Mother had surgery today without my knowledge and I am the agent in her medical POA. Should I have been notified?

A fellow caregiver asked...

I am and have been my mother's financial and medical Power of Attorney since April 2006. My mother was deemed incompetent to make decisions for herself in dealing with financial and medical matters. I talk to my mother regularly on the phone and today I was informed by a family member that our mother had knee replacement surgery performed by her doctor without my knowledge or authorization, or without confirmation as to who my mother's medical Power of Attorney is; how is this possible. The family is well aware that I am her Power of Attorney and yet they had knowledge of this surgery and I didn't. Her doctor/surgeon made no attempt to contact me or discuss this surgery with me. Something is definitely wrong here. I talked to my mother yesterday and she never mentioned having surgery today. She is 85 years old and has a lot of health and mental issues of which is a big concern to mine. And yet she's admitted into a hospital and undergoes knee replacement surgery without my knowledge!

Expert Answer

Barbara Repa, a Caring.com 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.

The situation you describe must be especially frustrating because you assumed that everything possible was done to assure you would be consulted when your mother needed medical care.

And it's a little puzzling to backtrack and try to put the pieces together.

If you and another person are named as "joint agents," many medical authorities will notify only one of the agents unless it's clearly stated that both must agree to all medical decisions.

It also sounds as if some family relationships may be a bit strained, so you may want to check to be sure the power of attorney document was not changed since April 2006.

In reality, doctors who are not fastidious about checking records sometimes simply defer to the family members who are present if the patient is not mentally competent to make his or her own medical decisions.

But if you remain the named agent on your mother's power of attorney, that document should be part of her medical records"”and you should have been consulted before the surgery. It's unclear where the slip-up occurred: whether the document never made it into her record, or the doctor simply ignored it. Neither situation is acceptable.

You obviously can't "undo" the surgery that's been done"”and at this juncture, should show your mother only your best wishes that she heals quickly and makes a great recovery.

But you will also want to take steps to make sure that this situation doesn't happen again. Make sure all your mother's attending doctors"”primary care and any specialists"”all have copies of the power of attorney that expresses her wishes. And make it a point to follow up with the surgeon's or hospital's patient representative or ombudsman to try to pinpoint how or why the POA was not honored before the knee surgery.

And finally, if you sense other family members are resistant or resentful about having you act as your mother's agent, it may help to address that directly. There's no legal necessity to do this, but there may be a practical one"”especially if others live closer to your mother and are more likely to be in the room during medical appointments and such.

An informal meeting at which you all agree that your mother's health and safety is the prime concern may do the job. But if relationships are particularly charged, it may help to get a third person to intervene"”perhaps a family mediator who could help you clear the air constructively, or a doctor or lawyer who could explain to all what a POA means and why it should be honored.