pt sign POA against will

[merricat]

not even my resident but her daughter comes in and wants me to get her out of bed and dressed. i am told it is so she can go to meeting to sign papers. my impressin is meeting is legit as she is getting out of bed for it and impression is other people will be there. so i get her out of bed and dressed-- while res. is in bethroom i go to put attends on her which she never needs but today appears she is impacted poss. and poopy not ocming out. so while i am getting attends daughter asks what i am dong and i explain and tell her i will OK w/pt and she says, "you can ask me, today we are signing a POA, my mother does not want to but we are going to," (not exact quote but that is essence of it-- she very clearly said "my mother does not want to") so my antennae are up cause this sounds bad. i get mom in attends after getting OK from her and she very clearly heard conversation outside door and tells me plainly that she can make her own decisions thatnk you. very polite but firm. i go to brush her hair and it is oily-- i say, "lets take a shower tonight, OK?" and her daughter says something very harsh to the mom about how her hair looks-- mean tone, very blunt. then the daugheter asks me to go get someone to witness the signing of the papers-- or maybe she asked me to do it-- but whatever. i tell her as is after five we have nobody. i say i cannot witness. i excuse myself to look for someone. i go and nark on her to someone -- first the nurse who is too busy to care and probably does not know what to do then someone in med room who says i did right thing and under no circumstances get anyone to witness. because at my LTC they make sure the pt really wants to sign it, not just that they do. so i go back to deliver message to daughter and she tells me she cannot ever come in before five because she works which makes no sense as she came in that day at four thirtyish and i make excuse to go and when i check back she has pulled a visitor for another res. in and is getting her to witness. as the mom is LEGALLY BLIND, she cannot see what she is signing and they are coaching her. i get supervisor of shift who tries to get DON but cant, supervisor goes into room (i did not witnesss, i heard) and tells daughter document will not be accepted as is not notarized. so........ i just dont like it. my friend (person in the know) said at soe care centers or in some situations this document would could be accepted as valid POA... (but he has no other advice unless she says more to me about it, the pt) also we do not know that is what she even signed, a POA. any advice? thank you.

[leslie :-D]

is this patient competent?

before anything is signed, she needs to have a psychiatrist to come in stat, and evaluate this pt. to ascertain her competency or lack thereof.

once those results are evaluated, the patient has a right to pick whoever she wants for the poa.

social services should be involved.

and you should definitely be documenting every relevant piece of information that you have either observed or heard from the involved parties.

if the don does not want it in the notes, then keep your own personal journal of what happened.

you may even want to contact the facility's ombudsman.

no one should be bullied into doing something they don't want;

and when they DO designate someone, it should be with someone they trust.

much luck to you.

leslie

[CoffeeRTC, BSN, RN]

another thing to remember is that the POA only has athourity after the patient becomes incompetant or unable to make decisions for themselves. The social worker needs to be involved in this also the administrator.

[merricat]

it is difficult, seeing how many old people get, their spirits so fragile or broken, where they just go in whatever direction they are led. "i dont want to do this but what else can i do?" i see it all the time ( i am sure we all do). we have one woman who constantly talks about how she wants to die-- like everyday. the other day i got like the angriest resident. we are supposed to ambulate her, and she got promised we would but the aide did not, and she was furious! she grabbed her walker and decided to walk herself! and tell everybody how pissed she was! and i was kind of pleased for her, in a way, (and i walked her for a half hour) because she was such a strong advocate in her own rehabilitation. but i do not see that a lot. it looks like people at my center are all over this situation with this woman so i think it will be okay-- i am still interested in what people have to say though. truthfully, to me, when you get someone who is legally blind and ask them to sign documents, and there is no advocate for them there, and they are old,and sick... well, to me, a crime has taken place. i honestly believe that.

[Blackcat99]

Yes I hope social services or an ombudsman will investigate this matter. My mother recently signed a POA for me to take care of her affairs. In order for the POA to be truly legal the document must be properly notarized. Best of luck.

[leslie :-D]

i am still interested in what people have to say though. truthfully, to me, when you get someone who is legally blind and ask them to sign documents, and there is no advocate for them there, and they are old,and sick... well, to me, a crime has taken place. i honestly believe that.

if the patient is legally blind, all she has to do is put her initials (anywhere) on said document; WITH a nurse reading to the patient, what she/he is signing and licsw present.

[babynurselsa, RN]

FInd out who is the Omnsdudsman Representative for your facility and get them in on this.

[Catsrule16, RN]

It is a good practice for facility employees not to sign this kind of legal document because of the possible financial gains through mishandling of funds that could cause problems. A good attorney would see a signature from an employee and imply that the facility expected to benefit from this. (I've seen it happen.)

Administration should be involved with this.

[Mister Chris, MSN, NP]

It is a good practice for facility employees not to sign this kind of legal document because of the possible financial gains through mishandling of funds that could cause problems. A good attorney would see a signature from an employee and imply that the facility expected to benefit from this. (I've seen it happen.)

Administration should be involved with this.

Most of the places I have worked forbid the staff to witness/sign any legal documentation such as mentionned. Yes do the right thing and pass it 'up-line to the DON/Admin staff. We nurses have enough on our hands without getting ourselves tangled up with a relative and their domestic problems and family politics. Once you have committed yourself to a signing of any document about the custody and/or care of a client you may end up being the one to be called into a legal proceding of some kind. Leave that to the senior admin staff or the doctors.

[Sheri257]

I agree with everyone here. You have to report this immediately. I don't about laws in other states but here, if you don't report this to the authorities within two days, you can be fined and sentenced to jail time.

My instructor had a very similar case which she had to report. The state jumped all over it immediately.

[merricat]

just an update. i think the facility is all over it because i went in early and very, very casually asked my res. about her day. she said someone had come and taken her to breakfast and talked to her. i suspect it is someone from our place, trying to figure out her place in what is going on. i did not pry. the person i talked to had told me to ask her casually what she signed, and to try to determine whether she wanted to, what her feelings were about it. id did not try; i think people above me are probably all over it anyway (who else took her to breakfast?). i donot want to seem like i have no faith in admin, -- i work in a good facility-- but i also feel like i found this problem and want to see it through, and the res. says things to me over and over like, "promise me you wont leave me, promise me you wont change." i am going to try to be there for her but i am leaving my job for another very soon-- and in a way this might be better as can spend as much time as i want with her, instead of being divided by needing to do my job and pay attn to all res. equally. i dont know-- well see. i could ask social services what is going on but kind of want to not seem like im telling them i dont have faith in them because i do-- also not sure if is out of my scope-- ia am only an aide!-- i know i am still inportant but i need to not go out of scope. so that is what is going on. i am going in today to drop off some treats for another res. who is not sleeping well- stuff like tea and maybe a special pillow, -- maybe ill try to talk to my other res. and see whats up. i dont want t otraumatize her in any way or be perceived as overly snoopy-- well see. i appreciate the feedabck-- ive never heard of being required to report htis to any agencies-- i am totally open to wat anyone has to say-- it occured to me inretrospect maybe when woman said, "she does not want to sign" maybe she meant her daughter was just tired and did not want to get out of bed to sign it-- shes very tired as many res. are--

[merricat]

if anyone else has been worried like i have-- trouble sleeping-- i have followed up in two different ways and it is getting taken care of. i feel weird about talking about it because of sensitivity and confidentiality issues but wanted to say thank you for all the input and not to worry because it is being handled. if i learned anything, it is to try to be less wary of... asking questions and making myself heard.