My 3 siblings are fully functioning adults so why do they not acknowledge I provide care for Mom more than they do?

It sounds like you have developed a good relationship with the staff. I seriously doubt they would start medicating your mom solely on her mPOA's request. Keep visiting. Make the staff aware that your sisters may request regular anxiety medication and of your opinion that it isn't necessary.

Your POA sister is wrong. You can always talk to the staff. You can't make any medical decisions for your mom but you can share your opinions with them. She can request that the staff not share information about your mom with you, though, so tread carefully.

I would save escalation of the issue for a more serious problem than you don't like the recommendation your sister might make to the staff. For better or worse, your mom- when she was in her right mind -chose elder sister as medical power of attorney. But she only gets to make decisions. She doesn't get to prescribe medications. The nursing home staff and doctors are the ones who will decide what medications your mom gets. Try not to worry.

You are going to drive yourself nuts trying to control sibs thoughts and ideas. You visit the most to check on Mom. Yes you have more familiarity with mom and the care she is receiving. I do not read anything that would warrant a call to APS. Why would you contact them?

I would cut back on the time I spend with mom. This is effecting you and it sounds like because sibs are not as closely involved you are holding it against them. Give yourself a break and just accept that your sibs are not going to be as involved as you are. Accept what is happening and do what you think is right by mom. You can only control your own actions and thoughts.

I'm pretty sure that POA sis was told and then passed on to you that that there needs to be ONE person who is contacted with any issues and ONE person who makes any decisions because that's the way it is - you could be there every day all day but you aren't the one with the legal authority to make decisions or to question staff procedures. That doesn't necessarily mean nobody will talk to you, but it could if you are perceived as making a nuisance of yourself and trying to thwart the POA's instructions.
As for your sibs relationship with your mom - what exactly do you suggest should happen? It sounds like they are living in the land of denial and are unable or unwilling to take the changes to your mother in stride, the only way to save your mother from that is to cut them off altogether, something you haven't the legal or moral authority to do.

If they acknowledged your contribution, it would force them to look at theirs’ and make them feel bad for not helping more. It seems that only when you live with someone with Alzheimer’s do you understand just how far and deep it reaches and being the primary caregiver, you’ve already had to go through all the stages of grief many times over along with the frustration and love it brings. Your siblings would have a lot of catching up to do to get as far as you have with your devotion.

I am sorry to hear you say that your going through all this. I too had the same problem and still do. My mom has a rare form of demita. Since I was the one with the medical background my 2 siblings left it up to me to take care of my mom and now my dad. So it was up to me to make ALL the decisions for my mom. No one wanted to help except my husband and occasionally my dad would deal with a lot too. It really made me very angry that I didn’t get help with her when I needed it. She was combative and mean in the end so it was extremely difficult to help her sometimes. If I were you I would definitely go try to get protective services involved and get medical POA transferred over to you since you are the one who cares for her the most. It’s probably going to be hard to do. You can ask the case workers at the facility where she’s at for help. You can also call the department of aging to get advise. You are in a difficult position so you definitely need to talk to someone about getting the medical POA off of your other sibling or I am not sure since the sibling doesn’t seem to see your mom maybe you can two different ones. I think your best bet is too get a poa for your mom in your name Bc it seems like no one really cares that much.
I wish you well. Talk to anyone you can. You mom is depending on you.

At the ALF where my in-laws stay, the family can periodically meet to hear the ALF assessment of them. The assessment includes inputs from a variety of staff members. We have taken advantage of these meetings to get everyone (staff, local family members and long distance POA) to understand my in-laws needs/capabilities without getting into siblings battles. Perhaps you can set up a similar meeting the next time the long distance sib is in town.

If your mother is able to sign legal documents (you mentioned siblings having her sign notarized paperwork), then maybe you can get her to change her medical POA to you. If she is sane enough for one set of legal documents, she should be sane enough for all legal documents. Do this sooner than later. If she is agreeable, definitely consult with an attorney. It sounds like you would have plenty of willing witnesses at her facility.

You are dealing with a tough, yet , not uncommon situation with sibs conflict when caregiving for an elderly parent. I agree that there doesn't seem to be a strong APS case. But still make the call to hear what they have to say. I fear there may not be much you can do legally as far as the medical POA. What screams at me is that you are spending so much of your time at the ALF. I would like to suggest that you start to focus on your self-care. Of course spend time with your mom. But you need balance and space. Caregiving will end some day. Your sibs won't come around to see things your way. Save yourself and let go of what you cannot control. Focus on your wellness and your life. In the end it is all you have.

It may be that it's already deteriorated too far but the way I see it your problem has more to do with your relationship with your siblings then anything, even more than their relationship with your mom. There may be jealousy, old and or new, contributing here (theirs of your relationship with her, yours of their graced responsibility by your parents or relationship with each other) family dynamics can be so old and complicated. If it isn't too late however and you are willing to let ultimately unimportant things go and suck it up on others for the sake of your mom here is what I suggest you try first.
Get on board at least outwardly with the current status, recognize your eldest sister as the POA she was made, she may not be as happy about this power as you think, it's a big responsibility especially from far away and if she feels like you are trying to help her with that responsibility rather than fight her she might just welcome your more intimate knowledge of how to help Mom, I would. Younger sis probably feels all kinds of guilty about not visiting more, it may be really hard for her especially if she knows she just doesn't have the patience and relationship you do or simply hasn't come to terms with watching your mom fade, we all have to do this in our own time, her need to promote her "health care" experience may be an effort to feel included and like she is contributing rather than a real effort to take over. Yes it is selfish but she may just need to be acknowledged and valued, she is a PT after all so maybe there is some helpful knowledge you can all draw on. If she doesn't work in an aging facility (I'm guessing she doesn't) maybe she does have contacts with professionals that do and do know a lot about working with the elderly. Maybe asking her opinion on things in her wheel house or asking her if she has contacts with PT, OT's who specialize with the elderly and cognitive challenged. If she were to go on meds how much does that increase the risk of falls...ask with true interest not just to challenge her. "I had been told some of those meds increase the risk of fall which is why they like to wait until absolutely necessary, is this one of those meds, how is is different?" Perhaps a conference call or facetime with your siblings or just individually where you can offer your experience with Mom. "Mom really does get anxious easily these days, I think it's been happening for a while but I find that when I simplify things it settles her down. I often realize I am throwing too many things or too big a topic at her at once and she needs more time to process and since her cognitive abilities have declined I find she really needs the assurance of understanding what's going on each day, especially the night before she will often call very anxious because she isn't clear about what she has scheduled the next day and if we go through it together on the phone, slowly she calms right down. I think it's a control over her world thing and once I understood that I learned how to help her through it. I can only imagine how frightening it must be to feel like the simple things in your life are out of your control or you simply can't process and understand something important that your child is telling you."
I say much of that with experience, my mom has the same issues since her stroke, it can get worse at certain times but she just calls me and say's can we go over my schedule? Well she did, now she has eliminated regular events and we have learned it's easier on her if we just tell her last minute, the night before often that she has an appointment the next day. This way she doesn't have time to stress too much.
If making real attempts at repairing your relationship with your siblings doesn't work I think the idea of having "team" meetings with the staff at NH and family mentioned is a great avenue. These can happen regularly with some members attending electronically or on the phone too. Electronic visits w/sis & Mom & you?

Rulanme;

This is a dicey situation. I can relate to the siblings being clueless AND not really visiting or knowing how to deal with mom. I researched a lot about dementia before we had to move mom and attempts to "educate" the brothers was met with denial or, even better, being call a 'know-it-all'. One brother is not local and at this point I don't expect him to visit anymore (he's no longer welcome in my house and we sold her condo, so he would have to pay for a place to stay and eat the cost of getting here.)

I would suggest seeking consultation with an Elder Care attorney. Generally most will do a one hour consult for free - if you schedule something, have as much HARD documentation as you can get your hands on and have all your questions prepared to make the most of your free consult. Although staff may tell you about incidents, more than likely they will not submit anything for you to back you up. If there were assessments, and any of the incidents were documented, you might be able to have these subpoenaed. You can seek guardianship (medical/decisions) and stewardship (finances), but it will NOT be cheap AND the others could fight you, costing more money and headaches. From what I have read, the courts can also assign an attorney to represent your mother as well (since there is contention AND she is on the cusp of being considered 'competent') and this could result in more costs if they decide to order evaluation. If both are approved, this would override ANY POA (and likely lead to more sibling contention, but you can block them out of your life if you need to!)

Generally the costs for this process can be covered by the "client's" assets, but if you don't have control of that yet, you might have to pay up and if approved recoup from her assets. If denied, you could end up eating all legal costs. If mom does not have enough assets to cover the costs, you will have to pay out of pocket, approved or not. This is why a consult with Elder Care attorney is advised - they will not be able to give you a total cost, but should be able to give a best/worst case estimate. Given that they fight you now, I would plan on worst case. They CAN and likely will contest.

Most posts I have read about APS sounds like this is a relatively useless avenue. If they are not there to witness the berating and agitation, they are not likely to do anything. It would be your word against theirs. Also, unless there is clear evidence of abuse, either physical or financial, they are not likely to do anything. Not being able to "relate" to mom in her condition and berating her could be construed as emotional abuse, but it doesn't occur often enough, from what you describe as their interaction with mom and isn't likely going to be enough for APS to get involved. Using mom's money to pay for their 'visits' may not be enough to say this is abuse of her funds. Morally perhaps, legally, maybe not. Sometimes a POA document can allow for this. Ours does not indicate funds can be used this way, but attorney recently said it also does not say we cannot do this. We three at least agreed to cover some of non-local brother's previous visits to assist in cleaning out/fixing condo. I do not pay myself for what I do.

Others suggested cutting back visits with mom. I do not agree with that - your visits with your mom are not really what is upsetting you, it is the negativity and lack of acknowledging your care and insight from the others that upsets you most, and seeing mom upset by them as well. THAT you cannot change, you can only try to block it out and not let it upset you. I would continue to do what you do for your mom and try to just ignore them (it isn't easy, and it is hard to see the effect on mom, but don't let their crap distort things.) If mom is upset by them, do your best to redirect her focus and calm her as best you can. It is not likely she needs medication for this.
TO BE CONTINUED - see my replies (2) to this, ran out of characters again... :-(

because if they refuse to acknowledge, they they won't feel guilty for not doing their share.

Well your sister who is a PT is probly the most knowledgeable out of the other siblings except you of course, but if she does not deal with elderly then she would not know as much about Alzheimer's but there is No Crime in giveing a small dose of anti anxeity meds Really for your moms and your own sanity think about trying a little anti anxiety meds its OK to let an Alzheimer's patient be comfortable and it is Ok for you to share the responsibilities with your siblings let them do their part and enjoy the break no matter how little they do ANY HELP is GOOD you know in your heart that you are doing Right and your mom knows you are the most reliable let the others fuss and fume and the STAFF SHOULD NEVER ever GOSSIP about your family ! Shame on them everybody handles situations differently the staff should not pass judgement on your siblings you have enough to worry about let alone the staff gossip your siblings will do what they are capable of
So let them! and if your sister is a PT and works with elderly then she really does understand more than you think she does !and maybe right about antianxiety it will just help her relax thats all...... try not to carry all the burden !! blood is thicker than water try to stick together as a FAMILY at this time!!! its nobodys fault mom is sick beleive me your siblings do care and they are doing their best your just doing it better but dont get mad at them because YOU ARE MORE CONNECTED its ok it always ends up 1 child does more...GOD BLESS AND PRAYERS TO YOU!!

I know two people can have joint power of attorney in legal matters, maybe you should try getting a joint medical power of attorney - you and the older sister. That way, you aren't ruffling your siblings' feathers and you can have a voice in what goes on with your mother. It's worth a shot. It doesn't mean you have to agree with your siblings, but it will help you keep an eye on them.

The caregiving usually lies with one adult child. For whatever reason, their siblings chose not to participate. As difficult as it may be, you can hold your head high or you can turn that around and say that "you are honored to do what you do." I am sorry that they don't help.

Part of it is that saying something out loud makes it real. As long as no one acknowledges or validates it, then it's not true that you do more. The other part is family dynamics, siblings forge alliances to balance out power. If you have something on them because you're more responsible than they, then they will forge an alliance to "act as though" it's not true.
You're right you do have to protect her if they are pushing her around. You're the one there, not any of us on this site. You have to use your best judgment, not mine or anyone else's.

I’m in the same situation as you
Im #2 of 4 and mom is living in memory care in my town.
I moved mom close to me so I could make decisions and keep an eye on things.,,
If your mom hasn’t been declared incompetent then she has the ability to change the POA to you (my mother did)
If that isn’t possible have your mother moved closer to the older sib with the POA
It would alow your sister to be there like she should and then get off your back!

I agree that talking with an elder care attorney would be a good step_ probably would need more than one discussion though. Who is financial POA? In the meantime document, document, document! track your visits including time spent and activities. Get staff to document as well - whatever they're willing to do especially as it relates to your sibs.. Sine your mom has Alzheimers, there may not be much you can do about POA without possibly going to court. It also does not make a lot of sense for you to complain to or about your siblings - you can only control what you do and complaining about them only affects you - not them. Take care of yourself first. You can talk with your mom about whatever YOU WANT - no one else can stop you. Another esource may be local Dept. of Aging.

If you think that the siblings are takeing your moms money then do not hesitate to speak to a lawyer a lawyer will talk to you free.... Have you all broke the silence Tell your siblings how you feel ...if you haven't put it all out in the open I mean how do they know how upset you are & have you all had a family meeting maybe this can all be worked out remember you were all little kids together ....I wish you the best and your mom , prayers to you and your family !!

ihave definitely had same experience where siblings want no responsibility but I guarantee when your mom passes they will be there immediately to get their payoff and how much they are entitled so get ready for that ride as well