What to do when a family members physician will not speak to you in regards to concerns about medications without the patient's consent?

Your profile says that you are caring for someone who is 68 years old with dementia.

Does MIL live with you?

What are the alarming side effects?

If they are life-threatening, you should call 911 and have the EMTs evaluate her. She may need to detox in the hospital.

Unless MIL has signed a HIPAA release, her physician cannot give you any information. But you can and should share your observations of her condition and your concerns with her/him.

Risk of overdose is quite high. See this article from WebMD: https://www.webmd.com/mental-health/addiction/news/20170315/opioid-painkillers-and-xanax-or-valium-a-deadly-mix-study

She has spells of memeory loss and confusion. When she cant find something she will accuse us of stealing things. She hets very aggressive and sometimes physical. She has even accused my wife of physical abuse and has even called police and in effect my wife had to spend days in jail for domestic abuse. We are the only people to care for her, but at our own risk of false accusations that can greatly effect the rest of our lives. Situation is very severe and scary. Nothing like we have ever had to deal with before. She refuses to sign an HIPAA since she knows we want her off the current medications of vicodin and valium. Her dependency is very strong. We have done the research on the effects of taking a combination of both. She fits almost all side effects. We really need help. Scared and do not know where to go for help!

Is she living with you, or you with her?

The accusations, paranoia and memory loss are all par for the course with dementia. Has she been diagnosed with dementia? Is she being seen by a neurologist or psychiatrist?

I think her meds could be causing these mood swings. Is this just a PCP. If so, maybe you do need a Psychiatrist to manage her meds.

I may even call APS and tell them ur situation. Ask if they can investigate for you?

Just wondering why you haven't either moved her out or left yourselves.

Lying and getting your wife thrown in jail is a BIG deal. You are correct that it could have adverse consequences for the rest of your lives. Plus, next time she will be believed again because your wife now has a record.

Her drugs obviously mean more to her then her wellbeing or you guys. Nothing can give you back your own wellbeing and reputation if she is allowed to destroy them.

Please get out before someone ends up in prison.

Did I miss the answer to, "Does she live in your house or do you live in hers?" This answer may determine your only "easy" course of action. If you live with her then move out immediately and don't tell her you're going, when you're going or where you're going. She may be more compliant after that and then you can negotiate some things with her, like getting DPoA, her going to rehab, signing a HIPAA release for both of you, etc.

If she lives with you, I'm not sure what you can legally do but if you can get her into inpatient rehab for 30+ days then you can get a legal eviction (based on your state's laws) and she can go live in a sober home afterwards or AL but do not let her live with you ever again.

If it's your home maybe you can set up cameras to see what she's doing and maybe even where she is stashing her pills. If she's doing anything illegal (like stealing) you may have grounds to kick her out. Does this person still drive? The minute she gets into her car and you think she's under the influence, call 911 and report her. Good luck!

I am thinking here that she will probably fight changing Drs since she has her's snowed about the behavior. I know the Dr can't tell you things, but there is no reason you can't keep a log of her behavior ( and maybe videos, not sure of the legality of that) and pass that info onto her Dr. They may or may not act on it, but your will have made that info available, and make sure it goes in her file. And keep records for yourself in case you are "reported" again. The next time she acts out, and if you can prove it, call 911 or the cops and have her removed. Then let the chips fall.. but don't take her back unless she gets help to withdrawal.

You are conflating two things which you need to separate.

1. Reporting concerns. You should put your observations in writing to the physician who prescribes your MIL's medication, emphasising that you believe her behaviours may be the result of [give the exact px details] and [second exact px details] in combination. Mark it "for the urgent attention of Dr [Name]." It will be attended to.

2. Discussing your concerns with your MIL's physician. Discussion implies two-way communication. Your MIL's physician absolutely is bound by her professional duty of confidentiality to her patient and cannot say a single word to you about her without her consent. It's basic. It may be a pain, but she can't do it.

Try again. Make it clear that you are understand the HIPAA rules and the requirements of patient confidentiality and are therefore not expecting a response to the information you have provided, but that you would like receipt of it confirmed. Or send it by a signed for delivery service, if you like. Taking information *in* is no breach of doctor-patient confidentiality; but stop expecting feedback because you won't get any.

Then again, if your mother won't see her what are you expecting the doctor to do? When's the next refill, do you know?

By the way, just noted a further comment: as the doctor won't speak to you, how do you know what the doctor believes the truth to be? I'm pretty sure that if this doctor, this mandated reporter, actually believed your mother's misrepresentations you'd already have been arrested. Do credit the physician with knowing her job.

You are dealing with a person who is mentally ill and possibly addicted to drugs. When she has her next fit, call 911, have her removed from the house, most likely she will be placed on physic hold, after that refuse to take her back home due to these issues. This will force the issue. Keep detailed records, recording all her out of control times, date, time, recap. If you live with her, move out and let the system take over.

When did you move in?
Why did you move in?
Did your MIL explicitly invite you to move in?
Why was your MIL prescribed Vicodin? How long ago?
Does she have any other health conditions?
Last one - I notice that you have included PoA among your subject headings. Does your wife have any kind of POA or health care proxy authorisation?

This is the VERY reason why I now have to stay away from my mom. I have to be very careful not to get into trouble, but because I cannot force her or get her to have an mental evaluation, therefore she is still of 'sound mind' (no she isn't) because of the stupid HIPPA law that keeps us caring adult children from helping our elderly parents from really hurting themselves.

HIPPA is is harming not helping. My mom is 88, and no one seems to be able to help me get her to a doctor for a psych eval so that I can move forward to get her out of a dangerous situation. Yet everyone agrees, she is in a dangerous situation. It's beyond me! Should be a 60 Minutes story, honestly.

How long has she been on meds? She’s an addict. She needs rehab. Tough battle! I’m so sorry.

You’re my neighbor. I also live in Louisiana. There is Townsend Rehab in Metairie.

I see on your profile, you live in Metairie. For opiate addiction they will do Suboxine. She will not have to go cold turkey. They used to have an inpatient program in Scott, LA. (Suburb of Lafayette). I think it closed awhile back.

I know a few people who have done Townsend. They have a pretty good success rate. The addict has to be committed to the program. No matter what program though, opiate addiction is really tough to beat. Most people relapse.

She can do the intensive outpatient program. They have counseling, medical doctor, group therapy and group therapy where family members join in. I know people who have been through the program. A woman I know that used to be in sales completed it twice. Relapsed the first time. She had an awful accident and got hooked on pain meds and Xanax.

Another guy I know who was a manager at Acme Oyster House, I am sure you are familiar with Acme. He started off just with drinking too much, pot, then opiates. He too went to Townsend. It was covered by insurance policy.

Some people do more than one stint in rehab before it sticks. Don’t get discouraged by this. It’s very common.

If you feel she needs inpatient you can do Grace House. It’s near Touro hospital in New Orleans and is an all woman facility.

Different atmosphere and different program but again, pretty good success rate. Totally different vibe though, more diverse group of people in New Orleans. Bridge House is the men’s program and Grace House is the women’s section. I know someone who did that one too. She did cocaine and it caught up to her. Became hooked. She is a musician. She did cocaine to keep up at the late night gigs. She’s very talented. Performs at jazz fest every year. I used to run into her at PJ’s Coffee on Maple St. Last time I saw her she had been clean for quite awhile.

Look, I don’t know her story how she started off on opioids but rehab will insist that you don’t judge and support them while in the program. So many people get into accidents and become addicted. Look at Cindy McCain, John McCain’s wife, happened to her after an injury.

Happened to my friend’s mom who broke her back after a fall. She was climbing on a ladder and fell. The pain was so great that she took meds to be able to function. She took them as prescribed and still became hooked. Now they don’t prescribe them as readily. When my husband had shoulder surgery they bump up PT to help and don’t rely on pain meds as much. Awhile back they just kept writing scripts and people got hooked.

We do not know how long the MIL has been taking valium or when she was prescribed vicodin, or what for, or what other health problems, physical or mental, she is dealing with.

She may be mentally ill, she may be unintentionally overdosing and unaware that she is (if her kidneys don't work well, for example), she may be an addict, or none of these things may be true and there is something completely different going on. We have no idea.

For goodness sake, get this woman to another doctor!
FI'll out the paperwork and list yourselves under the people that the doctor can talk to.
Sign her name in the signature area. There is a place to explain why you're signing..explain that she is unable to sign.

How about looking into the Baker act?

How old is she and does she need pain pills? What are her side affects?

"She has even accused my wife of physical abuse and has even called police and in effect my wife had to spend days in jail for domestic abuse."

You are prioritizing your mother over your wife.

Please move out and get away from this toxic situation.

Why on Earth would you not call 911 and have her taken to the hospital when she starts acting this way? If someone locks themselves in a bathroom for a week and doesn't eat by day 2 you should have called Adult Protective Services and the police. Frankly, someone is going to turn you in for elder neglect because to knowingly let someone stay in a bathroom and not eat for a week is neglect. Forget the doctor, he is the least of your problems, call APS and 911.

Find a new doctor.

Are you her DPOA or Guardian...if not make sure you are even go to court for this. Is your Mother able to make her own decisions on her health care does she have any form of dementia can you ask what the reason is for prescribing these medications to her.

OP has not volunteered more info beyond reporting boilerplate information.

You contact your State medical licensure board and file a complaint. Can also file complaint with APS.

Get her to sign a disclosure statement.
Her physician is just covering his behind from lawsuits.

If you do not have the patient's permission and/or POA to access her chart and information, the doctor will *NOT* discuss anything with you. As long as you have permission to access her chart, the doctor should never withhold any information from you. If you are not POA or do not have written authorization to access her information, the doctor is protecting his client in accordance to Federal laws.

If you feel the doctor is abusing the patient due to over-prescribing narcotics, contact your local sheriff's department.

Try and get Mom to Sign on for Someone to be POA for her. Or speak to Her about a Permission slip.

He's not allowed to talk with you about it -- but that doesn't mean you aren't allowed to talk to him. I was in a similar situation, also involving addiction, and I called the doctor and said exactly that: "I know that because of confidentiality laws, you're not allowed to give me information, or even to confirm that this is a patient of yours. But I have information that you as a medical provider need to be aware of." And the doctor did listen, though he was not allowed to comment. If you think this is a case of a doctor simply being unaware of how the patient is responding (as opposed to being negligent), you also could write out your concerns in a letter and send it to him/her. Obviously, if you think this is a case of negligence, you should consider reporting this, as other people have suggested.

I like the letter idea a lot. Written documentation! Great suggestion!

You can write a letter with the patient's name and date of birth to her doctor.  Give the facts, not the emotions, and let the doctor know about the alarming effects you are seeing, the amount and strength of medications she is taking and very importantly, other medications she is taking from other doctors. Make a copy of this letter before you mail or give it to the doctor's front desk. Medical charts are often incomplete or inaccurate so the physician has no clue how accurate the medical record is.  Your letter will help tremendously. Again, just give the facts. No promises if the doctor will or will not act on it but at least you know the letter was written and you have expressed your concerns to the person who monitors your loved one's medical care.

Without her consent the doctor legally can not talk to you. Your only way would be for her to be declared incompetent and someone to take her for her

Former EMS here - if you can get the Police there while she is in the middle of one of her meltdowns, they can Baker Act her. That will get her sent to a psych hospital or ward for evaluation. Maybe something will be done that way. But INSIST THAT SHE CANNOT SAFELY LIVE ALONE when it is time for discharge. And you have to stand strong and refuse to accept responsibility for her. The makes her the hospital’s problem. They will have to find a bed for her. Good luck.