Over the past year I have joined my mother in her doctor visits because her memory is declining and she doesn't fully relate any issues or medical care but, does rely on me to help her with it at home. She fully and agreeably relies on my judgement to help. Her doctor is extremely dismissive of me in person. On the first visit, I handed her the FULL DPOA and she immediately told us that means nothing unless mom is incapacitated. I thought that was a regular "springing" POA that worked like that. The last two times she asked mom about her affairs being in order and she was told (by mom) that I am her primary home care and take care of everything for them...bill paying, house cleaning, shopping, cooking, appointments. The second time when mom told her that, she got closer to mom and looked pointedly at her and asked "and the rest of your children know this". I kept silent but was a bit put off. My family is tight and they all support me and are grateful I am able to be there as I am. I have one brother who comes to assist when my father is more incapacitated as his health is in much greater decline. There was a recent episode and mom had a bad morning with dad's care before her visit so she was visibly shaken. The doctor made comments like "How nice of your son to come and stay with you and your daughter is able to "bop in". WTH - I more than "BOP IN". They live next door and I am there 2-3 times each day. I never leave my property without taking them for a ride. I cook for them, clean, yard work, EVERYTHING. I wanted to set her straight but, mom has had her as her doctor for 20 years and she's almost 89. How do I inform this doctor she is overstepping her bounds and that as DPOA that I DO indeed have a say in what goes down. I wished she had just tended to moms' health. Instead she spent the whole visit talking about my fathers and his impending death and what was mom going to do. We have that covered and she has been told that 3 times now. I am a professional who owns my own business and has assigned staff to handle it while I spend my time caring. I do not rely on any income or inheritance from my parents and seek nothing but to help them in their elder years but, this doc is really rubbing me the wrong way.
1. MOTHER: It probably has been a lovely 20 year relationship, but at the moment it going off-kilterYour mother needs to say to the Doctor, "I am so happy to have my daughter here with me today. She is more than my DPOA, she is trusted by me and the rest of the family."
2. DOCTOR: "and the rest of your children know this." It sounds like the Dr should have retired several decades ago. It sounds like she is projecting her fears in her life on to your mother. However that is not the professional thing to do. Are there others in the practice who could care for your mom? Or be a sounding board for you?
3. YOU: You're mad, insulted, angry, furious.... take a deep breath. This woman is not hearing the situation. Don't argue about it. "How nice of your son to come and stay with you and your daughter is able to "bop in." Yes, this is rude, wrong, and insulting. BUT remember you and Mom are there for medical care.
You can steer the conversation to medical concerns. Remember, you are looking in on the Dr-Mom relationship. Let your mother speak up. Don't talk for her...until the very end. If the Dr pulls this again, it would be a good time for a calm reprimand from you.
If Mom made it clear that she wanted you there, then there should be no problem. Try one more time and then change Drs. Will be easier for you because then you can make their appts for the same time frame.
The best advice and course of action is for us to tell her doctor one more time as to my role in the family and to double check our paperwork with a local elder care lawyer. If it doesn't work, I'll see if my fathers' doctor will take her because that doctor totally respects and praises my involvement and care for my father. We have extensive history as he is much sicker. Moms doctor sees her 15 minutes, twice a year and she no idea what my family is like. My fathers doctor sees us often, spends an hour or more with him and knows his family, history, hobbies, and is keen to keeping him healthy in his old age. I have been working with her, as his caregiver for about 5 years now.
I know I could switch anyway. Quite frankly, my mother trusts me above all others and I will go to the end of the earth to care for her. My husband and I have spent so many thousands of our own money to keep them safe in their own (multi-story) home. I am trying to respect their independence as they age. I don't want to tell her to change her doctor, even though she would. I would only do that if I didn't feel the level of care was not there. I am not certain it is because thus far, she hasn't done much for my mothers recent issues. It's been more about the end of life for my dad discussion.
This last visit and question about whether or not my siblings know seemed bizarre to me. I never thought she was thinking any sort of abuse until reading all over these comments. That was even more upsetting. Grateful though it's all brought us to the first paragraph of this comment. We have a course of action and will resolve my issue. Thank you for helping me process.
The fact that this doctor sees her so infrequently and has that dismissive air is just unprofessional. We had a similar situation and we found a new doctor that LISTENS both to her concerns and mine. She does the talking at the doc and add anything she might have forgotten. Mom introduced me as her daughter and that I handle everything for them both. I told the doctor that I'm her taxi/cook/maid, etc., but also will add things she may have forgotten or didn't think was important. It kind of broke the ice but trust that I do flip the POA card (not with him) when needed and I've made sure that any document that allows me to be involved concerning their health has been signed. I'm very transparent with my family and let them know what's going on with both of them - as you seem to be from what I've read. I wish you luck!
Your mother is not incapacitated, so the DPOA and any MPOA are not active.
Since that's the case, to be involved in the sharing of your mother's healthcare information while she's competent, she will need to have separate HIPPA paperwork completed,
https://mhanational.org/sites/default/files/Fact%20Sheet%20-%20HIPAA%20What%20are%20a%20Caregivers%20Rights.pdf
Your mom should also have an advanced directive (''living will', 'advanced planning') on file that clarifies her end of life decisions, and this may also include who can have access to her information WHEN she is in that terminal state.
Your father's death is going to be a major life event for all of you. It is not unusual for the spouse to follow the deceased within a year of their passing. A good doctor will be assessing your mother's mental AND physical health at each visit, screening her for depression, and trying to tell how prepared your mother will be for the impact. She can tell that best by conversing with your mom. Again, your mom sounds like she's having memory loss, but is still pretty with it, so the physician is being respectful of your mother's autonomy and listening to what she has to say. She's also making sure that your mother is well supported.
Additionally, although it may feel offensive to you, when your mother is under the care of family or outside help it is the physician's responsibility to screen for elder abuse, which requires her to confirm that the patient feels safe from harm and has autonomy. While it may be off-putting, she's doing a conscientious assessment. Not every doctor will do this. I'd prefer a doctor who keeps an eye out for their patient's wellbeing.
So. You and your mom's doctor are both doing your best, and both are on Team Mom. Ask for 5 minutes at the beginning or end of the next visit, or email the physician, and share how much day-to-day insight you have, and discuss what's the best approach for you to support your mom during office visits.
She won't know if you don't tell her and you should. The crack to your mom about do your siblings know you have the DPOA was totally out of line though.
A few years back I had to bring my mother to a doctor who wasn't one of her regular collection. She was able to give an Oscar-worthy performance coming off so pitiful and pathetic that the doctor got on me about how I need to be kinder and more patient with her. I swear I was that close to telling him to F-off. I really was, but didn't. Of course my mother savored every second of this. What he did not see is an exhausted, middle-aged person who was so debilitated from caregiver burnout that I constantly had tears in my eyes and my hands used to shake all the time. I lived in a constant state of panic and crisis and it showed. I told this new guy very calmly that he wasn't familiar with us and doesn't know what our situation is. That mother is lucky I even speak to her, let alone help her out. I told him he could talk to the other MD's in the collection and they'll fill him in on her hypochondria and that doctor collecting and appointments is her favorite activity. They'll fill in on our family dynamic as well. Every one of her collection has spoken to me privately and asked if I needed help with her because they could tell what the dynamic was. They were concerned for us both and offered some good resources that helped.
The I come to the being cynical bit - which I am afraid is something a family members we need to do with Drs especially long term ones who have become "part of the family". It is unfortunate but there are Drs out there who ingratiate themselves with patients for their own benefit when the patient becomes incapable of making decisions or dies. Drs who "end up" in people's wills etc. Your mother's Dr does not sound like the sort of person I would trust very far, and personally I would be getting her to change Drs at the earliest opportunity. If there is another one in the same practice then maybe just change to them because "your Dr hasn't got an appointment at the moment" which at least leaves her notes in the same place. But I would personally prefer a completely different practice and how I got her there would depend on what she understands. Anything from explaining your concerns to Dr X is retiring - yes if its in my mother's interest I will lie to her.
If you just don't get on with the Dr you could try the humble pie " I'm sorry we don't seem to have got off to a good start" and try and improve things and get agreement that you work together for Mum, but if you have doubts about his ethics then talk to the board that registers and monitors Drs in your state, seek their advice and consider moving mother having got the legal papers sorted.
It seems highly unlikely that these people are so wealthy that it would be worth some doctor's time to ingratiate themselves into a will or something like that.
One thing you do have to watch out for with geriatric specialists though. Some of them are in bed with certain nursing homes and LTC facilities and get a bonus when their patients get placed in certain ones.
Once you determine that you have the correct POA, consider writing to the doctor in a non-confrontational way. Explain that as you LIVE NEXT DOOR to your parents and SEE THEM MULTIPLE TIMES A DAY, you are best equipped to answer any questions about your mom's health WITH YOUR MOM'S FULL PERMISSION.
Also consider pointing out that yours is a happy, conflict-free family who, AS I'M SURE YOU'LL AGREE, want what's best for Mom.
(OK, maybe don't use all caps, but those are major points to hit.)
Finish up with your contact information, offer to let her speak with Mom alone for a few minutes at the next visit to confirm what you've said, but firmly emphasize that your presence at her appointments is a given from this point on AT YOUR MOTHER'S REQUEST.
Be sure to send the letter at least a week before the next visit to give Doc a chance to read and digest it. It'll likely end up in Mom's file, which is exactly where it should be. You might even request that it be added to her file.
These long-term doctors often get very protective of their patients to the point of not treating them so much as being their good listener/do-nothing doctor. I had to deal with that with my mom's old doctor, and my mother loved her even though she darned near killed her with a misdiagnosis, because she was a good listener. Don't hesitate to have a replacement doctor in the wings, and be ready to pull the trigger if you suspect the doctor doesn't share your goals for Mom's care.
If you only have one DPOA for everything, it would be worth the time to go to your state's attorney general website and look up what is required for your state. I have never seen a single document that covers medical and all of the things on a General Durable POA.
Another thing that I would caution for everyone, the HIPAA release forms that are signed in a medical facility are only valid for 12 months, some practices actually have them all expiring at years end. Please do not count on having a valid HIPAA release unless you have one that has been created with the specific wording that it never expires and is valid in any jurisdiction presented, this will save many grey hairs, because you find out you don't have the release when you need it the most.
her health care surrogate ? This is a very touchy situation . Are there other brothers or sisters or family members involved? I WISH YOU HOID LUCK BUT ONCE A FAMILY MEMBER HAS BEEN DIAGNOSED with dementia it’s hard to then take charge with our prier court papers .
This doc is rubbing ME the wrong way, and she's not even my doctor!
I've dealt with a few like that in the past - mainly pediatricians. If YOU the pediatrician are not listening to me and talking to me, then I don't want your "service." One was actually head of some children's hospital, but sorry, I have a baby who cannot speak for herself and if you don't work with me and talk to me, you won't have my children as a patient. I had to change pediatricians twice. The next one was referred by other mothers at the day care and she was the BEST! Sadly she decided to go "save the world" after 5 years, but hand-picked her replacement. I gave him a chance and he was second best!
I feel the same way about vets with my cats. Talk TO me, not AT me, and for sure DON'T IGNORE ME! I can fend for myself, but my children, when still young, and my cats can't. Same applied with my mother. I had to change docs when she moved to MC (too far away and could never get in touch with them, including the 9 months I tried to get the competency letter sent, which was NEVER sent/received!) The new doc seemed okay at first, but when dealing with dementia, it's the same as for my young kids or my cats - work with ME, talk to ME, LISTEN to ME! So, we had to find yet another.
If mom wishes to stay with this doctor, I would have her fill out and sign the medical release or HIPPA form or whatever they use in that office. It isn't just doctors who might reject a DPOA, banks are notorious for this as well. If you sign the bank forms or the doctor office form, they have to allow you access to her information and include you in discussions.
I really don't care what her reasons were for doing/saying what she did. None of that was called for. I wouldn't even waste my time having a "discussion" with her, as you are not likely going to change her attitude. She has shown her colors already. Once, maybe a bad day. Several times? Nope. I would do my best to find someone else and convince mom to change doctors. No one needs that BS from a doctor.
I just looked up my DPOA for my nephew. "Is this" is correct that a DPOA only covers financial. His medical reads "Advanced Directive for Healthcare." So, for a Doctor and Hospital a DPOA means nothing. Medical is a separate thing.
I have DPOA for medical and DPOA for financial for my Mom. They are 2 seperated legal forms but are both called a DPOA. There is also an Advanced Directive for Healthcare that I have for her that stipulates she wants no heroic actions to extend her life. I knew that before but this makes is nice and clear as her medical DPOA what her final wishes are.
The doctor seems rude and bad behaving! I would not let this doctor get under your skin either. Just ignore it all if possible for the sake of your mom.
I agree with you, though, that the doctor seems to have a bit of an attitude on her and I'm not surprised it's rubbing you up the wrong way. Having said that - do you really mean that the first exchange you had with her was to hand her the DPOA document? What, before you got to "hello"?
Maybe it might be an idea to make a short appointment to see this doctor by yourself and have a Clear The Air chat, being respectful of the fact that the doctor *cannot* discuss your mother's confidential medical information without your mother's permission - instead, use it as an opportunity to fill her in on the family background and support structure. Don't forget, you are both on your mother's side, and a 20 year doctor-patient relationship is not something you want to spoil.
Depends on how good that "relationship" was. From the sounds of it, there wasn't much of one. A good doc might have spent a little time in the course of 20 years to get a feel for the family dynamics, especially as mom started aging...
Spending 10-15 minutes with someone twice a year, doc hardly knows squat about her patients.
I believe a person managing care, legally, needs to be clear on what the documents allow one (you) to do. I am a POA for healthcare and POA for finances for my friend. I am unable to take any action on his behalf until he is diagnosed incapacitated EVEN THOUGH, I handle paying all his bills, manage all his healthcare, caregivers, everything.
* I was told medical professionals and an attorney that it is difficult and/or not easy to have a person medically diagnosed as "incapacitated." Clearly, a person can do or behave in ways that do not support their well being, don't know why or what they are doing and still be deemed "making a decision" - and competent to do so.
* Teepa Snow, a leading expert on dementia says that MANY people with dementia are driving, and that some MDs do not want to be involved with this issue (medical authorization that person should not be driving).
* I had a client who was (and is) an alcoholic for decades and still drinks - and is not interested in stopping.
Long story short: I would go in the MD office/visit with her and the MD would ask her about drinking - client would say overall "no problem" - I'm sitting there stunned wondering why the MD didn't ask me as the reason I was in there was due to memory loss due to a stroke. The MD had NO idea that her patient - my client - was an alcoholic.
Do people that have an addiction readily tell their medical provider about it? NO.
Nor do they tell what is happening to them medically speaking. They either forget or don't want to discuss. ... and a diagnosis is made upon this office visit. Really.
* With other medical specialists, they would ask her questions that she did not answer accurately, due to guilt for not doing prescribed (knee replacement) exercises, and/or other behaviors that affected her health/condition(s).
No one asked me. And, that is why I was there.
* If it were me and I felt dismissed by medical providers - in this situation - I would mention them on social media - YELP or something.
- While not legally binding, I would also write the MD a letter stating your concerns regarding his/her behavior / interactions with YOU. And, ask that your letter be added to the file.
- Some of these MDs need to be reported to the AMA or other certification boards.
- I'm sure you will get some (more) helpful suggestions/advice here. Thank you for asking. We all learn from a person's question / situation. Gena / Touch Matters
The doctor is a rude bully and likely violating the DPOA, but the only way you can be sure who is right is to contact a lawyer who is familiar with your state's laws.
Look up this for your state: https://californiamobility.com/the-4-types-of-powers-of-attorney-in-california/ - according to that, if you were in California, the medical DPOA would have to be part of a living will / advanced directive. That's a good idea anyway even if not a requirement.
I suggest that you have your own appointment with your parents' doctor. Please spell out how you are caring for your parents as they age. Make a list of the responsibilities that you are "helping" with and those that your parents still can manage. Let him/her know how often you visit and other family members visit. Let him/her know that your mom wants to there to relay medical information she tends to forget. Ask him/her for help identifying resources that may be helpful as your parents age and need more help.
If the doctor continues to imply that you are abusing your parents, consider finding another doctor that is willing to work with you.
This is the document that doctors understand.
Unless you have presented a DMPOA is doesn't mean anything as far as health care is concerned. It must be the medical POA to be valid. I think that the doctor is honoring your moms autonomy but, going about it in a terrible way.
I would encourage mom to tell her that she appreciates that she is looking out for her best interest but, that includes you being involved with her medical care.
Some doctors have god complexes and they are a pita to deal with. If mom standing up and addressing the issues doesn't solve them, I would be finding a different doctor. You can be assured that the current one will call APS if you do this, so be prepared to deal with that. Which is a good thing, it clears up any doubts about what you do for your folks.
Your DPOA has nothing to do with you being with Mom at her appt. She has a right to have you with her. By her allowing this, I feel she is also giving u permission to ask questions. This doctor was out of line and should be glad family is involved.
Were you prompting Mom or answering questions the doctor was asking her. If so, Dr may have seen that as controlling.
Next, go to the library and look at the Black's Legal Dictionary and make a copy of the definition of "Durable Power of Attorney. The next time goes to see this doctor, ask her to add these two documents to your mother's chart.
made the evaluations and decisions - something to that effect. Then he stared at me for emphasis (I do remember that!).
We discussed it later and decided that Mom deserved better. So I called the practice, cancelled the follow-up appointment and told the receptionist why we wouldn't be returning.
I think Notgoodenough has a good suggestion, and it raised an issue that I've been pondering. If a doctor doesn't respect the patient's family, would I want to continue with him or her? The answer is no. I think that a doctor who criticizes a family member can w/o realizing it undercut the patient's relationship to that family member, and to me that's inexcusable.
DTOller, if you do address this in person with the doctor, you might want to ask if she's concerned about family dynamics, and on what basis? She may think she's a geriatric doctor looking out for her patients, but she's not handling it properly by undercutting your involvement.
I would more than likely write a letter (marked confidential, obviously) to her and allow her to consider the issue privately, but in the meantime, I'd shop around for a more agreeable doctor. BTW, what is her specialty? Is she a GP?
I found with my mother's doctors, SHE needed to be the one to convey this message, clearly and without room for discussion, to the medical personnel.
If mom still has cognitive function, tell her SHE needs to set this doctor straight. A simple " hey, Doc, I appreciate your concern, but (your name) is my primary caregiver, not to mention my POA, and needs to know everything related to my care; whether or not my other children are involved is really of no concern to you. Now please explain to both of us what's going on with my health today."
My mom had this terrible habit of clamming up as soon as we entered the doctors' offices. I had to remind her that, while I was ready, willing and able to advocate for her, SHE needed to let the medical people know her preferences. It also kept them from speaking to her like some wayward child.
If that still doesn't seem to work, might be time to "fire" this particular doctor and find another one.
Hope this helps!