Hi, Carolyn here. I hope you are doing well and getting through your day.
Today we’re discussing frustrations with the healthcare directive (a document that enables you to act on another person’s behalf for healthcare decisions). Sometimes its also called a healthcare power of attorney, or a living will. Not everyone understands how it should be used, or even what it means. The following is a situation that really took place in an assisted living facility involving a caregiver daughter who is the lawful agent for her mom’s healthcare directive. Mom has dementia. The treating doctor decided to try her on a medication to treat the symptoms of dementia. But, now he’s out of town. The daughter, herself a nurse, noticed that her mom had diarrhea and it started exactly when she began the new medication.
Nothing else in mom’s diet or other medicines had changed. The daughter asked the administrator to stop giving the new medication until the diarrhea problem was discussed with the doctor. The daughter was appointed by Mom to be the agent on the healthcare directive. She has the legal right to stop the medication. The administrator refused to stop the medication.
The administrator is wrong in doing so. The mom is no longer competent to maker her own healthcare decisions. The purpose of a healthcare directive is to appoint a competent person to make healthcare decisions when an elder is no longer able to do this. The administrator insisted that mom had to refuse the medication or it had to be given. Regardless of diarrhea. Of course, this is dangerous. It could lead to dehydration and that could cause other, serious health complications. Mom has no idea what medication she takes and won’t remember if her daughter suggests that she refuse the medication. What should the daughter do? She had contacted us for a consultation before this incident, so we were familiar with the general circumstances of her mom’s health. We know that every assisted living facility in the state has a liaison, called the “ombudsman”, whose job it is to serve as a go-between when there are resident or family complaints about a facility. We advised the daughter to contact the ombudsman immediately. We suggested how she approach the subject and what to say. The ombudsman has the obligation to investigate the problem. It’s possible that a conversation among the administrator, ombudsman and daughter will lead to the desired result. But ombudsmen are volunteers, and are generally not medically trained. There is a chance the ombudsman won’t act or act fast enough. If asking the ombudsman for help did not work, the daughter would have several other alternatives.
She could contact Mom’s doctor’s office and find out who covers his calls when he is out of town. She could contact the substitute doctor, explain the situation, and ask that that M.D. order stopping the medication until the treating doctor gets back in town. Another approach is to stand by mom’s side when the medication is about to be given to her (along with the medications she needs and will take), and direct her mom to refuse the new medicine. Finally, she could put her request in writing for the medication to be stopped on the basis of her right to make this decision as mom’s agent for healthcare. It is amazing how making a written request creates a record and has a way of getting the attention of administration.
If your family is having aging parent problems and you need advice, we are here to help you. You can get a complimentary strategy session by clicking right here.
Until next time,
Carolyn and Dr. Mikol