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They asked me for consent to put in a medline so they could keep him on meds for infection, now they put him in a NH for rehab without asking me, I am his health care proxy. Do I have any legal rights to get him discharged and sent home with care?
Bharty, I'm going to share some observations that I think may upset you, but at this point I think it could be helpful if you stop, think, and consider the path that care has taken.
You are his health care proxy, but unless I missed something, you're not a medical person. You do have the right to make certain decisions, but the proxy doesn't give you the right to make other decisions, some of which are probably beyond the scope of knowledge of the average patient's family. That doesn't mean that you shouldn't participate in his care though.
You're upset b/c you feel you've been left out of decision making? As I read and reread your post, and checked an earlier one, what I see is someone who's angry and possibly hostile to the medical pros treating your husband.
I'm not saying this to be cruel or hurtful, but attitudes do come across in treatment, and medical pros can react. They may feel that it's not worth an argument to discuss an issue with you b/c you don't have the medical knowledge they do.
Another impression I get is that these have become adversarial relationships. E.g., instead of asking what your legal rights are, or considering taking him home, have you ASKED the DON at the rehab center what issues are existent, what their planned course of action is, and to explain these issues either in detail or to the level that you can research, study, ON YOUR OWN, and be able to discuss the issues and treatment options with them, more as a partner than a demanding and dissatisfied wife?
Others have pointed out the challenges and complications of home care. They're right. If you weren't angry at the hospital and med pros, would you even be considering this?
I can understand that you feel you need to monitor and approve his treatment. But remember, you can do so, but on a less confrontational level.
I reiterate that it's not my intent to criticize you. I suspect you're stressed from repeated challenging medical issues, and very frustrated as well.
But it's time for a mid-course correction. Think about how to accomplish what you want by working WITH the medical staff. Ask for explanations instead of making conclusions, and take legal action out of the picture for now.
If you do seriously think legal action is appropriate though, this is NOT the place to ask. There are some attorneys here, but you should see a medmal attorney in person, and explain the issues (not your dissatisfaction) and facts only.
You wrote that you're health care proxy, and ask if you have specific rights. No one here can tell you specifically what rights you have w/o reading the proxy, reviewing applicable laws for your state, and better yet, reviewing the medical records.
If you're serious about taking legal action though, find a medmal attorney, allow him/her to order the medical records if he/she feels it appropriate. I think you'll find that a good medmal attorney will not see malpractice, but rather a confrontational situation which has escalated.
There are situations that do require a firm stance, but there are also ones which require tact, diplomacy, sincere inquiry and cooperation. You could benefit from a break from the constant challenges of caring for your husband to help you see and choose a more successful path.
Bharty, if you are the spouse or if you have medical power of attorney, of course you can take your husband home IF you want to be responsible for providing personally or arranging for the care that the rehab is providing your husband 24 hours a day/7 days a week. Questions before you call the rehab: can you provide 24/7 care at your home, primarily out of YOUR pocket? Please be aware that medical care provided in the home that is needed for 24/7 management, especially skilled nursing like administering IV, is NOT paid in full by Medicare or Medicaid (unless you live in New York City because there are no beds in nursing homes). The hospital would have discharged your husband to rehab because (in their medical opinion) he continued to need medically supervised care and therapy to recover, but was not eligible any longer for hospital stay with Medicare. Can you manage a medline for IV drugs? Can you lift/move/change him if he is incontinent by yourself? Do you have relief so that you can get sleep if he awakes at night? You might be better served to be his wife and advocate, while he recovers in rehab, that researches with the social worker there what sort of recovery assistance will he need and the road forward while you are rested enough to be able to plan. If you bring him home and collapse because you are overloaded with care, there will be no one to advocate for your husband and you. It's stressful to have a loved one in rehab or hospital, but there's a reason that level of care is being provided. Again, that 24/7 level of available medicare care is not provided at YOUR house by Medicare or Medicaid for free.
After the sigmoidoscopy incident a few months ago, I really wonder about your husband’s health care. I find it unbelievable that he would be sent to another facility without your knowledge. Let me ask, how is your communication with his health care team? When you visit, do you converse beyond a simple greeting with his nurses and therapists? If you don’t get a satisfactory answer, do you pursue it? Nurses are very invested in their patients and often have more information than the doctors. Is your husband communicative? Do you ask him who was in the see him that day and what they told him? Now that he’s in rehab, you have every right to call a Care Conference to discuss their plan of action and the why’s and how’s of this plan.
Consider very carefully what you are planning to do. To bring legal action, you must be very, very sure that you have at least one solid leg to stand on. You’ll need a good (read: expensive) attorney who is willing to go up against a big medical institution, and succeed. You’ll need proof that the catheter caused the infection. It will be a long, costly and probably fruitless process.
As for pulling him out and bringing him home for care, are you able physically and emotionally, to provide 24/7/365 care for a man who is ill and whom you've said can be a bit set in his ways? Do you have family who can and will help? Home health care for respite? All the durable medical equipment and supplies you’ll need and the knowledge to use them? If you pull him out of rehab, you’ll have to have at least nurses to come to your home to provide medical care and possibly even a physician who makes house calls to monitor his health. If he can’t be left alone, you’ll be tied to the house unless someone will come in to relieve you. We all start out with the best of intentions, but...
Think long and hard before you make a decision about either of these and consider it from all angels.
My dad gets a UTI every time he’s hospitalized, and I mean everytime without fail. He also regresses quickly in his physical abilities, just a couple of days in a hospital bed and it’s a huge struggle for him to get back to what he was able to do before. So he’s sent to rehab following the hospital for therapy. So, yes, you can go ahead and bring your husband home, but it sure sounds like both of you could benefit from the help and care of rehab. Get him past the UTI and have therapy get him back to where he was before. Both are much harder to do on your own but that is within your rights
An elderly person can be going along at home and then something comes up and the person is hospitalized. Once the person's medical situation is figured out and gets under control they are often discharged to a rehab facility because an elderly person being hospitalized doesn't bounce all the way back, hence the rehab. And then in 3 months or 6 months or whenever when they're hospitalized again it's the same thing. They lose strength from the illness or injury that caused them to be hospitalized to begin with. Again, they're discharged to therapy and again, they don't bounce all the way back. Not bouncing back is cumulative.
As for legal rights, I'm not sure you can sue for a UTI. Many elderly people get them, especially in the hospital. And I would imagine that it was cleared up with antibiotics. To bring a suit against the hospital you have to show damages and if your husband's UTI was cleared up there are no damages.
I hope you keep your husband in therapy where he is. I understand that you're upset about not being notified he was going to rehab but rehab, in a facility with rehab professionals, is the best thing for him. I know it's easy to look at what they're doing and think you can do it just as well at home but at home people get lazy, they don't want to do their rehab exercises. We tend not to push our loved ones in rehab at home the way the rehab staff pushes them. And our loved ones who vow to do their exercises at home slack off every time. When we try to encourage them and praise them to get them to continue working on their rehab we've already lost control of the situation. PT's don't have to cajole and praise. Our loved ones do what they say because that's their job and our loved ones are expected to participate in their own recovery. That's not the case when they're at home. Oh, the person may have every intention of doing their exercises at home but once they're at home they want to sit in the their chair and watch TV which will weaken their fragile muscles and be detrimental to their health. Eventually there's another hospital stay and the whole thing starts all over again.
Keep him in rehab for as long as they'll take him. Let them work with him. Contact a supervisor and request that you be kept informed regularly about your husband's care. Be proactive. Call his PT and ask how your husband's doing in rehab. But please don't have him discharged before he's ready.
I don’t know about the legality of placing him in rehab without your consent. And not sure what kind of “care” you’re expecting them to provide...just PT a few times a week? But generally rehab works better in a facility than trying to do it at home. They have equipment and can make a more concentrated effort that I’ve found seems kind of half-arsed when attempting at home. But it sounds like your husband needs more than just PT type rehab, and medical issues are also addressed at “rehab.” In my experience they are just one step lower than a hospital in level of care.
he is staying in rehab till meds are finished which is sunday. I have a doctor who does home visits ans rehab is going to call him to do a reassessment so homecare will be 8-7. I can take care of him at night. I also give him his meds every day. I do not want him in a nh the rest of his life they suck.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
You are his health care proxy, but unless I missed something, you're not a medical person. You do have the right to make certain decisions, but the proxy doesn't give you the right to make other decisions, some of which are probably beyond the scope of knowledge of the average patient's family. That doesn't mean that you shouldn't participate in his care though.
You're upset b/c you feel you've been left out of decision making? As I read and reread your post, and checked an earlier one, what I see is someone who's angry and possibly hostile to the medical pros treating your husband.
I'm not saying this to be cruel or hurtful, but attitudes do come across in treatment, and medical pros can react. They may feel that it's not worth an argument to discuss an issue with you b/c you don't have the medical knowledge they do.
Another impression I get is that these have become adversarial relationships. E.g., instead of asking what your legal rights are, or considering taking him home, have you ASKED the DON at the rehab center what issues are existent, what their planned course of action is, and to explain these issues either in detail or to the level that you can research, study, ON YOUR OWN, and be able to discuss the issues and treatment options with them, more as a partner than a demanding and dissatisfied wife?
Others have pointed out the challenges and complications of home care. They're right. If you weren't angry at the hospital and med pros, would you even be considering this?
I can understand that you feel you need to monitor and approve his treatment. But remember, you can do so, but on a less confrontational level.
I reiterate that it's not my intent to criticize you. I suspect you're stressed from repeated challenging medical issues, and very frustrated as well.
But it's time for a mid-course correction. Think about how to accomplish what you want by working WITH the medical staff. Ask for explanations instead of making conclusions, and take legal action out of the picture for now.
If you do seriously think legal action is appropriate though, this is NOT the place to ask. There are some attorneys here, but you should see a medmal attorney in person, and explain the issues (not your dissatisfaction) and facts only.
You wrote that you're health care proxy, and ask if you have specific rights. No one here can tell you specifically what rights you have w/o reading the proxy, reviewing applicable laws for your state, and better yet, reviewing the medical records.
If you're serious about taking legal action though, find a medmal attorney, allow him/her to order the medical records if he/she feels it appropriate. I think you'll find that a good medmal attorney will not see malpractice, but rather a confrontational situation which has escalated.
There are situations that do require a firm stance, but there are also ones which require tact, diplomacy, sincere inquiry and cooperation. You could benefit from a break from the constant challenges of caring for your husband to help you see and choose a more successful path.
Questions before you call the rehab: can you provide 24/7 care at your home, primarily out of YOUR pocket? Please be aware that medical care provided in the home that is needed for 24/7 management, especially skilled nursing like administering IV, is NOT paid in full by Medicare or Medicaid (unless you live in New York City because there are no beds in nursing homes). The hospital would have discharged your husband to rehab because (in their medical opinion) he continued to need medically supervised care and therapy to recover, but was not eligible any longer for hospital stay with Medicare. Can you manage a medline for IV drugs? Can you lift/move/change him if he is incontinent by yourself? Do you have relief so that you can get sleep if he awakes at night? You might be better served to be his wife and advocate, while he recovers in rehab, that researches with the social worker there what sort of recovery assistance will he need and the road forward while you are rested enough to be able to plan. If you bring him home and collapse because you are overloaded with care, there will be no one to advocate for your husband and you. It's stressful to have a loved one in rehab or hospital, but there's a reason that level of care is being provided. Again, that 24/7 level of available medicare care is not provided at YOUR house by Medicare or Medicaid for free.
Consider very carefully what you are planning to do. To bring legal action, you must be very, very sure that you have at least one solid leg to stand on. You’ll need a good (read: expensive) attorney who is willing to go up against a big medical institution, and succeed. You’ll need proof that the catheter caused the infection. It will be a long, costly and probably fruitless process.
As for pulling him out and bringing him home for care, are you able physically and emotionally, to provide 24/7/365 care for a man who is ill and whom you've said can be a bit set in his ways? Do you have family who can and will help? Home health care for respite? All the durable medical equipment and supplies you’ll need and the knowledge to use them? If you pull him out of rehab, you’ll have to have at least nurses to come to your home to provide medical care and possibly even a physician who makes house calls to monitor his health. If he can’t be left alone, you’ll be tied to the house unless someone will come in to relieve you. We all start out with the best of intentions, but...
Think long and hard before you make a decision about either of these and consider it from all angels.
So, yes, you can go ahead and bring your husband home, but it sure sounds like both of you could benefit from the help and care of rehab. Get him past the UTI and have therapy get him back to where he was before. Both are much harder to do on your own but that is within your rights
As for legal rights, I'm not sure you can sue for a UTI. Many elderly people get them, especially in the hospital. And I would imagine that it was cleared up with antibiotics. To bring a suit against the hospital you have to show damages and if your husband's UTI was cleared up there are no damages.
I hope you keep your husband in therapy where he is. I understand that you're upset about not being notified he was going to rehab but rehab, in a facility with rehab professionals, is the best thing for him. I know it's easy to look at what they're doing and think you can do it just as well at home but at home people get lazy, they don't want to do their rehab exercises. We tend not to push our loved ones in rehab at home the way the rehab staff pushes them. And our loved ones who vow to do their exercises at home slack off every time. When we try to encourage them and praise them to get them to continue working on their rehab we've already lost control of the situation. PT's don't have to cajole and praise. Our loved ones do what they say because that's their job and our loved ones are expected to participate in their own recovery. That's not the case when they're at home. Oh, the person may have every intention of doing their exercises at home but once they're at home they want to sit in the their chair and watch TV which will weaken their fragile muscles and be detrimental to their health. Eventually there's another hospital stay and the whole thing starts all over again.
Keep him in rehab for as long as they'll take him. Let them work with him. Contact a supervisor and request that you be kept informed regularly about your husband's care. Be proactive. Call his PT and ask how your husband's doing in rehab. But please don't have him discharged before he's ready.