My housekeeper’s father is very ill, and she feels he’s not getting the care he needs. She has asked me to advocate on her behalf–she doesn’t speak English well and though I’m sure there are Spanish speakers at the facility where he is, I think she’s intimidated.
I want to intervene on her behalf and at least figure out what’s going on, but I know I can’t just barge in as a stranger and start asking questions. What do I need to do to have her give me permission to do this?
The father is non-responsive* so I assume his daughter (my housekeeper) IS empowered to make decisions/ask questions. But can she sign something giving me the power to inquire on her behalf?
This is in CA by the way, in case there are state law considerations.
*From what I can glean, it sounds like the father is dying and is in hospice care, and I may have to tell her there’s really nothing to be done. But I want to make the inquiries first.
She needs to call the hospice and ask for the procedures. It may involve setting up a medical POA of sorts, but it could be much simpler if she indicates that you are her translator (if you’re bilingual).
Got it. Maybe the hospice itself will help with this; but right now I’m trying to gather some basic information–like where exactly he is–with the help of my housekeeper’s daughter in law, who is bilingual.
And before you ask, yes, the daughter in law could be doing some of this advocacy herself, but these are people who are just scared and intimidated by the system, kind of with good reason. So I’m happy to get involved.
Realistically, you can go to the facility WITH the patients daughter and she can verbally give permission for you to become involved right away. It would be possible that the facility would request (not usually necessary) written permission which could be granted at that time. The purpose of HIPAA is not to block facilities from informing patients families about care. In fact IIRC there is a sliding fine scale based on intent.
Likely no. I work in medical records, and as I understand it, a medical power of attorney (and likely any kind of POA) is non-transferable. The father would have to make you his POA, and if he is non-responsive, he would be unable to do so. (Granted, there may be differences in jurisdictions, so consult a lawyer in your neck of the woods, etc.)
What you could do is show up with the daughter and help her request/digest/etc. the info available. Larger healthcare facilities should have access to trained translators as well (either on-site or available by phone), so if she needs to question providers directly, I would suggest making an appointment and making sure that this need is known ahead of time.
I work as a medical interpreter. IANAL, but I can tell you what goes on. People bring all sorts of people to medical appointments and to the hospital: relatives, friends, coworkers, etc.
No forms are ever required for them to be involved in the discussion. No form is requried for me to be involved, though there may be something between the agency and the medical facility (but the patient’s written permission is not required for me to act as an interpreter).
It’s as if, if the patient him/herself is OK with someone being there, that person can participate. That seems to be the standard.
This is very helpful and based on other advice I have received, it seems like an actual visit is going to be necessary. I am willing to do this, though it is obviously easier for me to make a barrage of phone calls than go to a bunch of appointments–and my housekeeper needs to work (I do too, but I can more easily take time away). But perhaps we start with an in-person appointment and go from there. I really DON’T want power of attorney at all, I just want to facilitate communication.
Re the phone, I have experience with my Japanese ex in this regard. They will let me speak on her behalf, but they first require her to affirm that this is OK. Still pretty informal, but there is that step. Hope this helps!
Before you get too deep in the weeds on this I would encourage you to have a very direct conversation about what her goals are this situation. If he is truly in some advanced stage of dementia, non-responsive and dying in hospice care what exactly is it she thinks should be done? You want to get straight on what her specific issues are before you go, you do not want to have these conversations on the fly.
I can tell you what my experience has been recently.
First, a person can verbally give consent for another to be informed of his/her health information, but frequently that is only good for the particular time and place. For example, over the phone my husband could tell a representative of his health insurance company that I, standing right there as well, could speak on his behalf. But that would only apply to that one phone call.
For the local hospital, when he stated in the ER back in November that I was to speak for him if he could not the hospital noted that and on subsequent visits they would turn to me and answer my questions with no hassle. But that only applied to that hospital.
I then got a legal document declaring me, in writing, his legal health care representative. I downloaded the version provided by my state of residence, we filled it out, he signed it, and when interacting with other health agencies I can show them that piece of paper and then represent him. But that is good ONLY for health care matters, it is not a Power of Attorney for any other purpose.
If you’re in California you might want to check the laws for the state and see if they have a form to be followed.
Yes, I’m trying to gather as much info through the daughter-in-law as I can before I do anything.
Having talked to a lawyer and a doctor, and based on what everyone has contributed here, I think an in person visit to SOMEONE is going to be necessary. If the guy is really at death’s door, I think my helping to ask those questions is going to reassure her that he’s not getting ignored, that hospice care is what’s best. But I simply don’t know yet, it’s slightly possible he really would benefit from more care than he’s receiving.