First off, I do not have Medical POA for Mom- that went to eldest sibling according to 25 year old will (note- re-visit your will). Med POA is two states away and has the tagline "We pay people to do daily care for Mom".

Mom has vascular degeneration in legs (wears compression stockings), documented nerve damage in most of her toes, curled toes (hammer toes?) fungus & corns -all this from the Podiatrist in previous AL facility.

Sister w/Med POA says a new Podiatrist is on board after the new facility changed their contract. Mom had her first visit with new Podiatrist, Med POA sent voicemail that "he's nice, he said he filed her toenails and kept asking if it hurt but she said no.."

I went to see Mom the next day and saw blood under 6 of her toes. I gave my family a pic of this. Sis with Med POA said "I'll talk to new Podiatrist"..and as of 10 days later no feedback!

Mom is an 85 yr old Alz patient in AL/transitional. After 5 days I asked my sis about the issue...she said "Podiatrist thinks it just the antibiotic turning the toenails black."

I live closer than POA, and see Mom at least 3 days/weekly. When I voiced concern to Facility Staff they jumped on it. They were concerned that this is dried blood from the filing.

My questions:

-Shouldn't a Podiatrist in a AL/MC facility do a nerve damage check on every NEW patient prior to foot care?

-Should we be a voice in expressing concern of new Podiatrist?

-Why does sister with Med POA think this is NOT a serious medical issue?

I am so frustrated, want to work with Staff but since I am not Med POA (and Med POA seems to want to veto me) what can I do?


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I’m just a bit confused by your post that “Medical POA for Mom- that went to eldest sibling according to 25 year old will”. A will has effect only after death, a POA has effect only before death. If your mother (or your father) made an old will that seemed to appoint your sister as POA, it is a mistake and has no effect. If your mother is still competent, you might like to discuss with her giving you the medical POA because you are on the spot. She can change both the POA document and her will.

I’m getting repeated worries that some people just say that they have a POA when it isn’t correct, and no-one checks or takes details.
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Rulanme Jun 2019
Mother received an Alzheimer diagnosis, which in our state means she no longer has authority to make her own decisions regarding health.
That's terrible. If this person is a Podiatrist, this should never have happened to your mother. I would get his contact number and question what the heck he did to your mother and find out if this person is qualified to trim toe nails. He should know much more than a CNA or other staff member at the nursing home. Question him and don't except excuses. Get answers from him and if it was negligent report him and ask that he never work on her again. You can find another podiatrist to take care of your mother's toe nails in the future. Your sibling doesn't seem to really care. It's really sad, because your mother is the one that will suffer.
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NH is probably understaffed and does not have the time to follow behind podiatrist to see if he is doing the right job.
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Turning the toenails black.
Dried blood from the filing.

These are not at all the same things, and they do not at all resemble one another even sort-of.

How closely has anybody *looked* at your mother's feet?

Next time you're there, if you're up for this and so is she, I should take a new plastic bowl, several soft clean towels, and some cotton buds, and wash your mother's feet in just-warm water before drying them extremely carefully and thoroughly. Let her care supervisor know you're doing this for a treat, and ask whether there are any creams or dressings that will need to be reapplied afterwards. This will allow you to have a really close look at what's going on. Dried blood will come away. Discoloured toenails - news to me that antibiotics can do this, but you'll be able to confirm whether it's possible. *Blackened* toenails (especially if it's just one side) could be the result of injury - terribly easily done, you don't have to imagine cruelty or abuse going on - or could, God forbid, be worse. Take pictures, both feet, and rather than send them to the MPOA take them to the Director of Nursing and copy them to your sister for her information.

Your sister is right about not buying a dog and then barking yourself; and there is a line to be drawn between supporting and interfering. But she is wrong to cling to her false sense of security about it, and to imagine that paying somebody to do a job magically makes them care about the outcome as much as you do.

What you're doing is fine, you know. You're being eyes on the ground. Don't get distracted by the sense of conflict with your siblings, or hesitant because you feel you need some kind of authority to be taking an interest - she's your mother, you've noticed a problem, you're doing something about it. But you're not trying to give orders or get anybody fired, you're calling attention to it. It's *fine*.
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Are you POSITIVE that a podiatrist did this? A chiropodist (not a dr, but with similar skills as a podiatrist) could be the culprit. The facility may have decided to 'cheap out' on this.

Elders with foot/toe issues should be seen only by PODIATRISTS with training for elder care.

There should be NO blood with a nail trimming. None! And fungus, corns, etc, are really common in the elderly. Their nails should be trimmed carefully every 2-3 months.

People do DIE from foot infections. Esp when there is poor circulation. You'd better get on this.
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Thank you Countrymouse! I forgot to include that due to the vascular degeneration in Mom's legs the first Podiatrist had said any wound to the toes/feet would be problematic to heal...and this information was provided to the Med POA over a year ago. That is the added risk that really has me worried.
I really am at a loss why a offspring of a elderly dependent parent would be so cavalier about such medical issues. I am shocked that the Med POA and other sibs commonly advise me "relax, we pay people to look after Mother".
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You don't have to have medical power of attorney for anyone, your own loved one or anybody else's, to report on a problem.

It won't, God willing, turn into a serious medical issue this time; but that podiatrist needs taking by the ear and interrogating as to his understanding of common vulnerabilities in elders including, e.g., skin integrity, compromised circulation, bleeding disorders (especially among those taking anticoagulants) and neuropathy. Or, rather, the neuropathies.

The facility's nursing staff should also be sharing with him any relevant patient information. As he's new, does he know how to access it?

These are legitimate concerns that ANY person can voice. Don't be shy!
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