My sister lives in a different state than I do with her boyfriend. Her son has a POA but is mentally unable to perform what needs to be done. She is refusing to go to assisted living. What can her boyfriend do, as she is living with him and the care will fall to him?
Not a whole heck of a lot, or not for long, and your sister will deteriorate further.
Her own son is the person your sister chose. I did not know he was 54. I didn't know that his being "mentally unable" to do this was your own assessment of him, not a diagnosis of his actual condition. Which you now tell us is that basically you don't feel he is up to it.
I think that the best thing that can happen here is that your sister's son continue to serve as her POA. Please try to offer your support to him. It is a big job. I am sure it will be apparent to him when the sister's boyfriend is unable to care for her. That will mean she will need placement. Work with her son to understand how important record keeping is now so that the 5 year look back will show your sister's money went only for her own needs. If the son is unable to care for her, which is likely the case if you are right, then she will require placement.
I would not try to do anything unless you suspect there is neglect involved. That will likely mean your seeing a lawyer and trying to assume guardianship or have the court take on guardianship. I recommend the latter, because this is a very very very difficult job.
So (and sorry if some of our answers seem judgmental; YOU know the whole backstory, we don't. Thanks for clarifying the major points--the enabled man-child who can't/won't make good decisions for his mom; the fractured relationship between him and S.O; all adds up to a very big mess, yes?)
If SO decides to step away and your sister is incapable of caring for herself and the responsible party can't/won't step up, someone (you? SO?) calls APS and reports a vulnerable adult in need of care. The state steps in and takes over.
Sometimes with stubborn folks, this is actually the BEST scenario, because then they actually get the care they need.
The way I put it to folks is "look mom/dad/sis: you can either play ball with what we as a family think is best for you, OR we can walk away and let the state take over; they will decide where you live. Would you rather have family determine that, or that State of >>>(CT, NY, MS?).
But honey, you have to mean that you will walk away.
No matter what, you all have your work cut out to get a solution. It is a bit late now to get a legal POA for your sister I would suggest that you need (not SHOULD) take that FACT as your jumping off point.
If were me, I would work on changing attitudes about continuing care facilities. Also, given that your sister's partner is 90 years old, how long is he going to be able to care for her on a 24/7 (I assume) basis. Being willing is all very well, but, believe me, there is nothing like "not getting sleep" for example, to challenge even the most willing of us.
Have you any idea why your sister is refusing to go "into care"?
I also think (my opinion) that YOU stay strong and not get sucked into all the drama. You have done your stint at caregiving --your MIL.
Has something happened to make this situation get to the stage that you are asking your questions now? Or is it a case of "we cannot keep on this way and need to do something now"?
Hang in here. We are simply sharing our experiences (and our opinions!) with you. Choose what seems "doable" and respectfully decline the other suggestions!!
Hugs to you all. This is not a simple dilemma that you are trying to sort out.
The boyfriend should work with your sister's healthcare team to come up with a care plan for your sister. They can then put it to the son for his agreement and action. If he *then* won't lift a finger and the situation continues to deteriorate, the son will be demonstrating that he is not able to use the POA effectively, in front of independent, credible witnesses who are also mandatory reporters, and balls will start rolling.
Beforehand, the boyfriend should sit down for a good think about what he is and is not prepared to do, and where his boundaries are. It will make it harder for him to get stuck with mission-creep care.
You should both stop rolling your eyes about the son and instead talk to him as neutrally as possible. He was given and accepted responsibility for his mother's welfare. Give him more opportunities to step up, and don't set him up to fail by being negative or hostile.
You may privately think that your sister was an idiot to pick him, and I might privately agree, but it happens all the time - she's not the only one to think that POA has to go to your Best Beloved.
It is very important for your sister to get a Medical Directive, so that the sig other and family members understands what your sister wants done when it comes to medical decisions.
If your sister's son is unable to to perform as financial and medical Power of Attorney, it is time for your sister to appoint someone else. She could appoint one person for the financial side, and someone else for the Medical side.
If your sister and her sig other have been together for many many years, I don't foresee him bolting. As what if the shoe was on the other foot, and he was the one who needed the medical care.
Anyway, they should definitely go together to an Elder Law Attorney. Again, you do not say how disabled you sister is--that is in what manner, for if she has now gone into dementia she can no onger change the POA. Having a mentally unable son assigned would be a complete mess if they are NOT married or Domestic Partners, in so far as guardianship. I am saying, if someone else in family wants guardianship they are more likely to get it.
So key things here.
1. In what way is your sister disabled so that she cannot manage her own affairs
2. What are the LEGAL ways she and her significant other are attached
3. How long has she been with that person/how trustworthy does family she him to be
4. What other family is involved?
5. In what way is son "mentally" unable? What is his legal diagnosis? How did he get appointed if mentally unable?
I would suggest a trip to an elder law attorney.
I see below you said "not competent. That means she CANNOT change her POA to the boyfriend at all. You may eventually be looking at guardianship by the state. You don't want it. The boyfriend can't get it, and the current POA apparently cannot do it. It is kind of a mess. So very sorry.
Surely, if he had a known, well-established learning disability, or a debilitating mental illness, your sister would not have asked him to accept this responsibility; so what's the problem?
He can, if he so chooses, provide in-home care for as long as he can and wants to. No one will take that away. However, without POA (medical and financial), he likely will run into issues. There are forms the hospitals/doctors use that she might be able to sign to allow him at least access to medical care, but probably not decision making if she needed extensive treatment. Without DPOA he technically can't manage her finances. If they have a shared bank account and her income (retired?) is direct deposited, he *can* use the account to pay bills, however there are rules about that (esp SS)- so long as no one questions anything, it can work, but if he decides to walk away, what then?
"I can't take care of her and so far, he seems willing to do it. Time will tell. I really don't feel it is my responsibility. I have other siblings and they are unable to take responsibility either."
Although it still means participating and some effort on someone's part, please understand that having DPOA and MPOA DOES NOT REQUIRE the person to provide the CARE. You handle the finances and medical decisions, but you do not have to care for her. If one of you decides you can do this, at least temporarily, and you find an attorney who will test/accept her ability to sign, the old POAs can be negated and new POAs added. At least for the short term someone can be "in charge." POAs can also be declined at any time.
If no one takes on these tasks, someone will have to ensure that the state "takes over" and assigns guardianship. Once the state steps in, you have no say in anything, how her funds are used, what happens to any of her assets, where she lives, how she is cared for, what treatment she gets.
Also note (many don't understand this!) - having any kind of POA does NOT allow you to forcibly move anyone. You can choose a place, sign paperwork FOR the person, arrange payments from their funds, etc, but oftentimes trickery or a medical emergency is needed to facilitate the move, especially when they refuse (been there, done that with our mother!)
If she is competent she can revoke son's POA and designate boyfriend or somebody else.
It appears none of her children beyond the "incompetant" son are able or willing to take on her care.
this is one of the reasons Gay Rights movement fought for so many years to have the right to legally marry.
I'm wondering a little bit what's actually happening here? Your question is about what 'rights' her boyfriend has if he's not the PoA. You say you don't feel it is your responsibility. You say she has given her son Power of Attorney but he is not 'mentally able' to do what needs to be done. Sounds confusing.
Is her son cognitively impaired? struggling with mental illness? or do you just mean that he's having the customary amount of emotional turmoil over a parent's decline? or do you mean he's not doing what you think he should?
You say she is 'pretty much on her own if the boyfriend and/or son walk away' ... okay, but that's true for nearly everybody: if the closest live-in family walk away, we are on our own.
You also say she is refusing to go to AL and that the boyfriend seems willing to care for her.
So what's really the issue here?
What is your sisters plan for getting care for herself? Is she competent enough and wealthy enough to hire in-home caregivers?