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Dad in nursing home since 2017, still on 2 different psych meds, although lower doses now. Dr Telehealth visit every 2 weeks, but this time also included an unknown nurse practitioner from out of state, who prescribed depakote. I told the floor nurse no, but prescription was already filled. Telehealth nurse practitioner will not return my calls. My Dad fell again last week, had stroke in April, has fallen 3 times since Jan, once requiring stitches on forhead, and the dumb dr adds another mood altering drug. How do I get this to stop?


Dad has vascular dementia, no formal diagnosis. I am only child living 1,500 miles away. My father is a stubborn man, always has been. I'm angry that the dr and unknown nurse practioner will not call me back, hate this hiding they are doing.

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Please listen carefully (I worked as an NP for 10 years in nursing homes. I did my best for my patients but kept getting fired after going through the chain of command didn't get major health or patient issues resolved, and I felt obligated to involve the State Dept. of Health, OSHA, and the State Board of Nursing.).

Unless you are your dad's Durable Power of Attorney and/or Healthcare Advocate, they do not have to listen to you. If you hold either of these titles, I would advise you to keep a journal of the dates and times you called the facility's management, the doctor, the APRN, the administrator of the facility...

THEN, although it should be posted in a visible spot but never has in any facility I've ever worked at, you'll need to obtain the name and phone number of the LONG TERM CARE OMBUDSMAN who covers that particular nursing home in your dad's state. Call him or her. You may need to leave a message. Leave a brief message and your phone number. Repeat your phone number slowly, a second time. Spell your name if it's difficult. Not quite sure how to say this but, the Ombudsman is the be all, end all, and when they hear that you've contacted this person, they'll be jumping to attention the next time you call them.

As a courtesy, you probably you make sure that you've tried to reach the director of nursing and the facility administrator. Again, document, document, document.
I had the opportunity to bring this person into a facility where my dad was one time and that's all it took. I had much better cooperation and I never had to call her again. Not that I would've hesitated... They are never going to tell you how much "power" you have in the decision-making process if you are the designated durable power of attorney. If they don't have a copy of this document on your dad's chart, send them another copy - Certified, Return Receipt.

Another option, is to call the Department of Health (again, in dad's state) and report what you have stated here. They will do an investigation of the whole situation to determine why your calls were not returned. This agency has the ability to substantially fine or even shut down a facility. Unfortunately, at least in my state, they are backed up with cases for at least 6 months and you may also have to put everything in writing. If all else fails, obtain the services of an Elder Care Attorney. They won't play games with an attorney. If finances are an issue, try some of the online websites for low-cost legal aid for elder care.

If finances aren't an issue, you may want to hire a case management service to follow his care and report back to you as often as you wish. I'd suggest hiring a service in the town or at least the same state that your dad is residing now.

I hope this information is helpful. Don't be pushed around and treated disrespectfully just because you live out of state. However, as I stated earlier, if you're not the POA or HC advocate, you probably don't have a leg to stand on.

Best of luck to you!

GG - APRN
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IMHO they want to keep him "docile". As an only child who, until recently, lived with M&D, I can understand why that might have seemed like a good option for that NP.

However, it is wrong of them to withhold information. Do you hold POA?


Depakote is very hard on the liver.

D
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"It can treat seizures and bipolar disorder. It can also help prevent migraine headaches."

I don't feel a NP should be prescribing this kind of drug without knowing more about the patient. My opinion, even a GP is not qualified. And why are they using an NP out of state? Is she licensed to practise in ur state? And, what Dr. affliated with the facility does she work with or for? In my state I have never seen an NP working alone, they are usually affiliated with a doctors office.

If you get no call backs, contact your Ombudsman or even the State licensing board for NHs and put in a complaint.
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Shane1124 Sep 2020
In this time of Covid, licensed staff have been extended by an emergency federal order to be allowed to practice across state lines.
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