Health Care Proxies

[CapeCodMermaid, RN]

Hi. What do you all do about health care proxies? I have had a terrible time with demented residents who were admitted long before I was hired who have no health care proxy and no one to make decisions for them. I'm saying no one will be admitted with out a health care proxy and my admissions person is arguing with me. He's not the one explaining to the family that since they are not the HCP they can't make decisions for their demented family member. I have one woman clearly at the end of life who has been a full code for years. She cannot speak for herself and there is no health care proxy. She is going to have to be sent out again and again because her condition is deteriorating and there is no legal way to make her a no code comfort care. We are getting a guardianship instated but even the 'expedited' one takes days and days. Sorry for the rant but I am very frustrated.

[LSWgirl]

It is incredibly frustrating, and the admissions office doesn't get it!:trout: Usually as the SW, it's my job to find someone, anyone, to act as the proxy, but often, we have to go for guardianship. It's so expensive that I finally have my administrator telling my admissions person that if someone is to be admitted with no responsible party, the hospital has to start the guardianship. That way, they come to our facility with a temp guardian in place.

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LSWgirl- a social worker going to nursing school fall 2008!

[CapeCodMermaid, RN]

The hospital we get 90% of our admissions from isn't at all helpful and won't even get one of the docs there to invoke a health care proxy if the person has one.