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Her doctor suggests that she be put in hospice, but her son (POA) is refusing. She is able to say the words, "I want to die." How is he able to make the final decision when she is capable of expressing what she wants. I'm so frustrated.

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I was POA for my mother and had to make this exact decision. I wanted to be POA to protect her from a sister that I felt did not have her best interests at heart. I listened to what the doctors told me and knew what her wishes were as far as not wanting to be kept alive by artificial means. I went ahead and put her in hospice but that was very very difficult as well, I was glad she was not in pain but it is a hard way to go as well.

My Mom had been injured in a nursing home accident and was unable to voice her wishes but I have a feeling she would not have wanted to go to hospice, so that kills me and I think about it from time to time.

Someone else needs to speak to him about the hospice care... he may love her deeply and not want her to go.

I am sorry for your pain in this situation, but it is a difficult decision to make one way or the other.
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I know this is a little off topic, but, hospice in a nursing home is not something I would recommend, from my experience. If your loved one is in a nh, and needs hospice, please consider taking them to a beautiful, peaceful hospice facility instead of having hospice come in to the nursing home. I can't speak for every nh, but I want to raise awareness by sharing this. My mom has been in a nh for less than a year, and in that time, two people on her floor have gone on "hospice." The care was below par and they died in paid. The so-called "hospice aide," that was suppose to be attending the person for a certain number of hours, was stretched so thin throughout the facility that the patients did not get the coverage they were entitled to. The patients were sometimes blown off and they got away with it because nh people cover for each other. I have also see people die in hospice facilities and the caliber of care is just better...in the same way the caliber of medical care is better on the outside than in a nh. Be warned. Be aware.
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JoANN I meant.
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Thank you JoAmn29.
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JoAnn29: DNR's AND Living Wills are all helpful to state as part of the thread.
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Moms Medical POA already stipulates her wishes.
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DNR has really nothing to do with this. According to the one I just had signed by Moms doctor a DNR is only good for respiatory and cardiac arrest. Living Will is different. That is where you stipulate what measures you want taken if u r not able to make decisions.
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Is there is a DNR order in place? I would thnk the medical professional, the doctor, calls the shots in this case. But be aware there is hospice care and there is also palliative care. Make sure the doctor choses the right one.
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POAs, medical or financial don't override what the person wants. They r in place to make decisions when the person can't. Hospice is a good thing of in her home. A Nurse will check on her several times thru the week. An aide can be requested to do her bathing. They provide whatever equipment that is needed. Medicare pays for everything even diapers. You get more being on hospice that just Medicare. You don't have to be dying in 6 months. Criteria has changed. She will be made comfortable. And since the doctor suggested it, I think it should be considered.
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My mom is in a facility and has been with hospice for a year and a half. She was declining and not doing well but then she leveled off but then she had some seizures out of the blue and they brought hospice back in. She has dementia and canNOT express her wishes. Wish she could. She can barely speak clearly. I hate seeing her like this. I agree, that IF she is still cognitively able, then her wishes HAVE to be followed. Has her son explained what hospice can do for her? Does HE know? So many people have a misconception of Hospice and don't understand it. They do not prolong life, they make it easier for the person to live with dignity until their end. Wamnanealz.....I'm so sorry for your mom having to go like that and you watching it. I watched my aunt die without hospice from cancer 37 years ago. I watched my FIL die WITH hospice from Parkinson's 10 years ago.....2 entirely different deaths. I hope, no I pray....that when I start to fail that there will be a sweet hospice worker there like there is for my mom and for my FIL. skuitwaard.....talk to her son and make sure he understands what hospice is. He might know a little bit more about her condition than you do (since he is POA) so ask him if there is anything you might not know. You might be surprised, might not but I know communication is the key to keeping everything and everyone safe. That's when arguments start and families are torn apart is when the communication is not there. I know you love your grandmother and he is probably trying to do the best he can, maybe he is overwhelmed with everything. Ask if there is anything you can do to help without seeming to put him down. He might feel like he's being attacked. If not the case then do what you can to make her feel safe, loved and taken care of while you can. Things will work out one way or the other. Good Luck and God Bless.....
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We don't have nearly enough information here. It may be that the grandmother is living at the son's house and he doesn't want hospice coming in. Perhaps he has other plans for her care that are also suitable. Perhaps he feels that a NH would be a better option. As others have mentioned, we can't really know without knowing the specifics of the living arrangements and care.

Saying "I want to die" doesn't equate to "I want hospice." It just means that she is ready to die. I hope that her son will work with others to make her transition as comfortable as possible, whether hospice is involved or not.
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K. Gabriel is correct. When I was made POA for my friends, one form was for legal matters, a second and more complex form was the Health Care/Medical POA that Minnesota uses. That one went into end of life issues as well and their wishes about extraordinary life-saving steps to follow or not as conditions warranted.
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As for the legal side, giving someone a POA does not take away your own rights and powers. For that to occur, a judge must determine you are incapacitated, in a guardianship hearing. At that point, the guardian--and not the patient--would have the legal right to make such decisions.

However, the holder of the POA does not have the power to override the person who gave them the POA.

One other point: A POA that is not specifically a HEALTH CARE/MEDICAL POA does not cover such types of decisions. It is normally limited to financial-type transactions, not personal decisions such as you are now faced with.
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In Alabama a POA does not cover medical decisions. Here we have to have a medical directive that names the person with that responsibility. However, because he is her child doctors would listen to him...at least in Alabama. When my Mom passed I made her decisions and was able to legally do so because I am her daughter even though I did not have the paperwork naming me as such. I want to bring this up too. Is it possible her son is not allowing hospice because that is a clear indicator Mom is dying and he hasn't faced the fact and doesn't want to let her go? He may not be being cruel, just upset and not wanting to face her imminent death. As was already stated, maybe the doc should have a talk with him, or get him some counseling or grief support or something.
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Has anyone told grandma (verbally or in writing) the simple truth that Hospice does not delay death...it just makes it less painful.?
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I would say it depends on what was marked on the healthcare power of attorney form. When I was given that authority for two friends of mine starting to show signs of dementia, they each marked the box giving me authority to make the decisions for their health care needs even if they disagreed. It felt, feels like a huge responsibility. By carefully explaining to them what was happening, I have been able to get them to agree to go to a memory care unit in an assisted living facility as the initial step for improved care, but I know the life and death decisions are not far off--which pathway would be closest to their desires as I have come to know them over the pat 30 years. There are no children or other family members to be involved, but two other POAs with whom I share all the information and concerns for input. I would want to know why the POA is refusing hospice when the grandmother and doctor agree it is appropriate now.
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If grandma is not suffering from dementia and she can clearly state her wishes then they must be followed. Perhaps waiting a day and approching it with her again would be good. Talk to the doctor and ask to speak with her caseworker, every patient in hospital has a caseworker, they can be of great help. If you can give us a bit more info like where she lives, home or hosp, does she have dementia etc we may be able to give you some more advice. But remember these things will work out so take a deep breath and spend some time with gram while you can. Keep in touch. Ruth Anne
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Dave, this granddaughter is clearly distraught and asks a poignant question regarding life or death, and you post with alleged information qualified by a disclaimer, especially one that has all the markings of being copied. "Products and services..." Give me a break, and have some compassion for the woman posting to seek assistance.

And stop advertising your so-called "knowledge network". You're just scavenging alleged information.
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I have to agree, Please follow the patient's wishes

A health care proxy is a document (legal instrument) with which a patient (primary individual) appoints an agent to legally make healthcare decisions on behalf of the patient, when he or she is incapable of making and executing the healthcare decisions stipulated in the proxy.

If you can get doctor (s) to sign off that he or she is incapable of making and executing the healthcare and ADL decisions plain POA's may be invalid and DPOA's and medical proxies may be force.


I participate and post for sharing of informational purposes only. I assume no responsibility for accuracy. Any actions you take based on my posting information are entirely at your own risk. Products and services are mentioned for informational purposes only and their various trademarks and service marks are the property of their respective owners. I am an independent un-paid individual I collect information from various Internet sources share information thru "Dave Mainwaring's Knowledge Network"
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I disagree. If she has expressed her wishes, I would think the person is morally responsible to follow her wishes. Of course she wants to die. When nature tells you it's time, the older person wants that. She wants to go on to the great beyond! If she were scared she would tell you that too. My mother wanted to die, but her body wasn't ready yet. She had to decline and go through hell because she did not have cancer, 25 years ago. Back then you had to have cancer to get hospice. How sad for her. She could have had pain management for those last 6 months that she lived and not have had to suffer like she did. Watching her go through those last six months was just pitiful and so difficult for her. Please follow the patient's wishes. Put her in hospice where they will be merciful.
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It's possible that the POA doesn't understand hospice so perhaps the doctor could have at talk with him? Doctors can't force hospice care but most know when the time is right. Hospice give the person who is already starting on the death journey a way to die with dignity and without pain. Hospice is a type of care that is offered to people in their own home home, a nursing home care or in some cases hospice care home. I would think that your grandmother's wishes should be respected by all of the care people including the POA. We wish you well. Please update us on how you are doing.
Carol
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You don't tell us where she is living and who is caring for her. You don't have to be "put" in hospice. Hospice agencies are kind folks who come to your house. You don't have adhere to a statement "want to die" from a person with dementia just as you don't listen to them when they want to go to see their parents. Chill out granddaughter. Get someone not related to you to visit grandma with you. Try to see the whole picture and also try to see your uncle's point of view. Then I agree with the advice to seek information about palliative care and hospice.
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A durable & medical POA are required or call APS & be done with it.
DO NO HARM.
Keep her safe.
Hospice is a good thing.
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Major hospitals should have an ethics committee available to offer guidance in this kind of situation. In my opinion the doctor is not acting ethically by refusing the verbal request of his patient unless she has been deemed mentally incompetent. Even then, the POA would benefit from some advice about the nature of hospice and the ethics of extending life at the cost of added pain and suffering.
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I as far as I know say if he can care for her needs and can deal with the his oun mental needs has the right to say no hospic care andhe may change his mind at any time and except it for her this care is done in her own home really we all die its how you choose to die softly wi try h ffriends loved ones or in a nursing home or simple alone as to her wish to die my husband says I am in every day many people at first glance think he's saying I want to die he's 58 and can't say more then 3 words can't see hear well walk or use his right arm eats some but not a lot and if you care for him you learn his speech and know he dose not want to die I was told a yr ago he was a veg and could not live out side a nursing home wrong he shops gose to events smiles at hisffriend's dress his self and cleans cooks and wheels is chair out to feed the dogs is he ready to die not today as for her the doctor gave a opinion the son said no end of storie
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I think the doc is between a rock and a hard place. Does the son think his mom is competent? Does the doctor think she is competent? Lots of greys there. And doctors really want the POA on board. Just because gram can speak doesn't mean she has much say, unfortunately. Did she have a living will? Does her son have her healthcare power of attorney? Usually that document discusses the wishes of the person signing it. You might ask to see it.

Some people are cowards. Is there a peer who could discuss his feelings with him? Could YOU discuss his feelings with him? He may be making the decision alone and in a vacuum and really only wants to do the right thing. Perhaps you or someone else could help him sort it out.

Doctors don't suggest hospice lightly. It's probably PAST time for that option. I wish you well.
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