My sister - 73- was recently admitted to the hospital after falling. She was dehydrated and they later found she tested positive for Covid. She has fallen before. She was moved from one hospital to another for "therapy". Now after assessments, although she has not been feeling well, they have deemed her unable to make decisions. I live in another state. She is single - no children. I speak with her most every day, and even in the hospital, I do not agree that she can make decisions, that she is not alert, etc . I have asked that the hospital not make her take "speech" or cognitive tests as long as she is not feeling well and focused. They have told me that they are activating POA. I was named in her POA many years ago. The doctor in the previous hospital did not see the need to activate the power of attorney. I have asked - She IS eating and drinking and moving about. Does she HAVE to go to a nursing home? Again, when I speak with her, she seems fine. Her memory seems fine. When I commented on this, the case worker at the hospital said "some people have a way of hiding it??" I don't know what to do for her. Help! I would think they would want to allow seniors to age in place. I am a younger sister - 66. I'm not quite sure what subject to select. Advice will be much appreciated.
Did they test your sister for a UTI or thyroid problems? Is she on any other medications that she could accidentally overdose on? I'd make sure of some of these other possibilities if you are able.
I myself (her POA) have just survived a 3 week case of Covid at age 76.
While I am fully aware that some people are able to present themselves as cognitively intact even as they are beginning to experience the symptoms of dementia, I will tell you from my own personal experience with Covid that it may be difficult to achieve a valid assessment of what her skill levels actually are.
As you read your POA document you may FIND that there is some descriptive language that can help you determine what role you need to be performing now concerning both her immediate future and appropriate long range planning.
The effects of even mild cases of Covid can be VERY difficult to deal with. Can you contact someone who can actually see her and talk to her? I can’t imagine that
you’d be able to actually see her whether you were able to travel to her present site or not, but it may be VERY helpful for you to understand her current situation if you have the input of a second witness present at her bedside so that you three can chat.
Hoping that you’re able to get the input you need to make the best decision for both you AND your sister.
Once she fully recovers from her hospital stay and illness, she can take over her own care decisions independently, but at the moment, even you say she feels unwell and is unfocused. Why do you want her to be vulnerable to bad decisions when she's in that state?
The American Bar Assn. Puts it this way: “Advance directives are legally RECOGNIZED documents and doctors must respect your known wishes, but doctors can always refuse to comply with your wishes if they have an objection of conscience or consider your wishes medically inappropriate. Then, they have an obligation to help transfer you to another health care provider who will comply.
So the hospital must honor your role as the POA except as stated above. You can make the decisions that your mom would make for herself. Your POA gives YOU the authority to decide for your mom, not them!
Thats what they social worker was telling my dad and he absolutely refused going for rehabilitation because of the way it was presented.
Ask about her prognosis and care plan, this could just be to get her strong enough to safely go home.
Be cautious with covid. I was told that a mild case in the elderly can come back around days 8 thru 12 and that is the dangerous time. It was for my dad and for many others from my research. Encourage her to be patient and accept the rehabilitation and other care she is entitled to with Medicare, all was not well prior or she would not have been hospitalized.
When the Dr says she is well of Covid, let her go back to her own home if that's what she wants to do.
If the Hospital won't allow her to check out on her own, go there yourself, check her out and let her go back to her own home and you should be able to see how she is the first 24 hrs.
You should have a couple Nest Cameras installed in her home and she should be wearing a Fall Alert bracelet or necklace..
Nest Camerasate not hard to install and you'll be able to check on your sister 24 7 on your computer or cell phone..
if she can afford it she might have a Caregiver come by for a couple hrs every day or a couple times a week whatever.
Prayers.
The "doctor at the previous hospital" probably conversed with your sister and got the answers he/she needed, no need for you to make decisions at that time.
Having a POA doesn't take away your sister's ability to make her own decisions, if she has that ability. A POA, in this case, merely allows you to make decisions for your sister should she become unable to. That's it. Not a big drama, just a safety net.
Being in a hospital alone is enough to cause confusion. It's been my experience as a caregiving daughter, a certified assisted living administrator and a Director of Admissions for a LTC that some people can definitely "hide" their confusion with some people and in certain environments. The hospital may feel that your Sis really need rehab before she can address returning to living alone; if she is refusing rehab when it is in her own best interest, they may be recognizing your PoA status in the hope that this is the way to get her to rehab. She may be able to get some rehab at home (social worker can tell you if she is eligible) but they may feel that it is slightly better in a STR facility (they have more equipment if that is what she needs). PoA and medical proxy are not forever but are to be used when necessary. See if you can talk to both the current attending and the hospital social worker to see if your Sis can even remember how/why she fell. Don't be alarmed if she doesn't remember - that is common if she lost consciousness. Also see if you can get in touch with her primary care physical to see what her/his findings were the last time he saw/spoke with her.
Wishing you luck, health and stamina on this journey. Please keep us updated on your progress. Hope your sister is soon well and back home.
Is there a rehabilitation center in the hospital?
I think the hospital needs to release her to a safe environment. It may not necessarily be in patient rehabilitation. However, as far as I know, Medicare will pay if transferred directly to in patient rehabilitation. Please, check the logistics. You need to act quickly.
Best wishes.
I am dealing with a family member with dementia. My family member was able to “ mostly” mask her dementia for the past several years. It’s only upon being with her for more than a couple of days did I really see it.
the MD had no clue. Healthcare professionals who have worked with her had no clue- she’s that smart and that quick to deflect, not answer, or change the subject. Now it’s very obvious.
As your sisters HCPOA- you can make informed decisions because temporarily she really should not and it appears she cannot because she’s (been) that I’ll.
You can let her know what is going on. If you truly don’t trust them, do you have a friend who can answer your questions about her? If so, get the person to ask your sister targeted questions - the SW can give some questions to guide you.
Bless you as you navigate these waters.