As POA, can I overrule my mother's request for no hospice care?

3 answers | Last updated: Oct 14, 2016
Sueinaustin asked...

I live in Austin, TX and have medical power of attorney for my mother, who is suffering from Alzheimer's. She is currently in a nursing home and in the final stages of this disease. She states on her POA that she does not want hospice involved with her care. This was the only stipulation that she put on her paperwork. I am not sure why since she never spoke to me about this.

The problem is that I and the rest of my family would like to bring in hospice for her final stage which is happening now. I personally would like to have the support of this group to help monitor her decline and make her as comfortable as possible. Also, in her final days/weeks, i wanted to bring her home so that we could care for her and have her die peacefully at home. But, without hospice care, this would be very hard to do.

Question - Is there anyway I and/or the family can overrule her wish in her POA and go ahead and bring in hospice? Or, is this not possible?

Expert Answers

Barbara Repa, a senior editor, is an attorney, a journalist specializing in aging issues, and the author of Your Rights in the Workplace (Nolo), now in its 10th edition.

As long as your mother was legally competent when she completed the power of attorney, there are two answers to your question: one based in the law and one based on common sense. Both answers are the same"”but not likely what you want to hear.

An agent named in a power of attorney is empowered to carry out the wishes expressed in that document; it's the very reason a power of attorney is created. An agent who is unable or unwilling to carry out that legal duty can step aside and let an alternate agent act instead if there was one named. That would take you off the hook legally if you do not want to follow the wishes expressed in the document.

But you also might want to try on the question from a common sense perspective. It is unfortunate that your mother did not discuss her reasoning for not wanting to involve hospice in her final care, as that might now give you and the other family members involved some insight and solace. But the wish seems to be clearly stated"”and the fact that it stands alone in the directive seems to underscore that she felt strongly about it. Despite the fact that your wishes differ from your mother's, bear in mind that the sentiments she expressed and the power of attorney she created relate to her life and death, not yours. I don't mean to sound harsh, as your intentions sound only good and caring.

It might make your role easier if you imagine the situation reversed. For example, say you finalized a power of attorney specifying your strong wish that you'd want hospice involved in your final care, but your agent ignored that and chose another route when you were no longer able to express your own opinions.

Community Answers

A fellow caregiver answered...

Hospice has representatives that can advise and counsel your Mother on what care she can accept and decline.

Sometimes, if you accept Hospice you cannot be admitted to hospital or vica versa so confusion might have occured and your Mother did not want to lose her option to be admitted to hospital for care.

Hospice could explain to her levels of care that are same as hospitals for pallalative care.

I am betting that this Mother has not visited with a Hospice representative but was asked the asked the either or question, DO you want hospital or Hospice. If you do Hospice, you cannot have insurance pay for hospital. This confuses people and they might be thinking of an incident that they are not passed yet and have need "hospital assistance" when actually Hospice does a lot and they will send you to hospital to stabilize and come back.

Most people do not understand what is available to them and if Hospice visits, they learn to like the concept and realize they are not stuck without assistance the same in hospital. Prior Radiation Therapist and Hospice worker

A fellow caregiver answered...

All I know is, I do not want hospice involved in MY last days, because I saw how they drugged my dad so that he was not able to communicate. They also refused to allow food and water at the end. When I hydrated him, he clearly was aware that we were there. When hospice arrived and insisted that they were in charge and no food or water was to be given, he never focused again. I want to be there to say good bye to my family. I would rather have pain and stay alert than be pain free and be in a fog until I am gone.