So, here's the cast of characters...
1. My brother and I, both out of state
2. Dad, in Massachusetts, 91, in assisted living, with Parkinson's, moderate cognitive issues, and depression. Already on some meds, and on Medicare (not Medicaid)
3. Stepmom, 88, living at home in Mass., with cancer (although doing better overall than Dad)
4. NP, the Nurse Practitioner who's seen my dad several times already
5. GP, Dad's doctor, who sees him all of about 15min four times a year. Somewhat contentious relationship between him and Dad.
6. Exec, the executive director of the Assisted Living facility.
So, Dad's been in AL for almost two months. NP visited him about a month ago (has seen him 3x, I think), and seemed to develop a good rapport. Initially, she mentioned having a psychiatrist colleague to come in and work with Dad and also test his cognitive capabilities.
She has since mentioned some suggested changes to his meds to reduce his depression and his anxiety (notably because his wife his not living with him). However, she has noted that, because she's an NP, she can only suggest medication changes.
NP did bring in a psychiatrist, who ran some tests. I have a copy of those results. He also suggested that Dad's health care proxy be invoked (putting me in charge). Those results have also been sent to the GP.
GP appears comfortable letting a psychiatrist make changes to the meds; I have not spoken to GP firsthand, but we have a woman who's been helping out there with both Dad and stepmom who has spoken to him.
Exec told us a 'registered therapist' saw Dad (and stepmom) this past week, and will continue to see Dad regularly. However, not clear she's an actual psychiatrist.
My brother and I think what Dad needs is regular psychiatric help and some changes to his meds, but aren't sure how to make that happen.
I plan to call GP regarding the psychiatrist's recommendation about the health care proxy, but am not sure what else to do to make all this happen.