Ok so I will say first thing, I have Medical Power of Attorney for my Mom, and she lives with me and I am her caregiver. She was diagnosed with Lewy Body Dementia, Parkinson's Disease, and has had 3 strokes. She requires assistance with all daily activities, is seriously impaired. We have had multiple falls, and they are increasing. She has reached a point where I am not enough to keep her safe, and my own health is now suffering as well. I need to get her into long term care as soon as possible, and even have a facility picked out and luckily have a niece by marriage that is in social services at the facility. The problem is my siblings and I want to get our ducks in a row before talking to Mom. We do not want to cause undue stress and fear for an extended period of time. She is easily upset and agitated and it sends her into a decline. I tried to get an appointment either in person or phone to speak to her doctor alone and tell her all of her many symptoms I am now dealing with and to get an order hopefully for the facility. The doctor had her nurse call and refuse me and said without guardianship not just medical power of attorney she can't lawfully see me or talk to me alone. I thought that medical power of attorney was for those very things, that the person with medical POA had say over medical treatment and could talk to the doctors? She told the nurse to tell me if I am thinking of long term care to contact social services at whichever facility I want. So my niece at the facility faxed info to the doctor telling her of Mom's condition of decline and our concerns, asking doctor what is needed and requesting a medical order, medications list, etc, etc. That was last week still no word to me or the facility as of yet. Afraid the doctor is going to refuse that too. I feel like I am hitting a brick wall. Hate to call the doctor's office, I felt like I was being talked down to with this disapproving tone that I am doing this without Mom present. I am just trying to get things moving without stressing her too bad. She is very emotional and I do not want to set off a really bad decline, or her to have terrible emotional fits that upsets the entire household for days or weeks with nothing definitive set in motion.
Also how will the SNF be paid for? Is mom on Medicaid? Medicare doesn’t pay for long term care. That will need to be established before she is admitted to a NH.
I don’t feel you should be doing this behind her back. Is mom mentally competent? I would begin to introduce the idea to mom gradually because either way, placing mom is going to cause her a lot of stress. She will need to deal with that. Keep your goal in mind - to get her out of your home to a SNF that will provide her with a team to manage her care. She will need to cooperate and attend a PCP appointment.
Hang in there. It’s a struggle but you can do it. It’s time for you to live your life as you’ve given enough.
Another consideration is how state law might affect MPOAs. Regardless, I don't see how this doc, knowing mom's condition, would put up such a wall to prevent even talking with someone, esp if they are willing to private pay!
The doctor is wrong about your Medical POA not being enough for the doctor to speak with you, as well. However, there is NO REASON to see that doctor. That doctor doesn't need to give you an "order" for a facility. The facility itself will have MD assessment of your Mom. You, as her POA will be there to help answer questions. Then that new doctor will order the records from the old.
Do not speak to people who speak down to you. Tell them that you simple have no time to be talked down to and will have to change doctors immediately and complain to the medical board about this doctor and his or her refusal to discuss their patient with the patient's POA for health care.
So sorry about your Mom's diagnosis. My bro had both early Lewy's and then a benign tumor over the medulla. Together they just about ruined balance. He worked hard with PT to stay on his feet. Your Mom has a dual diagnosis as well, as both Lewy's and Parkinson's messes with the gait. Wishing you good luck and hoping you will update us. The Lewy's will also affect mentation, but it can go up down and all over the place unlike other dementia's that go down in stairsteps or in slow but inexorable decline.
She probably agrees with your assessment, but again it's about the money. She knows if she were to sign the order for placement, she would not longer be her PCP, unless she was also on staff as the facility doctor, so no more seeing mom unless she would be brought back to the hospital.
Another way of putting what you want to do is that you want to go behind her back, then spring the arrangements on her when it is all-but a fait accompli, and you are asking her doctor to join in the conspiracy. Not gonna happen.
You are not going to get your mother's doctor to agree that it is in your mother's best interests for her future not to be discussed with her at the planning stage. Your mother is entitled to an opinion on this, and would be even if you were her guardian.
So. To get to the nub of it. What is your mother's view of what would be best for your mother's long term care? She may have dementia and she may be emotional, but she still has a view. Gently try to get her to talk about it - and let her tell you, don't comment on what she says or shoot her down - and then you can broaden the discussion out from that starting point. What her doctor objects to is your attempt to exclude your mother from a process which is all about her.
Does your POA say its in effect when Mom can no longer make informed decisions. Some need a Doctor's note making it effective. Does Dr/s have the POA on file? If not, give them a copy. As medical POA he can talk to you.
For what it's worth, if mom is easily agitated and stressed for days about things, she should be evaluated for meds for that, in my opinion.
My mom's anxiety about small issues was the most debilitating feature of her dementia. Getting her on the right combination of antidepressants was extremely helpful.
Does the doctor have to refer Mum to the facility?
Which country are you in?
If the US, can you call APS and tell them you need help?