I am being left out of the loop about the nursing home doctor visits to my mom's room, their findings, and why they are recommending certain medication changes. I am her medical POA. I asked one of the nurses if it wasn't the law that I be contacted on medical visits by the doctor, their findings, and medication changes. The nurse told me they do not have to contact me because my mom is able to make her own decisions. It is not only my opinion that my mom cannot make her own medical decisions, but she does have a cognitive diagnosis, and several speech language therapists have given me information concerning her cognitive and communication abilities since her stroke.
Record and take pictures of the "perps"? What kind of a crime fiction script are you writing?
The poster here needs suggestions for improving the communications with the care center staff. She does not need conspiracy theories.
Look at it this way round. You run a nursing home with fifty residents in it. The retained PCP comes once a week and does a round of anyone flagged up to see him, on a Tuesday, say. On Monday night Mrs X has a bit of a sniffle and you add her to the list, along with fifteen others. Oh, wait, can the POA who lives 350 miles away make it tomorrow morning..?
Get real. The people who look after our relatives in these facilities are there to look after *them*, not to look after you and obey your commandments. In a good facility, good working relationships with families are extremely important and properly respected; but even then they're not the aim of the whole enterprise. It is totally impractical to expect them to obtain your consent to every appointment, every px adjustment, every Advil.
Do not take their failure to do so, then, as a sign of sinister intent. They're busy. Meet them halfway.
When sis did not respond to questions I then posed them to the director of the facility. Mostly I do not receive reples from them either which has been very frustrating. Though that appears to be changing. I have not been told of quarterly care meetings. Not sure at all if they are even occuring. Sis will not provide any information and she signed the HIPPA release for mom that authorizes release of information to me.
Facility is very aware of dysfunction in this wacky family. In spite of that when I was caring for mom I would send extensive reports to sibs about mom's doc appointments and other occurrences. It is hard when after providing everything for my mom to go, so to speak, cold turkey.
What happens, Jeanne, since there is a POA, my sis with me as successor? Does the facility take over POA in effect? Does sis sign something that allows facility to make decisions for mom? What about instructions in the POA? They do not matter? Initially sis was very good about getting over to see mom, which has tapered off significantly, it seems.
Someone in our family (me or one of my sisters) attends every quarterly care conference about my mother. It is very clear to the staff that we have a strong interest in her care. We are complimentary and enthusiastic about their services. They say they appreciate our advocacy and wish all their residents had family involved.
And they answer all of our questions, promptly. No one has medical POA. They've asked us to designate a communications point, since they don't want to contact all 7 of us. They have never refused to provide information because of HIPAA or for any other reason. The DON has called me in the morning saying "The night shift noticed your mom has a rash and I have a call in to the doctor for xxx cream for her. I've inspected it and had the other unit's head nurse look at it also." And I say, "Thank you. I'll tell my sisters." We also initiate med conversations: "We're wondering if Mom's night med could be decreased now. She seems so much less anxious to us. Does she need to keep taking that?" And they either explain why it should continue or agree to ask the doc about reducing the dose. They don't even ask Mom at this point if she wants a flu shot. They call us to sign the consent form.
This is all done on an informal basis. It is based on relationships. If my brother who is never involved showed up and wanted information I'm not sure how they would react. They might refer him to their contact person (me). I just don't know.
The law probably doesn't require them to call the MPOA if the patient hasn't been declared incompetent. But common sense should tell them it is a good idea to contact you before (or soon after) they change medications or doses, if that is what you want.
Building a relationship with staff is an asset!
If you want to be informed about what is going on, talk to the social worker and unit manager. Let them know that you'd like to be updated on any changes the doctor makes. Call in and speak with the facility doctor if you have questions.
In a facility setting, make sure that you are talking to someone with authority and someone who is accountable. Not " a nurse". But DO find out who your mom's regular daytime nurse is, bring treats, and you'll find out when the doctor is coming.
The nursing home told you that for its own convenience. Insist on a doc call before meds get changed unless it's an emergency.