What can I do legally?

  1. I need some advice for all of you in this field of nursing.
    I know because of HIPAA a doc/therapist cant give any info to me re: a pt, but is there anything stopping them from listening to what I have to say to them, if I have first hand information about their pt?
    It's about my mom, who lives with me. She has always been hard to get along with for a multitude of reasons, but lately, it is getting just unbearable. Shes paranoid, screams and hollers at insignificant things, becoming more paranoid than she is normally,and an all around "joysucker" to say the least. She sees a therapist every few weeks, a nurse practitioner, has been prescribed at least 4 different anti depressants , anti anxiety meds, but refuses to take them, all the while claiming to the therapist that she is, and they are "just not helping". She claims she takes too many pills as it is, and doesnt want to take any more.She is starting to worry me, it is getting bad. So my question is, since talking to her about it is out of the question (tried that many times), what can I legally do to make sure she gets the help she needs to stop being so miserable? She is not suicidal, as far as I know. My home is becoming a toxic environment because of it on soooo many levels. (i have 2 kids) . What, if anything, can I do? Should I call the therapist, and if so, can she legally take my call and listen to what I have to say? Please give any advice you can..... thanks in advance.....
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  2. 11 Comments

  3. by   Thunderwolf
    I need to say first...this is NOT a legal advice board.

    However, since you posted this in the psychiatric nursing forum and issues of legalalities and patient rights are often part of the picture for some folks, I can say this.


    You CAN share info to her providers, but they can NOT share info with you...unless they as the treatment team with Mom's permission decide to bring you on. If a patient is in need of a legal guardian, there is a process for this. The legal guardian is granted by a judge. The legal guardian can be yourself, another family member, or a court appointed lawyer. If becoming a legal guardian is something that you or another family member wish to do and take on, make it known to the treatment team. They will give you information how to begin the process if they believe that mom would be of benefit or in need of such intervention.

    Again, legal issues cannot be discussed on this board. However, the process of legal guardianship is unique in the field to psychiatry and to psych nursing...unike other specialties. This is why I responded.


    I wish you well.


    Members, please note. You may discuss the process of legal guardianship as you have come to understand it on this thread. However, no posts are to contain legal advice.
  4. by   NoCrumping
    Quote from Thunderwolf
    I need to say first...this is NOT a legal advice board.

    However, since you posted this in the psychiatric nursing forum and issues of legalalities and patient rights are often part of the picture for some folks, I can say this.


    You CAN share info to her providers, but they can NOT share info with you...unless they as the treatment team with Mom's permission decide to bring you on. If a patient is in need of a legal guardian, there is a process for this. The legal guardian is granted by a judge. The legal guardian can be yourself, another family member, or a court appointed lawyer. If becoming a legal guardian is something that you or another family member wish to do and take on, make it known to the treatment team. They will give you information how to begin the process if they believe that mom would be of benefit or in need of such intervention.

    Again, legal issues cannot be discussed on this board. However, the process of legal guardianship is unique in the field to psychiatry and to psych nursing...unike other specialties. This is why I responded.


    I wish you well.


    Members, please note. You may discuss the process of legal guardianship as you have come to understand it on this thread. However, no posts are to contain legal advice.
    Thank you, and I must say I used a wrong term when I wrote "legally"..I was actually asking if, in relation to hippa, could i actually talk to her therapist about this, hence i used the term "legally", as in, would she be able to even take my call.......just wanted to clarify..... I can see the appearance of it now.... sorry....and thanks again for your reply... it helped.
    anybody else???
  5. by   Thunderwolf
    Great!


    However, the meat and potatoes come down to this in answering your question.

    You CAN share info to her providers, but they can NOT share info with you...unless they as the treatment team with Mom's permission decide to bring you on.
    This pretty much answers it all.

    Yes, you can share...they can not (unless the patient grants them that privilege).
  6. by   danu3
    Quote from NoCrumping
    I What, if anything, can I do? Should I call the therapist, and if so, can she legally take my call and listen to what I have to say? Please give any advice you can..... thanks in advance.....
    As others already indicated, you can contact the pdoc/therapist whomever but they can't say anything to you.

    You may want to document the symptoms and fax (or mail it) it to the appropriate care provider (better than just do it on the phone as you now have written documentation).

    Also you might want to check out if there is an active local NAMI chapter where you live. See if they have a Family to Family class (12 weeks down in the trenches class on serious mental illness; stuff you do not learn in school).

    Also depends on what state you live in, some state might have other things that might give the provider to do a bit more (beside being a danger to self/others or gravely disabled). California for instant has something rather new call the AB1424 which a family member can fill out and give it to the person who is doing the evaluating which can help them. Usually your local NAMI chapter will know about these things, sometimes before the care providers are aware of it.
  7. by   NRSKarenRN
    I contact mygrand mothers doc in the past and now parents doctors all the time regarding healthcare concerns ---even faxed info into them. However, my parents have informed the doctor I'm to be given info. I am also POA for healthcare.

    Have you discussed Living Will and POA with your mother? It may help provide you some leverage in the future.

    Would your mother be willing to have you attend a session regarding her medications "because you love her and want to see her get the right treatment?

    Medicare will pay for Psych home care too if she has that insurance-- Psych RN can be conduit to PCP to ensure proper med compliance and inform re side effects or coping/behavior issues.

    Love Danu2 suggestion about Nami.

    Thanks for being a caring daughter.
  8. by   Nurse Ratched
    If she's living with you, and her presence is destructive to your family harmony, you may need to make the difficult choice for her to find living arrangements elsewhere. Having a mentally ill parent is extremely difficult (first-hand knowledge .) I know that I would not want my father living with me, and that the remotest possibility of any such arrangement would be contigent on medication compliance at all times.

    May I ask your mother's situation and what might be an alternative suitable placement?
  9. by   NoCrumping
    Quote from Nurse Ratched
    If she's living with you, and her presence is destructive to your family harmony, you may need to make the difficult choice for her to find living arrangements elsewhere. Having a mentally ill parent is extremely difficult (first-hand knowledge .) I know that I would not want my father living with me, and that the remotest possibility of any such arrangement would be contigent on medication compliance at all times.

    May I ask your mother's situation and what might be an alternative suitable placement?
    Its even worse than you think....WE LIVE IN HER HOUSE (!!!!!) The plan is to move out, but it cant happen overnight......and I am really concerned about her state of mind, whether we live here or not, shes not right, and needs to get help. She doesnt have to be so miserable. to danu and nrs karen thanks for the advice, I will look into those things you mentioned, and I think I deff will fax/write the therapist....I think she is Borderline.... I would bet my life on it.....keep advice/suggestions coming guys......
  10. by   lucianne
    The suggestions above are good but wanted to add:

    1) Find a copy of "I Hate You..Don't Leave Me" if your mother is displaying borderline characteristics. Mine doesn't meet all the criteria for a formal DSM diagnosis, but I found it extremely helpful years ago before I was very experienced in psych.

    2) Find a therapist for yourself if you don't already have one. A good therapist will help you get through the time you have to endure until you can move out and may help you find strategies to deal with your mother better. Letting go of a mentally ill/personality disordered parent who refuses help for her condition can be very difficult and guilt-inducing, but it may be all that you can do as long as she is competent to care for herself.

    good luck, take care of yourself and your family!
  11. by   NoCrumping
    Quote from lucianne
    The suggestions above are good but wanted to add:

    1) Find a copy of "I Hate You..Don't Leave Me" if your mother is displaying borderline characteristics. Mine doesn't meet all the criteria for a formal DSM diagnosis, but I found it extremely helpful years ago before I was very experienced in psych.

    2) Find a therapist for yourself if you don't already have one. A good therapist will help you get through the time you have to endure until you can move out and may help you find strategies to deal with your mother better. Letting go of a mentally ill/personality disordered parent who refuses help for her condition can be very difficult and guilt-inducing, but it may be all that you can do as long as she is competent to care for herself.

    good luck, take care of yourself and your family!
    thanks, lucianne, and I have been wanting to go to a counselor for a while now, but everything gets so convoluted, and complicated, I sometimes feel I dont know where to begin with one.....but just posting here and putting it in words, helps. She is competent to care for herself, so I really must move now....but, whats your opinion, would you call HER therapist and tell that she is not being truthful, and not taking the antidepressants/anti anxiety meds that were prescribed? I cant seem to think they can only help.
    I got desperate one day.......on my day off, I picked her up a coffee per her request from the cafe. I sneaked one of her xanax (why she actually fills the script I dont know) and I put it in her coffee. It was a good day.
  12. by   lucianne
    I think in your situation I would probably let her therapist/NP know she isn't taking her meds.

    Don't worry about getting started with a therapist, just take that first step. I would definitely get some recommendations though. You could call your mother's NP to ask for recommendation and mention the non-compliance at the same time. Seeing the same therapist as your mother is an option and has some advantages, but in my personal opinion since you have a conflictual relationship it might be better to have your own therapist.

    Since you've found writing about your situation to be helpful, you might try some journaling. Just keep your journal with you at all times or keep it locked up so your mother doesn't read it. While it might be tempting to "accidentally" let her see it, that isn't a good or honest way to communicate with her about how she affects you. One of the benefits of journaling is that you can express all the really negative emotions you are feeling without worrying about hurting someone else.

    Good luck!
  13. by   DaFreak71
    I totally sympathize with you. My husband and I lived with his father who had a myriad of personality disorders. He was literally hell to live with. He also did not comply with taking his medications or following doctors orders to limit physical activity, which meant we were always taking him to the hospital when his lungs would fill with fluid from CHF. Anyway....

    If you are living with your mother in order to help her (as opposed to save money, etc) I would give her an ultimatum. Tell her she takes the meds every day and complies with doctors/therapists orders, or you will leave and limit contact. In truth, this is all you can do aside from moving out (which I highly recommend). I realize moving out isn't something that can be done instantly, but if the situation is bad enough, you'll find a way. It took us like 60 days of husbands nursing salary to get all the money we needed (and then some) to move out and furnish our new place.

    You cannot help her if she does not want to be helped. I wouldn't give up on her, but I would seriously limit contact between her and your kids if she's that unstable. This sort of thing can really scare a kid. Take care of yourself and your kids.

    Adri

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