I am the assigned agent to my father’s Health Care Directive. My sibling holds Power of Attorney. I happily oversee all caregiving duties. We have a private agency that provides 24/7 in-home care. Quite often we are left with caretakers that don’t come to their shifts. Each time I drop everything and fill in. (He is post-stroke and cannot be left alone.) Unfortunately, this is becoming a regular thing where I am left caretaking one or two days each week.
I asked the POA if I could be paid $15/hour for the days the caretakers don’t show and am needed to fill in. This is WELL below the hourly rate for our area.
He said absolutely not. He will not pay family for caregiving.
In a nut shell, even though I have the Health Care Directive and can legally make my dad’s caregiving plan, my sibling holds the POA and says he has the right to refuse payment of services he does not agree with.
Do I have any options for getting payment? It seems he’s overstepping his authority as I know my dad would happily pay me especially since it is half of what the agency charges. It’s so depressing.
But: any chance your father is still mentally competent (despite the stroke)? I'm guessing not. But if he is, your father can easily create a new financial POA, (1) naming you, (2) revoking all previous POAs, (3) explicitly stating that you, as POA, are allowed to get compensated (this is important, because a standard POA document normally doesn't allow for any compensation).
There is 1 more way to have your sibling removed as POA: but it's time-consuming, stressful. If you feel your sibling is abusing/neglecting your father, you can get APS involved to investigate.
I was in this situation with my twisted sissies, but I was the 24/7/365 in home caregiver. Twisteds accused me of financial exploitation, had me investigated by APS. It was at that time I retained an attorney, or course, there was absolutely no exploitation and the case closed quickly.
I then did take them to court seeking payment, which l won to a point.
Why doesn't bro step in when caregivers call out? If he were taking his fair share of caregiving responsibility, then fine. But, it doesn't sound like that is the case.
It's simple, when the caregivers are a no show you load up your father and drop him off with your POA sibling. Sibling is at work or doing something? Not your problem.
you really don't have an option I know of. Your brother is FPOA. He may, in fact, have to answer for allowing a "relative" of the principal to be paid to give care.
I am hoping that the principal doesn't like with you, and that you can simply refuse to do the care when the caregiver doesn't show up. If you are doing overseeing of caregivers you are ALREADY doing service without payment. Tell brother he is POA and he can now handle it ALL. If he wishes you might suggest medication on this.
For family medication contact:
APFMnet.org (Academy of Professional Family Mediators
or
ACRnet.org (assn. for Conflict Resolution)
they can guide you to mediators in your area.
Good luck.
And family in most states can be paid, but definitely a contract should be in place and it setup legally, dad becomes employer via bro POA, with all withholdings. And I would not discount l st because you are family. In fact the documents probably require market rate payment.
That said, you don't have to step in. Get your brother to handle hiring care and if they don't show up, hiring emergency care. It will come at a great cost. I think you would only need to do it a few times before you can discuss the situation again and get paid. If you keep stepping in without pay, he will keep relying on you. Unfortunately your Dad is stuck in the middle but he did decide this would be the best solution when he wrote his POA directives.
1. Take you POA with the additional duties assigned to a certified elder attorney and see if you have recourse. For sure I would always bill the FPOA, whether he paid or not, just to have a record. If your expanded duties spelled out in the POA state that you will decide where dad lives, then brother can’t put him where he chooses. His job is to pay the bills. But do let a qualified attorney go over this with you. Perhaps a letter to brother from the attorney could set him straight? I appreciate that he is holding you hostage with his threats and that can be frightening when you are worried for what is best for your dad.
2. Check with the service and see if they can hire you for the days the other attendant doesn’t show. Then they can pay you and brother can pay them.
Just a reminder to the both of you: as POA agents you are fiduciaries. You owe a legal duty to your father to act in his best interest. This duty of loyalty means that it really doesn't matter what either of you want. It means that whatever decisions the two of you make, they must support your father's needs.
The important thing right now is not that you get paid. It is that your father receives necessary care. You have to step in because the caregivers are unreliable. Therefore, it appears that the agency you are using is failing. Unless it is the only agency in town, I recommend that you find another one that can provide reliable caregivers.
The important thing right now is that your father get his care and not for your brother to decide that he doesn't pay family members to provide caregiving. Just as it is not about you getting paid, it's also not about who your brother feels it's appropriate to pay.
You both need to get your heads together and educate yourselves about being POA agents.
"Yes, I am female. POA sibling is male".
You have a brother problem.
Brother does not value your time & labour.
Ask him directly to explain himself. Is this because you are family? Or because you are FEMALE? Or because he sees this as your choice to turn up to provide such care?
If the care is getting unreliable, how do you all feel about residential care instead?
So it's NOT a case of brother wanting to preserve the inheritance, as he is willing to place your father in a facility.
What would happen if you just weren't available to be the emergency caregiver one time? Do you ever get to go out of town? Do you work? What if you are sick?
No, it's not. But it is a case of, "Well, I'll just exploit my sister then. And I don't care that our father is doing so well at home, and that she's doing our father and I, a HUGE favor, filling in the missing-shifts FOR FREE, which disrupts whatever plans she has for that day, and allows our father to stay at home, be happy and thrive."
Team work! Probably dad's intent but has blown up.
I would bet that the POA's include language about those providing services shall be paid a reasonable amount. My mom's did.
OP, you can even say brother's behavior (failure to pay you, or someone) is life-threatening. If you OP weren't filling in the gaps, your father would be having many more health problems.
Can Dad get out of bed alone? Move about his home? Get drinks & snacks himself?
Most agencies are still probably feeling the effects of Covid, may be finding it hard to get & keep staff. They will prioritise clients if they have to. So if staff are absent/ill etc the remainder staff on shift try to ensure safety of their daily client list.
Eg Mrs B who only needs a little light housecleaning will get skipped that day. However, Mr S cannot get out of bed alone so must be attended to - but may not get a full visit.
How does your agency handle their case load in such circumstances?
While missing his care service for a few hours or a shift is never ideal, I'm trying to gauge the severity for your Father.
My relative requires assistance to bathe & dress, so without staff coming must stay in night-clothes (usually wet). Not ideal. But not life threatening either for a day, as can get own food & medicines independantly.
While everyone would agree being home is best - the safety of being left alone really should be taken into consideration. It needs proper weight in the home care vs care home debate.
The agency works very diligently to find quick replacement but I happily fill in when there is a gap. As times are currently, staffing has its challenges no matter how diligent.
I think you should file a petition in court for conservatorship of your father and for his finances.
Your brother is out of state and it does not make sense for him to be in charge of anything when you are the one near your father and who handles all of his care.
Explain to the court when the hearing happens that you already have your father's Health Care Directive and that your brother the POA refuses to pay for caregiving services that you and your father's doctors deem necessary for him. Your brother is derelict of his duty as your father's POA by refusing to pay for his services. Even if those services are being provided by you.
I don't see how the court would not rule in your favor. Also, is your father at all able to indicate that he would be agreeable to you getting conservatorship for him?
When you file for conservatorship, your brother will have to be informed when the court proceeding will be. If he does not show up or send legal representation in his abscence he may lose his POA by default. That happens all the time.
Talk to him one more time and tell him that you will not provide free caregiving services again. If he still refuses to be reasonable, file for conservatorship.
people with hemiplegia are quite able to be alone or live alone independently - with or without visiting help. It really depends on the severity of limb weakness - from mild to paralysis, their general mobility, memory & cognition.
Can this man propel himself inside the home in a wheelchair? Use a telephone & falls alarm appropriatly? Make own drink/snack?
Keep in mind to account for dad's money, POA would probably have to seek the help of an elder attorney to set up a legal employer/employee relationship if he pays you. Meaning, income would be reported to IRS and taxes would be owed at the end of the year. This protects the money to verify an employee was paid in the event dad runs out of money and has to apply for Medicaid. Just paying you without the employee documents would more than likely be considered 'gifting' money in the eyes of Medicaid and create penalty months where they will not pay for the bed.
My in laws have always offered to pay for gas and lunch. It’s less a fractious matter than asking for paid time per hour, particularly the closer relations you are.
No. He has the right (in fact, a duty) to refuse payment of fees which he does not agree have been legitimately incurred on your father's behalf. But say for example that you commissioned a podiatrist to cut your father's toenails, and your brother didn't see why you couldn't do that yourself, he couldn't refuse to settle the invoice just because he doesn't agree that the service is necessary: it's a standard health care appointment solely and exclusively for your father's benefit and falling within your remit for decisions.
The sticky bit here is that you are not incurring any fees by doing the work yourself; and no you can't just award yourself a caregiver's contract.
Are you losing any money?
I certainly am helping my brother (and other 4 siblings) gain more inheritance money by doing the service for my father for free that otherwise would have been paid to a service.
Many people with hemiplegia can - varies of course between people a GREAT deal.
So I am wondering about Dad's day, can he self feed, toilet, use a phone on his own?
Also wondering who arranges the agency care & when a cancellation happens, who is notified?
Dad? The POA Brother?
Or does the agency call the OP direct?
Coz all know the OP is happy to fill-in right?
So Dad is happy, yes?
Agency are very happy.
Brother shrugs. Doesn't mind.
Crossed my mind that the OP could be taken for granted here? No-one is going up pay if the job is done willingly for free!
But if OP went on holidays for a month, who would fill in?
A. No-one? It would be inconvenient, but ok for a day.
B. A back-up high priced agency?
C. It wouldn't be safe - Dad would have to move into care accommodation?
I know from experience when we only have one side of the story, things often get a little skewed by the only side telling the story. Based on what you said about your brother wanting 24/7 care in a facility, it sounds like he is tired of hearing about the No-Show caregivers and would rather know for sure your father is being taken care of by having him in a 24/7 facility. It seems to me like you have two choices. Find a more reliable care giving company or put your father in a 24/7 care facility.
The real issue isn't your brother's unwillingness to pay. The issue is the care givers company's unwillingness to insure someone shows up when scheduled and arrange for a substitute when necessary. It seems you are barking up the wrong tree.
That being said, I personally wouldn't have any problem with paying you if you had to fill in. But I would want to know what the problem was with the care giving company that was causing you to have to do it in the first place. It wouldn't have anything to do with you getting the money. And I have a feeling this is how your brother is looking at it. Of course, without hearing what he has to say about it, all any of us outsiders can do is speculate, and that's not worth much at all to you.
I do feel for you. I would hate to know that my mom gave me medical POA and gave my brother financial and legal POA. That would have been a nightmare for me considering how my brother was. But fortunately, I have both medical and legal POA. It's hard enough dealing with my mom telling me what she will and will not do. I can't imagine having to deal with what my brother was capable of when it came to spending money that didn't belong to him.
I can't imagine having someone else dictating what they will and will not do financially. I love my mom and want to take care of her, but this is by far the hardest thing I've ever had to deal with. To be honest, if I were put in your shoes, I would give up my medical POA and let whoever is the back-up take over. I doubt you are legally bound to perform that role.
The one thing that people almost always fail to consider is their own well being. You should NOT have to give up your own life to take care of a parent. You should always consider your own well being. You need to do whatever is best for BOTH you AND your father. I don't give a flip how that sounds to the judges waiting to pounce. They can have at it for all I care.
Good Luck.
In theory agency should have plenty of staff on their books...
In reality may find it hard to get & retain good staff. Staff willing to be available 7 days for a 'maybe' shift. They will go take NHs or other jobs for regular confirmed shifts instead.
I have family members who use care agencies & this is the reality. However, they have changed providers at times & had some improvements. Agencies do differ.
I agree with you for the rest.
One child has POA for finance. That child is responsible for using the parent's funds to pay for goods and services on the parent's behalf.
The other child has POA for medical and welfare. That child is responsible for sourcing and commissioning goods and services to meet the parent's needs.
So that in this case, the OP can't just walk when the parent needs care: she is responsible for ensuring that the parent's needs are met.
But because there was no caregiver's contract, and the parent is no longer able to create one, and the parent's finance POA doesn't agree that there should be one, the Medical POA is left... up a gum tree, basically.
The remaining option is to source additional services and/or to get stroppy with the current provider.
The learning point for future MPOAs is to check that this particular duck is not missing from their row before they accept responsibility.
What can the OP do now to: support Dad, be compensated & also keep relations with POA Bro intact?
Just a thought…why don’t you contract with an additional agency, so when you are in a bind, you can call them to see if anyone can fill in. It may be more expensive to have a last minute fill in, but oh well, you offered to do it for $15.
Love the idea of contracting with an agency.
There are programs (in the state where I live) where medicaid/Medicare WILL pay family members who are caregivers. I'm not sure of the specifics of the program, since I have never applied for it, but the Caseworker for Community Long Term Care did mention it as an option to me recently. Perhaps you can look into that if you want to be a consistent caregiver for dad.
Another option:
If you and your brother have agreed it isn't safe for dad to be left alone, then you may want to look at an assisted living, if you can't find consistent care.
If you and you brother are uncertain, or if you disagree about the level of care dad needs, have dad evaluated and get a professional opinion of dad's abilities and the level of caregiving and supervision dad requires. Then you can decide if dad can be safely left alone if a caregiver is a no-show.
A third option is an adult daycare situation, to decrease your dependence on caregivers to weekends and nights. This would free you up to work and spend time with your friends and family.
This is a difficulty situation, and I hope that both of you can work together to find a solution.
Thank you all so much for your feedback! I spoke with a few attorneys and gave them my father's POA and Health Care Directive that he had drawn up. Essentially, my father had things set up a little differently than more common POA's and HCD's. (Please no criticism about this. It is what it is and I love my father.)
He requested two attorneys-in-fact and spelled out the rolls for each - one attorney-in-fact as the financial POA (my brother), and one attorney-in-fact as the medical HCD (me). The POA can't interfere with the HCD's role, and the HCD can't interfere with the POA's role.
By refusing to pay for health care it interferes with my ability to make the care decisions that have been entrusted to me. It also has an appearance of conflict of interest, as it increases the size of the estate he may one day inherit from our father, at the expense of our father's care today.
So, in this situation he must pay for caregivers (agency or family) the Health Care Agent deems appropriate.
We will see how he responds.....
Tough love may be required.
I fell into being an occasional fill-in when paid care were late/cancelled.
Then I saw a new pattern emerge. Paid care were attempting to reschedule a different time or send different staff but this was being declined! Being told *family will do it*. Because they had learner this is what happened. Then next, paid care being cancelled if weekend rates.. as family were *free*.
I did indeed quit.
The trouble with a world that is run by management accountants is that kindness, filial and sisterly duty, and the inability to turn your back on someone who needs your help have no monetary value.
One thing I don't think anybody has asked is whether your father is able to express a preference on this point (or any other). If he is, then your brother can consult him. Your brother is still responsible for making the best interests decision on your father's behalf, but he is required to act in line with your father's known and/or expressed wishes. You don't get involved; but your brother can explain to your father that you are having to cover many agency hours and that it would be fair to compensate you for this time as long as your father is happy to pay. If your brother gets a positive answer, then he can pay the rate he (your brother) thinks is reasonable.
Don't quote me on this, but we do have certain clients whose calls are never, ever missed even if the manager has to cover them. Usually this is because of need, but in one or two cases it's because nobody in the office ever wants to answer the phone to the family again. Don't be one of the clients who is really nice about it when agencies ring to explain they're short-staffed. You can be scary without being rude.