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What you should do is feel entirely justified in sharing with the staff at the NH the fact that your sibling is living with Bipolar Disorder and cannot take responsibility for your mother's safety and welfare.
BUT! - I am assuming two things:
1. That your mother does not have capacity. And, by the way, one has power of attorney FOR another person, not ON her. 2. That the bipolar disorder is currently causing your sibling problems.
Many people do of course lead perfectly satisfactory lives in spite of this mental health condition; and if your sibling is one of them, then the bipolar is not sufficient reason in itself for barring outings with your mother.
CM is perfectly correct that many persons with Bipolar Disorder lead perfectly ordinary lives. That disorder would not be enough reason to bar someone from normal activity with a parent.
If your sibling is not reliable in this regard, then let the nh know that.
Can you come up with alternates that might satisfy both mother and sibling? Maybe you go with them on some outings? Suggest that sibling attend some in-house activities with Mom?
Does your mom have behavior issues or increased disorientation upon returning from outings with your sister? Does mom enjoy the outings with sister? Has the facility told you there are problems? As POA you could stop outings with sis. But, unless the facility has told you of resulting issues, you should leave it alone. If the facility notices increased behavior issues with mom, ask them to take the lead on stopping the outings. Takes you out of the middle of it and will eliminate this problem with sis. You are POA but that does not give you right to stop outings if mom enjoys them. If, on the other hand sis is causing danger to mom you mey be able to do something. I would leave it to the facility to place this sort of restriction on your mom.
BiPolar in and of itself is not necessarily a reason to withhold visitations. Many people live with this disorder, including myself, who are the primary caretakers parents. I can say for myself that I work with my brothers to ensure there are not outstanding issues. I suggest you learn more about Bilpolar and work with your sibling until such time as they are determined to be unfit, working with professionals, not simply a personal bias.
POA does not afford you the right to determine whether a sibling could take your mother for an outing. You would have to have guardianship for that. That is a legal process that differs from state to state.
mickeymat's answer is correct. Decisions about association with others, attendance at church, and similar are part of either a guardianship or a Power of Attorney for Health Care matters. In NC, and I understand in most states, a HCPOA is only effective when the person giving the power is incapacitated, usually based on a doctor's determination. It should be about safety. Be careful that it does become a struggle for control. Your mother will lose there.
You are NOT to disclose ANY medical condition your sibling may have WITHOUT THEIR PERMISSION! And being bipolar does not make you a villain, nor an incompetent dunce! I got through nursing school, and a masters program, plus a paralegal program, so don't even think all of us with bipolar disorder should not be walking around without a guard. Perhaps you could serve your sibling well by talking to them, and then finding out more about the disease. With medication, most of us are high functioning and lead very productive lives. I am really insulted you have attached another stigma to anyone with a mental illness. Would you do the same to those who have diabetes, high blood pressure, a broken arm, etc.? Why don't you try going somewhere with your sibling, and your mother if she is able to leave the nursing home? Of course as power of attorney you have the ability to prevent such outings. Then you would be denying your sibling of time alone with YOUR mother since both of you were carried in her womb (I am assuming). What gives you the right to judge? Yes, I am very angry with your assumption about people who share bipolar disorder. Patty Duke, Winston Churchill, Ted Turner, Debbie Reynolds' daughter Carrie Fisher, and a host of other celebrities share our disorder (to name a few). Misguided to say the least...
Since when does one owe one's sibling a legal duty of confidentiality? You can say what you like about him or her to anyone you like as long as it's true.
Jewels1809, why do you think you need to control this? What incident or event precipitated your question? What danger do you perceive your mother to be in? I agree with the others that bipolar disorder is NOT RELEVANT to this discussion. Many of us have siblings who can be disruptive and damaging to the caregiving process; there's no need to point out your sister's personal challenge. That said, if I had a sibling who was causing chaos versus being helpful, I would definitely be looking at strategies to minimize her visits and/or to go along on these visits to supervise. You would have to supply much more information in order for most of us to give you helpful advice in this area, but I certainly hope that you find a solution, for your sake and for your Mom's.
Wow, I had to deal with this issue before myself.. Being bipolar doesn't necessarily mean that one is not capable of taking care of another, but it does give one caution. It is a lot of work to take care of an elderly loved one WITHOUT being bipolar. When I first put my grandparents in the NH, my grandparents needed to get used to the routine to allow them to be comfortable. My brother - who has bipolar and various other issues- would take my grandfather to the bank and get large sums of money and try to tell me that my grandfather did not have dementia and that he WANTED to give him money. I ended up having to take my POA paperwork to the bank and put my name on their account. Adult protective services did an investigation, but couldn't do anything because I wasn't on the account as POA, yet. I am now on the account with my POA paperwork on file. The issue is documented, so the bank only allows me to get money out. My brother ended up going to jail on unrelated issues, SO it has worked out for me. For you, you may need to get a guardianship to protect the NH if your sibling is not a suitable person to care for your loved one.
Does your sibling have the tendency to decide that they don't need their meds and go off them, without a doctor's supervision, with disasterous results? Or not on the prober meds or right dose? How does your mom handle the outings?
My experience with this has been both positive and negative as to how it affects our mother. Through our mother several years ago I found out that my sibling during a visit to the folks for a few months berated her (Mom) for signing me up to act for both my parents if they should become incapacitated (DPOA) as well their health directives also. Our father was in on that also and my sibling never said a word to father about it. Because I live very close to them they thought that would be the wisest thing to do. The sibling who was upset about it was diagnosed with bi-polar many years before - when on medication, the sweetest person you would want to know. When it wears off or is forgotten to be taken they become a sneaky, conniving, pot stirrer - just keeping things in an uproar by intimating things are going on and by their actions making it seem as true. It has split the family, but I'm not sure if or what has been said. It was bad enough for awhile that I consulted an attorney because I was a basket case emotionally. My attorney said that I just needed to not engtage my sibling at all by email, phone, snail mail, etc. especially when they started hurling accusations and threats my way. I was to keep all correspondence, phone messages in a file and to send my attorney the worst ones in case my sibling does file suit for whatever damage they believe has been done. Never would I stop them from visiting with our mother or our father when he was alive - although that was one of the things I and mother was accused of. Yes, I made sure I was always present when they visited and would step in and change the subject if it appeared the pot stirring was beginning. So far things are going along without the stress of the pot stirrer and I've learned to ignore but be watchful. Medical conditions within families is a tricky one - the sibling threatened to sue part of the family if we said anything because we all knew of the bi polar as - they told everyone. Anyway - that has been my experience and as long as things can go along, I'm fine with it - however when the pot-stirring starts . . . . . . . .
First, is the bipolar under control through medication?
Is the person who is taking your mom on outings endangering or abusing her?
If the bipolar is being successfully controlled by medication and keeping your mom safe on outings, I don't really see a problem with the person taking her out as long as certain conditions are met. However, if those conditions are not met, that's where there would be a problem. It's a good thing to take people on outings who are less fortunate if they don't get out much for whatever reason, and they should be kept safe from all angles. Life in a nursing home without the ability to go out is really no life at all
Bipolar according to whom? First of all, who claims this sibling is so-called "bipolar"? Many times, these diagnoses are given out online, based on Facebook posts, or based on phone conversations, or used as figures of speech. Or sometimes used as nasty name-calling simply because you do not like a person or do not understand that person.
On the other hand, sometimes, a person may choose to go to a mental health professional such as a psychiatrist or social worker who may then deem the person "bipolar" in a ten-minute interview, or possibly because he or she needs to put some sort of diagnosis on the insurance form in order to get paid. Or just because the person showed up at a hospital, and the hospital had to justify 10 days or so of psychiatric incarceration. Afterward, the unfortunate discharged patient most likely found herself without a job as well. Discrimination is rather common.
We all have moodswings. If we did not, our lives would be flat and lifeless. I was once called bipolar, too, and completely convinced of this dehumanizing diagnosis for many years, but I can assure you that any "moodswings" I had were nothing but the normal ups and downs of life. The best decision I ever made was to walk away from it all and not look back. Life gets better and better once you realize that all you need to do is not believe those that discriminate against you or bully you. There will be fewer and fewer. They will fade away. Just be yourself.
Please do not be unkind to your sibling nor call your sibling nasty names such as "bipolar." It is a dehumanizing label. The Diagnostics and Statistical Manual (where bipolar is written about) is not a scientifically-written book anyway. It is only based on drug company bribes and decisions made by a few rich white guys and should not be taken seriously.
Wow. You sure pushed a button with me with your question. Exactly, why do you think a sibling with bipolar, is reason for him/her to not take mom out to lunch or whatever? I have been diagnosed with bipolar for over 20 years now. It is one thing to be discriminated against from society, it is totally another for family to discriminate against me. As many on this site know, the last 3 years with my mom and 2 older brothers has been H-E....double hockey sticks. They have no clue about their mom and her intelligence. (They both think she is the stupidest person on the face of the earth) This is partly her own fault that this is their view since she never opens her mouth around them to show them how much she knows. My brothers have used her age (93 in a few weeks), and my disability, to think they can be "in charge". Well, lawyers finally took care of that line of thinking on their part. (I believe they still think this way, but at least Mom, who has 98% of her marbles, has been able to have 100% of what SHE WANTS. So, once again, I will ask you...... What EXACTLY are your siblings actions that lead you to say....."My bipolar sibling should not be allowed to take our mom out?" Do you have the agreement of doctors and the staff at the NH agree with you? Have they seen/heard things between your sibling and parent that your parent is in danger?
HIPAA only applies to health care providers who are privileged to access a person's protected health records. Anyone that is not a healthcare provider can say whatever they want to say----whether it is true or not. Just a piece of advice---be careful what you say about others in public. You could be looking at a slander/libel lawsuit if what you say is not true.
No Churchmouse, you cannot say anything about one's medical issues when you hold fiduciary responsibilities. Who died and left you in charge anyway??? There is a federal law that prohibits such discussions - HIPPA.
If the OP held fiduciary responsibilities for her sibling, no doubt. But the OP has these responsibilities for her mother, not for her sibling. It is the sibling whom the OP states to have bipolar disorder.
Just to clear up who is under HIPPA rules. According the HHS.GOV website the HIPPA rules apply as follows: "The Privacy Rule, as well as all the Administrative Simplification rules, apply to health plans, health care clearinghouses, and to any health care provider who transmits health information in electronic form in connection with transactions for which the Secretary of HHS has adopted standards under HIPAA (the “covered entities”). "
So this doesn't include individuals. But, I don't think it would be kind for a sibling to release any diagnoses to someone unless he/she was given permission to do so.
That is true about hippa however, telling the nursing home about bi-polar isn't an issue as long as it is managed by medication that are taken daily, if the person's judgement is questionable, the nursing home should be notified asap.
Right. Maybe it's indiscreet to tell the NH about the diagnosis, but it would be prudent to let them know that the sib "doesn't have the best judgment." A factual statement like that could possibly save the parent's life.
Poor Jewel! A simple question set of a minefield. I assume that she mentioned bipolar because it has caused problems in the past, and also recently. A diagnosis doesn't tell the whole story, but it can be shorthand for a frequent set of actions that are problematic.
jewels1809: ANYONE with MENTAL ILLNESS (Bipolar disease) should not be allowed to take your mother anywhere. What happens if said sib goes manic? Good grief! A BIG NO!
Wait! No one answered "Bipolar according to whom?" For all we know, this could be a self-diagnosis. For all we know, the sibling may have never set foot into the office of a shrink. THAT is the only way you can get diagnosed. You can't otherwise. Not online, not via any angry sibling's opinion or pissed-off relative who might think "gee, that girl's weird, maybe she's 'bipolar.'" Bipolar is trendy these days. Many just use that word simply to describe a person they THINK is nuts or they just do not like or don't want around OR want to get rid of. This goes also for unwanted spouses. Toss the gal in a mental hospital, simple as pie. It's abuse, but no one has to know that. She might be a revolving door syndrome for the rest of her life and no one will even know....nor care. Bipolar is a meaningless term that mostly means, "I went to a shrink and got a diagnosis." It does NOT mean dangerous. Actually, the poster did not say his/her sibling was dangerous, did he/shs? No! The poster said "bipolar." Moody. Big deal. I'll bet Mom is thrilled to be loved and appreciated and is dying to go out. And I'll bet Mom is sick of the name-calling, too. Who determined "bipolar' and where's the proof? If you can come up with a valid blood test proving it then you're probably lying. There is none. This is why the court cases taking ten minutes for a judge to commit each mental patient to long-term lockup are totally bogus.
Good point. What you described is exactly how to many people are wrongfully judged and labeled without ever getting to know them personally. This can be detrimental to their overall health and well-being in the long run when no one wants someone around just because of wrong ideas about them. This negatively affects a person's social life, putting them at risk for predators and other bad things to happen to them because that people are looking for isolated people. When bad people pose as friends only to be betrayed or have something bad happen to them, you can blame others who wrongfully charged and labeled that person when something happens to them, especially if they wind up dead
Dear Llama Lover, ANYONE who loves Llamas like you that would actually use it as a username has GOT to be crazy and put away forever!
"ANYONE with MENTAL ILLNESS (Bipolar disease) should not be allowed to take your mother anywhere. What happens if said sib goes manic? Good grief! A BIG NO!"
You are the most ignorant, uneducated, and mean spirited person to post on this site that I have read. How many NAMI or DBSA classes have you attended? my guess is none.
Guess if someone is a poor driver they should "NEVER' be able to take their elderly parents anywhere....what if they have an accident?
Guess an alcoholic should never be able to take their elderly parents anywhere since they might get drunk while with them and put them in danger.
I guess if the adult child has diabetes they should NEVER take their parents anywhere..........after all they might have a low blood sugar reaction and put their parent at risk.
Please, Please, Please, Llama lover...........get educated before you post on a site about a question regarding mental illness and their elderly parents. Your comments scare the poop out of me!
p.s. 26% of the population is struggling with a mental illness at any one time. It is no wonder they live in terror that someone might find out they are depressed, anxious, see people or hear voices, or any number of other disorders. I am just nodding my head back and forth in disbelief. I feel sorry for you.
Yeah, a lot of people, including those who have been caregivers, end up homeless due to suddenly finding out they have no rights to their parents' home. Then, due to not having any place to live, and living in the streets (caregiving causes you to isolate and lose your friends anyway) you end up looking and smelling bad, so you end up labeled with a mental illness. Now what? You end up ASSUMED to be violent. Remember Kelly Thomas? Kelly Thomas was a homeless man who was beaten to death by cops but was not violent, a homeless man assumed to be mentally ill. This as so, so wrong, but the cops' first thought AS A GROUP was "violent bad mental guy" so they beat him to death. This is a fear reaction, and it's totally wrong, actually delusional GroupThink, and this labeling behavior has got to stop, it's literally killing people. Many do it, not just cops, many medical professionals profile their own patients and assume they are violent without any evidence of violence. This is why I now work in human rights to stop this kind of thing. I can only cry for Kelly's family, and wonder if anyone ever apologized to them. I've testified for the FDA on damages done but obviously cannot supply links here. You can check out various books online, there are many published now by human rights activists and other people. I'm coming out with one myself, but I cannot say who I am. Leaving the drugs and Revolving Door Syndrome behind was the best thing I have ever done for myself. I promise it gets better, or can. Don't give up. And stop calling yourself or anyone by labels.
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BUT! - I am assuming two things:
1. That your mother does not have capacity. And, by the way, one has power of attorney FOR another person, not ON her.
2. That the bipolar disorder is currently causing your sibling problems.
Many people do of course lead perfectly satisfactory lives in spite of this mental health condition; and if your sibling is one of them, then the bipolar is not sufficient reason in itself for barring outings with your mother.
If your sibling is not reliable in this regard, then let the nh know that.
Can you come up with alternates that might satisfy both mother and sibling? Maybe you go with them on some outings? Suggest that sibling attend some in-house activities with Mom?
Does mom enjoy the outings with sister?
Has the facility told you there are problems?
As POA you could stop outings with sis. But, unless the facility has told you of resulting issues, you should leave it alone. If the facility notices increased behavior issues with mom, ask them to take the lead on stopping the outings. Takes you out of the middle of it and will eliminate this problem with sis. You are POA but that does not give you right to stop outings if mom enjoys them. If, on the other hand sis is causing danger to mom you mey be able to do something. I would leave it to the facility to place this sort of restriction on your mom.
First, is the bipolar under control through medication?
Is the person who is taking your mom on outings endangering or abusing her?
If the bipolar is being successfully controlled by medication and keeping your mom safe on outings, I don't really see a problem with the person taking her out as long as certain conditions are met. However, if those conditions are not met, that's where there would be a problem. It's a good thing to take people on outings who are less fortunate if they don't get out much for whatever reason, and they should be kept safe from all angles. Life in a nursing home without the ability to go out is really no life at all
On the other hand, sometimes, a person may choose to go to a mental health professional such as a psychiatrist or social worker who may then deem the person "bipolar" in a ten-minute interview, or possibly because he or she needs to put some sort of diagnosis on the insurance form in order to get paid. Or just because the person showed up at a hospital, and the hospital had to justify 10 days or so of psychiatric incarceration. Afterward, the unfortunate discharged patient most likely found herself without a job as well. Discrimination is rather common.
We all have moodswings. If we did not, our lives would be flat and lifeless. I was once called bipolar, too, and completely convinced of this dehumanizing diagnosis for many years, but I can assure you that any "moodswings" I had were nothing but the normal ups and downs of life. The best decision I ever made was to walk away from it all and not look back. Life gets better and better once you realize that all you need to do is not believe those that discriminate against you or bully you. There will be fewer and fewer. They will fade away. Just be yourself.
Please do not be unkind to your sibling nor call your sibling nasty names such as "bipolar." It is a dehumanizing label. The Diagnostics and Statistical Manual (where bipolar is written about) is not a scientifically-written book anyway. It is only based on drug company bribes and decisions made by a few rich white guys and should not be taken seriously.
My brothers have used her age (93 in a few weeks), and my disability, to think they can be "in charge". Well, lawyers finally took care of that line of thinking on their part. (I believe they still think this way, but at least Mom, who has 98% of her marbles, has been able to have 100% of what SHE WANTS.
So, once again, I will ask you......
What EXACTLY are your siblings actions that lead you to say....."My bipolar sibling should not be allowed to take our mom out?" Do you have the agreement of doctors and the staff at the NH agree with you? Have they seen/heard things between your sibling and parent that your parent is in danger?
"The Privacy Rule, as well as all the Administrative Simplification rules, apply to health plans, health care clearinghouses, and to any health care provider who transmits health information in electronic form in connection with transactions for which the Secretary of HHS has adopted standards under HIPAA (the “covered entities”). "
So this doesn't include individuals. But, I don't think it would be kind for a sibling to release any diagnoses to someone unless he/she was given permission to do so.
Poor Jewel! A simple question set of a minefield. I assume that she mentioned bipolar because it has caused problems in the past, and also recently. A diagnosis doesn't tell the whole story, but it can be shorthand for a frequent set of actions that are problematic.
Good point. What you described is exactly how to many people are wrongfully judged and labeled without ever getting to know them personally. This can be detrimental to their overall health and well-being in the long run when no one wants someone around just because of wrong ideas about them. This negatively affects a person's social life, putting them at risk for predators and other bad things to happen to them because that people are looking for isolated people. When bad people pose as friends only to be betrayed or have something bad happen to them, you can blame others who wrongfully charged and labeled that person when something happens to them, especially if they wind up dead
ANYONE who loves Llamas like you that would actually use it as a username has GOT to be crazy and put away forever!
"ANYONE with MENTAL ILLNESS (Bipolar disease) should not be allowed to take your mother anywhere. What happens if said sib goes manic? Good grief! A BIG NO!"
You are the most ignorant, uneducated, and mean spirited person to post on this site that I have read. How many NAMI or DBSA classes have you attended? my guess is none.
Guess if someone is a poor driver they should "NEVER' be able to take their elderly parents anywhere....what if they have an accident?
Guess an alcoholic should never be able to take their elderly parents anywhere since they might get drunk while with them and put them in danger.
I guess if the adult child has diabetes they should NEVER take their parents anywhere..........after all they might have a low blood sugar reaction and put their parent at risk.
Please, Please, Please, Llama lover...........get educated before you post on a site about a question regarding mental illness and their elderly parents. Your comments scare the poop out of me!