Nurse lied about visiting patient caused treatment delay.

[racincrazy]

What is the name of your state? Alabama

I think my mother was injured by negligent hospice nurse. She has been in hospice a little over two years. I am still not sure why she had hospice care because no doctor told any of us that she was dying. She did have dementia but she was still independent and lived by her self for the most part. I actually like the Idea of the nurses helping her. They told me if she needed medical help to call them instead of taking her to the doctor or hospital.
A couple of months ago she got a small wound on her hand and it started looking bad very fast. I texted her nurse about it and said mom was in pain and she needs to look at it. She said she would go see her the next morning. About lunch time I texted her to see what she thought and she texted me back that evening she said it looked ok. I was surprised she said it was OK and I trusted her judgment and just put some Neosporin on it. Two days later the hospice Chaplin stopped by for his weekly visit and he called her nurse manager and said her hand looks bad and needs attention. The nurse came by and wrapped her hand and called in a antibiotic to the pharmacy and said to give her morphine for her pain. Fast forward a few days and Mom was down the street look for her friend that had died in 1970. She had to stay at the geriatric psych ward for over three weeks.
The thing I think is neglect is I don’t think the nurse came to see her the first day I contacted her and it caused several days delay in getting treatment. Every time someone from hospice comes to her house they have a log book they sign and date. I have the log book and the day she said she came she had to sign between the lines because the Chaplin signed logbook after the bathlady. I think she lied about coming that day delayed treatment and it has made her go from living independently to living in a nursing home.
My main questions are where is the best place to file a complaint in the state of Alabama and what questions to ask lawyer if this is a case worth moving forward.
Thanks

 

[quincy]

What is the name of your state? Alabama

I think my mother was injured by negligent hospice nurse. She has been in hospice a little over two years. I am still not sure why she had hospice care because no doctor told any of us that she was dying. She did have dementia but she was still independent and lived by her self for the most part. I actually like the Idea of the nurses helping her. They told me if she needed medical help to call them instead of taking her to the doctor or hospital.
A couple of months ago she got a small wound on her hand and it started looking bad very fast. I texted her nurse about it and said mom was in pain and she needs to look at it. She said she would go see her the next morning. About lunch time I texted her to see what she thought and she texted me back that evening she said it looked ok. I was surprised she said it was OK and I trusted her judgment and just put some Neosporin on it. Two days later the hospice Chaplin stopped by for his weekly visit and he called her nurse manager and said her hand looks bad and needs attention. The nurse came by and wrapped her hand and called in a antibiotic to the pharmacy and said to give her morphine for her pain. Fast forward a few days and Mom was down the street look for her friend that had died in 1970. She had to stay at the geriatric psych ward for over three weeks.
The thing I think is neglect is I don’t think the nurse came to see her the first day I contacted her and it caused several days delay in getting treatment. Every time someone from hospice comes to her house they have a log book they sign and date. I have the log book and the day she said she came she had to sign between the lines because the Chaplin signed logbook after the bathlady. I think she lied about coming that day delayed treatment and it has made her go from living independently to living in a nursing home.
My main questions are where is the best place to file a complaint in the state of Alabama and what questions to ask lawyer if this is a case worth moving forward.
Thanks

Who lined up the palliative (hospice) care for your mother?

Do you know if the visiting nurse is board certified?

You can consult with a medical malpractice attorney in your area for a personal review of your mom’s medical records and her medical care, with your mother’s consent or through a durable power of attorney (as representative for your mother). Are you her healthcare representative?

You can go to the Alabama Bar Organization to search in your area for a medical malpractice attorney. https://www.alabar.org/for-the-public/

 

[quincy]

Here is another link, to information on Alabama’s palliative care, which your mother might have arranged on the advice of her doctor so that your mother could stay in her own home longer.

https://www.alabamapublichealth.gov/providerstandards/palliative-care.html

 

[racincrazy]

Who lined up the palliative (hospice) care for your mother?

Do you know if the visiting nurse is board certified?

You can consult with a medical malpractice attorney in your area for a personal review of your mom’s medical records and her medical care, with your mother’s consent or through a durable power of attorney (as representative for your mother). Are you her healthcare representative?

You can go to the Alabama Bar Organization to search in your area for a medical malpractice attorney. https://www.alabar.org/for-the-public/

How would I find out who set up her hospice care? I do have POA over legal. I had thought I had POA over medical too but I found out something was not done right on the POA medical paperwork. Thanks

 

[quincy]

How would I find out who set up her hospice care? I do have POA over legal. I had thought I had POA over medical too but I found out something was not done right on the POA medical paperwork. Thanks

Is your mother lucid enough to tell you? Can you ask the care providers?

You probably should look into getting a medical power of attorney.

 

[quincy]

Here is an additional link, this to an elder rights guide:

https://www.alabamapublichealth.gov/homehealth/assets/elderrightsguide.pdf

Does your mother have an attorney who she has seen in the past? Do you know if your mother executed an “advance directive” prior to the onset of dementia?

 

[racincrazy]

Is your mother lucid enough to tell you? Can you ask the care providers? She doesn't remember anything about who set it up. I do know it wasn't her regular doctor. I asked him after hospice started coming over and he was surprised because he said she didn't have anything terminal at that time. Hospice told us not to go to regular doctors medicare insurance would not pay while in hospice care. Hospice never charged her a dime even on prescriptions. She had been in hospice about 27 months.

You probably should look into getting a medical power of attorney.

I had thought that I had a Medical POA. We had asked for both to be included when we did the POA. It was not until she was in the hospital that I found out I didn't. I should have done my due diligence reading the document. My older brother had it before. They set it up when my father passed away. When my two brothers passed away a few years ago we set me up with POA. I will see about getting medical POA if I can with her in this state.

Do you know if the visiting nurse is board certified?
The nurse signed a RN after her name on visit logs if that is the same as board certified

 

[quincy]

I had thought that I had a Medical POA. We had asked for both to be included when we did the POA. It was not until she was in the hospital that I found out I didn't. I should have done my due diligence reading the document. My older brother had it before. They set it up when my father passed away. When my two brothers passed away a few years ago we set me up with POA. I will see about getting medical POA if I can with her in this state.

Do you know if the visiting nurse is board certified?
The nurse signed a RN after her name on visit logs if that is the same as board certified

If the nurse is an RN that means she is a registered nurse licensed by the state to provide patient care after having completed a board-approved nursing program and having passed a national nursing exam - but she would not be a certified registered nurse (CRNP), which requires a master’s degree.

Here is a link to the Alabama Board of Nursing: https://www.abn.alabama.gov

 

[stealth2]

How would I find out who set up her hospice care?

When my Mom was put on hospice (and I understand this is a relatively standard process), her PCP recommended it and contacted the hospice agency. They then sent out a case manager to evaluate her "fitness" for hospice and set up the appropriate services. They would normally require her PoA to sign/agree (in Mom's case, that was my brother), but since she lived with me and I was her FT caregiver, they accepted my signature/agreement. Depending on her lucidity at the time, they may have accepted her agreement to be placed in hospice care.

It's also my understanding that hospice is normally in effect for ~6mo periods, at which point the patient is reevaluated and either approved for further care or removed from hospice (due to improvement). I can't imagine that your Mom wasn't reevaluated at all over two years.

I would suggest you speak with an elder care attorney in your area about the medical PoA. Very often, with a d/x of dementia, a person is deemed unfit to make such decisions for themselves - you may need to go for guardianship at this point.

Also... hospice has changed over the years. While it used to be considered solely as end-of-life care, now it is more geared towards providing comfort for the terminally ill (and dementia is a terminal illness). Sometimes, people rally, are relieved of hospice care and resume their normal medical treatment.

it has made her go from living independently to living in a nursing home.

While it is certainly possible that a wound infection could result in a decline in her condition, be aware that dementia is a funny disease. Things can be ticking along on a plateau for a long time, and then take a sharp downturn. Since your Mom's in a nursing facility, has she been seen/evaluated by a doctor (they surely have one on staff)?

 

[quincy]

What is the name of your state? Alabama
... Mom was down the street look for her friend that had died in 1970. She had to stay at the geriatric psych ward for over three weeks. ...
... I think she lied about coming that day delayed treatment and it has made her go from living independently to living in a nursing home. ...

It sounds to me as if going from independent living to residence in a nursing home has more to do with mom’s increased vulnerability due to her dementia and less to do with the infected hand.

Because mom was not monitored 24-hours-a-day, it would be difficult to connect the increase in severity of the infection in the hand to the visiting nurse.

I followed on this forum stealth2’s personal daily experiences (and struggles) with her own mom and she offers you excellent information and advice. You can find legal and health care resources in Alabama in the Elder Rights Guide linked to in post #6 (see pages 49 and 50).

 

[commentator]

It is possible the morphine and other meds administered for the hand infection did cause a downward swing in her dementia/cognizance level, as it very possibly could have been the systemic infection in general. Things like UTIs are notorious for causing upticks in dementia behavior. My mother ended up in the geriatric psych ward for a few weeks for this reason. And it was very probably they evaluated her and decided she was no longer a good candidate for less than 24 hour a day monitoring. But except for possibly keeping the hand from becoming infected in the first place, I do not really understand why it would seem there was any severe negligence at play here. Do you live in the area? I would ask why you didn't check on your mom's hand after you spoke with the nurse. You do certainly need appropriate power of attorney from here forward. But is searching for someone to blame this quickly feels a little bit premature. Speak with an attorney.

 

[stealth2]

It is possible the morphine and other meds administered for the hand infection did cause a downward swing in her dementia/cognizance level, as it very possibly could have been the systemic infection in general. Things like UTIs are notorious for causing upticks in dementia behavior. My mother ended up in the geriatric psych ward for a few weeks for this reason. And it was very probably they evaluated her and decided she was no longer a good candidate for less than 24 hour a day monitoring. But except for possibly keeping the hand from becoming infected in the first place, I do not really understand why it would seem there was severe negligence at play here. You do certainly need appropriate power of attorney from here forward. But is searching for someone to blame this quickly a little bit premature. Speak with an attorney.

Yes, on the UTIs! My first go-to was "when's the full moon" and then "might she have a UTI?"...

 

[racincrazy]

But except for possibly keeping the hand from becoming infected in the first place,

If the nurse would have done something about treating her hand she would still have some quality of life.

I would ask why you didn't check on your mom's hand after you spoke with the nurse.

I did check on her hand myself and I thought it needed real medical attention because it was looking scary. Hospice told me to go through them before I took her to see a doctor or the hospital. I definitely don't want to make any unfounded complaints against anyone.
Is there a way to insert a photo or a link to one. If I could show a photo of her hand it would show how serious it was. Thanks

 

[stealth2]

If the nurse would have done something about treating her hand she would still have some quality of life.

Honestly? You don't know this.

 

[Zigner]

You stated that it got bad really fast. When it didn't improve the morning after your application of Neosporin, why didn't you take her to the doctor or contact the nurse again?
I'm NOT saying this is your "fault", nor am I saying it's the nurse's "fault". I am simply pointing out that infections can turn nasty very quickly, even if they don't look too bad at the moment. This, of course, does not answer your questions.

You are free to file a complaint with your state's medical board, and you are free to seek the advice of an attorney (or several). Tell the attorney(s) the story and be prepared to answer their questions.