Suspect nobody is following up on discharge instructions for mom in MC, what to do?

My 87-year-old mother is in Memory Care. She was diagnosed with COPD 15 years ago and she controlled it well with an inhaler and occasional use of a nebulizer at home before moving into the ALF. Other than COPD and dementia, she is in relatively decent health.

Her facility left me a message three days ago saying "your mother was in respiratory distress, so we had her sent out for evaluation". I knew that meant they had her taken to ER. She was just hospitalized for "respiratory distress" prior to Christmas which has only been three weeks ago. She tested negative for pneumonia both times. She also tested negative for heart issues and negative for infection. Prior to these two recent hospital visits, I know of one other time mom was sent to the hospital for difficulty breathing in the last four months.

My point of this post is this seems to be a pattern. I have concerns about the decision-making to automatically send an 87-year-old repeatedly to the hospital where she will become disoriented and be immobile for days in bed.

My other point is, I have a suspicion that my mother's COPD is a condition that is not being treated adequately on a daily basis. If true, then mom will be in for another hospital visit in a couple weeks - again. I fear that cycle in itself could kill her.

Honestly, I have barely recovered myself from mom's hospital visit from three weeks ago. At that time, I suspected the staff was either not trained in how to administer mom's inhaler or not giving it to her daily. You have to instruct her to hold her breath for five seconds before exhaling or the medication does not circulate to the lungs. I am unsure anyone is doing this for her.

When mom was released after the last hospitalization, I called the Director of Nursing to ask how mom's condition was being managed. She was very abrupt in attitude and began to record the call because I heard a computer voice say, "this call is being recorded." The Director of Nursing told me she accidentally hit a button on her phone with her cheek. She did not even admit to recording the call. That sent off red flags to me. I thought that was overly defensive, and it felt a bit hostile.

I no longer wanted to be on the call, but I did ask if she was comfortable that staff knew how to manage mom's condition on a daily basis, and she replied that she did not know off hand what mom's plan of care was, but that the staff there is trained on an ongoing basis and audited and that staff is skilled in how to care for those with COPD. It was a generic non-specific answer. I just said goodbye and ended the call.

It left me having no confidence in the staff at the ALF.

In addition to that, just yesterday I was at the hospital with my mom and talked to the respiratory specialist who was doing rounds. He said my mother needs to see a specialist as an outpatient after she leaves and should be on a schedule of medications to manage her COPD - not just using the inhaler. He further said those instructions would be in her discharge papers. I suspected similar instructions would have been in her previous discharge papers a few weeks ago as well. So, it made me think nobody is looking at mom's discharge instructions and nobody is following up as she needs.

This doctor also knew mom had just been there, and he agreed with me about my concerns about the cycle of bringing an 87-year-old into ER repeatedly. He said it was time to take a different approach and stop the cycle.

I am not POA. My mother's other daughter is POA. Nobody reaches out to me to coordinate plans, so I am somewhat at a disadvantage in how to influence any better outcomes.

Does anyone have any advice on next steps? It is so hard to sit on the sidelines without any official decision-making role.

Thanks.