Is a doctor required to consult the family before prescribing medication?

ImageIMP, Yes they do need to show respect. Mom was only in a home for approx. 5 1/2 months before we lost her, the first home was about 3 months and the 2nd 2 1/2. I learned so very much in that time. I would like to return to visit the last home BUT. The Texas Medical Board is moving very fast on this and already called everyone for Mom's health records. I have been advised that no one can talk to me until this is over and I totally understand. the whole thing is so sad.

Even in a private pay ALF they use sedatives to ensure that the clients are compliant. We should not be sedating our elderly family members with Seroquel and other anti psychotic meds because they are confused and agitated. There is no definitive evidence based trials that support these kind of drugs be prescribed for symptoms of dementia or alzheimer. Over medicating is not the answer.

no you need to get her away from that doctor they have there own mind !!!i dont know what it is but i do not think they are doing the good for the patient but for there own purpose..i say this my mom has a catheter she is not to have medication that will make her hold her self they had that medicine on hand if she was in there eyes she need the meds ..i say not all i really dont think they are for the good of them but for the home that they run ...!!!!!!!

I was POA with a written request from the patient to assist in decision making but was never included nor notified of any med changes or diagnoses change including canceling things like mammograms ... You mean you are notified when there is a fall? When this resident falls, she is told they will tell family so she doesn't need to bother but they never do....and if you ask for incident reports there is no response. one of these days.........moves are tough on these residents....hard to find a place to trust when you read the reviews.....this is a nightmare...

From one end of the spectrum to the other. I have asked over and over again for some type of anti anxiety meds for my mil. The NH Dr. has told me he doesn't like psych meds. So now she spins herself into agitation daily and has lost so much weight from anxiety it's ridiculous.

I do have Medical//durable/general POA for my Mom, but have mostly lost control or knowledge of her regular meds. (I’m working on that!) People also need to realize, though, that even “OTC routine” meds need to be monitored… I get really frustrated because I can’t even get them to listen to me regarding “regular bowel care” meds (namely laxatives). Prior to the fall 2 years that ended up with nursing home care, Mom had recurrent and serious issues with diarrhea, and after many tests the reason “couldn’t be found". When we saw her cardiologist for a different issue, he asked whether there was anything else he could help with? I laughed and said “nothing you want to deal with!” He said he was also an Internist, and what??? He immediately said sometimes antacids can cause chronic diarrhea (she was on Prilosec), and he took her off that and prescribed something different… Her “issue” cleared up immediately! (I added this info because it might actually help someone else?)

So – when Mom reported to me that in the nursing home she was having horrible, multiple, and humiliating diarrhea “out of the blue” – during dining room meals, going down the hall, etc. – and was so embarrassed I finally asked the meds nurse whether she’d been given laxatives or anything? Yes – as part of their “regular bowel care” routine, she’d been a little constipated, so they automatically gave her laxatives… It might have been nice to warn her? She’s not incontinent, and tells them when she needs help to go to the bathroom, so this really had her upset. Plus – I was worried at anything that could throw her into her previous issue with horrible chronic issues. I told them “Try prune juice! At the most, try gentle laxatives, or even short doses, and for Pete’s sake WARN HER!" They pay attention "sometimes"...

To me, this is showing utter disregard for personal dignity and quality of life. It's right up there with the time I took her to the doctor, and she was quiet and had her arms crossed over her chest... When I asked whether she was OK, she said "They couldn't find my bra! I haven't left the house since I was 13 years old without a bra!!" (She's 97 years old, and wears a DD/underwire bra.) She did have 4 good-quality bras, but when we got back, I checked and only found one which was so beat up from their laundry "care" - holes, hooks in back bent out of shape and only one sort of working - I was livid! These places need to have "training" orientation for (mostly) young CNA's and other staff about the dignity and respect  -and what that entails - due the older generation!

What do you mean by an "early by by"??
Is this a misspell or a colloquial expression?
As any RN knows, that many new meds in a month's time with her noted side effects is a red flag, and the RN is mandated to question this activity

It sounds to me like you'll probably need the help of a wrongful death lawyer and maybe even consult with an elder lawyer to see if they can help you also. If you were a contact on your loved ones medical records, I would think they should've contacted you.

If you were not listed as one of her contacts, then no they won't contact you according to Hippa laws

Adding to the answer I posted a few hours ago . . . talk to a D.A. about filing a criminal complaint against the Dr. and the Nursing Home. The Dr. and someone from the Nursing Home should go to jail. That would shore up your civil complaint and attorneys would have the case made for them if criminal charges are brought by a DA.

At Moms facility you can pick a doctor out of the 3 or 4 who have privleges. They all have their own practises in the area. A pychiatrist NP sees Mom monthly. And no, it doesn't seem like they have to tell u at the time a new med has been introduced. It was discussed at a care meeting as a new med. I have a RN in the family so I include her in updates. But, I was told by the facility Mom is in and my daughter, who works in nursing homes that they try to do less than more. With my Mom she has one kidney working half capacity so meds don't work out of her system as fast.

I encountered a similar situation with a facility where medications were pulled without tapering and new ones added without contacting family, changing diagnoses, making changes to directives without consulting family....caught it in time....got her back into a reputable clinic of doctors...reinstated her diagnosis...warning everyone. ALWAYS get printouts of the medications.from the pharmacy...not from the facility....stick to the clinics..serving the public ...remain very very watchful........my family member has reasonably recovered to a former level....

I don't think so.

As medical POA, you have a right to informed consent, and your mother, no matter her condition, would retain the right to refuse, as do you as her MPOA. They did this to my mother as well. They had her on black box warning drugs that kill the elderly in short order. At the time, I didn't have POA; my brother did, but he was uninvolved and uninformed about the drugs. My mother was incoherent (although I could generally get her point of reference) and could barely answer questions. She scored low on the comprehension tests, and the doctor told me there was never going to be any improvement. Well, after I got POA and managed to get her off the dope, she improved. They were surprised. Yes, Mom had behavior problems, but I think they need to find better ways to deal with nasty people other than doping them into oblivion. What they were doing was killing her. My condolences for your loss. I pray you are able to get satisfaction for what they did to your mom.

Contact a medical malpractice attorney. Businesses are not serious about a complaint until there's potentially money at issue. The nursing home may be liable in addition to the doctor. The medical mal attorney has at a bare minimum a registered nurse who works as a case manager and will review your mother's records in consult with the attorney.

Unfortunately abuse in the healthcare system happens more frequently than is reported. My father was a victim of it.

It IS all in the approach, but rotating staff bring a multiple variety of different approaches, and there is no expectation that the "love" that you said the one woman brought is expected of many - and in fact, many young or busy people don't know how to use a preventive approach. I mastered it over years, but always started with interest in patient's complaint, willingness to check it out or and respond to her - but briefly, and with love. Agree with the patient, pause, stay focused on task and present it positively. And NOT talk even among selves except to find best approaches - of someone's "bad" behavior, these are elders, not children. It is not easy to deal with some people - but it's the job of working with elders, and it should be the express job of all staff. Instead, the jobs listed are the ones the MD assigns, and the MD does not assign an approach. Different staff members bring different plans, the same task can be done many different ways and it is difficult for anyone to learn and follow several different teachers/task leaders - medications are what are used to "take off the rough edges" of a patient's disruptive behavior, but few consider the behavior's origin, timing, circumstances that led up to an incident, tracking to find what's wrong - instead the protocol is to write up the details within an incident only, which actually just serves to "prove" the need for meds. The system is broken, and it is in incident reporting that it's broken - because stasistics are misused.

I've stopped staff in meetings from saying, "your brother has had more falls recently", because my question when I receive any fall report, is not primarily his health afterwards as the staff reports - but what was he doing in order to fall? Where was he trying to go, what was on his feet, was he getting up or turning - one incident reported was when a new staff member was holding a door open for him, but she was in his way and he was tired and tried to go around her rather than ask her to move. I finally got Occupational Therapy in the residence, to work to study situations and find solutions, that way he is getting attention - and so is the approach!

My Mother was abused in a Senior Facility as they forced her out of Independent Living into their Personal Care Hellhole. My cousin and brother were supporting the facility when they didn't have any or very few interactions with Mother or myself. I was staying with Mother to give her a hand when she was in Independent living. I was witnessing Mother on the way to losing her life and/or eyesight through the facilities negligence and abuse. The facility was milking her estate and wanted to see her gone. I was dragged through the mud as I reported the abuse to agency after agency. That was a waste of time. Our attorney was not supportive and yelled at me. He didn't want to get it. My hours of visitation were cut drastically. I was not permitted to talk to anyone, accompany Mother to the dining room, etc. My brother saw the light after he saw money flying out of Mother's estate. He supports us now. Cousin is out of the picture. He is a retired Dr., in his mid 80's whose jazz band was booked several times a year by the rouge facility. He could have helped us instead of trying to take over my POA of Health Care. My son took charge, called him and we moved Mother to another facility. I stay with her 24 x 7 as full time caregiver. She has improved a good bit. Mother, my son, kitty and me have been blessed with the loving family I always longed for.  We are 5 generations with Mother having 4 Great Great Grandchildren. ; ). She will be 100 in October.   Mother has improved a good bit from where she was 9 months ago.  My heart goes out to you.  That is a horrible thing to happen to have your Mother taken away from you and have her abused / killed by the system. Try as hard as you can to have an attorney pick up your Mother's case on a contingency basis. It is not just the Dr. who has liability.  There is a facility.  It may be a civil rights case if the government is involved.  A win would help us all who have been through the nightmare of the system getting away with abuse of our L,O.

There are many red flags here, who was her POA? An appointed family member should be the first line of Mom's defense. The POA would be the deciding factor of Mom's ongoing medical treatment, if ever in doubt of a medication regimen, ALWAYS question and get a second opinion if needed. Being diligent with any care by extended facilities need to be scrutinized in an ongoing basis! Any deviations need to be brought to the attention of the director, upper management (& CEO if satisfaction is not given) and monitored for correction & corrective action needs to be enforced with all involved individuals. Getting in touch with the attorney that is involved with her estate, but if there wasn't, GET one to have a full investigation done. As POA of my mother's health & well being this would be my first course of action. Keep in mind each state has different guidelines, this makes having a legal representative a safe bet, I hope you get resolution for your mom & your own peace of mind. Best of luck to you & family.

As the POA, I constantly had to stay on top of the doctor...actually the nurse practitioner...who kept changing medications and/or dosages for my mom. Eventually, we had a family meeting with the staff, which included the doctor and nurse practitioner and made it crystal clear that nothing was to change, unless they called me first and had a conversation. One of the people above said to call an attorney. I would do that very soon, as this doctor of which you spoke seems to need to have her license removed. I know of a woman that went the route of going to the government first. As in keeping with the government, they dragged their feet until it was past any time the nursing home could have been prosecuted. Eventually, she went to an attorney, but, as I say, by then too much time had elapsed, thanks to the government. I am sorry you had to go through all of this. We POAs really have to stay on top of the medical community who are taking care of our loved ones, because though there are many good and caring people, others don't care and should be doing something else. The nursing home of which I spoke is having "empathy classes," to teach the Millenials how to have empathy for the residents. If you think about that, we have a serious problem coming down the road.

(We were not guardians but we did have POA. would that count?)
If you were the Health Surrogate then appointed by he having signed an advanced directive then you had authority. A genera POA or even a durable POA would not do the job unless somewhere in there it said that you were to make health decisions when she became unable to make them or herself. Otherwise the docs can do pretty much anything they think is best for the patient and that is an open door.

See your family Attorney.

We were not guardians but we did have POA. would that count?

The medical board will decide if there was a wrongful death. No the MD does not have consult with family UNLESS the court appointed one of you as legal guardian.

MsMadge, Thank you for responding. When my mom was moved to Twin Rivers the evaluated her and yes she had got to the point that she would cus and slap BUT they pay so much attention there that they soon discovered she was doing it because she was in pain, it was all in the approach. The requested to be able to give her the adavan rub on cream when they had to bath her and I had NO ISSUE with something like that. They did use it a few times but cancelled the order because they found out that my Mom did not need any of that stuff. They allowed her to sleep longer than 6:00am and the lady in charge I will not mention her name. Found that all she had to do was show Mom love, even if she happened to slap at her which when I say that my Mom was so tiny it was like a tap, she would just look at her and wrap her arms around Mom and say I love you!!! Mom would smile and it she had said or done anything wrong she would say I love you to, smile and tell her that she was sorry. I wish everyone could have a place like Twin Rivers I hold them in the highest regards that is possible. Plus the hospice agency I can't speak highly enough about. It was only the one Doctor at the previous home that I had an issue with. She is under investigation, I have signed my privacy rights away, which I never cared to have my name private. This is in case it goes to court. I'm pleased that I found that they have subpoenaed all my Moms medical records from both homes and the hospice agency for further investigation. The Doctor that I'm going after is currently under inditement with another Hospice agency for over medicating the elderly. I may have mentioned this in my original letter. I have always heard about Nursing Home abuse but until you go through it you have no idea the things that are done to our loved ones. I'm not a vindictive person and I'm considered by people as being to calm however I am so distraught over this that I'm determined to push this as far as I can. Just thinking about some people who have no one to speak for them brings tears to my eyes. I hope also that someone answers my question and thank you so much for your response.

Aveeno
So tragic and I'm so sorry-

I fought very hard to control what antipsychotic meds my mom was given in her memory care facility and I allow only one now

It becomes more difficult with a hospitalization and a nursing home which cannot cope with any behavioral issues and will sedate to control things

Even when mom spent time in rehab it was challenging but no where near as what your poor mom experienced

I don't have first hand hospice experience but understand your pain

Hope others can address your questions