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Mom's all set to move into AL but doctor wants to put a special diet as a requirement: low salt, fat and diabetic, on her plan of care. She is not wanting to budge on this. This facility doesn't do special diets and will not take her if the diet requirements are not changed to “regular diet" on plan of care. My mom doesn't eat this diet, never has. She has controlled high blood pressure, cholesterol and diabetes with meds. Is 87 and 119 lbs., with probable but undiagnosed dementia? Needs to gain weight if anything! I’m at the end of my rope, taking care of her 24/7 after she had a bad fall 3 weeks ago, nothing broken but can barely walk, very needy, terrified of falling again. We were already in the process of getting her in this facility for IL and realized she needed AL and desperate to get her somewhere safe so we are in a temporary 2 bedroom apartment here. I am Health Care POA, can I override this as health care proxy and say she does not want/need this diet? Should I find another doctor to fill out plan of care? Move her into IL with 24/7 care? I realize we can find another facility, but not really wanting to start back at square one as we finally able to get her safe and agreeing to leave her house to get help. We love this facility and the people and she is getting wonderful care here and has started physical therapy and is improving already. If this isn't resolved we may have to move her back to her house which we really don't want to do because it is not safe for her right now. Her furniture and things will have to be moved back. So much time and effort will have been wasted all because of this one doctor’s stubbornness!

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Update: WIN! After talking with ALF director and being told that no ALF facility in our state, by regulation, can provide the diet she is wanting to order, the doctor agreed to change the form. Of course she ordered the only restrictive diets they do provide, no salt added and no concentrated sweets. I question this doctors diabetes dx bec her glucose is always fine and she takes no meds. They emailed the paperwork 3 minutes before the Friday deadline pushing her admission to Monday the last possible day before we would have to move her back home. Talk about cutting it close! Lesson learned. Choose your loved ones PCP carefully, if they are being passive aggressive and unhelpful with their care (this doctor has been for a while, why did we stay?) then dump them and find another! You need them to work with you and not against you!
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Reply to BossBaby
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NeedHelpWithMom May 12, 2024
So happy that your mom will be able to enter the facility.

This doctor seems quite rigid about eating habits. I wonder if she treats all of her elderly patients this way. It’s a shame that she caused a delay in moving in.

Are you planning on staying with this doctor?

At your mom’s age many people would feel that your mom should be able to enjoy eating whatever she wants.
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I would say if Mom is a diabetic and 87 she has to have done well watching her diet all these years. I have lost two friends one juvenile diabetes died at 63. The other type 2, died at 70. Both with kidney problems and amputees. I think Mom has done well.

IMO the doctor can recommend doesn't mean Mom has to comply. Dear Dr is not God. The AL doesn't do special diets and Mom won't follow it anyway. Since both agree that the diet won't be followed, then I see no problem. The AL can't make Mom eat that way even if it was recommended or even ordered by the doctor. Does the facility have a doctor who can override the others recommendations. This is not a NH or hospital this is a residence that provides meals.
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Reply to JoAnn29
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Time for a move to palliative care MD and at the very least an MD who will cooperate in your mother's decisions for her end of life care.

A change of doctors is called for when doctors are unrealistic.

Your mother's blood sugars WILL have to be monitored in her facility so if they are not capable of doing that, then I am a bit worried about them. It also concerns me that they have only one diet? However, I do think at 87 your mom has the right to eat absolutely whatever she is able unless it is a diabetes so severe it would require SNF and administration of daily multiple doses of insulin for out of control Type I diabetes.
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Reply to AlvaDeer
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Nope. She was getting the boot anyway, but needed her for this. She is my doc too. She is now officially fired!
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Reply to BossBaby
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Does this doctor have any redeeming qualities that would make you want to be loyal to him?

I am only loyal to those that I respect. I wouldn’t think twice about leaving your mom’s doc.

You can do better than this guy. My mom’s doctor was the opposite. Mom needed to gain weight and she was told that she could eat ice cream every single day if she wanted to.

Your mom is thin too.
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Reply to NeedHelpWithMom
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They might! I think a new doc is the way to go! Thanks!
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NeedHelpWithMom May 9, 2024
Love your screen name. You are the boss! Don’t forget that 😆.
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Does the facility you want to move her to have a doctor? The place my mom is has an on-site clinic, and it makes things so much easier. Otherwise find a different doctor. Maybe the facility can recommend a good one.
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Reply to Dogwood63
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It seems a little extreme to me. I would try your idea for finding another doctor to fill out the paperwork.

Best of luck to you and your mom.
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BossBaby May 9, 2024
Thank you, we are leaning in that direction but were wondering if another primary doc would fill it out if she's a new patient? She doesn't really have any specialists that she sees. She is switching to a geriatrician but not seeing him til August.
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I would find a more reasonable doctor. I can’t fathom picking apart the diet of an 87 year old
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Reply to Daughterof1930
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BossBaby May 9, 2024
Yes, thank you! That's what we say, she's 87 let her eat what she wants!
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