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My brother, a physician who has DPOA of health care for my mother , tends to withhold some health information from the rest of us. For instance, after my mother, who is 92, had a laminectomy, he decided to put her in hospice because she isn't doing well but will not reveal the official diagnosis that gives her 6 months to live. I would like to gain access to the Hospice records to see what has been recorded as her specific diagnosis which is required to be eligible for hospice.

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Has your brother told your mother's health care providers not to provide her health care information to you or other family members?

Health care providers have flexibility when working with people who are helping a family member with health care arrangements. A government website answers Frequently Asked Questions and explains:

"The HIPAA Privacy Rule at 45 CFR 164.510(b) specifically permits covered entities to share information that is directly relevant to the involvement of a spouse, family members, friends, or other persons identified by a patient, in the patient’s care or payment for health care."

http://www.hhs.gov/hipaa/for-professionals/faq/488/does-hipaa-permit-a-doctor-to-discuss-a-patients-health-status-with-the-patients-family-and-friends/index.html

If your brother has given intrusions to the health care providers that makes them unwilling to talk with you, talk to an elder law attorney for ideas on how to help him cooperate with you, other family members and your mother's health care providers.

If your mother is able to communicate verbally, the regulation mentioned in the FAQ explains that your mother can verbally give permission to the health care provider to disclose her information to you.
https://www.gpo.gov/fdsys/pkg/CFR-2003-title45-vol1/xml/CFR-2003-title45-vol1-sec164-510.xml
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Your mother can ask the hospice people for you to be given the information you want. It sounds as though you don't agree with the decision to call in hospice? It's not as though your mom now has an expiration date, more that they acknowledge that a 92 year old has a limited lifespan and the focus going forward will be to keep her pain free and comfortable rather than trying to extend her life. Hospice will get her more visits from aides, nurses, social workers and spiritual care than she may be receiving now.
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manis1954, a DPOA is legally obliged to keep all information confidential. Bear in mind that it is the HOSPICE MD who controls the meds, not the DPOA. You don't get onto Hospice without providing Medicare with hard evidence, written test results that clearly establish a terminal condition, not just a request from a DPOA. Nobody makes this decision alone. Please seek counseling for your grieving process. Hospice can get you that much.
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Nursecarebear - one aspect of hospice as a Medicare benefit is the availability of counseling for family. For Medicare to pay for a service (like grief counseling) for a family member (who does not have to be on Medicare) totally apart from something done & coded as a specific action for the on-hospice individual is a pretty radical shift of thought & funding of what a health insurance benefit can be. It is part of the more holistic approach of what hospice is.
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Sophe509, it is not uncommon for family members to insist the death was Execution by Hospice. It's their own way of coping with death: there must be someone to blame for the "murder". Unfortunately, the POA becomes the focus of this delusion.
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I know Hospice can be a good thing but I had a bad experience with it 9 months ago with my father. In a nutshell - there's a lot of background that I won't go into- my brother was trying to get my Dad on hsipice for weeks before we even thought he was terminal. I asked my brother what his diagnosis was and my brother said there wasn't one - just old age. I begged and begged for testing which my brother tried to block but finally my dad was found to have a rare condition with his stomach to made him unable to eat. Only at this point did I agree to Hospice. But right away hospice ( as directed by my brother) put my dad on an antipsychotic called Seroquel for his agitation and his agitation did not get any better ( my mom felt it got worse) but they left him on it for 2 weeks. Then my brother decided to go with the Haldol and Morphine and Ativan instead of the Seroquel. In a very short time my Dad's vitals started to fall after his initial doses of these meds - then within 26 hours of starting the new meds he was dead. I kind of got the feeling the entire time that my brother wanted to get things done and over with as quickly as possible and I'm afraid he will use that strategy with my mom.
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Thanks for your answer - All I want to know is what is the specific diagnosis that has made my mom eligible for hospice since there is no diagnosis that I or the rest of my siblings know of.
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I too have had problems with hospice. Seems they dont care about quality of life. why my moms is on it has yet too be discussed been 9months. they hve made her bedridden causing 3 open sores buttocks. she is miserable and depressed. she wants her life back even if its up in wheelchair. i too find the situation fishy . theres money involved i sympathize with mans. Im told hospice doesnt have a MD do visits. I am a nurse and its very frustrating i cant do anything. Can you, mans1954 get from medicare or her last primary Doctor the diagnosis? Senior legal aid should also be able to advise. I find the response please seek counseling as an insult by the way evryone grieves differently and possibly this could be more of legal situation. than an emotional one.
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i meant the response from pamstegma to seek counseling. It may be of comfort dont take me wrong but follow your heart. You dont want to live with fact you didnt later.....blessings & prayers4u
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manis1954...as I'm reading your explanation of what happened with your father and the medications... my first thought is...we call that murder where I come from. Do other relatives agree even somewhat with what you are thinking?
Based on what you said, my suggestion would be to get a big tough attorney involved immediately, so that the medications your Mom are given don't shorten her life span, too. Maybe start with a criminal complaint down at the police department and see what they say.... I can sure see why you are concerned. DPOA or not, long death process or not, we are not allowed to intentionally over medicate someone to death. Mercy.
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