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Mom keeps cancelling appointments and refuses referral to neurologist. She also refuses to sign HIPAA form so we can discuss details with her physician. Dad is already in hospice.
My situation is different, but maybe this will help you?
I couldn't talk to my relative's Doctor (as patient not there, won't go, doesn't see problem, & won't sign for me to have permission to discuss yada yada).
So I talked to MY Doctor, who COULD discuss MY problem: Having a relative I was concened about.
She said with these sorts of situations; resistance, lack of insight or denial, it was often a waiting game. Three things she said really stood out that have helped me;
1. Many things are outside of my control. Let them go.
2. People deemed competent (ie everybody not deemed incompetent) have the right to make their own decisions: Good or Bad. She called this *The right to rot*.
3. Sometimes it takes a crises to effect change. No-one can predict the future, but having a plan to speak up when a fall or other event happens may be the chance for change.
A POA document needs to be written that includes HIPPA privacy documentation in order to access records.
So, I am going for guardianship of an individual and am in the same boat. My lawyer hired a neurologist and two phsychiatrists to stay at my home several days to determine competence. That is the backdoor method for evaluations.
So this is how to go about getting an evaluation of dementia? Do I ask the lawyer or make a neurologist appointment? My dad was able to make appointments for himself and pay his bills and go grocery shopping. But since his last fall and UTI, he seems a bit bonkers to me. He used to love my hubby more than me and now he hates him? I hope things work out in your favor for guardianship. Yes, I never had HIPPA. Just DPOA and guardianship & health care surrogate.
Depending on the DPOA you may or may not be able to act for your mother. My DPOA (both financial & medical) was effective upon my parents signature. However being POA doesn't make you her guardian - you are her agent and until she is determined incompetent she can countermand your decisions.
I promised my parents that as long as they were competent I wouldn't make any major decisions without going over it with them. Even as dad declined I continued to tell him what I thought was in his best interest until he ended up in SN where he died.
I continue to go over things with mom - Soon I hope to have her in a new facility - I took her to the 2 top picks for her to see. She told me I could have done it without her - but I felt she may want to have a voice in which facility she thought would be best for her. Mom is still competent and can at anytime revoke the current DPOA and appoint someone else her agent.
As far as her docs, I provided most of my parents medical providers with copies of the POAs and was able to call or ask for information. But then I also would accompany them to their appointments (pre-COVID) - because any time I'd ask what the doc told them, I'd get an "I think s/he said ..." So make sure the med providers have a copy.
As her legal POA you don't require HIPAA, I don't believe, but you should check the law for your state. I don't think that you can legally mandate she get examined. Were you to be her conservator or her guardian you could. But until she is diagnosed as having dementia your Mom remains legally competent. That means she is ALSO competent to remove your POA, as she conferred that upon you b y her own choice. Eventually your Mother's condition will come to a head. You may need to make a wellness check request to APS; they may send your Mom to hospital by Ambulance and help you arrange Social Worker to get you a temporary guardianship which amounts for her or him a simple call to a judge. However, if your Mom is examined and found to be competent in her own care, you will not receive letters to enable you to act in any way contrary to her wishes with your POA.
No, because your Medical POA is not in effect until Mom is found incompetent. So its a Catch 22. Your Mom probably has Dementia and you need to discuss this with her doctor but you can't discuss it with her doctor until your POA is in effect.
You are going to need to wait until something happens. Seems she is pretty with it if she can cancel appts and know what signing a HIPPA paperworks means. All you can do is keep her Doctor informed of any changes.
I was my dads DMPOA and I did not have to have a signed HIPAA release to act on his behalf. The Durable Medical POA was sufficient, even long distance.
My mom was having back issues along with really weird mental stuff that our family doctor picked up on. I also dropped a note off at the doctor's office with dates of things my mom said or did strange things. Obviously a family doctor can't help serious back pain, so we got a referral to another doctor. Oops, the referral was for a geriatric center that specialized in dementia (either ruling it out or diagnosing). I asked God a hundred times to forgive me for lying to my mom so she would go to that center! She was diagnosed with Lewy Body Dementia. For the record, we did take her to a doctor for her back a few weeks later.
I am my brother’s medical POA and health representative with my 22 year old niece and another brother as backup. We went to an elder law attorney who also added a HIPPA form. He had significant memory problems and needed a diagnosis. I live 1500 miles away from him but I found a neurologist on the internet, contacted the office and explained the situation. I filled out the patient forms and faxed copies of the POA, etc to the doctor.
I also wrote a letter describing very specific examples of his memory problems and sleep changes. My niece lives near him and took him to the doctor but I wanted the doctor to know what exactly was happening—I’ve wanted to keep the information and medical load off her as much as possible. My brother wouldn’t have been able to answer any of the doctor’s questions. The doctor spent ten minutes with him and ordered an MRI. It revealed a massive tumor which morphed into glioblastoma.
The POA is so important—it’s open sesame to doctors, hospitals and nursing facilities. Ultimately, after consulting with my niece, I made the decision to place him in hospice. She signed all the paperwork—including a DNR—while I was on speakerphone. Don’t waffle, hesitate or debate getting it. An elder law attorney can be very helpful in putting this together. Our attorney was also used to cancellations when the LO suddenly wasn’t cooperative.
Katie We lost a dear friend last year a month before he turned 65 with the same problem. Huge shock. we knew something was wrong. Thought it was dementia. It happened very quickly. He is blessed to have things in order and all the layers of care. Wishing him and all of you peace and comfort.
Jk The answer to your question is no. You can’t legally mandate.
However…. If she is cancelling appointments because the doctors office is calling her to confirm the appointment then change the phone number from hers to yours.
Are you the person who takes her to doctor appointments etc? If so, then you need to do that anyway.
An oncologist office called my in-laws office to ask MIL to come back in. They (in-laws) never told SIL who took them to their doctor appointments. She never followed up. The oncologist committed suicide. Several months later, SIL was on a routine appointment with her mom and the doctor said, I was sorry to hear about your moms diagnosis. Turns out she had cancer…from which she died. Not the out of control diabetes no one was helping her manage, not the dementia but the cancer she got no treatment for. Partially because a person who had dementia was still receiving phone calls from the doctors offices. I guarantee you MIL would have said no, she didn’t need the appointment but she would have never picked up the phone and called to say she wanted to cancel. Way beyond her ability.
It’s another thing to refuse to go in once you drive up. would she refuse to get out of the car, to go in? What if she thought the appointment had something to do with your dad? Would she be more likely to go in then?
You can manipulate in a positive way (see Mountain Moose’s post) to get them the help they need. In some cases, perhaps like Katiepaints, the diagnosis is a complete shock, not just “ordinary” dementia, and an early diagnosis may be helpful. In other cases, it is just confirmation that there is a problem that must be managed. One you are most likely already dealing with. Or, you need it in order to activate the POA? You will need to read your POA to see what powers were given to you and when they become effective.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I couldn't talk to my relative's Doctor (as patient not there, won't go, doesn't see problem, & won't sign for me to have permission to discuss yada yada).
So I talked to MY Doctor, who COULD discuss MY problem: Having a relative I was concened about.
She said with these sorts of situations; resistance, lack of insight or denial, it was often a waiting game. Three things she said really stood out that have helped me;
1. Many things are outside of my control. Let them go.
2. People deemed competent (ie everybody not deemed incompetent) have the right to make their own decisions: Good or Bad. She called this *The right to rot*.
3. Sometimes it takes a crises to effect change. No-one can predict the future, but having a plan to speak up when a fall or other event happens may be the chance for change.
So, I am going for guardianship of an individual and am in the same boat. My lawyer hired a neurologist and two phsychiatrists to stay at my home several days to determine competence. That is the backdoor method for evaluations.
I hope things work out in your favor for guardianship. Yes, I never had HIPPA. Just DPOA and guardianship & health care surrogate.
I promised my parents that as long as they were competent I wouldn't make any major decisions without going over it with them. Even as dad declined I continued to tell him what I thought was in his best interest until he ended up in SN where he died.
I continue to go over things with mom - Soon I hope to have her in a new facility - I took her to the 2 top picks for her to see. She told me I could have done it without her - but I felt she may want to have a voice in which facility she thought would be best for her. Mom is still competent and can at anytime revoke the current DPOA and appoint someone else her agent.
As far as her docs, I provided most of my parents medical providers with copies of the POAs and was able to call or ask for information. But then I also would accompany them to their appointments (pre-COVID) - because any time I'd ask what the doc told them, I'd get an "I think s/he said ..." So make sure the med providers have a copy.
I doubt this answer helps all that much.
Eventually your Mother's condition will come to a head. You may need to make a wellness check request to APS; they may send your Mom to hospital by Ambulance and help you arrange Social Worker to get you a temporary guardianship which amounts for her or him a simple call to a judge. However, if your Mom is examined and found to be competent in her own care, you will not receive letters to enable you to act in any way contrary to her wishes with your POA.
You are going to need to wait until something happens. Seems she is pretty with it if she can cancel appts and know what signing a HIPPA paperworks means. All you can do is keep her Doctor informed of any changes.
I also wrote a letter describing very specific examples of his memory problems and sleep changes. My niece lives near him and took him to the doctor but I wanted the doctor to know what exactly was happening—I’ve wanted to keep the information and medical load off her as much as possible. My brother wouldn’t have been able to answer any of the doctor’s questions. The doctor spent ten minutes with him and ordered an MRI. It revealed a massive tumor which morphed into glioblastoma.
The POA is so important—it’s open sesame to doctors, hospitals and nursing facilities. Ultimately, after consulting with my niece, I made the decision to place him in hospice. She signed all the paperwork—including a DNR—while I was on speakerphone. Don’t waffle, hesitate or debate getting it. An elder law attorney can be very helpful in putting this together. Our attorney was also used to cancellations when the LO suddenly wasn’t cooperative.
We lost a dear friend last year a month before he turned 65 with the same problem. Huge shock. we knew something was wrong. Thought it was dementia. It happened very quickly. He is blessed to have things in order and all the layers of care.
Wishing him and all of you peace and comfort.
The answer to your question is no. You can’t legally mandate.
However…. If she is cancelling appointments because the doctors office is calling her to confirm the appointment then change the phone number from hers to yours.
Are you the person who takes her to doctor appointments etc? If so, then you need to do that anyway.
An oncologist office called my in-laws office to ask MIL to come back in. They (in-laws) never told SIL who took them to their doctor appointments. She never followed up. The oncologist committed suicide. Several months later, SIL was on a routine appointment with her mom and the doctor said, I was sorry to hear about your moms diagnosis. Turns out she had cancer…from which she died. Not the out of control diabetes no one was helping her manage, not the dementia but the cancer she got no treatment for. Partially because a person who had dementia was still receiving phone calls from the doctors offices. I guarantee you MIL would have said no, she didn’t need the appointment but she would have never picked up the phone and called to say she wanted to cancel. Way beyond her ability.
It’s another thing to refuse to go in once you drive up. would she refuse to get out of the car, to go in? What if she thought the appointment had something to do with your dad? Would she be more likely to go in then?
You can manipulate in a positive way (see Mountain Moose’s post) to get them the help they need. In some cases, perhaps like Katiepaints, the diagnosis is a complete shock, not just “ordinary” dementia, and an early diagnosis may be helpful.
In other cases, it is just confirmation that there is a problem that must be managed. One you are most likely already dealing with. Or, you need it in order to activate the POA? You will need to read your POA to see what powers were given to you and when they become effective.
I am sorry about your dad.
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