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My MIL is at a SNF and I am her medical POA.
There was an outbreak of Influenza A., so the facility went on lock down.
We have kept in touch via phone and her memory is declining along with some dementia.
I found out yesterday 4/7 that she had been given Tamiflu as did all the residents.
The kicker is that I was never notified.
I found out because I got an email from the pharmacy that her bill was over $50.00. I have it set up that anything under that amount is autopay.
I called the SNF and the nurse said that she was given some cream because of skin issues behind her ears.
I then called the pharmacy and was told that her bill was $114.00 for Tamiflu.
We had a care conference 3/31 and none of this was mentioned.
I put a call into the DON and and was told that she was not presenting with symptoms but was given Tamiflu from 3/9-3/15.
She stated that the Health Dept told them what they should do. She apologized profusely and agreed that it was not handled correctly and could not tell me why it happened or there procedure for residents with a POA.
I then called the Health Dept and was told that they do not tell the facilites what they have to do, they only advise and the facility makes the decision.
I them had to call the administrator again as she was not returning my phone calls.
She was a bit snippy and condescending.
She too could not give me a reason or procedure but said that this will be used as a teaching tool at the next nursing meeting.
I did put them on alert and will be watching them carefully.
Is there anything that I should be doing next? Do I send a notarized letter stating this mistake and going forward I am to be notified before any prescription medication is given or discontinued?
My MIL likes it there and the staff treats the residents well. I don't want to rock the boat, but I am very concerned over this.
Thank you for reading this.

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I guess then I am a control freak. But if I wasn't, both my parents would have been dead before their time. And why, because the Health Professionals never looked at the paperwork supplied by me about allergies and likes and dislikes. For a UTI my Mom was put on a antibiotic that had penicillin in it. My Mom is allergic to it. Its in the paperwork supplied and the hospital admissions confirmed it when she was admitted. Right there on their computer. She was nonresponsive, hadn't eaten and they were sending her to rehab where she probably would have died or been sent back. (Big no no with Medicare) I complained and finally got the hospital dr on the line and got her an extra day. In the meantime, my daughter showed up and found the mistake and had it corrected. It took me a while to get the staff to even call the dr. All I got was " Dr already signed her discharge". Yeh, 24 hrs before my Mom did a 180.

You have to be on top of a LOs care. You have to ask questions. And, a resident/patient has the right to refuse. No NH or AL can't force them to take a medication or a shot. Don't think they look at the records. Her MIL could have gotten a reaction to the Tamaflu because she is allergic or sensitive to an ingredient. And Flu shots are not for everyone. There are people allergic to eggs should not even have them.

Be vigilant people. It could mean a loved ones death if u don't question.
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I'm sorry, but what exactly is the BFD?
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I’ve been wondering if anyone else was going to ask. Sounds like the facility is 100% on the ball and being pro-active rather then reactive. It’s becoming clearer and clearer to me every day that some folks here are big time control freaks and go looking for problems.
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Check your admission paperwork.
Sometimes these facilities have “standing orders” that are signed by the NH doctors that include protocols for these type of situations- ie residents must take the Flu Shot unless they refuse, given Tamiflu if the possibility of a flu epidemic in the NH presents itself, Hepatitis vaccine, etc.
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I would think this is something that first needs a Drs order and second, permission from the patient to give it. If the patient can't give permission then the POA is called. My husband was positive for Flu A and started on Tamiflu. I was tested and was negative but was given Tamiflu too. We were on our way to a family vacation. It was kind of a preventative thing.

I think you have made them aware of how you feel. For now thats enough. I don't think a letter is needed unless it happens again.
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Tamiflu has a incredibly tiny window - 48 hrs - in which to use. If you have run a high fever, other flu symptoms & all just like started, Tamiflu works incredibly well. But you have to get on it, Tamiflu, like ASAP. Again within 48 hrs. for adults. I bet that why it was done & Rx ‘d ASAP.

Type A flu (this flu can do a quick nasal swab & test to confirm) responds well to Tamiflu. Recover sooner & lessens severity. If others in the facility were already Type A confirmed, it was wise to assume A was spreading and everyone who started to present any flu like symptoms went onto Tamiflu ASAP. Tamiflu was a real game changer for dealing with the flu when it came out abt 2000/1999, we went thru gotta get Tamiflu with our kid when he was in early childhood program back then.... it was onto Tamiflu or you keep them home 10 days, and yeah you can guess what path most parents went, our pediatric group had it where you didn’t even come in, as they knew what schools your kid went to & which had flu outbreak and it was what pharmacy do you want Tamiflu RX faxed over to for pick up. Again for Tamiflu you can’t just wait & see as tiny window of time to start it. There’s a generic available. If it was brand name Tamiflu that was billed, could be that generic was flat just sold out. The NH imho was doing its job and being proactive on behalf of all residents to get on Tamiflu.

as an aside, a decade or hopefully less from now, there will be a new Tamiflu type drug for Covid-19. And we can tell our kids or grandkids about the dark days before it was available. Everybody wash your hands, get that mask on and do 6’ when possible.
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It sounds like the SNF just screwed up. Playing devils advocate here I will say that the flu running through a facility like that can kill people, and the health dept giving them a suggestion probably made the nurses feel like it was somehow mandated. It doesn't sound like it was done intentionally and their intentions were to look out for all the patients. That is no excuse, just an explanation.

It is a good learning experience for them.
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JustaHuman Apr 2020
Agreed! We went through numerous medical personnel with my FIL who had severe dementia.
We were his POA and the hospital made appointments, had him sign papers etc.
I didn’t know any of this until I got a reminder notice for an appointment.
This happened three times at the same hospital different admissions.
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Does she use the facilities doctor?

I required that they only gave my dad medication prescribed by his doctor and I was to be notified so I could keep the list current for his specialists.

After a few unethical prescription charges, I put my foot down and said no one is allowed to give him any medication without my approval and all charges would come off his rent if they did. It wasn't a problem after that.

My biggest concern was that he was paying for someone else's meds or they were changing things that it took specialists 2 months to get right and get him stabilized.

I would be nice and tell them that you want to be notified to keep her specialists on board.
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JustaHuman Apr 2020
Thanks! She was in assisted living and they put a lot of pressure on us to have her seen for depression.
We agreed and they put her on meds.
She wasn’t monitored and lost her appetite and slept most of the day.
Her primary was not notified when she was put on the meds and taken off.
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