How to prep for care planning meeting with staff at mom's MC?
I think I have two questions. One is, what do I need to ask or do to get the most out of the care planning meeting with the staff at my mom's memory care facility? She has COPD and dementia. Both conditions have declined rapidly in the last two months. It is my uneducated hunch that mom at 87 years old is in her final weeks to months of life. I base that on my observations and from the calls from family friends who have visited my mother and expressed concerns about her condition.
I am not POA so no one at the facility tells me anything. My sister is POA and we have been estranged for years. Long story. Anyway, my sister texted me to call her for a status update on our mother. Out of concern, I called her. She said staff has been asking her to put mom in hospice for over three months, but she refused. I asked my sister under what conditions did they want hospice, and she said nobody told her specifically. I asked her what meds mom is on for her COPD and dementia, and she said she did not know, but had a list of medications she would email to me. I was a bit concerned that my sister, as POA and the sole decision maker, does not have a grasp on these details. The staff contacted me twice in the last three months to tell me mom went to ER due to low oxygen. When I visited my mom in the hospital, the doctor told me mom needed to be seen by a pulmonologist and given medications beyond just the inhaler I have seen her use for years. The doctor told me instructions would be in mom's discharge papers. I asked my sister how the discharge orders were being followed up on by the staff, and she said she did not know. My sister also did not know if mom was being seen by any specialist for her conditions. My sister offered to set up another meeting with the same staff and include me. I agreed and am now looking to get a list of questions together, so wanted any advice on how to handle this meeting.
Second, I was appalled that my sister did not have answers to questions on mom's care. Is it odd that that a POA does not know these details? Would staff withhold this information? Not knowing how staff is managing the orders in the hospital discharge papers, and not being able to tell me the conditions the staff used as a basis for recommending hospice has me thinking everyone is dropping the ball and nobody is running the ship. Thank you for any advice.
The meeting, was a joke for me. I was given 15 min. Being my first meeting, I had a lot of questions. They told me what they were doing and really had no time for my questions. I learned to talk to the desk RNs to get my info. I held both POAs.
I am preparing a list of questions and meeting later this afternoon. I am getting upset just thinking about it but will not use that time to accuse or point fingers.
My sister told me the staff is giving mom Xanax twice a day for anxiety. I just did a quick AI search on whether Xanax was good for dementia patients, and the answer came back that it was NOT good due it causing increased confusion, sedation and fall risks. It is a benzodiazepine and said a different classification of meds are better. That was just one example of my suspicions about the judgement being applied to her treatment plan.
Thank you.
Edited to add: I agree 100% with MG8522.
If your sister has POA, then the staff cannot share information with you unless your sister authorizes this. The staff can follow the discharge instructions to the extent that they are able to, but they cannot initiate everything.
For example, the staff can order medications given in the discharge instructions, if authorized by the POA (which can be a standing order or an authorization each time one is recommended, depending on what their procedures are and what state law permits/requires). However, the staff would not be making an appointment with a pulmonologist and taking your mother there. They could arrange transportation to the appointment but would probably not send a staff member with your mother unless they have capacity to do so and your sister authorized it and arranged extra payment for it.
The details would vary by state law and facility protocols but it sounds like your sister has been dropping the ball.
It's good that your sister has included you in this meeting. Stay calm, and don't go in with an attitude of placing blame. Ask the staff to explain what is happening now with your mother, why they recommend hospice, and what will happen with that. If your sister disagrees, have the staff explain carefully and in detail what will happen if your mother continues without hospice. Then, if your sister is in denial about the need, sit there and keep at it until you, she, and the staff come to an agreement, signed in writing. Don't let her keep brushing this off and hiding in ignorance.
I wish you well. Let us know how it goes.