Is a doctor required to consult the family before prescribing medication?

MsMadge, Thank you for responding. When my mom was moved to Twin Rivers the evaluated her and yes she had got to the point that she would cus and slap BUT they pay so much attention there that they soon discovered she was doing it because she was in pain, it was all in the approach. The requested to be able to give her the adavan rub on cream when they had to bath her and I had NO ISSUE with something like that. They did use it a few times but cancelled the order because they found out that my Mom did not need any of that stuff. They allowed her to sleep longer than 6:00am and the lady in charge I will not mention her name. Found that all she had to do was show Mom love, even if she happened to slap at her which when I say that my Mom was so tiny it was like a tap, she would just look at her and wrap her arms around Mom and say I love you!!! Mom would smile and it she had said or done anything wrong she would say I love you to, smile and tell her that she was sorry. I wish everyone could have a place like Twin Rivers I hold them in the highest regards that is possible. Plus the hospice agency I can't speak highly enough about. It was only the one Doctor at the previous home that I had an issue with. She is under investigation, I have signed my privacy rights away, which I never cared to have my name private. This is in case it goes to court. I'm pleased that I found that they have subpoenaed all my Moms medical records from both homes and the hospice agency for further investigation. The Doctor that I'm going after is currently under inditement with another Hospice agency for over medicating the elderly. I may have mentioned this in my original letter. I have always heard about Nursing Home abuse but until you go through it you have no idea the things that are done to our loved ones. I'm not a vindictive person and I'm considered by people as being to calm however I am so distraught over this that I'm determined to push this as far as I can. Just thinking about some people who have no one to speak for them brings tears to my eyes. I hope also that someone answers my question and thank you so much for your response.

As the POA, I constantly had to stay on top of the doctor...actually the nurse practitioner...who kept changing medications and/or dosages for my mom. Eventually, we had a family meeting with the staff, which included the doctor and nurse practitioner and made it crystal clear that nothing was to change, unless they called me first and had a conversation. One of the people above said to call an attorney. I would do that very soon, as this doctor of which you spoke seems to need to have her license removed. I know of a woman that went the route of going to the government first. As in keeping with the government, they dragged their feet until it was past any time the nursing home could have been prosecuted. Eventually, she went to an attorney, but, as I say, by then too much time had elapsed, thanks to the government. I am sorry you had to go through all of this. We POAs really have to stay on top of the medical community who are taking care of our loved ones, because though there are many good and caring people, others don't care and should be doing something else. The nursing home of which I spoke is having "empathy classes," to teach the Millenials how to have empathy for the residents. If you think about that, we have a serious problem coming down the road.

The medical board will decide if there was a wrongful death. No the MD does not have consult with family UNLESS the court appointed one of you as legal guardian.

It IS all in the approach, but rotating staff bring a multiple variety of different approaches, and there is no expectation that the "love" that you said the one woman brought is expected of many - and in fact, many young or busy people don't know how to use a preventive approach. I mastered it over years, but always started with interest in patient's complaint, willingness to check it out or and respond to her - but briefly, and with love. Agree with the patient, pause, stay focused on task and present it positively. And NOT talk even among selves except to find best approaches - of someone's "bad" behavior, these are elders, not children. It is not easy to deal with some people - but it's the job of working with elders, and it should be the express job of all staff. Instead, the jobs listed are the ones the MD assigns, and the MD does not assign an approach. Different staff members bring different plans, the same task can be done many different ways and it is difficult for anyone to learn and follow several different teachers/task leaders - medications are what are used to "take off the rough edges" of a patient's disruptive behavior, but few consider the behavior's origin, timing, circumstances that led up to an incident, tracking to find what's wrong - instead the protocol is to write up the details within an incident only, which actually just serves to "prove" the need for meds. The system is broken, and it is in incident reporting that it's broken - because stasistics are misused.

I've stopped staff in meetings from saying, "your brother has had more falls recently", because my question when I receive any fall report, is not primarily his health afterwards as the staff reports - but what was he doing in order to fall? Where was he trying to go, what was on his feet, was he getting up or turning - one incident reported was when a new staff member was holding a door open for him, but she was in his way and he was tired and tried to go around her rather than ask her to move. I finally got Occupational Therapy in the residence, to work to study situations and find solutions, that way he is getting attention - and so is the approach!

Aveeno
So tragic and I'm so sorry-

I fought very hard to control what antipsychotic meds my mom was given in her memory care facility and I allow only one now

It becomes more difficult with a hospitalization and a nursing home which cannot cope with any behavioral issues and will sedate to control things

Even when mom spent time in rehab it was challenging but no where near as what your poor mom experienced

I don't have first hand hospice experience but understand your pain

Hope others can address your questions

As medical POA, you have a right to informed consent, and your mother, no matter her condition, would retain the right to refuse, as do you as her MPOA. They did this to my mother as well. They had her on black box warning drugs that kill the elderly in short order. At the time, I didn't have POA; my brother did, but he was uninvolved and uninformed about the drugs. My mother was incoherent (although I could generally get her point of reference) and could barely answer questions. She scored low on the comprehension tests, and the doctor told me there was never going to be any improvement. Well, after I got POA and managed to get her off the dope, she improved. They were surprised. Yes, Mom had behavior problems, but I think they need to find better ways to deal with nasty people other than doping them into oblivion. What they were doing was killing her. My condolences for your loss. I pray you are able to get satisfaction for what they did to your mom.

I do have Medical//durable/general POA for my Mom, but have mostly lost control or knowledge of her regular meds. (I’m working on that!) People also need to realize, though, that even “OTC routine” meds need to be monitored… I get really frustrated because I can’t even get them to listen to me regarding “regular bowel care” meds (namely laxatives). Prior to the fall 2 years that ended up with nursing home care, Mom had recurrent and serious issues with diarrhea, and after many tests the reason “couldn’t be found". When we saw her cardiologist for a different issue, he asked whether there was anything else he could help with? I laughed and said “nothing you want to deal with!” He said he was also an Internist, and what??? He immediately said sometimes antacids can cause chronic diarrhea (she was on Prilosec), and he took her off that and prescribed something different… Her “issue” cleared up immediately! (I added this info because it might actually help someone else?)

So – when Mom reported to me that in the nursing home she was having horrible, multiple, and humiliating diarrhea “out of the blue” – during dining room meals, going down the hall, etc. – and was so embarrassed I finally asked the meds nurse whether she’d been given laxatives or anything? Yes – as part of their “regular bowel care” routine, she’d been a little constipated, so they automatically gave her laxatives… It might have been nice to warn her? She’s not incontinent, and tells them when she needs help to go to the bathroom, so this really had her upset. Plus – I was worried at anything that could throw her into her previous issue with horrible chronic issues. I told them “Try prune juice! At the most, try gentle laxatives, or even short doses, and for Pete’s sake WARN HER!" They pay attention "sometimes"...

To me, this is showing utter disregard for personal dignity and quality of life. It's right up there with the time I took her to the doctor, and she was quiet and had her arms crossed over her chest... When I asked whether she was OK, she said "They couldn't find my bra! I haven't left the house since I was 13 years old without a bra!!" (She's 97 years old, and wears a DD/underwire bra.) She did have 4 good-quality bras, but when we got back, I checked and only found one which was so beat up from their laundry "care" - holes, hooks in back bent out of shape and only one sort of working - I was livid! These places need to have "training" orientation for (mostly) young CNA's and other staff about the dignity and respect  -and what that entails - due the older generation!

Even in a private pay ALF they use sedatives to ensure that the clients are compliant. We should not be sedating our elderly family members with Seroquel and other anti psychotic meds because they are confused and agitated. There is no definitive evidence based trials that support these kind of drugs be prescribed for symptoms of dementia or alzheimer. Over medicating is not the answer.

We were not guardians but we did have POA. would that count?

See your family Attorney.