Doc-
Have a situation here that has raised some debate.

I am the sole health care decision maker for my dad - granted by my dad in a durable power of attorney. I go to all of his doctor's appts and because I am the one who talks to all of his providers, I keep track of and relay all of their instructions, both written and verbal. When he was recently discharged from the hospital, I went through all of the dietary guidelines that have been given to him to control his CHF, diabetes, renal insufficiency, etc., and compiled them into a short list to assist the people who prepare his food. My mother's sister, an RN, took exception to at least one item on the list (fluid restrictions) and told my sister that the guidelines were invalid and should be disregarded - the list of guidelines was summarily removed. I must add that my siblings, led by the sister I mentioned, are actively undermining the doctors and me by telling my dad he doesn't have to follow instructions.

Q. What is your take on a medical professional who uses his/her professional status to give advice which results in alteration or disregard of physician instructions?

Q. How in the world do I fight this kind of nonsense, not only by my meddling aunt, but also with my siblings?

This is quite common. Many people "think" they know much more than they really do. They might be well meaning but as you have already mentioned it can be confusing to have too many cooks in the kitchen. Since you have durable power of attorney and go with your father to the office visits I would instruct his doctor that he is not to talk with other family members about his condition without your express permission. He should leave it up to you to disseminate whatever information you deem necessary. I would instruct all caregivers that they are only to follow your instructions . Should they do otherwise , suggest to them gently that they may well be discharged for further infractions. As far as the sister ( who by the way is wrong ) ( this patient most likely requires some degree of fluid restriction to prevent fluid overload) , I would simply tell her that you are in charge and that you would prefer she discuss any changes in your fathers treatment with you prior to implementation. If she refuses tell her you would not wish to get a restraining order but it could be done. She will back off. You are doing a good service. It is difficult to manage these types of tenuous patients with family interference.

Thanks, Doc. Although I wonder how a restraining order would work in this situation. The two people who are most active in the interference with my dad's care - my sister and my aunt - are also the two people who have durable POA for my mom, who is now in the hands of hospice because of terminal glioblastoma. So they are in the house with my dad frequently. What's truly ironic is that I respect their jurisdiction and decisions regarding my mom, even though I don't agree with a lot of it.

I would suggest, making a (hopefully brief) appointment with the doctor(after explaining the problem to him) with YOU and the relatives, to explain his care and the legal/ medical reasons for one person (YOU) to be making decisions on his behalf, and the importance of following the treatment /care precisely as prescribed.
Let him (DR) appoint you (in their eyes) as the person to consult, BEFORE changing ANYTHING.
If they are unable to accept YOUR authority, than ask a court to proscribe legal barriers.
While your mothers caretakers mean well, they are interfering in the care of your father, and perhaps his wellbeing/longevity

Funny you should suggest this. At a family meeting held in January, when the POA authorities were divvied up, my aunt (the same one), functioning as mediator/facillitator, explained all of this to my father and the others present.



I'm not so sure about them meaning well - the motivations appear to be a mixture of sibling rivalry, revenge on the part of my aunt & sister, and stupid resistance to change on the part of the others involved. And those are the kindest motives I can ascribe to them - there are a lot of conversations and activities going on regarding estates and who inherits what, and it is a fact that the people causing the problems stand to benefit more if my dad predeceases my mom. Suffice it to say that there are certain things that I won't let anyone else do for my dad.

That is sad It sounds like they've lost sight of their legal and moral obligation to do what is best for your parents.
seek legal remedy immediately