults. All i can say is that under the stress, and perhaps
growing sense of grieving and loss, people don't always act rationally. 

People clung to their legal power. I think they did so becasue it made
them feel involved and still an active part of my mom's life. However,
they were not involved in the day to day care for my mom, and over
time, gained more and more unproductive and flawed views of the
situation and what was best for my mom. And they even basically knew
and admitted this, but still, had to cling on to micro management. 

It was odd beyond belief and placed my mom in jepordy at times --
thankfully nothing serious happened. And I know my mom would have not
been pleased with the actions of the other two PoAs. She would have
said aomethng about common sense, and  "look who is living at my house
caring for me, who do you think I would have wanted to have primary
decision ability!!??"

I point this out because PoAs are set up and then things change. After
some point, the dcouments can't be changed due to incapacitation. As
Smart pointed out, the documents can be as specific as you care to
make them. I suggest that you think things through and add comments of
commen sense regarding order of PoAs over time, and possible new PoAs
to be appointed if the currenly listed ones don't meed certain
conditions -- such as proximatey etc. 

My mom's care would have been quite better if she  had added the
commonn sense supplement, "and of course the order of PoAs should
change if circumstances change. The person who is physically closest,
and/or most involved in my care and life at any particular time should
be the functional lead PoA." 







 






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