My parents have been separated for the last few years and discussing divorce for many years. My father lives far away but visits to help frequently. They keep delaying finalizing the divorce and although I am medical POA I would not assume that role until my father is no longer her spouse. Now she has a serious knee injury that will require a TNR. If she comes home with him as her caregiver and things don't go well, what will my options be, if he leaves suddenly? Can she go back into inpatient rehab if she cannot remain at home?
Please consult a local lawyer that specializes in family law. Ask him/her to outline your rights and responsibilities as medical POA in your situation.
Just my recommend. The decision is your and the POA is along with it. You should be able to explain this easily to Dad, and if not, explain it the hard way. I wish you the best with a decision now in your hands, for your Mom's own good. But do the best you can with what you think is best. Often advice, and too much of it, only lends more confusion.
(side story about Knee Replacement, I had been talking to my Dr. about it and when I asked about rehab he said he advises OUTPATIENT rehab and if I wanted Inpatient rehab he would not do the surgery. He said the chance of infection and other complications INCREASE with inpatient rehab)
Back to your mom.
If dad is there to help her, and she has no problem with that great.
I would also say she should hire a caregiver from an agency to be with her until she can manage.
With a caregiver from an agency if dad decides to leave mom still has help.
If this were me..I would opt to come home, if necessary hire a caregiver to help until I can manage on my own. I would have PT come to the house until I could safely drive myself to rehab.
Your POAs override your father. Your Mom has made you her representative and as such your pretty much in control if she is found incompetent. Dad being her legal husband means nothing.
The only way someone gets Rehab is if they have been in the hospital 3 days (I think it is) and needs therapy. So if Mom has her knee operated on and Rehab is suggested, she should go. She will recuperate better. Dad will not need to come and care for her. If she does not except Rehab at the time its suggested, I think she has a certain amount of days to change her mind. Medicare pays the first 20 days 100%, 80 to 100- 50%. Mom pays other 50% out of pocket unless her health insurance pays partial or all of it. The 100 days is not a given. If Mom progresses well and hits a plateau, Medicare will have her discharged and she will go home.
Having DPOA and MPOA does not mean you have to physically care for someone. They are tools. Makes life a little easier. As the financial POA, if Mom has the money, you can hire someone to care for her or apply to Medicaid for help for in home care or care in a facility.
Ex DH and I remained separated for nearly five years and didn't officially divorce until we were each ready to re-marry.
Your mother is 72 and of sound mind; and in any case your father is still her husband, so your MPOA is not in effect. You have no influence over decisions they make, therefore you cannot accept responsibility for the consequences of the actions taken by either of them. What will your options be? - is a non question. You will have no options, including not the option of moving in with her as her caregiver-by-default. Your father cannot be allowed to use you as a safety net. Either he commits, or she makes alternative arrangements; but in any case this is for THEM to sort out and not you.
Have they been kicking you back and forth for all the years they've been discussing divorce? Aren't you getting a bit of a headache from it yet?
I'm still sorry that your mother has this painful knee injury and wish her a successful operation and swift recovery. But as long as they want to continue their game, I honestly would keep out of it. Make that very plain to both of them.
No, rehab is prescribed as medically necessary by a doctor or PT -- the patient or their family doesn't get to decide this. Her Medicare wouldn't pay for it anyway unless it was medically prescribed. And, while in rehab, if she doesn't make progress they will release her if she plateaus or is uncooperative.
If her estranged husband "leaves suddenly" then you will need to step in, but if he may be prone to doing this, why go down this path of chaos to begin with? Consider hiring an aid with her money or contact social services to see if she qualifies for an Elder Waiver and in-home services. Whatever you do, be wary of becoming her full-time caregiveer. She needs to use her own resources to pay for her own post-surgery care.
Being a spouse does not trump MPoA. But the MPoA authority usually doesn't kick in until the conditions specified in the document are met. Do you know what they are? Usually it's one or two medical diagnosis of mental incapacity and outright physical incapacity. Them being separated has no bearing if he isn't the actual MPoA.
Who is the FPoA? This is where it might get stickier. If you took your mom to a consult with a certified elder law attorney, this professional can probably give a more clear picture of the down-the-road impact of their marital state financially. She should also see a Medicaid Planner for her state so that there's no surprises. It will get complicated with Medicaid and this resource needs to be preserved should she need it (and many elders do).