He is in charge of giving her meds, is making mistakes and will not listen to doctors when it comes to her care. He is very smart but not rational in his line of thinking. Both are 90. Is there something I can do other than seeking guardianship? I have POA over my dad medically and he has it over my mom.
In the short term if your father is a "value" guy you might try the approach that he is paying for the medication management service whether he uses it or not and he's wasting his money if he isn't using it.
Without medical POA, you can't do much. You may have to see if each of them qualify as incompetent to manage themselves.
In general you are going to need at least one doctor's statement that your parent is incompetent due to a cognitive decline of some sort. If your father is competent you are going to need evidence of why his POA for your mother should be overridden in favor of your guardianship so you will need to show he is risking your mother's health or safety by not allowing her medication management or not taking medical advise. It's going to be difficult to show he is endangering her safety while he has her placed in AL. When you file for guardianship, there is generally a guardian ad litum appointed by the court that will have access by court order to your parent's medical and financial information. The guardian at litum will also interview you, your parents and siblings and maybe others to determine if a guardian is needed and who that guardian should be. There will be hearing and the guardian at litum will make a recommendation the judge may or may not follow. This process normally takes several weeks or months to complete. If your petition states there is an immediate need, the judge may appoint a temporary guardian, perhaps you or maybe the guardian at litum.
The bill for court costs and the guardian at litum's time will be paid by the parent who's competence is being evaluated (your parent) in most states. If your father is still rational enough, the cost of this whole thing and the public venue may make him reconsider listening to the doctor's advise.
As someone who has gained guardianship of one parent and has defended the other parent against a guardianship attempt by a sibling (to override her POAs) I can tell you that it's not a process I would recommend if it's at all possible to avoid it. On the other hand, if you feel your parent's safety is endangered and guardianship is the only way to make things safer, then I encourage you to get in the right mindset and go see the attorney.
What kind of care does your Dad give Mom besides this. POA really does not give Dad the right to be your Mom's boss and it would not give you that right either. My mil has dementia and often she does needs to believe she is capable of doing some things for herself.
I would not worry about becoming the POA. Perhaps it might be better to figure out ways to make your Dad feel he is taking care of his wife but, in reality, she is getting the care she needs from the AL facility.
Good luck to you!
In a nursing home or rehab, the attending doc is on charge of orders, so that is the person you need to work with.
I know many AL facilities will start charging extra for additional aid with ADL's and that might be a concern of his that having them do this will cost more money. You might want to address that if it is the case. Tell him that there will be no added charge that might satisfy him to some degree if he is aware of costs.
If that does not work you have 2 options neither of them is wonderful
1. You need to seek guardianship for your Mom. This will most likely devastate your mom as well as your dad. And the possibility of having to gain guardianship of your dad as well if he is not making the best decisions.
Is he making good decisions for himself or is he failing in that as well? Possibly a transition to Memory Care for both is sooner rather than later. That would also take the medication out of his hands.
2. Continue as things are. Your mom will probably die sooner than she would but that is not known for sure as none of us have an expiration date stamped anywhere on our bodies. But you will not put either through the stress of a guardianship, you will not upset either by taking away the ability to do things for themselves. My Husband was on Hospice for quite a while and I volunteer at the Hospice and one of the things I have come to realize is at a certain point do a lot of these things matter. Quality of life is more important than quantity.
Not an easy decision to make anyway you go. And Guardianship is not easy. There are costs involved, granted they are paid for by your parents but there is time in court, paperwork, and a lot of what might be called silly rules that have to be followed. They make sense if the "guardian" is trying to profit from the guardianship but for someone that just wants the best for their loved one it can make things complicated.
Ask the Nurse if she could give him a note saying that State regulations now mandate that all medication has to be dispensed by a trained aid. No longer will residents be allowed to keep medication in their rooms. This includes OTC drugs. (In Moms AL, even OTC needed an order from the doctor)
Have you looked into the prepackaged pills. The aid could give Dad the packet and he could give the meds to Mom.
If Dad is making mistakes then I think your POA is effective here. There is some decline. The AL should be worried about Moms best interest not what Dad wants.
A guardianship will override a poa. Guardianship is a court process. I suggest you reach out to an Elder Law Attorney who can help you through the process.