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Care home objecting to stopping meds.....

prittlewell

Registered User
Jan 28, 2020
33
I have just spoken to the care home where my Mother resides. She is in her 90‘s with advanced dementia. She can talk but makes little sense, she is now in continent, and has to be lifted every time with a hoist as she has no mobility.

I spoke to her GP in December 19 to discuss Mum as I have PoA for health. He agreed at the time he would stop the medication for dementia, and also for her high blood pressure, as Mum had little quality of life due to the progressing dementia.

Mum had always hated the thought of going into care after the same thing happened to her Mother, and knowing my Mum well, she would not have wanted to live like she is. I reported this to the home in January, and advised them they would have less medication, once the next batch was received.

I have just spoken to the home who inform me she is still being given all the medication I agreed with the GP to stop, so something was not done right after the appointment back in December, and the home never contacted me to tell me.

When I mentioned to the home that I was very upset with this and would be contacting the GP, they wanted to know why I wanted the meds stopped, and said it was up to the GP, not the PoA.

It was agreed with the GP due to Mum having little, if any, quality of life. She just stagnates in the home, with them posting pictures of her (and the other residents) on their FB page pretending they are doing some activity, when clearly they have no idea what they are doing.

My view, is that they are desperate to keep residents alive, no matter what their mental capacity, just to keep the monthly fees rolling in.

What are my rights under the HW PoA? I assumed, Mum gave me the PoA because she wanted me to make decisions she could no longer make. I know for a fact that Mum would not wish to prolong her life in her current state. Do I have the right to refuse medication on her behalf if I believe it is what she would want?
 

TNJJ

Registered User
May 7, 2019
1,740
cornwall
I have just spoken to the care home where my Mother resides. She is in her 90‘s with advanced dementia. She can talk but makes little sense, she is now in continent, and has to be lifted every time with a hoist as she has no mobility.

I spoke to her GP in December 19 to discuss Mum as I have PoA for health. He agreed at the time he would stop the medication for dementia, and also for her high blood pressure, as Mum had little quality of life due to the progressing dementia.

Mum had always hated the thought of going into care after the same thing happened to her Mother, and knowing my Mum well, she would not have wanted to live like she is. I reported this to the home in January, and advised them they would have less medication, once the next batch was received.

I have just spoken to the home who inform me she is still being given all the medication I agreed with the GP to stop, so something was not done right after the appointment back in December, and the home never contacted me to tell me.

When I mentioned to the home that I was very upset with this and would be contacting the GP, they wanted to know why I wanted the meds stopped, and said it was up to the GP, not the PoA.

It was agreed with the GP due to Mum having little, if any, quality of life. She just stagnates in the home, with them posting pictures of her (and the other residents) on their FB page pretending they are doing some activity, when clearly they have no idea what they are doing.

My view, is that they are desperate to keep residents alive, no matter what their mental capacity, just to keep the monthly fees rolling in.

What are my rights under the HW PoA? I assumed, Mum gave me the PoA because she wanted me to make decisions she could no longer make. I know for a fact that Mum would not wish to prolong her life in her current state. Do I have the right to refuse medication on her behalf if I believe it is what she would want?
Hi. Has it been written up anywhere?? Although you can state it I believe they still have to carry on giving it to her as they have “Duty of Care” as well as the GP.. Do you have a DNR in place??
 

Marie 67

Registered User
Jul 25, 2020
38
I have just spoken to the care home where my Mother resides. She is in her 90‘s with advanced dementia. She can talk but makes little sense, she is now in continent, and has to be lifted every time with a hoist as she has no mobility.

I spoke to her GP in December 19 to discuss Mum as I have PoA for health. He agreed at the time he would stop the medication for dementia, and also for her high blood pressure, as Mum had little quality of life due to the progressing dementia.

Mum had always hated the thought of going into care after the same thing happened to her Mother, and knowing my Mum well, she would not have wanted to live like she is. I reported this to the home in January, and advised them they would have less medication, once the next batch was received.

I have just spoken to the home who inform me she is still being given all the medication I agreed with the GP to stop, so something was not done right after the appointment back in December, and the home never contacted me to tell me.

When I mentioned to the home that I was very upset with this and would be contacting the GP, they wanted to know why I wanted the meds stopped, and said it was up to the GP, not the PoA.

It was agreed with the GP due to Mum having little, if any, quality of life. She just stagnates in the home, with them posting pictures of her (and the other residents) on their FB page pretending they are doing some activity, when clearly they have no idea what they are doing.

My view, is that they are desperate to keep residents alive, no matter what their mental capacity, just to keep the monthly fees rolling in.

What are my rights under the HW PoA? I assumed, Mum gave me the PoA because she wanted me to make decisions she could no longer make. I know for a fact that Mum would not wish to prolong her life in her current state. Do I have the right to refuse medication on her behalf if I believe it is what she would want?
It's her human right to be given medication not youres to decide otherwise
 

canary

Registered User
Feb 25, 2014
13,437
South coast
The care home can only give (or not give) medication that has been writtenup by a doctor. When you spoke to the GP he listened to you as POA/NOK, but that doesnt give you right to change the care plan. I would guess that the GP has not updated the care plan, which is what needs to happen.
 

Baker17

Registered User
Mar 9, 2016
725
Recently my husband wasn’t resistant to taking his medication and there was meeting on teams to discuss the best way forward whether to stop all meds or try to continue. I was told there would have to be a best interests meeting to discuss stopping this would involve his social worker, the chess team, the care home and myself. We as a group of people decided for the meantime they would try to dispense his medication but it may come to the point that a best interests meeting has to take place.
 

prittlewell

Registered User
Jan 28, 2020
33
It's her human right to be given medication not youres to decide otherwise
What is the point of a HW PoA then?

So if my Mother is discovered to have cancer, then it is her ‘right’ to endure chemotherapy, even if I, as her PoA and as someone who has known her for 60 years, feel it would go against her wishes and not be in her best interests.

We do have a DNR order in place.
 

prittlewell

Registered User
Jan 28, 2020
33
Recently my husband wasn’t resistant to taking his medication and there was meeting on teams to discuss the best way forward whether to stop all meds or try to continue. I was told there would have to be a best interests meeting to discuss stopping this would involve his social worker, the chess team, the care home and myself. We as a group of people decided for the meantime they would try to dispense his medication but it may come to the point that a best interests meeting has to take place.
Do you have a HW PoA in place? If so, why would they not allow you to decide what was in his best interests, as he signed the PoA knowing he was giving you the authority to act on his behalf if he could no longer make the decisio.
 

prittlewell

Registered User
Jan 28, 2020
33
The care home can only give (or not give) medication that has been writtenup by a doctor. When you spoke to the GP he listened to you as POA/NOK, but that doesnt give you right to change the care plan. I would guess that the GP has not updated the care plan, which is what needs to happen.
Thank you...
I will be speaking to the GP tomorrow (covid rules allowing!)
 

Marie 67

Registered User
Jul 25, 2020
38
What is the point of a HW PoA then?

So if my Mother is discovered to have cancer, then it is her ‘right’ to endure chemotherapy, even if I, as her PoA and as someone who has known her for 60 years, feel it would go against her wishes and not be in her best interests.

We do have a DNR order in place.
I'm not against you in any way as I can read you're doing best intrest of you're mother . I'm only saying what convention of human rights have in the act that's one of them . under poa restrictions on too my bet is get legal advice I'm only stating facts don't mean upset you in any way .
 

Bod

Registered User
Aug 30, 2013
1,312
Who is currently prescribing her medication?
The GP you spoke to may not be the Doctor the Home uses.
I think the person you need to speak to is the Homes GP, taking the POA with you, to establish the validity of your thoughts.

Bod
 

prittlewell

Registered User
Jan 28, 2020
33
I'm not against you in any way as I can read you're doing best intrest of you're mother . I'm only saying what convention of human rights have in the act that's one of them . under poa restrictions on too my bet is get legal advice I'm only stating facts don't mean upset you in any way .
No offence taken, but it seems such a ‘grey’ area......
There seem to have been many PWD left to pass away in care homes, yet it would be in their best interest to go to hospital........or would it? Who makes that decision...
 

Marie 67

Registered User
Jul 25, 2020
38
No offence taken, but it seems such a ‘grey’ area......
There seem to have been many PWD left to pass away in care homes, yet it would be in their best interest to go to hospital........or would it? Who makes that decision...
Yes very complex area go citizens advice if still on restrictions there online has a live chat . Mon -fri theyl know also social care institute of excellence . loads online look on community care that's what it is called really interesting information on line I use these all the time . Good luck in you're quest 😀
 

Jaded'n'faded

Registered User
Jan 23, 2019
911
High Peak
This decision - no unnecessary meds, no more hospital visits - is usually made between next of kin and the person's GP when discussing DNAR. It seems like you've already had this discussion with the doctor and he/she has agreed with you about what would be best for your mum.

It sounds like a breakdown in communication afterwards - the GP should have put these details on your mum's care notes at the care home and this clearly hasn't happened. You'll need to contact the GP again to point this out and get the situation remedied.

To the best of my knowledge, such decisions are made in the best interests of the patient considering their health conditions, age and quality of life. I don't think it matters whether you have PoA or not.

But the CH can only do what they've been told to do. This isn't a decision that they make themselves.
 

love.dad.but..

Registered User
Jan 16, 2014
4,560
Kent
I had H and W health for dad and with a good understanding from the home's GP and mostly from the care home nurses and manager so was able to mutually agree what was in dad's best interests ...stopping annual blood tests as he was so frightened and resistant, stoppibg taking blood pressure, only going to hospital for an emergency that can only be dealt with there, reducing some medication as he was resistant and frightened to taking tablets and they could not be given in liquid form or subversably (we all tried) etc. I used the poa a lot...pushing for an emergency op with an understanding 2nd opinion surgeon/anaesthetist...to give dad comfort from a constant possible life threatening hernia...against the care home wishes to stop zopiclone as he was by then high risk of falls and with the gp full agreement.

My understanding was that the poa takes you so far in that decisions have to be fully justified and fully explained to an attorney in the context of an attorney being told by the donor their wishes pre loss of mental capacity and as though the attorney was the donor,but a medic's judgement can go against the attorney's if that was felt to be the right thing for the patient and that is as it should be...I am not a medic...unless the care home can provide a very good reason why the medication should be continued to the gp and that is a 3 way discussion..his decision should be strictly adhered to. As someone has said, maybe the care plan medication notes were not updated at the time of the decision. Having a DNR in place and logged in the resident's care plan often makes things clearer for the care home as certain questions in given scenarios are asked.

Speak with the gp again and take it from there
 

Sirena

Registered User
Feb 27, 2018
2,292
It does sound as if the GP failed to update the notes, so the care home were unaware of the agreement you reached. Hopefully that will be easily put right.

My mother has been in a care home over two years, and I only have financial POA, not H&W. However I am still consulted about medical issues, including any alteration to medication. The pharmacist who does the annual medication review always calls to update me, and this year she made a change to the meds because of information I gave. She said the fact I don't have H&W POA would not change anything she said to me.

In my experience it is a collaborative effort between relative, GP and care home, but all parties need to be kept in the loop for that to happen.
 

jennifer1967

Registered User
Mar 15, 2020
749
Southampton
I had H and W health for dad and with a good understanding from the home's GP and mostly from the care home nurses and manager so was able to mutually agree what was in dad's best interests ...stopping annual blood tests as he was so frightened and resistant, stoppibg taking blood pressure, only going to hospital for an emergency that can only be dealt with there, reducing some medication as he was resistant and frightened to taking tablets and they could not be given in liquid form or subversably (we all tried) etc. I used the poa a lot...pushing for an emergency op with an understanding 2nd opinion surgeon/anaesthetist...to give dad comfort from a constant possible life threatening hernia...against the care home wishes to stop zopiclone as he was by then high risk of falls and with the gp full agreement.

My understanding was that the poa takes you so far in that decisions have to be fully justified and fully explained to an attorney in the context of an attorney being told by the donor their wishes pre loss of mental capacity and as though the attorney was the donor,but a medic's judgement can go against the attorney's if that was felt to be the right thing for the patient and that is as it should be...I am not a medic...unless the care home can provide a very good reason why the medication should be continued to the gp and that is a 3 way discussion..his decision should be strictly adhered to. As someone has said, maybe the care plan medication notes were not updated at the time of the decision. Having a DNR in place and logged in the resident's care plan often makes things clearer for the care home as certain questions in given scenarios are asked.

Speak with the gp again and take it from there
it depends whether it is a care home or nursing home who employ qualified nurses care homes tend to employ care assistants and cant make medical decisions as they are not qualified
 

prittlewell

Registered User
Jan 28, 2020
33
Thanks all.

I will contact the GP tomorrow and find out what is happening, and why the conversation we had back in December was not actione.

It was so sad seeing Mum for the first time after 4 months, and it was the first time I don’t think she recognised me (I was the only one she still recognised prior to lockdown).

What has now made it worse is that the home have introduced a stupid rule that only one person can visit, and it has to be the same person each time. My wife and I live together, so if one of us has covid then the other one will likely have it, but they won’t let my wife visit.
 

Louise7

Registered User
Mar 25, 2016
2,400
What has now made it worse is that the home have introduced a stupid rule that only one person can visit, and it has to be the same person each time. My wife and I live together, so if one of us has covid then the other one will likely have it, but they won’t let my wife visit.
My mum's home are doing the same, as per government advice. It's not just about visitors potentially bringing the virus into the home it's also about them potentially taking it out from the home and spreading it amongst the wider community.
 

love.dad.but..

Registered User
Jan 16, 2014
4,560
Kent
it depends whether it is a care home or nursing home who employ qualified nurses care homes tend to employ care assistants and cant make medical decisions as they are not qualified
I agree but in dad's NH it was still the GP who made the decisions regarding medication for dad after discussion with myself and lead nurse who may or may not had voiced concerns but still abided by the GP decision.
 

love.dad.but..

Registered User
Jan 16, 2014
4,560
Kent
Thanks all.

I will contact the GP tomorrow and find out what is happening, and why the conversation we had back in December was not actione.

It was so sad seeing Mum for the first time after 4 months, and it was the first time I don’t think she recognised me (I was the only one she still recognised prior to lockdown).

What has now made it worse is that the home have introduced a stupid rule that only one person can visit, and it has to be the same person each time. My wife and I live together, so if one of us has covid then the other one will likely have it, but they won’t let my wife visit.
The one and same visitor rule is following government covid guidance which tbh is understandable in allowing at least some contact with a relative or close friend whilst still trying to minimise the risk to all in the home. Some homes I understand from media reports are not even allowing that, no visitors at all.
 

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