Mildly Demented Hospital Patients - Being a Fly on the Wall
I recently had back surgery that had me in the MetroWest Medical Center - Framingham Union Hospital for several nights. My last day and night I had a roommate. She seemed a pleasant enough woman. She had fallen and hit her head while living in her assisted living apartment. Sounds like it went undetected until she was suffering nausea, vomiting and being unbalanced.
When she arrived in my room she was accompanied by two daughters. Both stayed for a few minutes to make sure she was settled, showing her how to operate the television and her nurse’s call button. Then they were gone and the snoring ensued.
It was clear when nurses came in to talk with her that her competency was questionable at best. To her credit, she knew where she was but not why. She remembered living in the assisted living community, just not when she was last there.
Being a Personal Family Lawyer and elder law attorney, this was my opportunity to be a fly on the wall. Separated by a thin curtain, I was privvy to her experience. It was also my opportunity to hear how the hospital staff treated her.
I was impressed with the level of care I received while in the hospital. I was more impressed by the care my roommate received. I could hear call buttons ringing with regular frequency all night on the floor, and yet she was never ignored, overlooked or waited. The nursing staff always treated her with dignity, kindness and utmost patience. They helped her with her most basic biological needs, and repeatedly responded to her calls when she became active late at night, unknowingly making the same requests.
What I found odd, though, was the conversation with admissions personnel. A young woman came in and identified herself from the admissions office. She then asked for consent for treatment, consent for admission as well as a couple of other basic questions. My roommate clearly was trying to answer “correctly” while the admissions woman guided her with her questions. I thought it odd that the questions were not being asked of her health care agent or attorney in fact. But then again those agents were not present.
It got me thinking, if hospital personnel asks questions but there are no legal agents present, do the answers count? The legal declarations we create, Health Care Proxies and Durable Powers of Attorney, name agents for decision making. But when a person’s decision-making ability is borderline, it’s not unusual for personnel to ask the routine or obvious questions of the patient.
If you are a named agent for a parent, child or friend, it is important that you take the initiative to set limits with personnel. The agent needs to direct what questions may and may not be asked of a patient. Don’t be afraid to be direct, and set limits as necessary. This is how you will protect your loved one when you can’t physically be present.
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November 26th, 2008 at 1:11 pm
Tracey
“Agents” - usually children of our older clients, need to be a bit more pro-active in their roles. I find that many clients presume that since the hospital, for instance, has a copy of the older patient’s health care directive (or POA) that administration and medical staff will naturally check the health care agent when seeking important information (such as consent). I’ll tell my clients who are HCPOA agents to make some noise with their POA and be pro-active. Let the floor nurses and doctors know that they need to keep the agent “in the loop”. Just handing in a POA in during the admission process in oftentimes not enough.
B Treacy, Esq.
Bluffton, SC