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I have another question. This one is about my Mothers primary care doctor's nurse telling my mother she has dementia before any test and/or interviews were conducted to determine if she does in fact have dementia. Last October Mom had a stroke the doctor called it a TIA stroke. She was discharged from the hospital 2 weeks afterwards and there was a follow-up appointment with the primary dr 2 weeks after that. The hospital sent over all her records of her hospital stay and when we went to that appointment the nurse told her the report said she had dementia. I don't know why this nurse would rely that information because the doctor sure didn't. The last time we were at the doctors this same nurse was very cold toward me and if looks could kill I would be a goner. Today I called the doctors office to inquire about a fax number and was told it was a private fax number and why did I want it? I wanted to fax over some questions to the doctor for another follow-up with the stroke and the new info on the dementia. She flatly refused to give it to me and suggested Mom and I come early and she would give the questions to the doc and if he had time he could look them over. I also asked if the geriatric doc had sent over the test result on the dementia, I'm not exaggerating here this women was so rude on the phone it was like she hated me and I've only seen this woman maybe 4 times in the last 3years. Anyway my question is can she tell people things that are in their records that the person doesn't even have a clue as to what is going on yet and if she is telling my Mother who else is she telling that she shouldn't be? BTW I have POA for medical and health on my Mother and this nurse has that paperwork in Mothers file.
Thank you

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You might ask the doctor during your next visit whether it is his office policy to have his nurse present a diagnosis to his patients before he has had the opportunity to review the file and discuss the diagnosis with the patient himself. That may be the most diplomatic way of letting him know what his nurse has been doing.
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Today with PC doc things went good. He started talking about his medical problems and his nurse's I broke his chatter and ask him to talk about Mom's medical problems and not other peoples, he did and the appointment went well after that until the my sister showed up. The PC let Mother know that he would not be able to deal with the dementia because it's way out of his field and to stay with her geriatric doctor for now. He also mentioned her that he has seen changes in her that weren't just because she was getting older . Anyway the nurse was okay toward me. Doctor gave my sister his copy of geriatric doctor's report and laughed while she read it. She also kept saying that "Mom is old of course she forgets things. These 2 women don't have a clue I fear as to what is going to happen. However the doctor tried to let them know things were going to get worse not better. So on to the geriatric doctor next week. Fun time in the city.. Keep smiling everyone and hope to see you in the funny papers. (one of my favorite aunt's always said that. She had Alzheimer's and has past away)
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I too have had to argue with people because of HIPAA-phobia, even with documents in hand. I don't get the cold shoulder thing, and it is not something that everyone does by any means, maybe it's just some people still feel free to be rude to patients or customers or maybe they are threatened by the HIPAA or other misunderstandings that they think everyone asking them for information is liable to cost them their job and their license. It's a sorry excuse though, and it is absolutely awful to be treated as if your loved one's condition and care is None Of Your Business. The **reality** is that patients have rights to their records, and medical POAs have the same rights as the patient. You can try looking up the doctor's fax number on one of the physician locator/rating services (Google for your state, the physician's name, and the word physician.) Of course, then you are dependent on the staff to actually give the doctor your information...who knows, someone could be callous enough either not to bother, or dumb enough to think HIPAA somehow covers information sent TO the health care provider, or both. So, seriously - if you can accompany to the visit, that really is ideal. In general, if a patient brings friends, loved ones, pastor, teacher, or case manager to any meeting and are explicitly OK with it, everything can be discussed freely during the visit.

I also second the opinion that it could be worth making a complaint about this nurse. To just say oh BTW the report says you have dementia, without anyone being able to take time to explain that, does not seem right...and if it was just a tentative or a rule-out diagnosis in advance of getting a full evaluation, it was definitely not right. Aphasia is not dementia, and mild cognitive impairment is not dementia, and those might be the correct diagnoses after the evaluation. I think the nurse who is acting hateful might know she screwed up and might be trying to put you off by being hostile and avoid having someone tell the doctor what she did.
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Was she an RN an NP or a PA? Do you know the difference? Do you ask for tests results with your mother present or do you go behind her back? Doctors offices are not obliged to engaging in secretive Q&A without the patients knowledge or presence. The woman told you the medical office policy is to bring it up with the MD and the patient present. You don't accept that. You challenge the patient's right to know they have dementia. None of this is productive for your mother. You can't help her by keeping her away from the factual reality of her condition. Maybe it is hard for you to accept, and you might need counseling.
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Mmn. You've got two options.

1. Look for another primary care practice, one where the partners and their support team have a good track record on dementia, and move your mother there. She may love this doctor, but to be honest these decisions are not long going to be hers to make - might as well start as you mean to go on. If you do decide to change doctors, do your homework carefully - don't want to jump from the frying pan into the fire.

2. Stick with the devil you know. In that case, you complain formally. I still don't think there's a confidentiality issue, but you have legitimate concerns about how your mother's care was approached on this occasion and, by the sound of it, on others too.

You complain in writing: check with your local authorities for guidance on how you go about it. Your complaint should detail what happened, when, who was involved and what you're worried about; and you should also be clear about what response you expect - for example, an explanation, an apology, a change in personnel or process, an undertaking that no new information will be given to your mother without your explicit approval, whatever you think is appropriate and proportionate.

This nurse's attitude to you, though, is a tricky one. The feeling you get that she's got something personal against you is something I'd be inclined to leave out of a formal complaint. She might just not be a very friendly person, or maybe you remind her of the school bully - it could be absolutely anything. I agree with AandA that I might, if it seemed the right time, say "is there something I've done to offend you? I always have the feeling that you're annoyed with me." It could be that she's harbouring a grudge on totally mistaken grounds and you succeed in clearing the air; or it could be that she'll start imagining you're accusing her of something and she gets in a strop - only you can judge the right time for this, of course. More importantly, how is she towards your mother, though? Sweet and kind or on the brusque/dismissive side? It could be that she takes issue with your attitude to your mother, one way or the other - thinks you're too soppy/thinks you don't include her enough - who knows.

On the other hand, specific instances of rudeness are something you perhaps should complain about. Is it just this one nurse, or do all the staff at the practice take the same kind of line? If it's just the individual, personally I'd rather take it up with her direct that complain about her to her superiors; if it's all of them, then cite examples but don't name names.

Whatever you decide to do, try not to get upset, and try not to sound accusatory. You're stating facts, clarifying what the problem is, and asking for it to be put right. It's called a complaint because you've spotted a problem and you're proposing a solution to it, not because you're a heart-sink nightmare relative!
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If it was me and I got "attitude" from the nurse today I would call her on it.. I would nicely ask her " did I do something to upset you? because I've been getting the feeling that I have ". Clear the Air....
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I have NEVER heard of an assistant to a Dr. whether it be an RN or CNA etc. divulging information and/or rendering a diagnosis BEFORE the doctor had a chance to. I'm afraid I'd raise a stink about that along with her attitude, then I'd find a different doctor if at all possible. BUT at the same time I'd worry that this doctor and/or staff would put something in your mother's file saying she was 'difficult' or 'family is difficult'. You know what I mean? Don't want something like that following you and yours around forever either. Still, everyone has to answer to someone and doctors and nurses are no different, so I'd complain till there were changes made somewhere.
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Mother's primary doctor uses his medical condition's and conditions of his other patients to compare them with Mother. I personally don't like him but Mother loves him. I just wanted to know if the nurse had to right to tell my Mother what she did. I knew Mother was going to be checked for dementia and was told not to say anything to her just on the off side chance she didn't have it. Well she has it and is in total denial about it so we shall see. Today we have a follow-up appointment with primary care doctor for the stroke. The POA is up to date but my Mother is still able to make her own decisions to a point. I think but not to sure that her refusal to taking anymore medicine either for the stroke or the dementia isn't all the sound of mind.
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Is your POA active? That is, is it an accepted fact that your mother no longer has capacity?

Technically, in either case, there is no breach of confidentiality in this nurse's giving your mother information about your mother. There is, or at least may well be, a significant breach of common sense and professional judgement, though; added to which if she has given a firm medical opinion before your mother's doctor was prepared to hazard one, then frankly she's gone well beyond her pay grade. She is a blabbermouth. It happens.

How much do you like your mother's primary doctor? Do you rate him, would you be reluctant to switch? Because what you do about Blabbermouth would very much depend on how keen you are to stick with this medical practice.
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I would change DR...Ask her Geriatric Dr if he prescribe her Rx for now on..
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