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Cici22 Asked December 5, 2023

When does a POA ( medical) get to override patient consent for sedative medication?

Im the private caregiver to an 83 yr old woman- her life partner needed help with her carez Ive been caring for her 20 hours a week for 4 months.
She has become very very anxious,paranoid and delusional. Panicked- and stating several times a day she " want to kill myself!"suddenly believing her partner is trying to kill her and take everything,pleading with me several times a day to help her,insisting that we whisper our conversation,pointing out random items in the house that are listening devices etc! She is in a wheelchair,highly OCD, suffered a stroke 3 years ago and cannot speak well but has not exhibited any signs of dementia. Now- its unbearable for me- her and her partner- all trying to keep her calm! Reasoning does no good whatsoever! She refuses to go to the doctor- or to even leave the house!
When is her partner "allowed" legally to give her a sedative or meds against her will - or without her knowledge? Is there a protocol for doing this?

lealonnie1 Dec 5, 2023
She has "not exhibited any signs of dementia ".....except for anxiety, paranoid delusions, insisting random items are listening devices, and extreme OCD.....plus she's a stroke victim! Which are ALL signs off dementia. Neither you nor her husband are allowed to force medication upon her that she refuses to take, with or w/o POA.

Next time she states she wants to kill herself, immediately call 911 and have her transported to the ER for a psych evaluation where they WILL put her on meds and get her diagnosed.

Southernwaver Dec 5, 2023
Why does she get to decide if she goes to the doctor or not? She needs to go to the ER in an ambulance and get checked for a bladder infection. You don’t need to run these things by her and get her permission.
AlvaDeer Dec 6, 2023
Absolutely agree.
This needs evaluation.

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Midkid58 Dec 5, 2023
You should have this person in Hospice or Palliative Care--they will come to the home if needs be.

Many people get this way as they age--free floating anxiety that cannot be 'talked down'.

It's considered illegal to drug someone w/o their consent, yet I myself have done so with the drs approval a couple of times.

It would be best if you get her on a benzodiazepene and keep her on a schedule with those. Maybe also some anto-psychotics too.

No, you cannot reason with someone whose brain is basically broken.

You say she's NO showing signs of dementia? Hon, she's the poster child for it.

An evaluation, soon as possible and the appropriate drugs to calm her and everyone will be better off. She won't be cured, but you'll be able to live with her.

I'm sorry for this. We're going through this with my MIL. Without a dose of Ativan or Xanax or both in her system at ALL TIMES, she becomes a screaming harridan. Not fun for anyone, including her.

JoAnn29 Dec 5, 2023
The woman is showing signs of Dementia and anxiety. POA medical is in effect when the woman has been declared incompetent by a doctor usually. The partner needs to read the POA to see if its immediate or needs a doctor to sign off.

AlvaDeer Dec 6, 2023
Southernwaver is absolutely right. This needs medical evaluation. You could be looking at a severe UTI or other medical problem involving too much or too little of any electrolyte. She needs medical evaluaton.

It is not your job to force medication upon this woman.
I would not continue in this particular job whether through agency (explain everything to them as you did to us) nor on your own.
Let the husband know his wife needs medical evaluation NOW, and that you will not be medicating her when something may be physically wrong here.

You may want to consider asking APS to evaluate this if you are working without an agency. You are a mandated reporter of things you find suspicious at all.
Cici22 Dec 9, 2023
Thank you for your reply, and your information! I quit the position with the explanation that I was in no way providing any care or comfort to the client and experiencing her panic and highly stressed state for an entire 6 hour shift ( for 4 days in a row) was beyond my capacity. I explained to her partner the need for immediate medical attention. He understood but insisted she would never agree to leave the house. I am relieved to be out of that situation.
AlvaDeer Dec 9, 2023
Cici,
Thanks for your update below that you have left this position. So few return to update us. I do hope that you left the husband with advice to get his loved one medically thoroughly checked, as Jem and others are right here; there could be a lot being missed, such as an acute or chronic UTI.

applefrom Dec 6, 2023
"When is her partner "allowed" legally to give her a sedative or meds against her will - or without her knowledge?"

My understanding is NEVER!
AlvaDeer Dec 7, 2023
Just Bouncing in quick to say that what medications can be given without consent depend upon the capacity or lack of same of the person receiving the drug and the Medical POA or lack of same of the person who OKs the drug administation. A MPOA may OK a medication that is believed in the best interest of health and safety of an INCOMPETENT person. Many suits out there now occurring with administration of psychotropics to people in nursing homes without ANY consent from ANYONE. So this is a real concern and a really hot issue at present.
Pyrite Dec 9, 2023
Yeah, giving sedative without permission or authority can be murder.
MargaretMcKen Dec 9, 2023
No 'murder' chance unless they die - and it's not the normal outcome of a sedative! Don't be silly, Pyrite.
VickiJeff Dec 9, 2023
She needs a medical evaluation. This could also be a major depressive episode.

my2cents Dec 9, 2023
This can also be sign of a urinary infection. Possibly one that's been going on for a while. UTI creates terrible confusion, paranoia, etc.

If she is not trusting everyone all the time, call her doctor and ask if he will order urine test that you take in to the lab. You might have to be creating in collecting the urine. Dr's offices have a hat looking device that can go into the toilet and urine collected and put into a sterile urine cup. The dr or the lab he uses can probably give you some of the cups and the urine collection (hat) bowl.

There's all kinds of labs now located around neighborhoods - Quest, Labcor, etc. You could call them to see if they'd give or sell you the collection cup and toilet hat.

If she refuses to go to dr, at least you could rule this infection out by taking the urine directly to the lab or dr office and have it tested.

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