They want my mom off of Seroquel, her neurologist wants her on it. We are in Michigan. Her days and nights get mixed up. Her neurologist wants her on Seroquel, he says it will help her with that and also help with her high anxiety. The nursing home is taking her off of it, they say the state (Michigan) won't pay for psychotropics. If they are taking her off the meds her doctor puts her on, why bother even taking her to a specialist?
My question is can they do this? Can they do this without telling me (I'm her POA) ? If they CAN do this then who is responsible legally for her care? And finally, can I just pay for the medication myself if that is indeed the reason they want her off of it?
I'm frustrated.
Try to have a talk with the resident doctor and let him or her know why the neurologist prescribed this medication. See if you can get some cooperation between doctors. I know this shouldn't be your problem, but sometimes this happens. Good luck,
Carol
The nursing home is responsible for paying for her meds. As such, the doctor for the nursing home may try to pull crap. As soon as they know you're watching, they change their tune.
It's Medicare who is picking up the tab, correct? If state funds are involved, try contacting the person in Michigan who oversees the nursing homes and get the real story.
Been here : ( Be strong. Be a fearless advocate! You'll be surprised how people back down when they know you're up for a fight ; )
The doctors I've worked with have been some of the most ethical people I ever met. And yes, billing issues do play a part in medical decision-making-- maybe not the best thing about American medical care, but it is our current situation.
Assume your MD is doing his or her best. First, ask why a change was made. If you still disagree, respectfully seek another opinion or ask the internist to speak with the specialist.
There's nothing wrong with getting a second opinion. In fact, I periodically encouraged patients to get a second opinion (or sought one myself) on my own decisions. And you know what? It wasn't unusual for the second opinion to disagree with me, the patient would agree, and we would all go in that direction.
My point is, if you disagree with a doctor thats fine, or even great in that it means you care and are diligent. But, when you address the issue, assume that the doctor is sincerely trying to do his or bes.
In this case, you are right. It sounds like it is just about the money. Seroquel has not been covered by Medicare unless it is for treatment of a bipolar disorder. It is specifically contraindicated for treatment of insomnia.
Assuming it is within your means, I would write a letter to the facility and the attending physician(s) stating that unless it is an emergency, you do not want any of her medications changed without prior authorization from you. You may wish to state that if the item is not covered by Medicare, you will pay for it as long as you are giving reasonable notice of the situation and the cost.
Pharmacy laws are done by state. Depending on where you live, it might be possible to provide the medication to the ALF for them to dispense. In Maryland, this is not possible as the laws specifically require medication to be dispensed in a blister pack under controlled circumstances.
Some Medicare part D plans have covered Sarah quell. However, there is now a movement from the Obama administration to limit the use of several medications citing improper use and high cost. There was an article in the New York Times on February 21, 2014 about the subject.
Dr.'s in nursing home are elusive creatures. You never see them. They don't evaluate the patients in person, you can't catch up to them if you're there while they're there and if you'd like the Dr. in the facility to know someone you have to tell the nurse (not an aide but the nurse) and then follow up to make sure a notation was actually made in the chart. Dr.s in nursing homes are like smoke....or unicorns. No one can ever really get their hands on one.
But I agree, it's the Dr. that you have to talk to. And if the state is discontinuing psychotropics that's going to be one lively facility.
Sure, have a nice talk first, but make sure they understand you mean business and you're watching closely.
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