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He has removed her off so many important meds. Example, leg nerve, dementia, preventive uti, vit D, OMG the list goes on. He refuses to deal with me. I'm beside myself. My mom is going downhill.

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If your medical POA is in force because your mother is unable to make decisions, the doctor has to deal with you. He needs your consent on your mother's behalf. Send him a copy of the documentation with a firm but courteous note asking him to contact you to discuss her px.

Do bear in mind that his clinical judgement may well be right, i.e. in your mother's best interests and better for her quality of life too. Also, it may be that he has done this to untangle suspected interactions and start again. In any case, don't *start* the conversation by demanding that he change everything.
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Why are the meds being stopped? Sometimes facility doc's will do this when a resident has been on something for a long time to figure out what is and is not needed. Have you talked with mom's previous doc? Is it an option to request a second opinion from another doc? With covid many appointments can be held virtually. You may be able to get a consult with a geriatric physician yourself to ask questions about mom.

Who told you this? If mom, it may not be at all true.
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shad250 Jul 2020
Previous doc probably would not get involved since she is now under the care of the facility doc. They don't step on each other's toes.
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Vitamins quite honestly do not much of anything. He may be seeing symptoms that are leading him to feel she is on too many drugs and they are causing her hard. If you are her POA for health care and she has dementia, however, it is his DUTY OF CARE to speak with you about his reasons. And you have the right to choose another medical practice to give her care and will know what coverage she has supplementally and etc. He may have removed these medications believing THEY are the cause of her going downhill. Her move to Assisted Living may contribute to her adjustment. There is just too much involved here to give you a hard and fast answer. Only the doctor can do that. If he refuses to speak with you, get another. As to medication for alzheimer's, I am unaware of any that cure it, and they are mostly a huge moneymaker for the MDs, and can have side effects. If you know a proven medication, it is one I surely don't know of.
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If he is removing supplements from her regimen it may be because he is concerned about interaction. I agree with gladimhere that he may be doing a "process of elimination" to see what is working and what isn't, or they may be trying to introduce new meds, like for depression or mood and need to "clear the deck" for a bit as they see what works. It's chemistry and it's complicated and each person is different. But you have every right to know why he's doing it so ask for explanations.
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Do you need to use the facility Doctor? I used Moms reg PCP when she was in our local AL. He should be talking to you if Mom is not able to handle her own health. If Mom is incompetent, I may go to the lawyer who drew up the POA and have him write a letter saying that because Mom has been found incompetent that your POA is in effect and that the doctor needs to consult with you concerning her health needs and any concerns you may have. If not that lawyer, any lawyer should be able to help.
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When my mom moved from her home to an Independent Living facility and ditched her internist for a geriatrics doctors, the FIRST think he did was to review my mom's meds and take her off everything except for one blood pressure pill.

He had her keep careful track of her bp for a week and then added another med and gave her instructions on tracking her bp and when to withhold one of the meds.

My mother's quality of life improved greatly. He then sent her to a geriatric psychiatrist who replaced the anti-anxiety med she'd been on for year and sent her for a cognitive evaluation.

Although we had HC POA, my mother engaged in these discussions with the doctor herself; I showed up at her second visit to observe what he was doing and assure myself that he knew her history.

I guess what I'm trying to say is that I think it's very common for the internists who operate outside of facilities to "thow" pills at older patients in an attempt to fix what the current complaint it. Geriatricians take a broader view about what is fixable and what is not, in my experience.
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Tothill Jul 2020
This is exactly what happened when my MIL moved to our town 18 years ago. She started seeing my family doctor.

He had her bring all her pills in on her first visit and asked her why she was taking them. She did not know why she was on most of them, nerve pill, etc is what she called them.

He took her off everything but her metformin and blood pressure med. After a few weeks he had her back in and redid her labs to see where things were at.

We learned that her nerve pill was an anti-psychotic drug for goodness sake. She had also been on Valium for decades.
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Two considerations: 1) in most Assisted Living situations you are not required to use their 'house' doctor and can maintain your medical care through your existing physicians. It's inconvenient but not impossible to do so. You could just change back to your original doctor(s). 2) Many older people are on many medications that have been prescribed over the years and have not have a good review of the need and usefulness of them. When my niece was in pharmacy school she took a list of of her grandmother's meds to her professor who found that many of them were contra-indicated with others she was taking (different doctors over the years prescribed stuff) and suggested her doctor do exactly what this new physician is doing - basically start over to see what she needs and why. Her health was significantly improved after they got her on a new, reduced medication plan.

If your mom signs a HIPPA release the doctor will be able to discuss her care with you. Without that release he can't say anything and you'll only be able to get information through your mother. Get her to sign that and be there for her next appointment with him so you can have a reasonable discussion.
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There could be any number of reasons. Do you know if they have done recent blood test? Those results may indicate certain things need to be stopped. Also, with all those meds, it’s likely she may have an interaction. I asked that my LO’s meds be discontinued, except those for her comfort when she went on hospice and she’s about the same two years later.

If you are her duly appointed POA, I’m not sure why he would not discuss it with you. I’d find another doctor and/or consult with an attorney about the matter if changing doctors is not feasible.
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