she has already been diagnosed with dementia and they are telling me she has to be totally incapacitated for me to take over. that she has to refuse even though she is not capable. is this correct?
Call the pharmacy and tell them your are filing a notice of claim for damages to a patient with hypercalcemia. They will recant. Then give the MD hell for not reading his damn faxes and tell him to rescind the order IN WRITING. Then report the entire medication error to the joint commission. That will make them wake up and smell the coffee.
ooh, Pam - I'm not sure I'd want to do THAT over calcium carbonate. If she does it will be guaranteed adversarial from then on out. There probably weren't any actual damage done, and I think she implied she was about to get it stopped, it just should not have been such a hassle. Pharmacy is trying to be helpful with their little bone health protocol, but they are doing the cookie-cutter thing with it, and a doc or a nurse practitioner who would have the authority who is swamped with paperwork can easily just check the little checkbox. That's why a person getting meds and anyone looking after them have to stay vigilant - mistakes like this happen all the time when a basically good protocol is misapplied.
Actually, the doc needs to look at her for hyperparthyroidism and renal function if he or she hasn't already.
I always had troubles with that too. I had healthcare POA and HIPAA documents up the ying yang and made so many copies of them I lost count, but still, people want to mess with meds and don't want your input on it. I rarely had a doc that was enough of an ally that they would TALK with me about meds and get my input on past experiences before restarting or changing something, and the nurses tend to fuss when you want to see the current med list, but I kept insisting on doing just that, finally got it on a regular basis. I caught most - but not all - errors before harm was done. And then, I'd get called every time they wanted to put triple antibiotic ointment on a new spot, but you know what, at that point, I'd just say thaks for letting me know!
I'm going to guess your best bet is to tell folks your mom has had unusual reactions to meds, even something as innocuous as calcium carbonate, and you want to be contacted about all med changes. Make sure you are totally reasonable about it when they do want to try something and are willing to halfway explain why - I will admit to being very frustrated with people who like to refuse meds that are very low risk compared to the risk of the condition they are treating, just because they think there are "too many pills" given in general. SO, take an assertiveness training course somewhere, you're going to need it trying to deal with this and getting to win-win...Things are changing, but the old ways of paternalistic medicine, of there is one right way to do everything and one size fits all so don't question my judgement, are still very much with us in way too many settings.
PS try the ombudsman or grievance procedure which should be posted if you have to. And if they say you *really* have to get an incapacity letter or two so the healthcare POA is in full effect (I say "really" because, hey, why not just pleasantly cooperate with you instead, as if you were a caring person with at least the same desire as they have for your loved ones well-being??) I'd bet you could do that too. You just ask her doctors who have diagnosed dementia; it does not have to say much except that the person is unable to manage their own affairs due to the medicla diagnosis. It might be handy to have it anyways for financial POA issues; back in Pennsylvania, I had to have two of those to sell a house though other routine bill-paying and banking had not required it.
I called attorney in California who drew up papers and waiting for answer. but I can not fathom that they can do whatever they want and my legal paperwork means nothing?
Lizzy your DPOA paperwork means a lot, but nursing homes are required to follow the doctor's written orders. They are also put under pressure by state auditors who follow the cookie cutter orders that come from on high. These edicts are health care fads from the state capitol. Years ago they wanted everyone to take more iron. Now it's a calcium fad. I am my sister's guardian, and I still need written orders from an MD for changes. PLUS calcium is something that blocks other medications. So when they added the calcium to my sister, it blocked her seizure meds. Things got ugly, and so did I. But I still had to get the MD to write a stop order.
The Dr did send them signed statement NOT to give her the calcium. So they say they have stopped. I was so mad and raised my voice when talking to all. They will probably want to kick her out now since I am so problematic. She has dexa scan and cat scan this week. Hopefully will find what's going on. I don't believe it's the normal progression of her dementia because it's come on so fast. Sleeps all day tired joints ache urinated constantly. No uti though. I feel so bad because I can't have her with me and she doesn't like new place. She's lonely too. My father died last November and they were married 60 years.
The thing is Amsterdam the Dr didn't write an order. The facility pharmacy ran an audit on all residents meds and thought she would benefit from this 2x a day. She was on it once a day but prescription ran out so Dr decided not to refill it. The facility sent this "suggestion" by there pharmacy to dry office and someone there checked the box that said "I agree with this" and signed. The facility said to me that's as good as a prescription.so we're going to give her a new double dose against my and drs wishes
lizzy, no - facilities have to follow physicians orders - this has to be stopped and the office of long term care or the equivalent will not let this stand. Hospitals and other facilities have just become incredibly stricter about this, to the point of absolutely ridiculous calls to physicians to make sure that everything they do is covered by an order.
Actually, the doc needs to look at her for hyperparthyroidism and renal function if he or she hasn't already.
I'm going to guess your best bet is to tell folks your mom has had unusual reactions to meds, even something as innocuous as calcium carbonate, and you want to be contacted about all med changes. Make sure you are totally reasonable about it when they do want to try something and are willing to halfway explain why - I will admit to being very frustrated with people who like to refuse meds that are very low risk compared to the risk of the condition they are treating, just because they think there are "too many pills" given in general. SO, take an assertiveness training course somewhere, you're going to need it trying to deal with this and getting to win-win...Things are changing, but the old ways of paternalistic medicine, of there is one right way to do everything and one size fits all so don't question my judgement, are still very much with us in way too many settings.
Best regards and best wishes!
PLUS calcium is something that blocks other medications. So when they added the calcium to my sister, it blocked her seizure meds. Things got ugly, and so did I. But I still had to get the MD to write a stop order.
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