S/O--medical records, POA, etc.

[OnTheBrink]

If you have Power of Attorney over a loved one, please make sure you have read and understand what your roles and limitations are as POA. In most situations, the POA has no power until the patient is declared incapacitated, either by the attending physician or a court. Also make sure your role as POA includes medical decisions and rights to records. If your loved one has died, you are no longer POA and the POA documents are null and void. At that point, if you're executor of the estate, you then have the rights to records. If your loved one passed without appointing an executor of estate, then the rules of death indicate the next of kin would be a living spouse, or if no spouse, an adult child. If no adult child, then a living sibling, or a parent (depending on the age of the decedent).

 

If you're POA and your loved one is alive and you want hospital records, the loved one must fill out and sign an authorization naming you as the recipient of the records. You will only receive the records specified in the document. If there is anything considered "highly confidential" such as mental health records, lab work looking for STD's, drug and alcohol levels, or documentation regarding physical or sexual abuse. You may not even be aware some of these lab tests are done and even if they come up negative, the test is considered highly confidential and that document will not be released unless specified. Also, being appointed POA does not mean you're entitled to every medical detail while your loved one is alive, conscious, lucid and functional. (We had a woman call once demanding to know why her father was having testing in the hospital and we wouldn't tell her anything, as there was nothing in his chart indicating he'd authorized her to know. And we give NO info out over the phone, anyway, signed authorization or not. She informed us she was POA and we had to tell her that didn't matter in this current situation and she would need to speak with her father regarding these tests and it was up to him to share that info. She INSISTED that as POA the hospital should have called and asked her permission for these tests. It got ugly and she was 100% wrong. Last I heard of her end of the conversation, she was suing us all. Ok.)

 

So, it pays to be educated on exactly what your rights and roles are as a POA, or Executor of Estate and what privacy law allows (or doesn't allow) regarding obtaining records or info on someone other than yourself (including your children). And, don't assume the nice medical records person is out to make your day harder; we're not. Our main objective is patient privacy and staying within the parameters of federal privacy law. If you're the POA for your parents or other loved ones, read those papers carefully and know exactly when your role begins and what the responsibilities and rights are concerning that role. It can really cut out a lot of stress and misunderstanding if ever your parents/loved ones become unable to make these decisions for themselves.

[Mrs Mungo]

And a regular POA will not necessarily grant you the same powers as a durable medical POA or financial POA. Not every POA is created equal.

[Pod's mum]

Also be aware that even if several nurses etc tell you on the quiet that you need to see what is being written in your child's records and you jump through all the hoops of the records dept; when you eventually get the inches of records they may just be filled with many blacked out sections so you are still unable to help your loved one.

 

So much for 'Freedom of Information' eh?

 

Sorry you copped a dose of frustration. Not your fault but it really is a scr3wed system.

[OnTheBrink]

It can be a messed up system! We get parents who get so upset over the fact we won't release highly confidential info on their kids. Totally understandable, too, but we're bound by the law, so we have to abide by it. I'd say most people, once we explain the law to them, understand even if they don't like it. And we do try to provide what they need and want but when it comes to brass tacks, we won't give out what we can't give out, no matter how sorrowful the story is. We just can't put ourselves and the hospital at risk. We're happy to explain to patients/families how they can get documents if there's some sort of issue. We're happy to call our supervisors at home and on weekends if calling them helps the patient/family get what they need. But we just won't and can't hand out records without the required authorization from the patient. And sometimes that creates...conflict. LOL

[Mrs Mungo]

Can I PM you with a question?

[OnTheBrink]

Sure.

[Orthodox6]

Thank you for posting this! (What prompted you to bring up the topic? -- if you wish to divulge the reason) I'm smack in the middle of this with both of my very elderly parents. All paperwork is in place (since the mid-1980s), but I'm actively navigating the mire of both medical and business legal matters. This topic is essential knowledge for all adults. Don't wait until your spouse falls ill to have both types of POA drawn up. Life happens, and can happen fast, without warning.

 

I freely admit, though, to implacable frustration with "the system" when I see responsible and loving parents of children who have mental health conditions, when those children reach age eighteen, toss their life-necessary medications out the window, and refuse to allow any doctors to share any information with their parents. I do not speak of myself, but of friends.

[texasmama]

I have Durable General Power of Attorney for my dad, in addition to Medical POA. My dh has both of these for his grandmother. We have been able to do everything we need to in order to take care of dh's grandmother's affairs so far with the DGPOA. It is null and void upon her death. It has to be filed with a court in order to sell real property with it (not an issue here), and dh had to present the original signed and notarized copy in order to sell his grandmother's car. My dad is not at the point at which he needs someone to take care of his affairs, but I agree that these are important documents to have now rather than later. Dh's grandmother did not plan ahead, and that left us scrambling to get things in order, as she has Alzheimer's.

[OnTheBrink]

Thank you for posting this! (What prompted you to bring up the topic? -- if you wish to divulge the reason) I'm smack in the middle of this with both of my very elderly parents. All paperwork is in place (since the mid-1980s), but I'm actively navigating the mire of both medical and business legal matters. This topic is essential knowledge for all adults. Don't wait until your spouse falls ill to have both types of POA drawn up. Life happens, and can happen fast, without warning.

 

I freely admit, though, to implacable frustration with "the system" when I see responsible and loving parents of children who have mental health conditions, when those children reach age eighteen, toss their life-necessary medications out the window, and refuse to allow any doctors to share any information with their parents. I do not speak of myself, but of friends.

 

The thread about organ donation got me going, but I'm toying with doing a presentation at church for the seniors about how to obtain records and advanced directives. We get so many people in our office daily that really are clueless about how it all works. I mean, who tells you these things? No one, really; and usually people only find out how it works when their in an emotional or crisis situation. And, it's hard to have to tell someone they don't have the rights to their loved one's info when they're in the midst of dealing with an accident or terminal illness.

 

Mental health issues are hard, too. Even though the patient may have an illness, they still have the same privacy rights as someone who doesn't have a mental illness, and if they want to cease meds, they can and no one can really make them or have access to their medical info without their permission or the permission of the courts, which can take a long time if you're trying to prove someone is not able to make decisions for themselves and you want guardianship over them. Mental health issues are so hard. No one wants to take the rights of the patient away, but if they're not acting appropriately for themselves, no one can really step in until they become a danger to themselves or others. Privacy rights and mental illness can be a dual-edged sword.

[mysticmomma]

I have a full hipaa release incliding mental health, substance abuse, sti's and HIV/aids in addition to a poa that specifically states I have access to records posthumously.

[Hen]

Question, if you don't mind, - I assume that as a spouse, that if my husband was incapacitated in the hospital, that I would automatically be asked to make medical decisions and asked to authorize tests/treatment, etc. Is this true, or do we need a POA done? Same for my husband, if I were incapacitated, I assume he would make the decisions.

[Mrs Mungo]

Question, if you don't mind, - I assume that as a spouse, that if my husband was incapacitated in the hospital, that I would automatically be asked to make medical decisions and asked to authorize tests/treatment, etc. Is this true, or do we need a POA done? Same for my husband, if I were incapacitated, I assume he would make the decisions.

 

 

Usually. But, if there would be any doubt, then you want a medical POA. My dh and I both have one on each other. We don't want our parents or other family members fighting any decisions we make. We have talked a lot about it.

[Pawz4me]

Question, if you don't mind, - I assume that as a spouse, that if my husband was incapacitated in the hospital, that I would automatically be asked to make medical decisions and asked to authorize tests/treatment, etc. Is this true, or do we need a POA done? Same for my husband, if I were incapacitated, I assume he would make the decisions.

 

 

Having worked as a legal assistant to an attorney who dealt with these things, I think the safe answer here is that it really depends on your state's laws and, to a certain extent, on how picky the particular hospital is. I can tell you that when my mother was hospitalized (two different hospitals) and incapable of making decisions, permission for everything was obtained from my brother and/or me. Some things were such big decisions that they needed permission from both of us to make sure we were in agreement. We didn't have a health care POA, which is the only type of POA that would be applicable to medical issues. A general/durable POA is only for business/financial matters. Now the big "but" in our story is that none of my mother's siblings disagreed with anything my brother and I decided. That's where problems can arise--disagreements among relatives of the first degree (spouses. children, parents, siblings) about what procedures should or shouldn't be done. A health care POA ensures that the person named is the one who has complete authority to make decisions.

 

But again I'm speaking strictly from what I know is the law in my state. And for all I know those could've changed since I worked and was *really* familiar with them. Everyone needs to research their own state's laws.

[Ottakee]

We have guardianship over 25ds and will have over 17dd once she turns 18. It is still a huge pain to make phone calls for him, set up appoitnments, get tests, etc......esp. with the higher up stuff. Our primary care doctor is no big deal as they have a copy of hte guardianship and have actually known him since before we adopted him. Trying to get SSI or Medicaid though to talk to me is a huge hassle. If he is home I just hand him the phone and he tells them to "ask my mom" and then we go on.