Location: Texas, USA.
Hi y’all,
My Dad has been in the ICU and, save for a few days, on a ventilator for going on five weeks now in Texas. This was an unexpected diagnosis, we are completely unprepared.
I became his PoA the day following him being emergently intubated. He is unmarried and I am not his oldest child, but he wanted me to be in charge. His first month or so on the ventilator was spent in Facility A, where they considered him being on a light sedative to tolerate the ventilator cause for him being legally incapable of any consent. I was called for 100% of literally anything and everything. Thankfully for me he was still very much conscious, oriented/aware, and could communicate by white board or a thumbs up/down.
He liked it this way. I’m a biologist and have a good grasp on what’s going on. He, despite being oriented and aware, is so exhausted that he is not reliably conscious, much less (what he considers) capable of making medical decisions. I was with him in the ICU at facility A for a while. Afterwards, because I live out of state, they respected his wishes to have me on speakerphone for any meetings with physicians or care team members. Even though he can write on a whiteboard some, he cannot communicate very effectively. At best he can write one or two full sentences, and then is so exhausted who can’t do much else at all. The few days he spent trying to be off of the ventilator in Facility A, he asked how to “restore my oversight” because he couldn’t comprehend making the decisions he was being asked about. Because he was not long thereafter put back on the ventilator, nothing came of this.
Now, he is at Facility B for long-term care. This basically means that yes, he is on life support (the ventilator), but there are no short-term plans to get him off of life support. Whereas the ICU is more intended for people with a hope of release in 4-5 days. Makes perfect sense. This facility claims that the old one is as completely incorrect, which may or may not be true. I am not positive I care. But their stance is that they do not communicate patient information by phone unless my Dad were to call me from his phone……… which he cannot do. They also insist there is no remote access to any medical records or charts. If my Dad had his way, I would be driving literally 100% of his medical care. As it stands, I learned yesterday that he has an infected bedsore only because he had the wherewithal to ask why his changes were taking long. No one is available to oversee in person to the level that I am remotely, but this facility contends that despite verifiably being PoA, I might as well be a stranger all but in person with an ID.
Is not being aware of what the fuck is going on here worth consulting a medical attorney? He wants me in the captain’s chair. I don’t know what I can do, what I should be asking for, or when they are justified in telling me no. Is there any way to go about this?
The more immediate question of what on Earth being PoA in the state of TX means would be great if anyone has insight. The idea when I signed up was that he’d be all good to go within the week. Now, four weeks later, we are confronting that that is not the case.
Comments
Poa is only valid until the person passes…and is it a medical or tangible poa? There is a difference
And if you’re his medical poa then EVERYTHING goes through you….they will push you around if they can…look up tx patient rights to get an idea of a patients rights….you can also request a patient advocate
If you already have his poa then let them know you know your rights and you contact the ombudsman if they don’t stop trying to shove you aside
Did you ever get a signed health care POA? Or did the hospital just agree to go with a verbal or nonverbal okay?
Facility B is BSing you big time about their unwillingness to contact you. They can call and discuss care. There are systems in place for you to review medical documents if you want to. Unfortunately, some LCFs don’t like any oversight.
Okay being POA does not mean you direct his day to day care in any way. Doctors went to school to make these decisions on their own as far as what type of care he needs. They’re not going to ask you what they should do with your father. But it DOES mean when they need consent for something like a procedure, or a decision needs to be made between two choices like doing surgery or not doing surgery, they ask you instead of your father because he has been deemed incompetent to make these decisions. This ONLY applies if he is incompetent such as on sedation to tolerate the ventilator. Being on a ventilator period and being unable to speak does not automatically deem him incompetent. If he is no longer on sedation and alert, awake, and not confused then they will ask him for his own choices as he is an adult, not you.
Do you have a formal medical POA written up by a lawyer or this was just a verbal agreement as his next of kin because he was in the hospital and incompetent to make decisions at the time? Most long term care facilities like he is in now do not have any kind of remote chart access they are correct regarding that. They can call you and give you updates over the phone on how he is doing but they are not obligated to IF he is now competent, it is simply a courtesy. But technically it could be seen as a HIPAA violation because there is no way over the phone to verify who we are speaking to. Anyone could call and ask for personal health information on let’s say an estranged child or something and claim to be their next of kin. Some places have an issue with this and some don’t.