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lorriedjn Asked February 2014

Long distance medical decisions. What can I do?

I live in CA and dad lives a little north of NYC. He calls 911 almost daily to help him get up after falling or to help him out of bed. He also calls lifeline. All my sibs live far from NY. He is an 83 yo Korean Vet. recovering from colon cancer, with diabetes. He lives alone w a home health care "Angel" coming in daily to change diaper, feed and clean up. I try to see him at least once a year. My other siblings are mentaly disabled so are unable to help. Finally my question, Is there any way to get access to his medical providers (he says he never sees a home health nurse)? Another detail is that my father has no money besides SS. He has been hospitalized a few times and refuses to go to the ER when he has fallen or when he exibits signs of recurring cancer or pneumonia. He has not signed a HIPA form giving me access - after repeated requests. I am at a loss. This has been status quo for about 10 years but has gotten much worse since my last visit, What can I do?

norestforweary Feb 2014
What gets me.... he won't get help yet calls 911! Geeez! I'd stay in California too!

golden23 Feb 2014
lorriedjn - you have done what you can. It is frustrating, isn't it and I know that exhaustion ((((((((hugs))))))) You have done the responsible things, but as your father is competent, you have little or no say it his care. I am not impressed with his doctor, but your dad has made the choice to stay with him. 7 days of listening would be terribly hard. All you and your sibs can do is, as sunflo says, wait until something happens, then try to get financial and medical POA in place and even then you really need a diagnosis of incompetence to do much.

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sunflo2 Feb 2014
Welcome back from the front! These parents are so exhausting and frustrating! Good for you. You should find comfort in knowing he is "managing" and his instinct is for survival... So guessing he will get help if he needs it. I know you worry about the dr not doing a full exam...that seems inexcusable to me, but maybe dad never listened to him in the past and he decided not to bring up all this stuff.

You've done all you can do, so now you just keep loving dad, call when you can and when the hospital calls at some future time, you just say " I can't talk to anyone until I have HIPPA and DPOA with dr declaring incompetency and leave it at that. This is what My plan is and as it stands with my mom.

One day his current aide will have had enough or his care needs will be greater such that he needs skilled care and VA or other support services can step in.

lorriedjn Feb 2014
Well I have returned from the front. I must say I have never been more exhausted that I am after one week with my father. AND I foster 3 & 4 year olds!
Dad was as mean as a snake growing up and he has not changed. I found out 3 things. 1) He is not on death's doorstep, he will do what he wants to do but will shudder in agony if his aide tries to wash him (even his hands). 2) He is not mentally compromised. He has great short and long term memory. He KNOWS common sense but refuses to act on it. 3) He has multiple diagnosis of PTSD, Depressive Disorder and Narcisism. (refuses all treatment).
I took him to his doctor, who did not listen to him. Nor did he provide a cursory exam. When pressed the MD did perform a glucose stick test (Dad is diabetic). He would not look at his swollen feet. BUT Dad will not change doctor nor sign any document allowing any of his 5 kids the ability to assist.
I spent 7 days listening to an 83 year old Archie Bunker on a very bad day. I think I am done for awhile.

anonymous10656 Feb 2014
Have you looked into hiring a Geriatric Care Manager to be your local advocate? Yes, home care agencies can be your eyes and ears, but a professional, neutral individual who is familiar with the entire senior industry might be a helpful way to go. Learn more here: www.caremanger.org.

lorriedjn Feb 2014
Thank you everyone - I am off to the airport!

sunflo2 Feb 2014
Yes, you will need HIPPA to get any medical info unless you know his dr and can work with the doctor to help convince dad to sign HIPPA. Without it, you get nothing. My mom signed one and then after I left revoked it out of paranoia -- luckily I had established an earlier relationship with the dr and he provided some criptic info for me without bein illegal but admitted he couldn't divulge much with moms consent.

911 will have to set the boundaries and if dad continues to call them and you know the hospital, you can always call the social services case worker at the hospital and explain your relationship, your contact info, and tell them the situation and that dad refuses HIPPAbut next time he is admitted, advise that they look into his home and care situation and in your opinion it is no longer safe. It is up to them to investigate or decide to discharge him back into same situation.

In the meantime, you should research VA assistance he might be entitled to and care facilities that accept VA along with his SS and other potential assets for his care.

He may or may not agree to move into care.

This is all you can do. Best scenario for you may be to let him be admitted and then transferred to care facility via the health system for his own health and well being.

Good luck this week.

InWyoo Feb 2014
Definitely contact the Veterans Administration for advice. The V.A. has been very helpful to several families I know. It could be that your "old soldier" father will accept some direction from another "old soldier."

gladimhere Feb 2014
There are numerous services available through the veteran's administration. In fact maybe that is where his doctors are. It is too bad that he will not sign POA for you. Does he know that without it, if an emergency occurs that he cannot make his decisions, that the State will? Would he rather trust the State to make his decisions or you? With a DNR, Advance Directives, etc, it would still be on his terms if you have POA and the courage to make the difficult decisions that will probably become necessary.

lsmiami Feb 2014
Without HIPPA permission to his records, you will get no access, so don't waste time trying to get numbers and call people.
He wants minimal medical care, be there for him. Call him, let him know he is loved and accept his decisions.

lorriedjn Feb 2014
Thank you, Pstegman, He was just reminiscing this morning about Korea. yup soldier says it all.

pamstegma Feb 2014
Lorrie, your hands are tied. He is going to live his way and die his way and my father was just the same. Enjoy your visit and do not bring up his needs. If he brings it up, listen intently and follow orders (or pretend to). These old soldiers will only agree when they think they are in command.

lorriedjn Feb 2014
Thank you for your responses. I found the agency but cannot get a phone # for the weekend. I tried to get POA the last few times I visited but he refuses. He wants to go out the way he wants. Absolutely no hospital.. I am trying to get a flight out tomorrow. -fingers crossed

golden23 Feb 2014
I gather you don't have POA medical or financial. Sounds like it is time for someone to help him. Has he been evaluated as regards his overall ability to function independently? You could contact the Agency of Aging in his area and also Social Services and ask them for advice. It sounds like he is barely managing even with his "angel". If he is hospitalised they should not release him except to a suitable environment. With him falling so much, he really should not be living alone. Good luck and let us know who it works out.

BarbBrooklyn Feb 2014
Call the agency that is providing care. Ask when rn is next scheduled to be there.

lorriedjn Feb 2014
Thank you for responding, yes I speak w/Dad everyday and try to speak w his aide. Unfortunately there is a bit of a language barrier. On top of this he will not follow her recommendations. This morning when I spoke with her she told me she tried to call 911 for him to go to the ER but he told her he would not go with them.

I am going to fly out next week and nicely "strong arm" him into giving up his doctor's phone numbers, etc. What do I need to get besides a release to help with medical decisions. Also - I need to find out what the rules are on a patient that refuses medical treatment - I do not want his aide to get in trouble for his decisions.

assandache7 Feb 2014
Are you in contact with his home health aide?

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