My mother is the POA for my grandmother with Alzheimers. My grandmother was admitted into the hospital for treatment of pneumonia. Last night was her last night being admitted into the hospital, as she got discharged today. I went to give her a fresh change of clothes to go back to her memory care facility in, and when I got there she appeared extremely angry, combative, and was swatting at nurses helping her change and get her wires off so she could be transported to the home. I asked the nurses if she had been given any medication, as sometimes my grandmother doesn't act like herself when given certain medications (her memory may be bad, but she is the sweetest woman). They told me no and that she was up and just "like this" all night, and told me if this wasn't her baseline to let the doctor know. It definitely wasn't her baseline, but I chalked it up to stress from being in the hospital and being confused because of her Alzheimers. So we continued with the transport back to Memory Care. Come to find out, the hospital had called her Memory Care facility and informed them they gave her Haldol the night before so she would lay down/sleep. My Mom was not called to ask if this was okay even though my grandmother's issues with strong medications was made clear to them upon her admittance, and she had never taken this medication (Haldol) before. This medication caused her to be very scared and confused once back in her Memory Care facility and she definitely had a bad reaction to the medication. Is it illegal that they did not inform my grandmother's POA (my Mom) before administering a brand new medication? Just to have my grandmother lay down and sleep all night because the nurses didn't want to deal with her? I mean this is an anti-psychotic for people with schizophrenia. We want to know if her rights were infringed upon and if we should take any legal action. This occurred in the state of Ohio.
SO, the best you can advise your mom to do - is to inform the staff of the problems grandma had with this medication. The facility and your mom can get a copy of your grandmother's hospital record to see exactly what medications your grandmother received and any unexpected reactions she had to medication. Medications that caused documented adverse reactions (see list for each medication) should be noted as an "allergy" in your grandmother's record.
In addition, look for another hospital that deals with elderly patients. The next time she has to go to the hospital, "demand" that she needs to go there rather than the other hospital.
My Mom went into a large, federally funded hospital in early June. To "calm" her agitation, they administered Seroquel. They found a 4-year old prescription that we had never filled and they just assumed it worked. They ended up putting her in "soft" restraints because she got more combative after the Seroquel. The problem with the restraints is that here, most care homes will NOT take someone who has been in physical restraints for the last 24 hours. Luckily, the people at my Mom's care home knew the type of person my Mom was and allowed her to return without waiting the 48 hours, which exposed more than a few lies within the hospital system. There were so many things wrong with that stay, I just wanted her out of there.
Fast forward to September and my Mom is hospitalized for sepsis. This time we are in a hospital that is elderly-friendly. Again, my Mom goes through the combative, biting, etc stage. However, this time, I can stay the night. I noticed that they have put up padding on the rails of my mother's hospital bed. They have also taped a huge note to her bed saying that she was in the hospital. Again, to calm her agitation, they give her Seroquel. Again, it does exactly the opposite. However, due to the padding and the height of the hospital rails (6-8 inches), my Mom doesn't have the strength to climb out of bed (ingenious!) Because I am there, they ask me to buzz if I need anything, and just to let her tire herself out. 7 hours later, my Mom finally goes to sleep. No restraints needed and no need for the nurses to check in on my Mom during this time. Instead of giving her a shot that reduces the chance of blood clots, they put her legs in sleeves that help move the blood in her legs (My Mom refuses compression socks.) What a difference in the hospital stay.
My Mom remembers the second hospital stay as a big party. In fact, she said she had a great time and was hoping we could go back there again. I told her that it was too expensive of a place and hoped we didn't have to return. She was sad...for a moment.
So, what I would suggest to you, is to start researching other hospitals in your Grandmother's area. See which ones will allow you to stay overnight. See which ones are preferred by the elderly or specialize in the elderly. See which ones have doctors who actually like talking to the patient's "advocates." Yes, all hospitals are low on staff. However, the ones that are elderly friendly, will have policies, procedures and equipment that are flexible enough to deal with the nuances of elderly patients.
To me, the question is not if something is legal or not. The answer is whether what they do does more harm to the patient or not.
He/she cannot admit patients to just any convenient hospital. The hospital halls would be a traffic jam if every doctor was allowed to practice there.
Likewise, the hospital only allows doctors of their choosing to practice in their facility.
If you like your mom's doctor and feel the he/she is good for your mom, ask the hospital or facility if Dr "Well-Liked" is on their staff or does he practice there. If the answer is "yes", then ask the doc if he will see her at that facility. Many times you will find a good "match". If you do not, ask the facility that you like, what doctor(s) they would suggest.
Not guaranteed perfect...but I had to do this with my mom some years ago. And it worked out well. Mother got good care and a new Dr. that handled her case well.
OK....I just remembered how OLD I AM. "hospitalists" didn't exist in my earlier days. These days the patient's doctor actually works for the hospital and is called a "hospitalist". They take over care from the patient's own private physician when the patient is hospitalized. So my advice above probably doesn't apply...But "hospitalists" specialize in acute care, not long-term care or nursing home care.
So for long-term care you may still have some choices.
it may be with the while…
maybe I’m just tired…
I could’ve had a lot of litigations… maybe i should have..
I don’t know…
On the issues you now see with your grandmother; my mom was also recently in the hospital and we never left her alone, one of us (her children) were with her all the time, sleeping there in the chair next to her so when she woke up confused she always had a familiar face. After about a week there was an obvious change in her mental health and she developed a psychosis that isn’t uncommon for elderly patient's, particularly ones with some dementia, to develop when hospitalized. She has been home for over a month now and she is still on an anti-psychotic which is helping a lot but has taken quite a bit of adjusting. Your grandmother may have some form of that as well, having nothing to do with the Haladol so I would urge you to take her to a geriatric psychologist who can determine if she needs medication or not and what would be best if she does. For future reference you can ask that geriatric psychology see her in the hospital too so that they then have some control over any psychiatric drugs she is given. I learned this the hard way.
In my 98-year-old mom’s case, she was writhing and screaming in pain. They ignored the pain and were going to give her Haldol despite my protestations as her HPOA. Then I called the patient advocate, whose only job is to protect the hospital, not the patient. I don’t know if it was coincidence or if the fact that the patient advocate just by virtue of being there, but mom got a room upstairs and better doctors.
These Haldol - pushers are not good doctors AND take advantage of the most vulnerable.
What is truly inhumane is letting an elder suffer with hallucinations because ill-informed or paranoid relatives think anti-psychotics are just meant to hurt their loved one.
If the doctor ordered medication it will be given by the nurse.
NOW it is up to the POA to be certain that an allergy to haldol is added to her medication list so it is not given again. THEN if they order it they are at fault. When she is admitted the intake RN may ask "what kind of allergy to Haldol does she have" and the answer will be "severe combativeness and anxiety".
These drugs do have side effects.
A POA is not called every time a medication is added to a patient's list unless that is the agreement made between the POA and the Doctor. IF your Mom is POA she should now make clear that she wishes any and all new medications discussed with her as POA as your grandmother is unable to act in her own behalf. This should be added to her care plan with EVERY ADMISSION anywhere, as it won't travel with her autoatically through different doctors and facilities.