Can a POA for care have the NH withhold food from their loved one? Have family who thinks Mom is too fat, want her on a diet, can they?

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Using a rationale of, I think the extra weight is causing her joint pain. Only fruit for dessert, regardless of what others at table are having, bread only if in the form of a sandwich, and only 1/2 a sandwich, 1 piece of toast at breakfast, no sugar in tea, coffee, only fruit for snacks etc. Also mother refuses care, becomes physically responsive to staff, family insisting that she is made to have a bath/ shower.

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My only comment on this was my observation that during my brief say in rehab the NH patients all seemed to be overweight with few exceptions and were given huge amounts of food and easy access to snacks all day if they were mobile.
This lady's diet sound too restrictive so a consultation with a dietician is in order. She may need to loose weight but it should be done with a sensible amount of food. things that need to be cut out should be reduced gradually, then she may not notice the lack of sugar in her coffee.
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Assuming you're one of the treating nurses, and the proxy is asking for food management that you're not necessarily comfortable with, I think I would speak to the DON and suggest a care meeting with him/her, the proxy, and the visiting PCP or internist as well as the physiatrist doctor.

I think I'd be thinking about my legal situation as well, so start documenting. Is the proxy someone with medical background? What other characteristics have you observed about this person?
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Don't believe pain is an issue, she walks all over with no issues. Just questioning the legality of what the POA is asking. I don't think they should be able to decide, no Dr order, believe it is the management trying to avoid a lawsuit
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I'm very curious about this question. My mom was in a NH for the last 4 years of her life, and it wasn't as though we could simply "demand" that something be done. If it was detrimental to mom's health or well being, they explained WHY they were doing it, or not doing it.
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At first I thought you might be a family member, then I thought you're a nurse at the facility and questioned the family's attitude.

It would help to know first how valid the assumption is that extra weight is causing joint pain, absent any other identified medical conditions. If this is just the family's observation, I'd take it with a grain of salt unless it's corroborated by medical opinion.

Also, has the facility doctor made an observation of this, or has an orthopedic doctor been consulted? if the staff concurs with the diet, is the patient resistant?

I get the impression from your last statement that there's more going on here than just the diet and weight issue.

I do think though that if the family is making an issue out of either what she eats or her weight, that it would be appropriate for staff to counsel them that their attitude should be supportive, and that the medical staff could more legitimately handle the weight issue.

It's hard enough to be in a facility, away from home, probably not feeling great in the first place, w/o being nagged about what she's eating, especially from the family.
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Are you getting this information from the patient, the facility or the family?

Does the patient have dementia?

Do you mean the patient attacks staff because she doesn't want to bathe?
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Are you saying that the doctor has prescribed a diet for medical reasons? I think that is fairly common. If she's having pain and the extra weight is making it worse, then, I could see the benefit of her losing weight, having less stress on the joints and helping with her overall mobility and health. I would think that it's pretty common. Normally, I saw seniors should eat what they want, since they are in the final stage of their lives, but, if there are medical reasons that places them in harm or in pain, I'd likely listen to the doctor.

I'm not sure what you mean by refusing care, becoming physically responsive, etc.
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