Can I be forced to assume responsibility for my brother's medical decisions and bills?

Canan asked...

My brother has dementia. He is in a nursing home in PA. I do not have a power of attorney nor do I want one. His nursing home has asked me sign a DNR directive for him. Should I do this? I am his only living family member. He goes back and forth between the hospital and nursing home and the hospital wants me to sign for him on his medical bills and Medicaid stuff. I don't want to do this as I am not his POA and do not want to end up with all his bills which I cannot afford. He also has no life insurance. What happens when he passes away and I can't afford the expense and he has nothing. I am ver worried and need some words of advice. I don't have to sign these hospital papers do I? Thanks for your help.

Expert Answer

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.

You should not be coerced to sign any type of document you're not comfortable signing.

That written, there are some documents, such as a DNR, that will not make you liable for any of your brother's debts or obligations: It merely indicates that your brother should not be resuscitated medically during one of those shuttles between nursing home and hospital. Still, if you're not comfortable giving this direction"”especially if you're not sure what your brother's specific wishes would be in the situation"”do not sign the document.

But you can see where the nursing home personnel and medical providers are pinned: They are hoping for some human to give directions for your brother since he is likely unable to do that for himself now.

To get that person in place, it may be time to secure a guardianship or conservatorship for your brother. In such an arrangement, a person is named to make decisions and handle finances for the one who is no longer able to do so.

Such arrangements must be approved and monitored by a court, but most courts these days are affiliated with services"”often volunteer attorneys serving through local bar associations"”that will help arrange for a guardianship or conservatorship free of charge. If there is no family member or friend willing and able to take on the task, the court will often appoint a person who is trained in such matters.

Your first step may be to contact the nursing home's ombudsman to explain your concerns and help explore how to get a named decisionmaker in place for your brother. The ombudsman is a neutral person at each facility who is charged with helping resolve problems for residents and their family members.

The nursing home should have contact information for the responsible ombudsman posted or be able to give it to you over the phone. If you can't get it that way, you can find it through the national organization at