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Hospital threatened to take guardianship unless I brought an advanced directive. I brought a living will, as there was no advanced directive. Mom is still in hospital, just over three weeks. I know they are buying time by keeping her here. I've taken mom to this hospital many times before. I don't know why other than their anger at my not consenting to some medicines she had known allergies to.

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Just a thought: Whoever is watching your Mom's room via the "very large monitoring camera" might be able to HEAR YOU talking to your Mom, so be careful what you say to her.

Non-medication ways to help your Mom relax are: listening to music-play her favorite songs or hymns on a CD player, your IPhone or IPad or tablet or laptop; if she will allow you to touch her--massage her hands or just hold her hands or lightly give her a back rub; tell your Mom that you love her and reminisce about positive & fun events or activities that your family did while growing up; bring her a (small) bouquet of flowers--we wouldn't want to obstruct the view of the camera ;) have friends and family members visit and talk to your Mom as normal as possible (tell any visitors that they need to avoid complaining about the camera other than saying "What is this big thing doing here?" and then they need to talk about other things with your Mom.

DO NOT TALK ABOUT THE LAWYER with your Mom because the hospital personnel monitoring the camera will be able to hear what you are planning to do. Please let us know how you and your Mom are doing. God Bless!
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CALL YOUR LAWYER ASAP!! You can also contact your state’s Elder Care Ombudsman (each state has a different name for this office)
Many state health departments (Department of Public Health--Dept. of Health & Human Services) have a hospital licensing division that is responsible for ensuring health care facilities comply with state laws and regulations. Patients can register complaints with the hospital licensing division and trained personnel will conduct an investigation and issue a report. Patients should check with their state health departments for information on how to file complaints with the hospital licensing division. You can check this website for your state’s Department of Health.
www.empoweredpatientcoalition.org/report-a-medical-event/report-a-hospital-or-facility/

Oh, Good Lord! What is the **** are these doctors doing? I’m sorry but this hospital is being VERY unprofessional!! The hospitalists are being unprofessional!! Your Mom has been on oxycodone for YEARS and they aren’t giving her ANY narcotic pain medication to take its place?? No wonder your Mom is so restless. She’s experiencing WITHDRAW SYMPTOMS from the oxycodone!!

You left your Mom’s room for one hour and returned to find a very large monitoring camera in her room. {The hospital was waiting for you to leave your Mom's room so that they could put the camera in her room because it normally takes longer to get a camera like that authorized and set up.} THEY may say that the camera is for “fall monitoring”. BUT I have the suspicion that THEY ARE WATCHING YOU to see whether you are going to give your Mom some pain medication since they won’t give her any pain medications. Especially since “They watch from ELSEWHERE in the hospital and CAN TALK through this large camera. It only gets turned off when they clean Mom and the nurse has to call to request it.“ (AND they set it up on FRIDAY evening b/c they know lawyers aren't in their offices over the weekend...they think that you will be defenseless for 2-3 days until you talk to a lawyer on Monday.) A Fall Monitor camera is usually not set up with a camera that someone can "talk through" and with a monitor set up elsewhere in the hospital (Security Department??) so far away from the nurses that they have to CALL someone to have the camera turned off while they are doing patient care.

Please be careful how you act while you are visiting your Mom in the hospital. They are looking for you to do something wrong. Do not get upset with the doctor or the nursing staff. Be calm and concise when you talk with them. Keep a journal of all of the events leading up to today and take photos (quietly) of the camera to show to your lawyer. I wish you luck in dealing with the hospital. It sounds like they are ready and willing to fight you to the death (of your mother) to determine who has control of your Mom’s health care. Good Luck!
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Juju, you can request a change of doctors from a hospitalist to your mother primary. It's probably unlikely that anyone would mention this or suggest it, but it can be done. I did it, in a reverse situation.

The PCP wanted to discharge my father well before he was ready, on a high liter flow of oxygen.
I disagreed, asked to have a hospitalist take over and it was done, after a day or so. PCP was upset, called me at home, but his concern was more whether we would be returning for care than for the specific reason for the switch.

If you have to, go to the charge nurse to make the request, and if that doesn't work, ask if there's an ombudsperson, or ask to see the hospital administrator directly. I've done that in the past as well.
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Old Sailor - yes, they tend to be partial to what they think will work. Mom's primary is easy going and will work with other alternatives if something if causing side effects. Wish he could help her in the hospital.

DeAnna - Mom isn't on NSAIDS. They cause intense gastric pain, even with food or pepsid.

This doctors are hospitalists. They won't even consider her primary suggesting medications. I already tried. Mom is not getting any pain medication. She was awake all night and the doctors will not provide her with anything. She has been on oxycodone for several years.

She's not interested in eating now because of the pain. I explained this to the doctor when she didn't want her to have any. They really don't care, frankly. No matter what I say, nothing is being done.

I left earlier today for an hour and came back to a very large monitoring camera placed in Mom's room. I asked why this was done and they said its for fall monitoring. They watch from elsewhere in the hospital and can talk through this large camera. It only gets turned off when they clean Mom and the nurse has to call to request it.

If only they would be more concerned about her not eating and pain levels.
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Your Mom would be a challenge to any doctor no matter where she is because of her unusual response to medications.

Coumadin 5 mg is a rather high dosage to start on unless there is a crisis. Many doctors start at 2-3 mg per day and work the dosage up after checking INR, clotting time or Prothrombin time (PT) daily or every other day.

Lopressor (metoprolol) is a beta blocker that has also been given to patients diagnosed with LOW blood pressure to INCREASE their blood pressure—so your Mom’s increase blood pressure after taking the medication can occur, it just isn’t one of the EXPECTED results of taking Lopressor.

Does your Mom take any NSAIDS (aspirin, ibuprofen, etc.) as they can interfere with hydralazine’s effect? According to Davis’s Drug Guide for Nurses 12th Edition: “80-90% of Eskimos, Japanese and Chinese are…at risk for decreased levels (of the drug in their blood stream which leads to)…treatment failure.”

Why did the Doctor discontinue pain meds? Did the doctor prescribe ANY pain medication at all? Or did the Doctor discontinue just the more potent pain meds? Has your Mom been taking pain medication prior to her hospitalization? If so, which one?

"for the first time in over a year, Mom was moving her right leg and arm" (she was writhing in pain)...Still, I hadn't seen her move that side in a long time...She follows commands for me", apparently your Mom has NOT moved her arm deliberately to hold a glass or spoon/fork, or uses her arm when eating or getting dress or performing any ADLs. This arm and leg movement might be caused by pain and physical therapy isn't going to help her arm or leg get better function.

Some doctors have a difficult time working with patients who do not have the expected results to medications and are not often willing to listen to the patient or their families which is SAD and counterproductive for the patient and the doctor. Is the doctor who is taking care of your Mom a “Hospitalist” or is it her Primacy Care Physician? You need to continue to be your Mom’s Advocate in this situation.
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It could be that the Doc in the hospital is changing BP meds because HE prefers a certain brand and strength. What does Mom's primary say about this change of med. Somme docs get nasty if you don't follow their Holier than thou scrips.
Had this happen to me twice. I just went back to my original Physician.
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jjariz lopressor; hydralizine

Garden - Great idea! I'll be calling them tomorrow; though I still don't have a discharge date.

Deanna - Mom had a long list of BP medications she had taken for 35 years. Not only did most of them not work, but made her feel lousy. Before her stroke, they started her on coumadin for the first time at 5 mg. Within four days, she was vomiting up blood. She needed 6 units of plasma and almost died. From that point, she refused anticoagulant therapy and that was her choice.

Her blood pressure never responded to these medications like other patients. The more they would give her, the higher it would go. When I would discuss this with the doctors, they would say that's not possible.

Mom's still in hospital. Doctor discontinued pain meds and Mom is hurting pretty bad. The doctor refuses to take out the midline IV that has been hurting for five days now. Mom tells me it hurts and she keeps trying to shake her arm to get it off.

The doctor doesn't believe her. The nurses tell the doctor but she won't do anything for her.

Today, for the first time in over a year, Mom was moving her right leg and arm (she was writhing in pain).

Still, I hadn't seen her move that side in a long time. I brought the nurse in to show her and asked if doctor could maybe order PT consult. Nurse told me PT seen her several weeks ago and said she wouldn't follow commands so they discontinued therapy at that time. Doctor wouldn't reorder consult. She follows commands for me though.
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I need to clarify something:
Your Mom was taking medications for high blood pressure while she was living with you. When she was hospitalized for dehydration and congestive heart failure (CHF), the doctor at the hospital changed the high blood pressure medications. You objected to the doctor changing the medications because ___________________? You do NOT want your Mom to receive ANY medications for high blood pressure—for what reason? Does your Mom have a past history of adverse reactions or allergic reactions to high blood pressure medications? What medications did your Mom take at home and what medications did she take at the hospital?

You state that your Mom has had a stroke and that you “have always refused certain medicines”.

Is it possible that the hospital thinks that your refusal of certain high blood pressure medications for your Mom may have resulted in your Mom having a stroke and that if you had allowed your Mom to receive these medications, that your Mom might NOT have had a stroke? Or maybe the hospital is concerned because the high blood pressure medications are being given to treat your Mom's CHF and not just to treat the high blood pressure. (Just a guess.). High Blood Pressure is the Number ONE cause of Strokes!

Here are some websites that discuss high blood pressure and stroke:
http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/HealthyLivingAfterStroke/UnderstandingRiskyConditions/Blood-Pressure-and-Stroke_UCM_310427_Article.jsp#.Wvz0OsKou1s

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/LearnHowHBPHarmsYourHealth/How-High-Blood-Pressure-Can-Lead-to-Stroke_UCM_301824_Article.jsp#.Wvz0zMKou1s

https://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-high-blood-pressure-stroke#1

I hope that you and the hospital can resolve your differences without too much legal involvement.
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JuJu, Medicare can investigate the discharge decision and prevent the planned release. It's not indefinite, and might be only for a day or two (I don't recall) but it gives you another day or so to work something out that's more satisfactory to you.

Jjariz, I think Juju wrote that her mother was allergic to these meds; I'd have to reread the initial posts, but that's my recollection.
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Why won't you give your Mom blood pressure medication?
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Barb. Just blood pressure meds. They took her off what she was on but no one ever did that before.

They gave her these medicines without my consent every time and still are.

Garden. Ill have to find a probono hopefully.

How do you think medicare would help?
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Can you tell us what meds you are declining?
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Juju, hire an attorney, ASAP. You can also file an immediate appeal with Medicare. The hospital should have given you a form to this effect when she was admitted. If you didn't get one, you have a right to demand one now.
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Thank you everyone for your kind advice. I am grateful for your words.

I just found out hospital will not release her to my care because they say its not safe due to my declining some medicines.
It's been 24 days now.

Told me yesterday she's ready for discharge.

Says I have to file for medicaid and she will be placed in nursing home.

Mom started crying ... As did I.

I live with her and have been providing 24/7 care since her stroke.

I have always refused certain medicines; don't know why this time is different.

Hospital said they will obtain guardianship and temporarily then give to family member or state.
(New Jersey)
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FIGHT. You don't needan attorney, the judge will want to see your fight. Who knows more bout everytging than you. Today I won guardianship of my mom, it was the hardest but most empowering thing I hav ever done it went on for 2 1'2 years 32 court appearance then the trial where I made myself the most educated person in the room, I made all of them look like the liars they are, but you need proof of everything. Tips for ya the regret of not fighting will haunt you till the day you die. Document everything call logs, pictures, save all emails, bank statements most important research every law, research everyone involved even judge. Court service center make a best friend there cause all documents you need there help. Have a plan tell the judge what u r goin do as guardian review and reserch every thing bout your parents disease and potential LTc facilitis, do reviews on all of them. This won't be easy there will be a lot of lies anintimidation and a lot of sadness, but never give up always remember your parent would have already been in the right for you. You got this and you have never experienced pride like this. Start the fight right now
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Definitely get with Mom's lawyer. He should be able to speak for her on many subjects including who has contributed to Mom's care. That just may shake the brother up a bit.
I was granted guardianship when the DW's lawyer spoke in favor of me and no one contested my request.
Incidentally, the judge froze DW's savings account since she is living at home. I could only access her checking account until it reached a level of being frozen. So I have placed excess funds from checking to savings and I am only allowed to withdraw $250.00 on a monthly basis for DW's expenses and needs.
Those actions were in accordance with NV laws. It may be different in your area. If brother thinks he has found a money pit, he may be in for a rude awakening.
Best wishes and good luck to you and Mom.
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So your Mom has what is known as "expressive aphasia" where the person knows &/or understands what is being said to her, but is unable to express her thoughts or ideas or wishes clearly or coherently through speech or written word.

Did your brother ever get involved with your mother's previous hospitalizations? If not, then there was no reason for the hospital to ask for more information than your POA & Healthcare POA documentation. Now that he is involved the hospital is caught in the middle and they are trying to clarify who has legal authorization to make healthcare decisions for your Mom.

Where does you Mom live--at home alone, with you in your home, in assisted living? Lots of people don't want to go to a nursing home, but sometimes their health gets so poor that the best place for them is in an assisted living or long term care facility/nursing home.

When a person has lots of medication allergies or tends to have adverse reactions to many medications, it becomes that much harder to treat the person because they might be allergic to or have adverse reactions to the "normal" or regularly prescribed medications used to treat a condition.

Did your Mom have a stroke that caused her aphasia and does she have other problems such as weakness of her arm(s) or leg(s) so that she needs someone to help her get dressed, transfer, feed her, etc.? Is your Mom's CHF and aphasia (& other health problems) so bad that she could qualify for a nursing home or even hospice? These organizations do intake evaluations prior to accepting someone as a resident or client? If your Mom does go to a nursing home or into hospice care, who is going to pay for her stay? Is your Mom going to be private pay? Or will Medicare or Medicaid pay for part or all of her stay at the nursing home or hospice?

You need to talk with your Mom's lawyer ASAP and let him/her know what is happening so that he/she can assist you in doing what is BEST FOR YOUR MOM.
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Mom made me POA, healthcare POA, my name is in living will and also as executor. Hospital has copies of healthcare POA and living will.

What I can't understand is Mom has been here multiple times through the years, and I have always not consented to a few medications because of side effects/concerns of risks. Nothing was ever said until this hospitalization.

Mom understands what is said to her, but her aphasia prevents her from normal conversation. She recognizes her family and friends and whomever she has met before. She can speak yes and no and a few other words and can sing beautifully.

If my brother wins guardianship, he could also put her in hospice. He definitely has an agenda.

Mom knows what they are doing, but cannot speak her thoughts. She doesn't want to lose her daughter as her caregiver and protector.

Shameful what they are putting her through.
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Any ethical judge would not speak to anyone about a case.
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jeannegibbs May 15, 2018
But many a relative would lie about what has gone on.
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He spoke with a judge, ex parte? And the hospital supported this? I'm more than a bit skeptical that a judge would speak with one party unless it was at a hearing.
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Ah. There is family conflict over who gets to make decisions.

You say you are in charge. Brother says he is. Hospital needs decisions so they need to know which of you can make them. Hence the need to see the written documentation. Does the Living Will name someone as the person to make decisions? That is all that is needed -- it doesn't matter what the document is called.

In the absence of clear authorization for either of you, the hospital is apparently seeking some emergency authorization to make decisions for her. I'm not sure if that would be full Guardianship, but the intent seems to be to allow them to control the meds she gets.

Have I got this right?

What is Mom in the hospital for? CHF symptoms? Does Mom also have dementia? Is she unable to make decisions for herself?
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Hi Garden

Mom had dehydration. They said it was chf. Her bp has been good for the past week. From past experience, that's what they wait for to happen and then discharge her.

Adversarial brother somehow got involved with hospital and said he wants guardianship over mom. He has been trying to take her from my care for many months. He has never contributed anything towards her care. He just wants control of everything and to put mom in nursing home, where she doesnt want to be.

He told me he talked to the judge and the hospital is behind him. That i will be served.

Mom is being used as a pawn unfortunately.

The point of contention was always refusing certain medications that cause adverse reactions in mom.

When asking doc why can't she go home, I just get a different response each day. Nothing in particular or that makes any sense.

Thanks for your concern Garden.
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Juju, not providing an Advanced Directive is to my understanding NOT a basis for guardianship. I doubt if any judge would entertain that kind of guardianship action.

However, I'm wondering what other issues are involved. Why was she admitted, what are her diagnoses, and what are her prospects for recovery?

I can think of a possible situation when someone might have threatened, trying to intimidate you, and that's if some medicine to which she has a known allergy might be the only life saving or appropriate medicine under certain conditions, and those conditions are a factor either now in her treatment or could be, based on her conditions.

Even so, only a temporary guardianship would make sense. Hospitals don't have the capacity to manage guardianships.

Could you explain why you "know they are buying time by keeping her" there? Hospitals don't do that; Medicare standards are strict and if a patient doesn't qualify to remain in a hospital b/c of a Medicare standard (s) , then the hospital isn't going to get reimbursed by Medicare.

I suspect there are other issues at play here.
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