I am still mystified by this concept 2+ years into Caregiving for my DH, now with VaD as well as Learning Disabilities and Mental Illness.
When he was in the hospital,at the time of the VaD Dx, Personnel went into his room and explained to him that they were taking away one med. and giving him a new one. They explained all the pros and cons (a Black Box med)and had him sign a sheet saying they had explained it all and he understood. 20 mins. later they brought him his meds., and immediately after he was on the phone to me in tears because they hadn't given him his "pink pill". He'd been taking that pill for over 18 years (the underlying problem for his admittance in the first place). I told him I'd check it out and all would be okay. I jumped on the phone to the Case Manager to ask what this was all about. "He has the right to be informed of his treatment. I asked if maybe his Caregiver should also be informed? Their obligation is to him. As for having him sign the paper that they'd told him and he understood? The Personnel are well trained to be sure that is true at that time. (Sounds like a CYA event to me).
While he was in the hospital and after when at his first Dr.s Office, his Caseworker and another sociasl worker topld me more than once , in various conversations, "You can't MAKE him do anything."
Stuntgirl said in one of her posts that when she asked the NH to pull her DH's phone because of his excessive amount of abusive, rage filled calls, she was told they can't do that because it would infringe on hiis "rights".
We can't MAKE them take their meds.
We can't MAKE them stay home.
WE DO FIND WAYS--- but why does this have to be so hard? Admittedly, they are adults. However, they have an illness that endangers them and it would seem to me that would place them in a category where their Caregiver could be extended the authority to do what must be done for their care, with more cooperation from the professionals involved.
I know this, I will do what I must to prevent my being the one sitting home with a Silver Alert out for my DH. He will take his meds.
i was under the assumption that with a power of atty for heathcare specifically which we both have signed notorized and 3 witnesses, that i have been GIVEN the power to make any /all decisions with regards to my DH as soon as he signed the paper it became effective EVEN if he became incapacited. so in my mind, i have the right that he intened me to have to make the decisons for medications, nursing home, hospice, end of life decisions and ANYTHING pertaining to his care. i have never had any dr of such refuse me what i ask in his behalf after 9+yrs. they say tell me what you need and i get it. i dont know why others have such a hard time. even the pharmacy here will allow me to make changes or discuss his meds over the phone. i have had no issues so far, i guess i have been lucky. if i did have anyone question my actions, i would have my atty address them on my behalf. divvi
This is an excellent topic. I have NO answers, but it sure makes me angry. What is it about - HE HAS DEMENTIA - do the laws NOT understand??????? Can anyone clear this up for us? I have Health Care Power of Attorney. Doesn't that make me the decision maker? At this stage in my husband's illness, we still discuss things like whether or not to participate in a trial, but the final decision is legally mine. At least I thought that's what the HCPA was for.
Oops - Divvi and I "crossed in the mail". Just as I posted, her's appeared.
I also have my husband's medical power of attorney and have not had any trouble with any of our medical providers. Of course, he can't speak, read or write so communicating with him is not an option.
I believe part of the problem with POA's, DPOA's or Health POA's, is the person granting the power CAN still act on their own behalf. They haven't been declared incompetent. If they were incompetent they couldn't sign the POA. Laws need to be changed regarding dementia and powers given in POA's.
Hot topic....The power of attorney actually can be invoked only when the person becomes incapacitated...In the case of ad, the patient usually can still converse, and to a dr. who only sees them for 5 min, they conclude that they are competent....therefore the poa becomes a mute issue...I do not have power of attorney for my dh..I appointed my daughter, because she then can make the decisions provided that my dh cannot. She truly represents my wife, since I would have to make all decisions alone. My daughter acts as the second party and together we can make a good decision. As a spouse, I use my marital rights and become outspoken when my input is ignored... I have been refused several test results, several requests to the medical field, and they all quote hippa laws..I usually show them my POA badge....a phony document signed by my wife, witnesses by a jury of 12 peers, signed by our former president, giving me all rights to act in her behalf and possession of mind and body. Usually no one reads it, and then they apologize and do what I ask.... Please do not reveal my secret to the medical community...that paper contains only the smallest print, and the most eloquent legalese terminology, and I doubt that anyone could truly understand what it says...Even a Harvard attorney would have problems trying to understand the context and intent...The phony document works well, and no one so far has questioned it.....so they think I have poa......but in reality, my daughter has it.... POA's are sometimes worthless, because the person must be declared incompetent for the document to b e totally effective...the person can still act in their own behalf......big loophole
I've had DPOA since the '90's. It was invoked by the agreement of a medical Dr. and a psych Dr. when he was hospitalized. I have also had Medical Patient Advocate Status for the same time. All in place before the hospitalization. And still I had to fight to get information and be included in decisions, while they "kept him in the loop"(?) When we filed for Bankruptcy, before the matter goes to the Judge, you meet with a Court Representative. She would not allow our case to go forward,until I acquired Guardianshipof DH. Did that. A few months ago I had to update medical records with one of his Drs. As Guardian, I had to sign a new HIPPA form on his behalf authorizing them to talk to me about his case. This is nuts!!!
For what it is worth... I had to get guardianship. The POA was useless!
Just because you have a POA, EVEN WITH AD.....it does NOT mean you can make your LO do something against their will. Crazy!!!! But it is the truth.
Everywhere I went, with POA in hand, I was told, if he says no, we can't do anything. Just drives me nuts!! Even after I had it "Activated" meaning a neurologist said he could not make decisions for himself, they still would not do what I asked unless he consented.
Examples.... ER... he refused blood work. They would not do it even when I insisted!
Home health care, He refused bathing, they would not even try once he said no.
Nursing home.... if he refuses to stay, even with a POA... they WILL NOT keep him!!!!!!
CRAZY!!!!!!!!!!!!!!!!!!!!!!!
Your POA is wonderful if you have a docile spouse. If you have one who will resist and refuse verbally... GET GUARDIANSHIP!
It was simple to get, and not too expensive either. I did not need a lawyer, the Alzheimer's, his history, the doctor notes, was all the "proof" I needed. The court appointed him a lawyer. In a half hour tops, I had guardianship.Truly IS worth the effort.
I've had the same experiences several times. You bring your HCPOA in, they copy it ,then ignore it. I can spend 18 hours a day at the hospital and nothing happens. Leave to get coffee and the s--- hits the fan. DH had surgery in Dec. He was scheduled for 2:00. I got there a 10:00 and he was gone! Hunted down his nurse and she said,"Oh didn't he call you?" Through gritted teeth I told her he had FTD and can't use the phone. She said that information wasn't comunicated to her at the morning meeting. I suggested (again through gritted teeth) that should be in BIG RED LETTERS on his chart. When the bills started comming I was shocked by the number of specialists,consults and treatments he had. Only one nurse kept me informed, even calling late in the evening to update me. If there is another hospitalization I'm bringing my blankie and pillow. Oh and a toothbrush. cs
I never seemed to have these problems & no one every asked to see my 'papers.' It was years ago, maybe things have changed, I know there was no HIPPA, for instance. When he went berserk in a care facility & police took him away, he was placed in a lock-down mental facility. I didn't know where he was for some time, people kept calling me, telling me he had been moved here & there, I was always informed. When he was finally settled in the mental facility, the doc in charge called and asked me, just over the phone, if I had POA, I said yes. He asked if he could do the things he felt necessary, I said yes. I'm in Los Angeles, it's a big place, I had no idea where the facility was, but I was told where it was and I could come visit whenever I wanted. I said 'yes' because by that time I was emotionally exhaused and had no idea, anyway, what could or could not be done--I don't have the med background and we'd been thru all the meds, tests, etc. They got him stabalized.
His surgery was a horror because docs & nurses don't really know about AD. They're concerned about IV's and cathaters & incisions & healing & infections, etc. He could use the call button. They'd bring him lunch, straws wrapped, food hidden under plate covers, juice in cartons, plastic silverware in packages--he couldn't open any of it. I was with him 24/7 in the hospital except when our son came in a few hours from work to relieve me each day. Yes, stay in the hospital--or avoid surgery altogether, which I later learned I could have done. It really took me down a lot.
Exactly. I provide a computer printed list of his meds and the ones he can't have to the Ambulance people. I bring another copy and give it to the first operson I see with his chart, and they still get it into his records wrong. And they don't like to have me insist they correct it so he gets the correct stuff. If they see a reason to change something, no problem, as long as they're starting from correct Info. He wasnb't eating. They're concerned. Had they bothered to pay attention to information that 1.; he has no teeth. 2. he may need help opening packaging./ 3. If the tray of covered dishes is set on the bed-table beside/ behind him he has no clue it is his meal. Grrrrrr!!! I know they need to talk to him to get a read on how he is. But, when I'm there and it's true info they need, why do they (not always, but sometimes)go straight to treatment or treatment options without verifying that the answers he gave are true. Sometimes they've been close enough to sound okay, but aren't.
After reading some of the above comments, I am glad I live in a small town. We have a great hospital here and good doctors. We may not have the eldercare lawyers and many of the perks that that many of you have, but our doctors know our name and care about us. I would never have the problems that you are having and the doctors tell me what is going on. I know they have our best interest at heart.
I never cease to be amazed at the stupidity of some of the so-called medical professionals you run into in the hospitals today. You can ask the nurse if they can give you a piece of information from the chart, the morning nurse says she can't only the Doc can give me that information. I can ask the evening nurse for the same piece of information, they open the chart , look and answer my question. I am amazed at the number of them that do not know what certain medications are given for, that they don't even recognize they are giving two different blood pressure medications at the same time because it says one pill a day. I have had to go to war with several of them about blood pressure medications, they look at me like I'm from Mars.
I can't even open some of the juice packages and packaged foods they serve, I don't know how they expect a person with Dementia and Arthritis to manage the packages. They put food trays on the rolling tables and leave them two feet out of reach of a person who can't even stand up, they move the telephone one foot out of their reach.
Murphy's Law assures that the Doctor will show up, just after you go around the corner for five minutes, even though you haven't been out of the room for six hours. They will disapear into thin air and can't be found anywhere for at least another day. But most of what amazes is that they try to treat and deal with a person with Dementia or AD as if they are perfectly normal.
Whew, that felt good, I'm out of breath, I'd better get down off my soap box.
All this discussion about POA, DPOA can be confusing. I have a DPOA and I it was explained to me, it was effective immediately and it does not get revoked when he becomes incompetent. However, I had understood POA would be null and void when they become incompetent. I have DPOA for both financial and medical. Financial is in place now and I am filing it with the bank, insurance benefits, pension, etc. Medical is a different issue. It doesn't legally go into effect until the doctor decides he is not competent to make decisions. So far, I haven't had any issues at all.
DianeT-- part of the confusion with the POA, DPOA has todo with how they're written. Some are written in a manner that makesthem immediately active. Others say they become active when a consesus of 2 different Drs. say the LO is not capable. Some can be revoked by the LO (question of competency?) at any time, others not so easily.