Does POA allow us to stop mum's meds?

[andrean]

We (my father, siblings and I) have healthcare POA for Mum, which we registered about a year ago but have never used.

Recently Mum's condition has deteriorated suddenly. The doctor keeps giving her different antibiotics, and has now prescribed 4 hourly paracetamol - yesterday, Mum had 8. Dad is very concerned about this - he's very anti-medicine anyway, but is particularly concerned about the effect the paracetamol may be having on mum's liver. As an ex nurse, I can't see any reason for the paracetamol; she has no fever, and does not appear to be in any pain.

Dad has asked the CH to stop the tablets, pointing out that he has POA (which they have a copy of). They say they can't because the doctor has prescribed it so they have to keep giving it. Is this correct? Surely POA means that you're empowered to make decisions on behalf of the person who granted it? If I were in hospital and a nurse tried to get me to take something, I would be perfectly at liberty to refuse, regardless of the fact that it had been prescribed for me. Why then don't we have the right to refuse medicine on mum's behalf?

 

[Saffie]

I think it is the problem with the Care home having to abide by the Doctor's prescription. They do not have the authority to stop the medication any more than a nurse would have without the Dr's say-so. I would ask to see the doctor and put your concerns to him.

 

[Sue J]

Hi Andrean

I cannot answer your query but just wanted to say I too am an ex nurse and started symptoms about 4 years ago. I regularly take paracetamol because it helps with all of my symptoms. I don't like taking tablets either but feel that paracetamol is one that I can take, I try to keep it at a minimum and sometimes only take one dose a day, sometimes none. At my worst times I was taking it at 8 a day but now I am improved I do not take so many. It can really help with agitation and anxiety where anything else has simply aggravated it.

I wonder if the paracetamol the CH has given your Mum has seen any improvement in her symptoms?

Best wishes
Sue

P.S. It is a shame the carehome didn't say they will discuss it with the Dr as Saffie has suggested and that you could too just as you would if you refused something prescribed for you if you were in hospital.

 

[andrean]

thanks, sue, that's very interesting. I googled it and can see that there is some evidence that paracetamol can reduce agitation in people with dementia. However, Mum is not agitated nor anxious; she's basically just lying in a bed, largely unresponsive. I've worked with a lot of people who had dementia, and I know how it can cause terrible agitation, but this absolutely isn't the case with mum, at least at this stage of her illness. Which leads me back to the question (which we can't get any answers for now, on saturday night): why has the doctor prescribed it? And why can't dad say he doesn't want mum to have it?

 

[Saffie]

There is no saying that you can't but again, I think you have to speak to the Dr who has prescribed it rather than the care home.

 

[scared daughter]

Just pondering another thing paracetamo; does is bring down temps along with pain relief, if your mum has a temperature it will help bring it down so she didn't feel poorly

Not sayign that is what it is for but its one of its uses deffo speak to her Dr xx

 

[karenjoy]

Hi my mum was put on something for thyroid can't spell the name sorry ,she was on it for about 3yrs she was supposed to have blood tests every 6 months,which she never had,anyway we noticed it Wes making her sleepy most of the day so we jut stopped giving them to her ,when the doc asked why we wasn't getting the prescription for her we said we don't like the side effects so she is not having them false stop,the doc has never said nothing to us so if you don't want them to take anything you don't agree with and you don't think it is helping them then do what you feel is right.

 

[kkerr]

From a medical point of view:

1) paracetamol - up to 8 /day (=4 grams/day) is a completely SAFE dose of paracetamol for anyone over 50 kgs in weight UNLESS they have underlying severe liver disease such as cirrhosis. When patients are unable to communicate - it is often used to help ensure the patient is not in some sort of pain that they cannot tell staff and family members about. Again, this is a relatively gentle and safe option to increase comfort with minimal risk (much less risky than codeine or even ibuprofen).

2) In order to be involved in medical care of a loved one, a person needs to have "Welfare Guardianship" which is different from POA - which only covers financial matters.

3) Agree with one of the previous posts - if you have concerns over medication, speak to your loved ones doctor. Once medication is prescribed, nurses have a duty/responsibility to administer that medication.

4) I suspect the thyroid medication is levothyroxine. It side effects do not normally include fatigue/tiredness, if anything that sounds like your relative may have been under-treated. Levothyroxine is a synthetic thyroid hormone for people suffering from hypothyroidism. Untreated it can be very dangerous and very unpleasant for the person (feeling cold all the time, dry skin, lethargic, etc).