On 3/17/2015 4:52 PM, jps wrote:

On Tue, 17 Mar 2015 11:25:56 -0400, "Mr. Luddite"
wrote:


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


Thanks for sharing this. I have a similar situation with an elderly
parent who refuses to move out of her house, doesn't trust anyone.

We're waiting for circumstance to dictate the path forward.

Hope we're all smart enough to figure a more graceful finish.


I am sure laws vary state to state but in general they are very
protective of the rights of the elderly. Unless a medical doctor or
psychiatrist declares them incapable of understanding their situation,
they cannot be forced to accept any form of treatment, help or be forced
into assisted living or a nursing home. The key is competency to make
rational decisions.

My wife and her sister (with support by others) have tried to convince
their mother to move to an assisted living facility for years without
success. It's hard for elderly people to give up whatever dignity and
independence they may still have.

My mother, who had a rare form of MS, fought the concept of assisted
living for years but finally realized she needed help on a 24 hour a day
basis. After my father died, she lived in a house that we purchased and
refurbished, equipping it with handicapped access and features. It was
located at the end of our house's driveway so it was convenient for us
to check up on her two or three times a day. We even got her a golf
cart so she could get outdoors and occasionally come up to our house to
visit.

But, after 7 years there her condition deteriorated to the point where
she realized she needed 24 hour assistance. It's tough when simple
things like using the bathroom are impossible without help. She stayed
fairly active in the assisted living/nursing home and had many new
friends. Fortunately she stayed mentally sharp right up to the end even
though physically her condition worsened. She was a bright woman,
understood her situation and didn't want to burden evey one else.

On Tuesday, March 17, 2015 at 5:24:08 PM UTC-4, Mr. Luddite wrote:
On 3/17/2015 4:52 PM, jps wrote:

On Tue, 17 Mar 2015 11:25:56 -0400, "Mr. Luddite"
wrote:


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


Thanks for sharing this. I have a similar situation with an elderly
parent who refuses to move out of her house, doesn't trust anyone.

We're waiting for circumstance to dictate the path forward.

Hope we're all smart enough to figure a more graceful finish.


I am sure laws vary state to state but in general they are very
protective of the rights of the elderly. Unless a medical doctor or
psychiatrist declares them incapable of understanding their situation,
they cannot be forced to accept any form of treatment, help or be forced
into assisted living or a nursing home. The key is competency to make
rational decisions.

My wife and her sister (with support by others) have tried to convince
their mother to move to an assisted living facility for years without
success. It's hard for elderly people to give up whatever dignity and
independence they may still have.

My mother, who had a rare form of MS, fought the concept of assisted
living for years but finally realized she needed help on a 24 hour a day
basis. After my father died, she lived in a house that we purchased and
refurbished, equipping it with handicapped access and features. It was
located at the end of our house's driveway so it was convenient for us
to check up on her two or three times a day. We even got her a golf
cart so she could get outdoors and occasionally come up to our house to
visit.

But, after 7 years there her condition deteriorated to the point where
she realized she needed 24 hour assistance. It's tough when simple
things like using the bathroom are impossible without help. She stayed
fairly active in the assisted living/nursing home and had many new
friends. Fortunately she stayed mentally sharp right up to the end even
though physically her condition worsened. She was a bright woman,
understood her situation and didn't want to burden evey one else.

If you don't have it already, get a durable Power of Attorney for both general (financial) and medical. I'm going through that right now with my dad. He's still living in his house, but refuses to accept much help or admit he even needs it (he does, IMO). He's past the point of being able to take care of himself, but won't agree to go to an assisted living facility. We have a lady that comes in twice a day to make sure he gets food and meds, and my siblings and I do that on the weekends, but he really should be somewhere with 24hr care in case of a mishap. He'll have none of that, however.. They can't force it on him, and neither can we.

It's really a sad situation.

On 3/17/2015 6:37 PM, wrote:


If you don't have it already, get a durable Power of Attorney for both general (financial) and medical. I'm going through that right now with my dad. He's still living in his house, but refuses to accept much help or admit he even needs it (he does, IMO). He's past the point of being able to take care of himself, but won't agree to go to an assisted living facility. We have a lady that comes in twice a day to make sure he gets food and meds, and my siblings and I do that on the weekends, but he really should be somewhere with 24hr care in case of a mishap. He'll have none of that, however. They can't force it on him, and neither can we.

It's really a sad situation.



Good advice. Fortunately that was done a few years ago when both her
parents were reasonably healthy and able to make rational decisions.

My wife has power of attorney for all their financial matters. She's
been paying all their bills for years. Her sister has the medical power
of attorney. Since they are both on the same page regarding the
remaining parent, there is no conflict.

Both are sad of course but at 90 years old, are hopeful for a fairly
swift and peaceful passing of their mother.

It's a lesson for all of us I think. These issues should be discussed
with off spring while we are healthy and clear headed. Wishes should
be documented in a will and power(s) of attorney should be put in place.

The last thing we should do is become a burden on our kids. They have
enough problems in this day and age.

"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.

On 3/17/2015 9:30 PM, Califbill wrote:

"Mr. Luddite" wrote:


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.


I have a bit of a problem with psychiatrists. I think it's a very
inexact science more prone to guess work and personal opinions.

In this case family members became concerned about unusual behavior
including indications of a lack of sense of reality and requested that
she be evaluated. Two different psychiatrists were
involved and both declared the mother to be "fine", the first about 3
weeks ago and the second after she was admitted to the
hospital three days ago. Their mother was also complaining of a severe
headache and my wife and her sister were the ones who requested the
initial CAT scan (which was followed up by the MRI) that showed the golf
ball sized brain tumor.

The psychiatric evaluation is key to determining competency which
becomes a legal issue. By declaring her as being "fine" the
psychiatrists prevent rational decision making in her behalf by others
and is also key to to other services. Fortunately in this case the
medical doctors noticed the hallucinations and overruled the
psychiatrist's determination of her condition and competency to make
rational decisions. Otherwise, the hospital could not keep her there
against her will.

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.





That's tough. I lost my mother to a blood clot in her leg that moved to
her lung. She waited far too long to see a doctor about the clot -
three days earlier and she might still be around. Her mind was solid
but she procrastinated when there were hard decisions after my father
died. When she was in the ICU different doctors gave us different
opinions. There also seemed to be a lack of communication between the
doctors, specialists, and ICU nurses. I really wanted to move her to a
bigger, and hopefully better, hospital but that wasn't an option in her
condition.

It's a shame there is nothing they can do for the tumor. It probably
has everything to do with her behavior. If she is otherwise healthy, a
second opinion couldn't hurt. One thing I've learned is that medicine
is far more subjective than I ever thought.

On 3/18/2015 8:14 PM, Someone wrote:
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.





That's tough. I lost my mother to a blood clot in her leg that moved to
her lung. She waited far too long to see a doctor about the clot -
three days earlier and she might still be around. Her mind was solid
but she procrastinated when there were hard decisions after my father
died. When she was in the ICU different doctors gave us different
opinions. There also seemed to be a lack of communication between the
doctors, specialists, and ICU nurses. I really wanted to move her to a
bigger, and hopefully better, hospital but that wasn't an option in her
condition.

It's a shame there is nothing they can do for the tumor. It probably
has everything to do with her behavior. If she is otherwise healthy, a
second opinion couldn't hurt. One thing I've learned is that medicine
is far more subjective than I ever thought.



It seems to be becoming more subjective with more knowledge.

My wife's mother is 90 years old and in deteriorating health. She's a
diabetic and requires daily insulin shots. We were also told today that
it appears her kidneys are starting to fail. All things considered, it
is obvious that she is entering the final, end of life stages. The
question on the table now is where should she go ... home, nursing home
or should we take her in at our house.

The hospice people are excellent in educating family members who are not
familiar with the signs and symptoms of impending death. I learned a
lot from them with both my father and my mother as they went through the
process of dying.

One of the conflicting issues in our health care system ... be it
hospitals or even nursing homes ... is the objectives and mission of
health providers (doctors, nurses, etc.) and those trained to make the
dying process natural and as comfortable as possible (Hospice). The
medical people's objective is to save lives and respond to any life
threatening situations. The hospice people provide comfort and care
to allow the process to proceed.

All a doctor can do ethically is to "recommend" hospice when he knows
the time is drawing near.

Mr. Luddite wrote:
On 3/18/2015 8:14 PM, Someone wrote:
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.





That's tough. I lost my mother to a blood clot in her leg that moved to
her lung. She waited far too long to see a doctor about the clot -
three days earlier and she might still be around. Her mind was solid
but she procrastinated when there were hard decisions after my father
died. When she was in the ICU different doctors gave us different
opinions. There also seemed to be a lack of communication between the
doctors, specialists, and ICU nurses. I really wanted to move her to a
bigger, and hopefully better, hospital but that wasn't an option in her
condition.

It's a shame there is nothing they can do for the tumor. It probably
has everything to do with her behavior. If she is otherwise healthy, a
second opinion couldn't hurt. One thing I've learned is that medicine
is far more subjective than I ever thought.



It seems to be becoming more subjective with more knowledge.

My wife's mother is 90 years old and in deteriorating health. She's a
diabetic and requires daily insulin shots. We were also told today that
it appears her kidneys are starting to fail. All things considered,
it is obvious that she is entering the final, end of life stages. The
question on the table now is where should she go ... home, nursing
home or should we take her in at our house.

The hospice people are excellent in educating family members who are not
familiar with the signs and symptoms of impending death. I learned a
lot from them with both my father and my mother as they went through the
process of dying.

One of the conflicting issues in our health care system ... be it
hospitals or even nursing homes ... is the objectives and mission of
health providers (doctors, nurses, etc.) and those trained to make
the dying process natural and as comfortable as possible (Hospice).
The medical people's objective is to save lives and respond to any
life threatening situations. The hospice people provide comfort and care
to allow the process to proceed.

All a doctor can do ethically is to "recommend" hospice when he knows
the time is drawing near.


My mother died in the ICU. She had a living will with a DNR if
"extraordinary measures" would only delay imminent death. They followed
the DNR and didn't try to resuscitate her when her heart stopped. They
did ask us for that approval and we had no choice but to let her go
since her kidneys had also failed and weren't responding to dialysis.
She was intubated and in a chemically-induced coma so she, hopefully,
felt no pain.

My father died while in Hospice after a few days. It was a nice
facility that was set up like a normal bedroom. We were called in the
AM and told to head over there. He lasted maybe an hour after we
arrived. I still wonder if they play with the morphine a bit to adjust
the timing of the outcome but you might be right and they just see the
signs. It didn't really matter except that I'm glad we were there for
him (or us?).

I'm sorry you and your wife have to go through this. 90 years is a
great run.