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Nursing Homes Woes

 
 
Reply Sun 30 Dec, 2012 07:36 pm
Can a nursing home be liable for any suffering, discomforts, or even a death, due to denial of a resident's prescribed medication at the request of the person's family member? The family member is NOT a physician, but arbitrarily instructs the relative's hospice caregiver to stop suppling the medication to the nursing facility...the request is honored.
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Type: Discussion • Score: 5 • Views: 1,955 • Replies: 31

 
Butrflynet
 
  1  
Reply Sun 30 Dec, 2012 07:56 pm
@rcooper6,
It depends upon whether the family member is acting according to the patient's instructions in a living will and/or medical directive.
rcooper6
 
  1  
Reply Sun 30 Dec, 2012 08:11 pm
@Butrflynet,
The person was not given permission by the family member, because the family member, who is the nursing home's resident, was even more surprised and shocked by the revelation. That said, I have no independent knowledge of the existence of a living will; however, there could be one. Either way, the family member who is in need of the (prescribed) medication, is by no means able to refuse medication his doctor deem wholly necessary for life.
Phoenix32890
 
  1  
Reply Sun 30 Dec, 2012 08:41 pm
@rcooper6,
I have no legal training, but I have learned a lot of things in life. One of them is that even if you have a health care surrogate, and a living will, the person named in the will as surrogate cannot make medical decisions for another person, unless that person is unable to make the decisions herself.

If I were the resident, I would put legal pressure on the nursing home.
0 Replies
 
ehBeth
 
  1  
Reply Sun 30 Dec, 2012 08:46 pm
@rcooper6,
rcooper6 wrote:

Can a nursing home <snip > hospice


is this a question about a nursing home or a hospice? or is hospice care being provided in a nursing home?


chai2
 
  2  
Reply Sun 30 Dec, 2012 08:58 pm
@ehBeth,
I wondered about that statement saying the doctor deemed a medication wholly necessary for life, yet the patient is on hospice.

Hospice nurses are concerned about administering correct medication in proper doses to minimize pain.

They do go to nursing homes, if that is where their patient is.
rcooper6
 
  1  
Reply Sun 30 Dec, 2012 09:07 pm
@ehBeth,
The hospice worker is independent of the nursing home, the hospice care worker is employed with an outside agency. No idea the agency, yet. But, essentially, I'm underscoring the actions of the nursing home, the hospice care provider and the family member who is acting under some authority. Meanwhile, the relative suffers, needlessly, because of their involvement.
0 Replies
 
Phoenix32890
 
  1  
Reply Sun 30 Dec, 2012 09:12 pm
@chai2,
Chai- Not all people who have hospice care are on palliative care only.

My mom lived in an assisted living facility. Hospice was brought in to provide some extra services. She had a physical therapist, a nurse, and a social worker who would come into the facility, and provide those services.

I believe that it was every six months that she had to have a reevaluation. They reevaluated her for two years. At the end of her life at the age of 97, (she had dementia, kidney and heart problems and was declining rapidly,) the hospice doctor called me and said that she believed that it was useless to keep her on the dementia medication. She asked for my approval, which I gave, as her health care surrogate.

The last few days of her life were spent at the hospice facility.
roger
 
  2  
Reply Sun 30 Dec, 2012 09:14 pm
@rcooper6,
I wonder if the family member is either guardian or has medical power of attorney. An advance care directive would assign the responsibility to someone.

What is your position in this, rcooper? Are you family member, friend of the patient, or what?
rcooper6
 
  1  
Reply Sun 30 Dec, 2012 09:17 pm
@chai2,
Correct, hospice care providers are required to administer medication doses relative to their need. All the more reason why it is baffling, to say the least, that this particular hospice care worker would follow the orders of the authoritative family member and not continue with the orders of the doctor. It is the hospice care provider who stop providing the nursing facility a prescribed medication necessary to reduce the intensity of anxiety attacks the family member's relative experience periodically. During such attacks, breathing is extremely hampered.
0 Replies
 
chai2
 
  2  
Reply Sun 30 Dec, 2012 09:17 pm
The hospice care worker would not listen to some arbitrary relative. When a person goes on hospice, the patient assigns who they want to speak for them if necessary. If the patient is unable to do so, it wouldn't just be some random person.

What proof do you have this is happening? Or is this just hearsay or things you've overheard?

Oh wait, you're probably not someone who can legally discuss the patients care with the nursing home or hospice, or the doctor. Have you been made the patients medical power of attorney? If not, who is? Or don't you know.

Silly HIPPA regulations.

chai2
 
  1  
Reply Sun 30 Dec, 2012 09:20 pm
@Phoenix32890,
Phoenix32890 wrote:


I believe that it was every six months that she had to have a reevaluation. They reevaluated her for two years.



Yes, I'm very aware of that.
0 Replies
 
rcooper6
 
  1  
Reply Sun 30 Dec, 2012 09:23 pm
@Phoenix32890,
Very sorry about your mom. But was your mom able to communicate, coherently? In other words, could she have been able to refuse or continue her own medication? I would think not, with dementia.
rcooper6
 
  1  
Reply Sun 30 Dec, 2012 09:26 pm
@roger,
I am a concerned witness to what I believe to be (questionable) decision making.
roger
 
  3  
Reply Sun 30 Dec, 2012 09:30 pm
@rcooper6,
Then look for a state ombudsman in whatever state that nursing home is in. Most states have them. Do not expect them to report back to you.
0 Replies
 
rcooper6
 
  1  
Reply Sun 30 Dec, 2012 09:35 pm
@chai2,
The patient in the nursing home is very much lucid with communication. I see no reason to halt much needed medication by any family member, if the nursing home patient is able to (logically) express thoughts. The things I note here, I've witnessed and the halting of the medication was confirmed, to me, by nurses at the facility. No hearsay.
chai2
 
  2  
Reply Mon 31 Dec, 2012 05:48 am
@rcooper6,
Sorry, but you're still really short on facts here.

Where is the physicians involvement in this?

The nursing home, and hospice would not stop administering a medication unless a doctor wrote an order to dc it. If the hospice doctors was not also the patients facility doctor, the two colleagues would have conferred.

Did the nurses at the nursing home actually say to you "We stopped the medication because the hospice worker told us to."?

Is the hospice worker a nurse, an aide, a nurse practitioner?

Both hospice, and nursing homes have their own interdisciplinary teams of doctors, nurses, nurse practitioners, aides, social workers, therapists, dietitians, clinical supervisors, etc. When hospice comes into a facility, they have a contract with the facility as to how all practices are to be carried out, being very specific. When in a facility, the hospice interdisciplinary team works with the facility interdisciplinary team. Hospice attends the facility care plan meeting, they hold their own care plan meetings.

I find it extremely unlikely that one "worker", not even indicating what this persons credentials are, walked in, said "stop this medication" on his/her own volition, and those wishes were complied with by every staff member, dc'ing a medication.

Then again, you aren't apparently the patients legal representative, so you would not be privy to all the details.
If the patient is responsible for themselves at this time, they can be asking what the physicians involvement in all this was.





amygarside
 
  1  
Reply Mon 31 Dec, 2012 06:26 am
@rcooper6,
Maybe you can ask a lawyer about this condition.
Phoenix32890
 
  1  
Reply Mon 31 Dec, 2012 07:29 am
@rcooper6,
Yes, she could communicate coherently. But towards the end, she did not have the ability to make well thought out, important decisions.
0 Replies
 
rcooper6
 
  1  
Reply Wed 2 Jan, 2013 05:05 pm
@chai2,
Okay, one crucial fact I over-looked, the relative in the nursing facility, is now deceased. I won't examine too much, the details here. But whether they be practitioner, aide, or cyclops, I have irrefutable evidence that persons acted of their own volition and prevented needed medication from reaching the former nursing home resident. That evidence suggests to me that this hazardous mistep, potentially, facilitated an untimely death.
 

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