My aunt is currently wanting to leave AMA from a SNF. The social worker at the facility verbally relayed that a family member who will be staying with my aunt must go to the SNF in order to be shown how to work the medical equipment. This was the PA's recommendation per the social worker. The social worker said that if this is done then my aunt would not be leaving AMA. Is this true?
As of today, neither an MD or PA has verbally relayed the consequences of leaving AMA to my aunt. No paperwork has been shown or signed.
Can my aunt make an appointment with a local medical transportation service to come pick her up form the facility and just leave? Would that be considered elopement?
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How did the term "against medical advice" come to be bandied about in the first place? Patients leaving a hospital, which could get sued for negligence if they do not have it on record that they have warned a patient against failing to continue/complete treatment, must sign a waiver of this sort; but in your aunt's case it sounds more as if her ability to care for herself at home has been questioned, an answer has been found, and the answer is for your aunt's primary caregiver to be shown to have had the safe operation of equipment explained to her.
Whether or not this is a good idea does kind of depend on what sort of equipment we're talking about here. Your profile mentions mobility problems and heart disease, so - stand-aide? Hoist? Oxygen generator? What is the equipment?
And what happens when the family member needs a break?
If the equipment is capable of causing anyone's injury or worse, God forbid, there might conceivably be insurance issues. Again, it very much depends on what it is.
If there is special care that will be needed than I would comply. I really don't see a problem. The SW is trying to explain what should be done to make sure Aunt has a safe discharge. You take her out AMA with nothing in place, then she will likely be back in the hospital and as Alva said, this SNF does not need to take her back. They can pick and choose who they take in.
If everyone is not on the same page concerning Aunts care, then she should not leave the facility.
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It is not necessary for her to sign AMA papers either. This cannot be forced, but will be asked. It will be charted that the family refused to participate in care, in learning equipment, in safe discharge. If the Aunt is hospitalized it is quite unlikely that this SNF will accept care of this "non-compliant" patient.
Again, not a prison. It is a CARE facility. If she is mentally able to make this decision she can make it. It may have repercussions to her future care. The facility will explain to her the dangers of doing this, but they cannot hold her against her will UNLESS she is considered mentally incapable of this decision (which would constitute unsafe discharge).
It is very sad that Aunt and caregivers will not cooperate in her future safety and care. Wishing all good luck and safe passage.
You do not say what equipment is ordered for Aunt but it will ALMOST CERTAINLY NOT be delivered to the home. The operation of equipment without training in safety is not a good thing nor a safe thing. So no cooperation with training means no equipment.