I have the DPOA for my sister. What recourse do we have other than remove her to another facility?

I would be interested to learn how this doctor threatened you.
I am also wondering did your sister exhibit reasons to prescribe an antipsychotic? You mention that she has anxiety. I think it is a giant leap from anxiety to psychosis.

Each facility should have posted the number for the State Ombudsman. I think a call to that office might help.

If you do not want to change facilities maybe a change her doctor. Does she have to be seen by the one that saw her initially?

Is this Moms private NP or supplied by the facility.

Sorry, I know that a NP can prescribe meds, but I would go over this persons head. There has to be a doctor who oversees a NP. The NP either works for a doctor or if allowed to have a private practise in ur state have a doctor they answer to. Find out who this NP answers to and talk to them.

He isn’t a Doctor he is a nurse practitioner - Big difference - most of these nursing homes and assisted living don’t have regular Doctors . I would definitely report his behavior and take her off this drug . And If you don’t get anywhere remove her . A lot of times one Doctor will cover 20 nursing homes .

Get another doctor asap. Any doctor that exhibits the anger and reaction to family questions that you describe, should be reported to medical board.
If this doctor is a staff doctor at the facility where she is presently, report your experience and questions to the facility administrator or whoever the " top dog/ buck stops with me" person in charge is.
If this is a personal physician who is not a part of the facility treating her , still report your concerns to the facility and, arrange for a new physician to assess her. There could be any number of issues contributing to her decline and behaviors.

Or, insist that she be transported to a hospital ER for symptoms observed and, have her assessed by staff at ER, possibly admitted for more observation, assessment and, share your concerns with the hospital staff. Then go from there regarding placement when she is ready to be discharged.

If your POA also mentions health and mental decisions then you have the right to refuse the drug. The doctor has to listen to you or escalate the matter. This happened to my mom, when I found out they prescribed her some pain medication instead of trying to treat her UTI that developed hemorrhoids. Took mom immediately out of the facility.

It's a mood stabiliser isn't it? Also to reduce hallucinations?

Of course you have the right to ask questions & report differences - you know your sister best!

I am wondering if there can be a 'family meeting' set up? Kind of like they do in rehab, where OT, PT & Doctor give their opinions for a more wholistic approach to the care plan.

This could involve the Facility Manager or Nurse in Charge, that Doctor & yourself & sister. Discuss how she is settling in, what is going right, what is not going so right. A wider view. I dunno... maybe this could help get everyone (inc Dr Ego) onto the same page??

It can be a balancing act... reducing hallucinations is a good aim but if the meds cause more or cause falls ir other negative effects, then another approach is required.

* Do no harm *

That's the aim afterall: a care plan that is best for your sister.

Wishing you success.

We had a similar doctor at my father's NH. He accused us of micro-managing him. Ask for a copy of the MAR (Medication Administration Record) to see what else your sister may be getting that is not in her best interest. Do your research, be sure you are using websites of the manufacturers of drugs in question, or other respected websites such as Mayo, NIH, Medical Universities, etc. Do not quote anything on wikipedia or other non-medical websites. Especially since she is new, ask for weekly copies of her record (if there is a charge, at least to sit down and review them) which will include the MAR and look for red flags. When we did this (unfortunately too late) we found notes where the doctor said he was prescribing Prozac and was sure the family would not like it! We also found there was a document saying our father was not competent to make his own medical decisions, signed by this doctor and another doctor as required in our state. (Again, we found this too late.) Without knowing this document was in his file, we constantly were telling nurses we did not want him to have certain meds creating tension with the staff because they had to follow doctors orders. They obviously weren't even aware of the document because we were told our father had to refuse them! So we would have to tell our father to tell them he did not want them and if we weren't there he got them. One was a huge red pill (over the counter) that was hard to swallow that was suppose to slow down his cancer... yet it was on record he had requested stopping all cancer treatment... age 90). My father too was over medicated with the Prozac on top of Haliperidol along with others. Once we demanded they stop those drugs he miraculously became much more alert and functioning! We wish we would have removed him to another facility but of course you never know if it will be an improvement. I hope you or another family member are able to be there often to observe the care she receives.

As someone else has said, you should have the right to take your sister for appointments outside of the facility. This may depend on her insurance program.

FYI, in our state a DPOA (Durable Power of Attorney) is only for financial issues. A Health Care Power of Attorney is required to make health care decisions.

Despite the answers posted you may have no recourse other than a move. Here’s why. Certainly you can seek out a better medical practitioner, but the treatment - disrespect in addition to harmful prescription- coming from the facility’s nurse practitioner could be a reflection of problematic underlying attitudes and practices. We moved my mother shortly after admission to an AL when a relatively small problem couldn’t be resolved due to a complicated hierarchy in the facility.

Yes Drs and Nurses do not like it when we disagree with them... My doctor doesn't but I do. I have refused medication and that is just too bad. If you can move her. Ask for a social worker to assist you in this. My daddy was in a large facility, covid hit and I was not allowed to see him. (which I was doing 3x's a day) during that first month and a half he cut his big toe and it festered to the point that it had to be amputated. Yes he had diabetes and I had always been there to help him to bed and when I did I checked his feet daily. Well after his toe was amputated (remember covid happening at this time) that facility would not accept him back because they would have to allow the wound specialist to come in and out and they did not want that. It came to the point that I had to put him in a group home! That turned out to be the best thing ever! Even during covid I could visit my daddy 3x's a day because each room had a separate entrance and I just needed to be 6 feet from him. OH that was great! They treated him like family and I treated them like family. So that might be the avenue you may need to take. prayers for you and yours!

Sounds like NPs must not have to take a bedside manner class. This guy is completely out of line.

Go over his head, make it real clear to the supervising doctor and the administrator in charge that the NP has a people problem and request that he not see your sister any longer.