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Can nursing home deny communication with MPOA? Can doctor threaten Reprisal/ move rather than address medical concerns? Dr never told of even Medical Power of Attorney (son of end stage dementia patient)
Nursing home cut off ALL communications after MEDICAL CONCERNS brought to their attention during a family care meeting....which in pt rights is cutting off communication with the pt because MPOA does speak for the resident that is unable to speak for selves)
MPOA was changed without notification & signatures WITNESSED only by NH staff NOT NOTARIZED or legal attorney.
MOM cannot possibly sign a POA with advanced end state dementia & POA NEVER signed transfer to brother.
Pt is in harms way and we are perplexed why & how it happened if homes have such legal powers??
MPOA feels responsible but now home will not allow him to EVEN see the POA document or records to affirm who is legally responsible for Mothers care?
Can all this be done? is it legal? What to do?
Is Nursing Home responsible for following PATIENTS RIGHTS which in this case is residents right NOT FEAR REPRISAL in exercising HER rights...rather than addressing the medical issues (in this patient with dementia events including difficulty swallowing which could cause aspiration pneumonia!!) the DOCTOR threatened, in a meeting that she could be asked to move to another home. NO changes were made by nursing staff or doctor. Instead of assuring communication with MPOA the doctor just gave us his cell phone number so we would not have to call the nursing home since no return calls FROM Director of Nursing, Assistant Director of Nursing, Nurses, Social Worker or Director of home!!!!
Mom is in harms way given her advanced end stage dementia with dementia events & swallowing difficulties, being forced to eat when does not want to eat, no mouth care after each meal to prevent the food stashed in her mouth because she cannot swallow at that time therefore Mom SPITS meals out during day from various meals, denied right to get up & sleep when she wants to i.e. she is non responsive during the dementia events and cannot swallow (she will eat well when she comes out of an event & can swallowing, not waiting to put pt to bed after eating before waiting 1-2 hours after meals to prevent possible aspiration pneumonia, Head of bed not elevated to prevent same, gets skin tears when aids try to transfer her from bed to chair DURING a non responsive dementia event when she is DEAD WEIGHT& THE LIST GOES ON. The nursing staff nor aids have knowledge or experience about non responsive dementia events. Nursing Administration has cut off all communication with MPOA & we have been told the POA was transferred by nursing home WITH ONLY Nursing Home witnesses not notarized or by attorney or filed at courthouse.
The doctor states he does unnecessary tests because he does and always will "treat the family". As MPOA the desire was requested for no unnecessary tests or treatments to allow her to die in peace which is her RIGHT!! Not torture.
Additionally now,with Mom drawn up in a fetal position with rheumatoid arthritis, hand and leg muscle with atrophy,physical therapy is ordered, without regard to comfort & peace as he lay dying...therapy to her deformed hands and legs along with the atrophy. Comfort Care was requested with pt right requested on no transport to hospital, no unnecessary tests, treatments etc, palliative care she has requested and deserves. Please help if you are able we are scared for her being and are asking what to do including addressing the ethical issues too.
Thank you for this opportunity perhaps it is a beginning to get headed the right direction as we take another step, hopefully, forward

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You need an Elder Care Attorney immediately to get this straightened out and your mother's needs met and for you to be able to understand what is happening. It sounds like the NH just wants her to do what they want without your input so they can collect the fees for her and wants you to stay out of it. I wouldn't at all. You need to get to the bottom of this immediately and an attorney can help you.
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Wow. I can relate. My mom is in a nursing home so I know their game. A few comments that I hope will help/comfort you. #1 They cannot just MOVE her to another facility. They have to give you 30 days notice of intent to discharge and then you have the right to appeal. My home threatened us, too, to send my mother with dementia to nut house. They then used that leverage to bully us into hiring our own aide, which I resented until I saw what joy this young girl brings into my mothers life. But back to your story: what that doctor did is not right, fair or legal. Call your ombudsperson and they can help you by telling you your rights, speaking with the powers that be at your nursing home, or suggesting other nursing homes that may be better for your mom. As for changing the POA, since your mom has advanced dementia, the new POA is void. Speak to the lawyer who did the original POA and let him know what's happened. He can help you get them into legal trouble for elder abuse, fraud, and possibly falsifying documents.

Two things jumped out at my on your post. 1-your mom wants to be able to die in peace. Have you considered hospice. Many hospice facilities are wonderful, and cost a lot less than a nursing home. Start shopping around now. 2-they don't know how to properly handle her unresponsive episodes. I'm going to ask you a question I've had to ask myself: do you really want to fight to remain in a place where you are being mistreated by staff and your mother is receiving poor care? I know it's not always possible to move someone, and it certainly is NOT easy, but ask yourself if it's something you want to start looking into. What if you visited other homes in your area and asked what, if any, experience they had with people with unresponsive episodes, and you found a nice comfortable place that understood your mom? Wouldn't that be so much better than trying to fight with the snakes at her current place?
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I am an Ombudsman, but not for your facility.
The new POA or MPOA is legal if it is signed and witnessed. They do not have to show it to you.
If you want to challenge the new POA based on neglect, you must do so in court. See an attorney. You will need to have the MOLST form that was signed by the patient and their MD to prove treatment should be withheld.
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By all means, try to contact an attorney in the state where the nursing home is holding the patient. I have had experience with state-run patient rights organizations PAIMI and these have no power or they exist to STALL any action taken against medical institutions. They ARE the state and this presents a conflict of interest since so many patients are on Medicare or Medicaid. That means conflict of interest. My attorney friends are running into the same problems, the state will protect hospitals and even protect private facilities. In-house "Patient rights" offices are also only there to please people, never to uphold rights. In fact, they do more harm by stalling people and discouraging people from getting lawyers. Bypass the state-run institutions and go to anyone you get referred to. Do you know anyone or do your friends know attorneys in that state? Do you live in that state? This site has listings of elder attorneys. I'd suggest calling down the list.

Please also be aware that sometimes you are speaking to the attorney or paralegal, but other times, you're talking to a data entry person. You can usually tell because the data antry person has no medical knowledge. A real legal person will have basic knowledge so you shouldn't have to give lengthy background information such as, "The kidneys are in the upper part of the abdomen and they work like filters..." etc. When you call, try to have stuff written down. That helps you stay organized. Some are ridiculously impatient. Others very kind. It saddens me that secretaries rush people off hte phone before they get a sentence finished.

I am a firm believer that the truth wins. Hold onto that. My experience is that wrongdoers try everything they can to discredit those that cry out, "Abuse!" including calling you crazy or "disgruntled." You will hear such nonsense, and it gets extremely illegal. Please be careful, don't stop, don't give up, don't cave in, don't waver, don't let them beat you down. Stay alive, too, cuz this is one heck of a ride. That's part of the not shutting up bit.
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I'm a retired long term care administrator from PA. You need to follow the advice of ferris1 above, IMMEDIATELY. Each state has different laws regarding your question and an elder law atty will be the best to advise you. Also file a formal complaint with the state agency in charge of licensing. Call the local number for faster handling. (This may have been provided in the admission paperwork you received.) You can also call the local ombudsman from the local area agency on aging- check county listings- to help resolve the communication issue as the state agency will only cite the facility for noncompliance with regulations and the specific outcome you are trying to achieve may get lost in the weeds of the process. But an atty can also cut to the chase.
May God bless.
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Can you not move your Mother to another facility so she gets better care? I'd be afraid that she may die in the meantime if the care center she is in isn't taking care of her!
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...and set up a meeting with the ombudsman.....
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Report your allegations to the governing board in your state that licenses nursing homes. Their investigator will get to the bottom of your concerns and give a written finding. Since you are not identifying who is MPOA and who has POA, I'm confused as to advise you. Are you siblings? An incompetent person cannot sign legal documents, and those documents can be challenged in court. It sounds like you need a good elder family attorney. Good luck!
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I am so sorry to hear about your mom and the clearly unethical doctor and staff at the nursing home. My bil has epilepsy, aspiration pneumonia and swallowing issues so yes I do understand and am again so sorry. The only thing I can suggest is, it's time to get a lawyer. There is no "legal" reason a MPOA cannot be show to the family of a patient, so they know who's handling a love ones care. I wish there was more I could say. By writing this question and opening it up to others you have made the first step and I'm for one commend you.

Please keep us informed as to how things go.
Kreisler at pickyourpain
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