Have POA, do I need Dr. confirmation of incapacity to use it?

So POA and DPOA are two different things, in some states (like my mom's) they are linked so a POA becomes durable (DPOA) when criteria is met and other states the choice is made (usually suggested by attorney probably) to write it as a combined or do both. But the point is with POA you are able to do everything your mother is on her behalf when it comes this stuff so yes you can just make those adjustment's, however if your mother doesn't agree with the steps you are making or can't be brought around to see the reasoning, you can't go against her wishes. You really should be consulting with her or at least telling her what you have done on her behalf. If and when the time comes that she is insisting on things that really are harmful or simply can't be consulted anymore and a doctor agrees she can't make decisions for herself and or the parameters are met for the D (durable) to kick in you can then start doing things she doesn't want that you feel are in her best interest.

For now since you are her POA and it sounds like she is still somewhat self sufficient just not capable of always sticking up for herself and needs some guidance I would approach it the way we have with my mom. We consulted her on everything at first, well informed her of our plan to get her blessing and very quickly she lost the need to be informed on "everything". My brother takes care of her banking and bill paying, she has access to one account with her Debit/credit card and he keeps a minimum in there so he can keep an eye on the spending. We have all of her mail now going to his house so she only really get's the stuff we give her. Now there is some mail that get's through, some junk mail but not enough to be a problem. She uses her cell phone rather than the house phone now and we have it set so that the only calls that ring through are the ones from us, her sister and her brother, all the rest go through to voice mail and she has given up trying to get messages. We review the calls and messages to see if anything is important but we have all the import calls, doctors offices etc coming to us rather than her anyway and she likes it that way. I say this only for ideas but as long as you do it in a not threatening and more helpful way your mom will likely adapt and maybe even be relieved to let you run things. There are bound to be things she digs her heels in about even though you don't agree, with mom it was setting up her pills for one...and you have to be willing to say ok and let them make their mistakes, pick your battles so to speak and try hard not to let it become a battle. Easier said than done to be sure but know you are doing such a service and such a loving, caring thing for mom and she knows it too. Just do all you can to give her the feeling of control, at least in my experience it's when they feel out of control that things start to go sideways. Control is happily turning responsibility over remember and that happens easier when they trust you will keep them in the loop when they should be or anytime they ask. Understandable, they are adults and they are our elders/parents, deserving of being respected as such. IMHO

Yes, as someone said, read the language of the document carefully. My POA was very broad in scope and there were no triggering mechanisms. I was told that was unusual when I had a lawyer look it over.

as a practical matter, most banks and medical people hardly glanced at my poa. They’d make a copy for the files and most of the time hospital personnel just asked if I was the medical poa, I’d say yes, and we’d proceed with whatever had to be done.

I did have trouble with one bank bank who would not accept my poa. They were total jerks.

Read the POA, it will clarify if there are requirements for it to become effective.

However, if she has not been declared incompetent, and that requires a judge, she can still do as she pleases and you don't have any recourse.

Try to get her agreement with everything that you do on her behalf and keep good documentation about what you have done and what her money was spent on if you spent it. Keep all receipts and make copies of ones that fade. This protects you if there are ever any allegations of wrongdoing.

Your POA responsibilities are to do for her as she would do for herself if she was of sound mind, you can't force her unless her safety is at risk.

Good luck, this is a difficult time when you see the mental decline but they don't or won't and others tend to believe the elder.

My brother has his dad's and step-mothers POA's, both financial & medical. His name was added to their checking account and savings, he is handling everything for them, paying all their bills and so on. They are not declared incompetent. Keep good records, only spend her money on her, you will be fine.