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Our elder was brought to the ER for fear of dehydration. We refused care regarding surgery and followed an AMA. Now we’re being forced to bring him back for consultation. He doesn’t have anymore symptoms doesn’t have covid. He has dementia.
The ER doctor could decide to call Elder Protective Services if they believe the elder is not receiving appropriate treatment. EPS would investigate and determine what needed to be done or require a court appointed second opinion.
I never heard of this. Usually when discharged from an ER you are told to see your PCP. I know, this was AMA.
I agree need more info. What did they want to do surgery for? Did the elder refuse? Or does the elder suffer from Dementia and your decision was based on age? You didn't want them to go thru it.
Did you take the elder to their PCP? If not, maybe you should. I say this because of the previous responses concerning the Hospital calling APS if they feel your care is not enough. By seeing the PCP you show you are consulting with the Dr. who knows your elder the best. Who can help you make the correct decisions. No need to consult with a Hospital who knows nothing about the patient or their life. If u tell them you have consulted are going to consult with ur PCP that should be enough.
An adult in their right mind, can not be forced to take treatment they don't want or can't afford. We can all die the way we want. If the elder has a Dementia and there is a POA than the POA makes informed decisions for that person based on their wishes.
At 89 my Mom was pretty much in the last stage of Dementia. If she contracted Cancer would not have put her through surgery and chemo. If she stopped eating would I have allowed a stomach tube, no. This actually was written in her Medical POA, no stomach tube.
"An adult in their right mind, can not be forced to take treatment they don't want or can't afford."
FWIW, even with dementia they can't be forced to do something they don't want to do. Initially it was when we needed to move mom to MC and she wanted no part of moving anywhere (she was just fine, thank you.) The Elder Law atty told me we could NOT force her to move, despite dementia. He suggested guardianship, but the facility we chose wouldn't accept a committal. We had to work around that.
Once she was in MC, staff also told me they can't force a resident to do anything, whether it's bathing, taking medication, going to appt for wound care, etc. They have to get creative and coax the person as best they can.
This came into play early last month when my mother had a stroke. She refused to go with the EMT, so they called me. After some discussion, in which I said even if I say take her, you'll have to force her to go (she can be REALLY stubborn!!!), so what does that accomplish? Plus, she's 97 with dementia. I suspect they'd have quite a task in trying to do any testing (we know she had a stroke, so why the testing?) and I said no to hospitalization. She would be LIVID and it would be a disaster. I left it to him - if YOU can convince her to go and get testing, fine, take her. Otherwise, leave her alone. I know she and my dad wanted no heroics, no major interventions. Given her age and dementia, exactly what would testing accomplish? She was already in a wheelchair before the stroke (lack of strength mainly because she wouldn't stay active.) Funny though, after he left, she confronted the staff nurse, demanding to know who called him? The nurse said she did and mom got mad at her and tried to kick her!!! From a wheelchair!
They brought in OT/PT to work with her some, to try to strengthen her right arm and leg, to assist in feeding herself and pivoting. Didn't accomplish a whole lot. She's on hospice now (denied at first - hasn't lost weight in 6 months - whaaaat? She didn't have a stroke 6 months ago! Not even a month later, nurse demanded they come back and reassess. Sure enough, she lost weight. She has trouble swallowing and feeding herself, but she still tries to be the boss!)
Anyway, the point is that even those with dementia can't be forced to do what they refuse to do.
As for the initial query - hard to make any suggestions as there isn't enough information. A quick follow up with primary doctor to ensure all is well would likely have been sufficient to shut the others up, but if they suspected neglect and no follow up was done, they can get APS involved.
Age? Surgery for what? Dehydration? Was the dehydration treated at the ER? Does this elder live alone or with someone?
Regarding WHAT surgery. There is no surgery for dehydration, so clearly something else is going on. Does this elder have dementia? If this elder has dementia does he or she have a POA and an advanced directive for health care. If this elder is competent was it his or her own choice to leave the hospital? There is a whole lot of information missing here. So no one can answer. For instance, if you removed an elder who needs lifesaving surgery from care and access to that surgery, and if you did so without that elders permission and signature on the AMA form, yes, you could be accused of endangering the elder's life. Or in another instance, in the case of an elder who has made known his wishes to have no intervention, and to enter hospice or palliative care, and you were the POA for this directive, then you can remove the elder to hospice care in the home. We need to know what is happening specifically in your case to be of even the slightest help to you.
There's not really enough information here to give an answer. If the hospital has concerns you aren't taking care of him, they can make a Vulnerable Adult report for neglect to the state and they can get involved and possible appoint a guardian.
There are very few situations where you can be FORCED to have surgery these days. My mom has a bad heart at 90, and is in frail health, Her cardiac Dr always mentions she can have surgery, but she really would not survive it. every dang visit we go over this. It is her choice, and mine as her health care advocate ( and POA) I agree with following up with his GP, and then at least if there is push back you have done your job. Mom just got out of the hospital for CHF, and I am taking her to the GP and cardiologist next week,, to go over all the new meds.. and review the things they sent home ( like an inhaler there is NO way she can use)
It is hard to offer advice when you leave out important details.
It would appear that your "elder" is not drinking enough fluids - either because he/she refuses to drink or because he/she does not have access to fluids. The first is a matter of elder's choices; the second is a matter of neglect and can become a legal problem if not addressed. If it is the second, he/she can not live alone anymore and will need round the clock care.
When you say "you refused care regarding surgery," was that in the capacity of POA (and you have paperwork to back up the claim)? Is the surgery crucial to survival or elective? If the surgery is deemed crucial to survival, you may be "forced" to bring him back for consultation - and you should have been served a legal document from authorities stating so.
Once you sign AMA you are not forced to return. Is your dad a DNR? Did the hospital forced or recommended? you to come back for surgery or to be evaluated for more aggressive treatment? You can ask for Palliative consult if you don't want any aggressive treatment and possible hospice. If you really like your GP you can keep that while you're on Palliative. Hugs and prayer.
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 agree need more info. What did they want to do surgery for? Did the elder refuse? Or does the elder suffer from Dementia and your decision was based on age? You didn't want them to go thru it.
Did you take the elder to their PCP? If not, maybe you should. I say this because of the previous responses concerning the Hospital calling APS if they feel your care is not enough. By seeing the PCP you show you are consulting with the Dr. who knows your elder the best. Who can help you make the correct decisions. No need to consult with a Hospital who knows nothing about the patient or their life. If u tell them you have consulted are going to consult with ur PCP that should be enough.
An adult in their right mind, can not be forced to take treatment they don't want or can't afford. We can all die the way we want. If the elder has a Dementia and there is a POA than the POA makes informed decisions for that person based on their wishes.
At 89 my Mom was pretty much in the last stage of Dementia. If she contracted Cancer would not have put her through surgery and chemo. If she stopped eating would I have allowed a stomach tube, no. This actually was written in her Medical POA, no stomach tube.
FWIW, even with dementia they can't be forced to do something they don't want to do. Initially it was when we needed to move mom to MC and she wanted no part of moving anywhere (she was just fine, thank you.) The Elder Law atty told me we could NOT force her to move, despite dementia. He suggested guardianship, but the facility we chose wouldn't accept a committal. We had to work around that.
Once she was in MC, staff also told me they can't force a resident to do anything, whether it's bathing, taking medication, going to appt for wound care, etc. They have to get creative and coax the person as best they can.
This came into play early last month when my mother had a stroke. She refused to go with the EMT, so they called me. After some discussion, in which I said even if I say take her, you'll have to force her to go (she can be REALLY stubborn!!!), so what does that accomplish? Plus, she's 97 with dementia. I suspect they'd have quite a task in trying to do any testing (we know she had a stroke, so why the testing?) and I said no to hospitalization. She would be LIVID and it would be a disaster. I left it to him - if YOU can convince her to go and get testing, fine, take her. Otherwise, leave her alone. I know she and my dad wanted no heroics, no major interventions. Given her age and dementia, exactly what would testing accomplish? She was already in a wheelchair before the stroke (lack of strength mainly because she wouldn't stay active.) Funny though, after he left, she confronted the staff nurse, demanding to know who called him? The nurse said she did and mom got mad at her and tried to kick her!!! From a wheelchair!
They brought in OT/PT to work with her some, to try to strengthen her right arm and leg, to assist in feeding herself and pivoting. Didn't accomplish a whole lot. She's on hospice now (denied at first - hasn't lost weight in 6 months - whaaaat? She didn't have a stroke 6 months ago! Not even a month later, nurse demanded they come back and reassess. Sure enough, she lost weight. She has trouble swallowing and feeding herself, but she still tries to be the boss!)
Anyway, the point is that even those with dementia can't be forced to do what they refuse to do.
As for the initial query - hard to make any suggestions as there isn't enough information. A quick follow up with primary doctor to ensure all is well would likely have been sufficient to shut the others up, but if they suspected neglect and no follow up was done, they can get APS involved.
Age?
Surgery for what? Dehydration?
Was the dehydration treated at the ER?
Does this elder live alone or with someone?
Does this elder have dementia? If this elder has dementia does he or she have a POA and an advanced directive for health care.
If this elder is competent was it his or her own choice to leave the hospital?
There is a whole lot of information missing here. So no one can answer. For instance, if you removed an elder who needs lifesaving surgery from care and access to that surgery, and if you did so without that elders permission and signature on the AMA form, yes, you could be accused of endangering the elder's life. Or in another instance, in the case of an elder who has made known his wishes to have no intervention, and to enter hospice or palliative care, and you were the POA for this directive, then you can remove the elder to hospice care in the home.
We need to know what is happening specifically in your case to be of even the slightest help to you.
It would appear that your "elder" is not drinking enough fluids - either because he/she refuses to drink or because he/she does not have access to fluids. The first is a matter of elder's choices; the second is a matter of neglect and can become a legal problem if not addressed. If it is the second, he/she can not live alone anymore and will need round the clock care.
When you say "you refused care regarding surgery," was that in the capacity of POA (and you have paperwork to back up the claim)? Is the surgery crucial to survival or elective? If the surgery is deemed crucial to survival, you may be "forced" to bring him back for consultation - and you should have been served a legal document from authorities stating so.
Stick around for answers.
Best wishes to you and your family.