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Does health care POA give me the ability to contradict a nursing home decision?

My father is in a nursing home because of advanced heart failure and dementia. One of his recent med changes has resulted in fluid retention and breathing difficulties. The staff refused to change the medication and he ended up in intensive care. The nursing home said they cannot change medication without a physician order and the physician had not called them back before he went to the ER (over 24 hours since the initial request). Why do we even bother with POAs if they cannot help in situations like this?
Status: Open    Jan 08, 2016 - 10:20 AM

Elder Law, Senior Health & Nutrition

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Jan 20, 2016 - 07:56 AM

What you describe is a difficult situation. The nursing home was correct that the nursing home must follow doctor's orders. If your POA allows you the ability to make decisions about medication you can direct them not to give him the medication but the nursing home does not have to keep him. He could be discharged from the facility.
If you were my client I doubt that I would ever advise you to authorize the withholding of medication prescribed by the doctor without you speaking to the doctor. The fluid retention could have been caused by something other than the change of medication. It seems to me that nursing home was reasonable in his care. When the doctor orders were not working they sent him to another doctor at the ER.
If you withheld or authorized the withholding of medication and that resulted in his death you could be charged with a crime (not in a terminal illness or permanently unconscious situations).
I would advise clients to do just what was done. Call the doctor to inquire about the medication. If no response, ask another doctor or send to ER.
Doctors are not infallible but probably know more about medication and illness than I or other non-doctors do.

Have a conference with the nursing home to see if they will honor your POA in the future regarding medication. If not, look for one that will and move your father there.

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