"But I'm the Medical Proxy!"

[Richard B the EMT]

As most here know, "Momma B", my surviving parental unit, is in a rehab/nursing home, suffering from senility dementia, following our coastal evacuation from Super Storm Sandy. While my question is directed at the Doctors, Nurses, and Physician Assistants in our group, it is open to all.

I'm the youngest (age 58) of the 3 of Momma B's offspring. I was, and am, still living in the only home I've ever known, a private house with my mom's name on the ownership papers, in Belle Harbor NY, following storm repairs that made the house habitable again (repairs continue). I've never "left the nest," living with mom before the evacuation for the storm, acting as caretaker for both her and the house. The middle child is my sister (age 63), married, and living both at a house 7 miles from me, and in a time share in Vermont, at least 6 hours away. My eldest sibling is my brother (age 65), living in North Dakota with his wife.

Momma B (age 88) was admitted, on the Thursday after the storm, to an Assisted Living Center in Flushing NY, before I relocated from a cousin's house in Forest Hills NY, to the motel near Stuart AFB. From there, she was sent to 2 different local hospitals (local to the assisted living center) over 2 different weekends, including Thanksgivings Day weekend, first returned to the Assisted Living Center, and after the second hospitalization, with my input, to a rehabilitation and nursing center about a mile and a half from our "family homestead". From the rehab, she was eventually sent, for another weekend, to a 3rd hospital, which was bypassing 2 closer hospitals. At each hospital, they mentioned Momma B as a candidate for a pacemaker, due to apparent Bradycardia, but they never went through with insertion of such device. Momma B was readmitted to the rehab center following the 3rd hospitalization.

I was just informed by my sister, that, although I am legally both Momma B's medical proxy and acting with Power of Attorney, all 3 of the hospitals, on the Monday following those weekends, contacted her at roughly 6 AM, to advise Momma B was to be returned to the sending facility. If I understand correctly, whoever called implied Momma B was being discharged, where should she be sent? When I was notified, it was more like a courtesy call at 9 AM.

Does anyone know if this is some kind of standard policy, bypassing a younger proxy for an older, but not so geographically closer, relative? If this is standard, is it just New York State, or policy in other states as well?

[ERDoc]

The hospital is likely contacting whoever they have on the admitting papers. Next time she is admitted, make sure they have you as the contact person and encourage your sister to inform them of your status the next time they call her.

[ClutzyEMT]

I'm not a doctor...but are you the "alternative"? Or are you the primary?

[paramedicmike]

The hospital is likely contacting whoever they have on the admitting papers. Next time she is admitted, make sure they have you as the contact person and encourage your sister to inform them of your status the next time they call her.

This.

[ChaseZ]

Agree with the above. Did your mother have any paperwork with her stating who was the POA and primary contact? The Assisted living center "should" have sent a med recon and face sheet when sending her to the hospital. On our quick sheet we have up to 3 urgent contacts and their relationship listed and It is usually assumed that the first person listed is the POA/Proxy but it does not always work out that way. We have to dig through the paper chart to find the admission paperwork and see if there is any POA listed. Not to make excuses for the hospital but your sister should have corrected them or called you.

[island emt]

Richard: You state " I am legally both Momma B's medical proxy and acting with Power of Attorney," Are you legally appointed as such?

If so then you should be listed as primary point of contact for ALL medical decisions. Make sure the nursing home has you listed as such and being the primary contact.

Don't know what your family dynamics are< > but it should be worked out with your sister & brother so there are no misunderstandings & put in writing so there are no questions.

Another thing that should be done is to make sure your mothers final wishes are documented and filed with an attorney.

Have been through this with my parents, so I feel for you.

[Arctickat]

My guess is that the first time Momma B was admitted to said health facility she had your sister as the contact person and that has just never been updated in the past 40 years.