SHOULD ELDER CARE FACILITIES HAVE TO SECURE FAMILY CONSENT…
Who determines what treatment is in the best interest of the patient? For children, it is usually the parents who review options with a doctor and then sign off on an informed consent form before medical treatment is continued. Once an individual turns 18, he or she is given the right to make decisions for themselves and eventually, their children or if necessary, a spouse.
But, who has the final say in certain medical treatments given to the elderly who have dementia or Alzheimer’s? If the aging adult is living with a family member, has signed a medical or health care proxy, then a designated person to make medical decisions on behalf of the aging adult is more clear cut. However, who has the final say regarding medical treatment if a Dementia or Alzheimer’s patient is living in a nursing home or another long-care facilities? The resident doctor? A family member? A nurse?
Unfortunately, anger and violent episodes can be a symptom of dementia and Alzheimer’s disease and a commonly accepted method of treating this behavior is through anti-psychotropic drugs. However, such drugs may have side-effects, such as seizures, in dementia patients.
According to a recent article in Sentinel & Enterprise, some Massachusetts family members with loved ones suffering from dementia or Alzheimer’s are concerned that nursing staff in long-term care facilities may oversubscribe anti-psychotropic drugs, without a family’s consent, to reduce disruptive behaviors among patients. In an effort to regulate the use of these types of drugs in nursing homes and elder care facilities, Massachusetts legislators have been petitioned to strengthen the laws around informed consent of anti-psychotic drugs for patients in nursing homes and long-term care facilities, requiring the facilities to “receive informed written consent from a patient’s family, guardian or health-care proxy if doctors prescribe psychotropic medications to a patient, under an amendment added to the Senate budget” in May 2014.
It is important to note that the debate is not about the effectiveness of the prescription drugs with these types of patients, but centers around informed consent and who determines what is in the best interest of the patient. While “Alzheimer’s Association of Massachusetts spokeswoman Betsy Campbell said the organization has been watching the use of these medications for years, and advocating for families to be informed when they are prescribed,” according to Sentinel & Enterprise, Dr. James Ellison, the director of the geriatric psychiatry at McLean Hospital, conveyed the concerns psychiatrists have about consent requirements because “managing behavioral and psychiatric symptoms for patients with dementia is critical to caring for them and optimizing their quality of life. It is problematic if that process becomes very cumbersome.”
If your loved one has been diagnosed with dementia or Alzheimer’s, talk to the primary care doctor about treatment options so that you and your family have an understanding about what types of treatments are available, why certain drugs are being used or may be prescribed in the future. If your family member is currently residing in a long-term care facility or may be moving to one soon, make sure you talk to the doctors or psychiatrists as well as nursing staff to make a game plan that gives the family informed consent but doesn’t tie the hands of the primary caregivers to effectively care for their patients.
For assistance locating elder care services or if the time has come when you or a family member is no longer able to live independently, contact California Registry to discuss the options and learn about assisted living services and facilities throughout California.