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Just curious - am I permitted to ask a health care worker NOT to tell mom I’m asking questions or discussing her care? Or are they required to tell mom that I am asking questions? Mom was admitted only about five days ago into skilled nursing. Any time I ask mom a question to her directly - about anything - she gets on the offensive and thinks I am overstepping my bounds. I am only trying to help her or trying to figure out what is going on. She shows signs of memory loss - can I ask for a mental health assessment and they won’t tell mom?
On a good day before mom had health issues, she was a difficult person and mom was always extremely private with everything. She lives several states away.

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Unless state has a specific law (and I use to teach Health Care Law and 12 years ago most didn't) physicians are not required to disclose discussions with patients. HIPAA is about protecting patient privacy -- so your Mom's doctor can listen and decide how they want to use the information you provide.

But more important, than HIPAA is the physician's own belief system, I would ask them point blank -- "I want to tell you about some health issues mom is having, I'd prefer if you did not disclose that you received this information from me, Do you have a problem with that?
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I would ask the head nurse, one time, you will find out if mom has authorized you.

On memory loss, it is very common for people, of all ages especially the elderly, to become disoriented when hospitalized or with a change in living location. Without asking specifically about mom you could ask staff of they see this disorientation and confusion often.

Remember that you can give them any information that you want. The facility is not prohibited from listening to your concerns, they just cannot give you information unless mom has signed a HIPPA release.
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HIPPA applies to patient confidentiality unless you have a power of attorney for medical. With HIPPA, your mom needs to agree to let you have access to her medical information. With a medical power of attorney, you can handle her medical needs when she is not "mentally competent." Seems you need to pursue the medical POA first so you can be covered legally.
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Geaton777 Mar 2021
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I'm assuming you are an "authorized person" on her contact list. If that's the case, unless Mom wants you stricken from the list, you have the right to ask questions about her health and care. I don't know that the staff are obligated to voluntarily inform her of your queries if Mom doesn't ask. (And if you're not on the list, you won't be able to get any information.)

If Mom specifically asks if you've been in contact with them, they may feel obligated (or even be required) to answer her question honestly. The best thing to do is call the facility and see if this is the case.

BTW, a mental health assessment is usually a part of the admissions process, especially for those in their great old age. It may already have been done, and if you are authorized to participate in care conferences, they should share the result with you during a conference.
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Are you her medical PoA? Did your mother designate you as her medical representative on a HIPAA release form? Does she have a diagnosis of memory loss or such which would make the PoA enforceable? If your mom has not assigned anyone as her durable PoA then this is a discussion that should be had with her.
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You can ask all the questions you want. They are not required to answer if :
You are not listed on her HIPPA form
You can mention to the doctor, or the nurse that is assigned to her that you have noticed some cognitive changes over the past few months. (or however long it has been. If she has a PCP that she has been seeing you can send them a note via the Patient Portal as well.)
I really like MsRandall's suggestion to ask them before you ask your question that they not tell mom you are disclosing this information and if they have a problem then do not bring up your concerns.
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Uneeds she has your name down or you're her POA then all of her Medical Records will be kept confidential.

You might contact her Dr and tell him of your concerns.

But, her business is her business.
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It was my experience that a mental health assessment is done upon admission. And if she is showing signs of memory loss or the inability to care for herself they will reach out to family. They also want to determine if she has a POA, living will etc.

They want to plan for a safe discharge and that will involve family if she cannot go home safely alone. You need to decide now what part you will play in her future care. I would go ahead and ask all the questions you need to know to make those decisions. Go ahead and call social services or speak to the head nurse. Tell them your concerns and don’t worry about what they will tell her. My mother was also “private” and “difficult” because she was hiding her dementia and the horrible condition of her apartment.

All the staff can say is “no I cannot share any information.” But if you strongly feel she has memory loss and is at risk for being discharged back home, it’s good to speak up now on her behalf. I know how stressful this can be and I also worried about the wrath of my mother when I first stepped in. But she needed an advocate and it can be like stepping into a fire ant pile! Be brave! And keep us posted.
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Gibby06 Mar 2021
Thanks for your input. I finally called the nursing home after hearing nothing from staff. When I’d ask mom questions everything was vague. They told me she was “her own responsible party”. They never gave her any type of mental assessment. I talked to a social worker and expressed my concerns over mom’s memory issues and gave them examples of the conversations she had had with me. They seemed very surprised and agreed to start mental health assessments. She was always good at fooling people. Praying she can get the help she needs.
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I've never had any problems discussing things with healthcare workers. I would think if you started the conversation as 'don't tell her I said this', maybe it could create a red flag.

Who helped her sign in to the facility? Their name is likely on the paperwork and would be able to get information more freely. Get that person to ask the questions.

If if you have been excluded from asking questions, you can always contact the doctor with examples of things causing you concern and possibility of a mental health assessment. He may not call you and talk about it, but he has more info to determine what treatments he sets up for her.
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Do you have POA for health care or has your Mom given permission to medical to discuss her case with you? If not, you don't have any rights to information. Certainly you can proVIDE all the information you like, including a diary of actions Mom has taken that are inappropriate. This may lead to diagnosis of her condition and staging. What she thinks about that, should she learn of it, would concern me none whatsoever. You are acting in her best interest, whether she likes it or not. Medical personnel may listen to you or they may not. Up to them. Eventually this will all come to a head when a Social Worker calls you and Mom is lost and found, injured or otherwise, and the Social Worker pleads with you to accept emergency guardianship or conservatorship that the social worker can get from a judge in about 15 minutes time.
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