Find Senior Care (City or Zip)
Join Now Log In
F
Fancicoffee7 Asked April 2014

Can I use a MPOA even if the patient says "no"?

My pc got a virus and I miss this forum because it gives great feeback. We are doing fine for now. Oh, I did get a medical power of attorney and if anyone has any information on these, I am great at learning. I learned that if the patient says no, then the POA is no good.

vstefans Apr 2014
There are times when you actually need a guardianship instead. You would think POA plus incapacity letters would do it, but not always, either due to how POA is written, or interpretations by healthcare professionals. We are all very HIPAA-phobic these days and sometimes go overboard, plus forcing people to get care when they are resisting is hard enough and takes so much documentation that we want that like we want a hole in the head.

Fancicoffee7 Apr 2014
I had not thought of the note tactic. However, when my husband and I go to the doctor, I will let him answer all the questions himself and if it is not true, I will insert my "say so" and then the doctor talks to both of us. My husband does say "no" alot, but this last time he is willing and is quiet more. He understands it is not an option this time. This time, his kidneys are getting worse, and he has gained more weight, his ankles are definitely swollen, etc. So he is willing to cooperate.

ADVERTISEMENT


anonymous158299 Apr 2014
great strategy gigi. i usually slip doc a note too then let him and the patient talk. as far as mpoa when my cuz sharon was denouncing my doc appointment with edna , i found out later that doc sat and put edna thru some basic cognizance questions. when she answered enough of those questions correctly , what sharon thought no longer mattered. of course to stay on everyones good side doc has ask sharon recently if she was ok with me being on the team.
once my mom was hauled to the hospital against her wishes. i dont know the terminology but when the medics had decided she was hallucinating, they strapped her down and hauled her to hospital. i guess that time mpoa trumped phsycotic rambling.. in hindsight tho the hospice nurse on the phone helped to open the proper channels..
strangely in the last couple of days the rehab nurses for edna have openly shared medical info with me. they dont even have a hipaa form on file. if the patient allows you to be there, your privvy to a certain amount of info.

ferris1 Apr 2014
I recently had the experience of arguing with staff at our local hospital whose computer and phone services were inoperable. After trying to reach them, I went there and told my husband we were going home. He did agree and the nurse mgr. asked him if he wanted to go then telling me our insurance would not pay for the bill. I told him the last time I checked him out AMA, our insurance paid the bill, so I was taking him home. The next day, his doctor agreed nothing was wrong with his heart which the cardiologist was finally able to note in his chart. I just exert my authority as MPOA and since I am a nurse (I guess) I get resistance, but I keep my husband safe. He's still going strong at 87 and we look forward to many more years with hospital intervention (at least ones that don't have a backup system). People with dementia are much like 2 year olds. "No" is still a constant word in their vocabulary. I would still get him to the hospital because there is a reason he is losing consciousness.

pamstegma Apr 2014
Ferris, her husband will pass out then refuse transport from the EMT's. By the time they get there he is conscious again and says NO. So scary for her.

ferris1 Apr 2014
Where did you learn this? The purpose of the medical power of attorney is to act in the best interest of whomever gave you MPOA. They are expecting you to handle their medical wishes when they cannot, especially when they have dementia (to-wit the reason for this forum). I get "no" all the time from my husband who has dementia, but he gave me permission by the MPOA to do what he would have done had he had all his mental faculties.

Gigi11 Apr 2014
My experience with my elderly dementia patient mother is that she says NO to everything except dessert.

I give her choices as often as possible on small things such as which top to wear, food, etc. -- choices among alternatives I know to be okay for her.

Otherwise, I don't ask; I tell her.

You don't have to be bossy. But firmness is needed and that comes from your inner strength and conviction you must take charge in order to protect your mother from herself.

On medical issues, I enlist the support of doctors, nurses and aides. For example when her cataracts neared the point of no return, I wrote a letter to the eye doctor ahead of Mom’s appointment. I was impressed when the assistant looked at Mom's chart, then looked at her and said, "I see it's time for your cataracts to be removed." Mom nodded and it was smooth sailing after that (except for trying to keep her from bending forward during recovery).

One cautionary note concerning surgery is that general anesthesia can have a very bad effect on mental capacity in older people. This is a factor to consider if going under the knife is at all optional.

Good luck and God bless.

nevergiveup1966 Apr 2014
There is Health Care Proxy for when your parent is in the hospital and you can basically express your wishes to the doctor but if you also have POA you are the one you has the final say if the parent has any type of dementia or memorey issues, this is hard since it comes and goes and you want them to make there own decision but sometimes you have to step in, my mom always was the boss of the house now she is the boss of her TV but I let her assit me in anything she still is capable of doing so she has a reason to live since they can become really depressed especially if there were married for 65 years and lose the spouse, that is THE HARDEST THING OF ALL!

Countrymouse Apr 2014
Not if the patient has lost capacity, though - that's kind of the point of them. As MPOA you should do your best to respect the choice of your parent as the parent expresses it at the time, but when the parent has lost the mental capacity to understand what is medically in his or her best interests, it becomes up to you to protect them. Nothing is ever simple, alas: you just have to do your best, in the best interests of your parent, taking into account principles you know him or her to have held throughout life but not if they fly in the face of current circumstances and wishes.

The example that's always at the back of my mind is people who may always have held that were they to become incapacitated they would rather not be kept alive - but have an abrupt change of heart when it actually happens. I wouldn't hold someone to something they'd previously believed if they'd found out they might have misjudged the situation..!

I sympathise with the pc worries, by the way. Me too: what a migraine :(

ADVERTISEMENT

Ask a Question

Subscribe to
Our Newsletter