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My sister has POA for our mother who is in the final stage of alzheimer's disease. The medication sustains her thyroid.

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Rainmom: I'm with you on that one! My late Mother had a cream she had to apply under her rashy breasts. She did it faithfully, but quite honestly, as she was legally blind, oftentimes she got meds mixed up. One time I caught her brushing her teeth with the cap still on the toothpaste tube! Oh, dear, some things are just too comical not to share!
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Several months ago I was going over my moms medication with a home health nurse. We came to a vaginal ring that released hormons. The nurse asked why my mom was using it. Frankly she had been using it some time before I began managing her meds and hadn't really given it any thought. But yeah, why was an 88 yr old woman taking hormone replacement? Pardon the "ewwee" factor here - So I asked moms GYN. Seems mom has a skin condition "there" that without the hormone ring, would become very itchy. Pretty sure no one at the NH wanted any scratching going on...needless to say the ring stayed. Morale of my story: ask the doctor before making any medication changes - even to ones that seemingly make no sense!
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Pamstegma: "Only a thyroid med"...her doctor needs to be alerted and yes, she needs to REGULARLY take her thyroid med.
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bdinehart, is your mother on hospice care?
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There are only 2 reasons for medication-to cure a disease or to provide pain relief. At the end stage of Alzheimer's disease, no one is curing any disease. The only reason for meds is for the comfort of the patient.
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I would think that withholding a prescription medication without a doctor's advice or support -- presumably to speed up the end, because I can't think of another reason -- would be illegal in most states.
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My Mom has Graves desease which is a form of hyper tyroid. So many things are effected by thyroid. I would ask a doctor first.
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Excellent advice.
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The first thing to do is find out if your sister is withholding through physician knowledge. Next, and this may be the most difficult to find out, is this a decision your mother made prior to her incapacity. Certainly, your mother cannot make this decision now, however was this a decision by your mother, stated in front of a medical professional.

This is a situation which comes up many times in dementia care. If the physician was a part of the decision or if an attorney has a voice in this decision you have your answer. I have known many people who are faced with decision. And the question comes up in Pallatitive Care or Hospice care. Your information needs to be more structured so you have the information to clearly see the whole picture.
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Follow the advice here about checking with Mom's doctor or hospice. If she isn't under hospice care, now is a good time to do so. Hospice will provide support to those of you caring for Mom. Your sister may feel guilty later on if she withdraws Mom's medication on her own.
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It is common at the end of life to gradually remove any meds that are not absolutely essential for comfort. They are difficult to administer and there effects for the last few weeks won't be missed, i.e. those for high cholesterol and osteoporosis. if Mom has absolutely no thyroid function because it was removed then it might be a good idea to continue as it is only a tiny pill and easy to take. however blood tests need to be done on a regular basis to determine the dosage. is this being done. Thyroid meds could be considered in the comfort spectrum as the patient will become very lethargic and other things without it.
Is your sister caring for Mom at home? If she is there is no one there to supervise what she does or does not give Mom. If not she can not legally order another person to with hold meds. Same goes for any meds, they can not be decreased or increased without a prescription. What a patient or caregiver does in private is usually considered to be done of their own free will. If someone takes extra medication and runs out early the Dr will not give a new prescription to automatically make up the difference. A patient has the right to refuse any and all treatment. i don't know if this extends to the POA's powers. Pam will probably know.
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bdinehart, does your sister give an explanation as to why she is withholding your Mom's thyroid medication? Have you or her ever sat down with your Mom's doctor to discuss your Mom's medications and tell the doctor that your sister is your Mom's POA and wants to withhold your Mom's meds? My best advice is to talk to both your sister for her motives and your Mom's doctor and hopefully you will understand what is going on better. Best of luck and lots of hugs for your Mom and for you and your family.
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bdinehart, If it is only a thyroid med, I wouldn't lose a lot of sleep over it. In a hospice situation, all meds are discontinued except comfort care. For my MIL, the only med they kept was the roxanol, which is liquid morphine, which can just be applied into the cheek and absorbed in the gums.
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Question, is your Mother now under Hospice care? If yes, then it is up to the Hospice doctor to remove or assign any medications. Therefore, unless your sister is a Hospice physician assigned to your mother's case, she cannot without medications.
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