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Did Richard ***formally*** put Tyler in charge of his medical and financial affairs? If yes, then Tyler gets to decide once Richard becomes incapacitated. As long as Richard is competent to make his own decisions, he can let his sister help him. But, as of now, she *may* only be moving back to town - that does not sound like a sure thing. And no one person can take care of another 24/7.

You wrote on your profile: "I am caring for my friend, living at home with age-related decline, anxiety, arthritis, depression, diabetes, incontinence, and mobility problems." You do not mention dementia, so Richard is still free to make his own decisions.
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