Resident's POA said they don't want their mother taking a med any longer. Does the caregiver have to give that med until the Dr pulls it?

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ArtfullyDun Asked March 2020

Resident's POA said they don't want their mother taking a med any longer. Does the caregiver have to give that med until the Dr pulls it?

I have a resident whose POA has told me, as well as the RN that they don't want their mother to take a certain medication. Does the caregiver have to give that medication still until the Drs order says to discontinue it? Or is a written statement enough for a caregiver to not give that medication?

Care Decisions Home Care Medication Management Medications

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score 1 · Answer 1

Caregiver meaning a CNA? It really doesn't matter, I guess. Neither a CNA, LPN or RN is authorized to stop a medication because POA requests it. All you need to tell the POA that she needs to talk to the Director of Nursing or the Doctor and put the request in. If there is a Drs order, then the staff follows that order until the Dr discontinues it.

I am not trying to be rude here, but why are you or the RN not aware of the procedures of ur facility. You must have a DON (unless ur an AL) that oversees the staff? Why didn't you tell POA that you cannot make that decision and send her to talk to the right person, the Doctor.

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We are an AL. And we are aware. I have told the POA to tell the RN, and the Dr. She is aware I can't just take her off etc. As far as I'm aware, we've followed the procedures needed, but the doctor will not listen. The doctor is making this hard. And I knew that if the POA said they didn't want the medication given, the doctor had to listen, but I was wondering if there was a loop hole, since the doctor isn't listening. It's hard to watch, and figured it was worth a shot. I knew it was a shot in the dark that there would be. But worth a shot either way. Worst case was that the situation didn't change.

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score 1 · Answer 2

I completely agree with Countrymouse - there is no excuse for not getting this sorted out ASAP, all it should take is a phone call to the doctor.

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score 2 · Answer 3

[hopping up and down and spitting feathers here - !]

The DOCTOR must speak to his PATIENT'S POA, NOW, and get this SORTED!

It is totally unfair that you are being left in this position, which is a tricky intersection in the ethics maze.

A patient must give informed consent. A patient has the right to refuse any treatment.

This patient lacks mental capacity. Therefore, decisions are made in this patient's best interests on her behalf by her appointed representative, who has legal power of attorney.

Therefore, on the face of it, the POA has the right to withhold consent to treatment on behalf of the patient.

But - is the POA's decision in the patient's best interests? It's this last question that has to be tested; and the *&*%$%&!!! DOCTOR must get his finger out and address it RIGHT NOW.

If abrupt withdrawal of the medication might harm the lady, then you cannot just follow the POA's instructions and stop giving it. You MUST get clear directions from a medically qualified practitioner. Explain this to the POA if she is giving you a hard time.

Why are you being left to handle this impossible situation on your own? It's outrageous. I hope you get clear guidance very, very fast.

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The medicine is clearly not helping any. And this doctor is the one is making this difficult, the doctor is not listening. Every time she gets prescribed a non typical psych med she has bad effects from it. Her POA and I have been going back and forth. So I was hoping I could see if there was a loop hole.

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score 1 · Answer 4

If you're referring to a Power of Attorney or Durable Power of Attorney for financial, legal and similar decisions, it typically wouldn't apply for medical issues.

OTOH, if you're referring to a Medical POA, or a Living Will, then you'll need to check the terms of the document to determine what authority the proxy has.

I think though that you need to find out why this person is opposed to a specific medication; there may be a valid reason.    I had to intervene a few times to advise doctors that my father doesn't want to take a specific med, and I advised of the reason why he (and I) felt that way.

What is your role in this situation? You mention that you "have a resident..." Are you the owner of a home care facility?   And who is the proxy for the resident? A relative? Someone who knows this person well?

I'd get to the basis of the objection first; it may be legitimate.

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I am the caregiver. The resident's POA is her daughter, who I believe has power over everything, and her mom has dementia. Up until the COVID, visited multiple times a week. I know why she does not want her mom on this medication, and I completely agree with her. This medication is causing horrible side effects. The medication is not recommended for those with dementia either. Anyways, her POA has told both our facility's LPN and I that she does not want her mom on this medication. I believe the LPN has told the doctor, and I'm not sure if the doctor said no, which I don't think she has the ability to say, or what. I was wondering if we as a facility have to wait for a doctors orders to reduce the dosage to where it was, and then off of it? Or are we able to do that with the fact her daughter has stated that she does not want her mom taking this medication. She has to be weaned off the medication because of the length of time and high dosage.

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Resident's POA said they don't want their mother taking a med any longer. Does the caregiver have to give that med until the Dr pulls it?

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