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webcarpenter Asked January 2020

Person assigned Healthcare POA wont give me permission to have access to my fathers healthcare status. What avenues do I have?

Found out that my father was prescribed an anti-psychotic medication called Seroquel which the FDA has deemed to be contraindicated for elderly. Called the assisted living facility to talk to nurses on staff. They refused to give me any info since I was not his POA. My fathers POA ( who is not a blood relative) refuses to give permission to have me receive medical updates. Not sure why, other than it being a control issue. As an RN, I realize the laws governing giving out medical info. I also am aware of the dangers this particular drug has , especially to an elderly person. What avenues do I have?

Isthisrealyreal Jan 2020
Webcarpenter, one thing that you said to your niece jumped out at me. "You are not a medical professional." I have to say that I learned so much dealing with my dad in the hospital and SNF for 2 months that I had his cardiologist and nephrologist ask me if I was a nurse. I laughed and said nope, just had to learn the language to make sure that my dad was okay and I could understand what is happening.

Maybe your niece is so involved that you could discuss this with her and if she can't competently answer something then maybe that would open the door for you to be able to talk to the doctor.

One thing that I see repeatedly on this site is upset POAs that are the boots on the ground help being frustrated by long distance family criticizing them but never helping them. They shut down and stop communicating because they have enough on their plate dealing with their loved one. Something to consider when talking with your niece. Honestly, as a POA she doesn't need to see him frequently or do any hands on, yet she is doing this, sacrificing other areas of her life to do so.

Hilly20 Jan 2020
Hi, I’m an RMN and I can understand your reservations regarding your father being prescribed anti-psychotic medication. I have known elderly patients suffering with dementia to be prescribed this in small doses, only when they have become psychotic and as a last resort. As others have said, as far as POA goes, if the person with POA is not willing to allow you to have any info, then as far as I can see your only option is to take this to court, if an amicable agreement can’t be arrived at. If you were privy to the reason why he had been put on Seroquel then it might make some sense to you and put your mind at rest. In your position I would want a very good reason as to why such medication was being prescribed. I’m sorry I can’t be of more help except to say given that you are an RN and I’m an RMN, I understand why you feel as you do. Good luck with this. It’s a very difficult situation xx

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MargaretMcKen Jan 2020
It’s good advice to let the doctor and the POA know your worries and try to mend the breach, if any. The nurses at the facility are not the people you need to talk to. Your father may still be legally competent. If so, can he sign the HIPPA forms? That might solve the ‘privacy’ problems that the doctor and POA may have. It may be a good idea to get a copy of the POA document, because they can vary quite a bit – some can only be activated if the person is no longer competent, but that’s certainly not always the case.
webcarpenter Jan 2020
Thank you Margaret for your advice. I cant even get an answer as to whether he has been deemed "incompetent" by his MD. Being that I live in another state, I cant know for sure if he is displaying signs of incompetency. His phone calls are lucid, but low energy, flat affect and some signs of depression. I will go the HIPPA route.
gemmab123 Jan 2020
I'm with Barb. Geriatric psychiatric is an art. If you are worried, have a convo with the doctor who prescribed it. People have different responses to delusions, and when the response is fear, paranoia, and panic, these drugs may help. My mom was put on a small dose of an anti psychotic with that warning but before I agreed to it I was able to learn a lot through a discussion with the doctor. It has helped her. Once she moves into AL and has people around, we are thinking she may not need it anymore.
As far as the relationship with POA, perhaps that can be healed. Expressing why you want to be aware of your fathers health details might help. If it becomes a power struggle that can be rough.
best wishes
webcarpenter Jan 2020
The Seroquel concern is only one aspect of the total picture. In your case, you had the opportunity to gather knowledge about this drug so you could give an informed consent. In my case, I didnt even know he was on this med. When I pointed the contraindications of this med to the POA, she didnt seem that concerned. I am glad that the med helped your mom, though. Being in the nursing field , Ive seen this drug used to sedate patients with extreme agitation. But unfortunately, facilities keep them on it for long periods . They become tired, isolative, overly sedated. Thank you for your input.
bluefinspirit Jan 2020
I have to assume your father assigned POA to this particular person for a reason. Your father must trust him/her to make medical decisions for him, so you have to honor his wishes. That being said, if you believe the POA is not acting in your father's best interest, and they are not being reasonable by allowing you to be informed and involved, then you'll have to take it to court. Contest the POA and ask for guardianship, but understand that guardianship is a whole different thing than POA. Having POA means you have the ABILITY to act on a person's behalf; having guardianship means you are legally REQUIRED to act on a person's behalf. Every State is different, so please seek counsel from an attorney before rushing into anything.

Your father's doctor may not share info with you, but if you're just worried about this particular medication, then there is nothing to preclude you from informing your father's doctor of your concerns. This may not change the current plan, but at least your father's doctor might think more carefully about prescribed medications if he/she knows a caring family member is concerned.
webcarpenter Jan 2020
I can accept and respect that my father picked his niece instead of myself as his POA. I am his only living son. I live in Texas and he lives in Illinois. She sees him almost everyday. I obviously cant, since I live out of state. I do believe she has his best interest at heart. What I cant understand as to why she, as his POA, wont give his facility permission to give me health updates. When I ask her that question, she states " I can give you all the information you need". I replied that the medical questions I have should be answered by a nurse or doctor, not by her. " You are not a health care professional", I told her. She became upset and now communication is pretty much at a standstill. I thought of guardianship but the whole episode would ultimately be too traumatic for my 95 year old dad. He has verbalized that he simply wants to spend his last days in peace. Although this whole situation pains me, I can understand his feelings about this. Thank you for your input.
BarbBrooklyn Jan 2020
Seroquel has a Black Box warning. So do lots of other meds. If you've got an elder with dementia with psychotic features (paranoia, delusions, hallucinations) it's actually the best drug around.

One of my best friends, in her 60s, has unremitting depression She is on Seroquel. It works. It allows her to work and remain sane. Geriatric psychiatric is an art.
webcarpenter Jan 2020
Yes , your right Barb. As an RN, we used to give Seroquel to young patients suffering from bipolar and schizophrenia. The FDA never intended for Seroquel to be prescribed to elderly patients suffering from dementia. This is the "off market " use for this drug. The side effects are frightening. Stroke, diabetes, heart failure and, in some cases, death. Does Seroquel work? Yes, in some situations, it is very effective. In my situation, my father has a history of stroke, diabetes and heart anomalies. Knowing this, why did the Nurse Practitioner prescribe this med? And why did the doctor sign off? Without being a POA or getting permission from a POA, no one will give me the time of day. Thank you for your input.
worriedinCali Jan 2020
You will have to pursue guardianship through the courts if your father is Incompetent or incapacitated and cannot authorize you to receive information on his behalf. As you know, the POA isn’t just allowed to share information and isn’t legally required to authorize the release of information to you. So the only avenue really is guardianship if you are willing and able to take over complete management of your father.
webcarpenter Jan 2020
Thank you very much for your input.

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