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 What do I request? I am going to ask for hospital records. 
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Joined: Sat Mar 27, 2010 6:15 am
Posts: 44
Location: USA
Post What do I request? I am going to ask for hospital records.
Hello to everyone.
I am going back through nursing home records and working with family to determine what medications my father has bad reactions to so that I can speak to my dad's doctor at the nursing home and tell him/her what we feel is he allergic to and why.

When he was in the hospital in early 2009 he went from mildly confused for 3 days in hosp. to completely out of it with horrible scary delusions and for the first time ever he struck out (fought) with nurses.

I am going to request records from the hospital so I can try to determine what happened. When I go in and complete the request what do I ask for?
Nurses Notes? Doctor Orders? Medication List?

I want to know when behaviors started and what and when various medications were started.

I also know they did MRIs, blood tests, spinal taps all kinds of things trying to find out what was wrong with him. How do I get copies of those results? Can I get a copy of the MRI to take to a neurologist?

How much should I expect to pay for copies of these documents.

Thank you for any help you can give me. I am learning.


Sun Apr 11, 2010 4:16 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
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Every hospital is different in terms of what they charge, if anything, and what they provide by "default." Usually if you request a copy of the medical records covering a specific time period, they will give you a copy of the file that includes typed notes as to medication and either hand-written or typed up MD notes. Typically nursing notes and imaging or test reports are NOT included by default but you can often ask for copies of the reports.

I always found it was better to go to the hospital medical records department in person, armed with the healthcare POA.

They may be able to give you a copy of the MRI on a memory stick. I suggest you ask the MD's office to request a copy of the MRI.

An MD's office can also request a copy of the medical records.

It may be that these symptoms were due to delirium or LBD, and not reactions to medication. So, to that extent "the answer" may not be part of the medical records. Medicine is often an art as much as it is a science. And you may end up going with the MD's gut-feel as to what caused these symptoms.


Sun Apr 11, 2010 5:01 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
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We got my husband's MRI on a disk. Medical records, if you have health care POA, should be yours for the asking. We have never been charged for these things but, as Robin said, things differ from place to place.


Sun Apr 11, 2010 5:25 pm
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Joined: Sat Mar 27, 2010 6:15 am
Posts: 44
Location: USA
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Thank you Robin that is helpful information.

I know when he came back to the nursing home Haldol was on his list of medications to give as needed so I know they must have given it to him in the hospital. I suspect this is what made him nuts and delirious in the hospital.

When all his hospital test came back okay they stopped all treatment and he cleared up in about 2 days and moved to the PT department. Prior to that they were thinking he could not even get back onto the same Resident wing of the nursing home and would be bedridden.

I picked him up from the PT part of the hospital and returned him to the nursing home. We stopped at Wal-Mart because he wanted to get a treat basket for the nurses and aides at the nursing home. We bought lots of nice chocolates and made a nice basket for them.

Dad was doing very well and all cleared up from what I suspect was Tylenol PM, Robitussin DM, and Haldol toxic reaction.... (none of which I knew at the time, I figured dad had a blood infection or something that cleared up)

WHY DIDN"T I THINK DRUG REACTION at the time?
They were suppose to know about no sinus, allergy, or cold meds already.

Although dad came back to the nursing home doing fine -

I guess the nursing home doctor read his hospital notes on re-admit to the nursing home and re-admitted him back into the nursing home with a NEW medication 1 mg of risperidone (none of this I knew at the time)
Within 2 days dad was acting inappropriate and being confused and sometime delusional. They did not think... wait a minute he was perfectly fine before he got sick, he came back perfectly fine,,, we start this NEW medication and now he is screwed up!

Instead -the doctor addressed the new symptoms with another med, and then another, and just lately one more related to depression, alzheimer, etc.... after 5-7days on the risperidone they declared the POA in effect (with me as POA and they did not even tell me it was in effect)

I wish I had been as informed then as I am now. I feel so stupid and I know I let my dad down. I believe if I had been aware of his medications I would have been able to stop this current decline.

I am just trying to figure out what condition my dad truly is in.... and what is being caused by these drugs.

I am very afraid of instigating something that will make my dad worse but I am also afraid of not trying to get him backed off some of these meds so we can see if he can live a better life. My dad is to the point where he does not care. He just wishes he could die. He is now incontinent which he has never been in his life and he hates that. It came on right after the 3rd new medication was added which was an alzheimer's medication.

I wish I had the strength to take care of him so I could have taken better care and done the monitoring if and when new medications were started. I can see by the notes of the NH that they wrote down his reactions but they never made the connections that new drugs were started within a few days before.

I think this whole thing is going to drive me completely crazy. Dad is in a nursing home in a town 90 minutes away. I never thought it was going to be like this. I expected to visit him, take him out to eat, bring him home to spend some weekends, and have him ask to go home etc... and that is the way it was for 4 months-- until that "cold" and hospital visit.

I think everyone taking care of their parents at home are truly amazing.

Even with all this running back and forth and now me FINALLY waking up and realizing I need to watch out for my dad even though he has doctors and nurses.... even now I know I could not take him into my home without both of us ending up resenting each other.

Anyway, thanks for the information and I think I know what to ask for from the Medical Records department of the hospital now.


Sun Apr 11, 2010 5:42 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3402
Location: Vermont
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Grace - unfortunately your situation seems to be how a lot of our LOs are handled by the facilities and/or some drs. My sister and I have asked each dr. and the folks at the ALF where our dad is to let us know when they are going to change or add to his meds, inform us of any changes in anything about his health. We both try to get to every dr. appt. with him, but ocassionally that doesn't happen because we are away (I live 500 mi. away, 1/2 the year my sister lives about 1,000 mi. away).
Unless one of the nurses at the ALF tells us about a change, we are not told by anyone, including the head nurse at the ALF, despite the fact that we both have Med. POA and each of these folks has been told that as well as given a copy.
I don't know if they're too busy, don't give a damn, or what, but it drives me crazy. At least I think I have the new exec. dir. at the ALF on board with communicating better with my sister and me.
In Feb. mo. my dad was put on Namenda (which I just discovered this week at a neuro appt.) and Aricept (which I found out a month ago from a nurse who calls me despite her supervisor't telling her not to give info. to the families).
Anyway, good luck. I try to get this stuff straight every time I am there but something new always seems to happen. I hope you have more luck with this than I do. It is a constant job keeping on top of all this stuff and trying to be the project manager of your parent (or other LO) and then trying to take care of your own life. You have my empathy! Lynn


Sun Apr 11, 2010 8:16 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
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Quote:
despite her supervisor telling her not to give info. to the families

Lynn, this is so wrong! If you have health care POA on file with the facility, they are obliged to give you information on your father. They should also furnish you with the name of an ombudsman who can help you with these issues.


Sun Apr 11, 2010 8:30 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3402
Location: Vermont
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I'm hoping the new Exec. Dir. will take care of things at the ALF. One of the nurses there has gotten really good about calling me and spending lots of time with me when I am there. The ED told me she has met with the head nurse and has made it known what is and isn't acceptable. She was horrified when I quoted some of the things the head nurse has told me in my last few visits there.
I made it totally clear that if caregivers, nurses, whomever, are not supposed to talk with family about their LO at his ALF, I'd find a place where that is EXPECTED behavior. This particular person who has been the problem for us, it turns out this sort of thing is going on with her and others too, so I am confident that it will be straightened out. It's not just my family who is experiencing problems.


Sun Apr 11, 2010 8:38 pm
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