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I spoke with the head nurse this morning at dad's AL. She informed me that his doc (whom his hasn't physically seen in 18 months) has discountined his daily prescription of Tramadol. He now can only take it as needed. State of WI rules about class 2 substances changed April 1, 2017. Dad has been in hospice care due to terminal prostate cancer as well as having advanced dementia since May 2017. Tramadol was started June 1st. Now the staff has to watch him for cues if he is in pain. Then tramadol can be given as needed. If you ask dad if he is in pain he always says no. He has lost close to 35 pounds mainly since August and at 6 ft he is about 150#. Hospice is an exclusion to the class 2 rules. As I'm his DPOA can I call his doctor and discuss this prescription change?

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Was this the Hospice doc? That's the only person who has any say so if he's on Hospice.

Call the 24 hour hospice number right now.
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His Hospice Dr should be the one who is Prescribing now. I'd start with his Hospice Nurse, who will speak with the Hospice Dr. My FIL Never said he was in pain either. We had to watch for cues to know when he was in pain, there are many non-verbal pain symptoms cues that they watch for, facial expressions, grimacing, groaning and guarding the area's that are hurting them, and many more. Plus, my FIL had Lung Cancer, and the Morphine helped him with his breathing. I am pretty sure they will assist you, if he truly needs it, and more as his symptoms worsen over time. Good luck, Hospice really comes through, and always advocates for the patient and their family!
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Definitely take this up with Hospice. His former doctor's clinic is probably just going through records and making sure they comply with regulations. Hospice has the authority in this case.
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His hospice nurse was surprised at this change. I’ll have to get some clarification on who is in charge as I would think it would be the hospice doctor as well.
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I think that Jeanne has the right idea, that the family doctor was just going through records and bringing his scripts into compliance. Someone took down the information not realizing that this was no longer the prescribing doc.

You've got a good DON!
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