"Mr. Luddite" wrote:
I feel badly for my wife and her sister. Both have been the primary care
givers for their elderly parents for many years. Their father
passed away a little over a year ago and the demands of taking care
of their mother have been ever increasing since.

The mother is *very* old school Italian and doesn't trust doctors,
hospitals or social workers. She is 90 years old now and has adamantly
refused any suggestion of moving into assisted living or a nursing home.
She wants to remain in her house but my wife gets calls from her
constantly day and night complaining about something or demanding that my
wife go to the store for her or help take car of her dog.

They have arranged for professional social workers and nursing help to
visit daily (their mother is also diabetic) but the mother keeps kicking
them out, accusing them of stealing things or simply complaining about them.

Two weeks ago something happened and the mother called 911, was
transported to the hospital but then refused any medical services.
One of her legs had swelled up and was bleeding. My wife requested
a psychiatric evaluation and the psychiatrist declared that the mother
was fine and was capable of making decisions. So, she was released.
The medical docs can't keep people against their will.

Then, two days ago it happened again. This time my wife called 911
and the mother was whisked off to the hospital again. Same thing after
she arrived ... refused treatment. Again, she was evaluated by a
psychiatrist who determined her to be "fine" mentally.

Then the medical docs called and reported that the mother was
experiencing hallucinations. They also, despite the shrink's evaluation
declared the mother as being "incompetent" regarding making decisions
which now puts the onus on my wife and her sister to determine what's in
her best interests.

At my wife's and her sister's insistence, they convinced the mother
to stay in the hospital and allow a few tests to be conducted.
The docs quietly sedated her to make her more cooperative. A CAT scan
followed by a full body MRI revealed she has a brain tumor the size of a
golf ball in her head and a life-threatening clot in the swollen leg.
The docs have given her 3 months, max.

So, one of the two issues is going to do her in, the clot or the brain
tumor. A procedure to minimize the clot threat is available but it
involves risk and all it will do is buy a little time for someone who
doesn't have much time left and who's quality of life is dismal.

Tough decision for the kids. It's not my place to advise, but I know what I'd do.

My heart goes out to your wife and sister in law. My brother and I went
through this with our dad in the early 1980's. Bone cancer. We went with
no heroic measures and let nature take it's course. Was hard, but he was
terminal and really poor quality of life.
As an aside, seems as if those Doctors of competency are really lacking.
My mother in law was bipolar, and was under a doctors care most of her
adult life, and never really was fixed in anyway. Other than a lithium
regimen later in life.