Follow
Share

My brother, an m.d. and the DPOA of my mother's healthcare, recently pushed to enroll my mother in hospice. There is no known terminal diagnosis and when I ask my brother what the diagnosis is he remains silent. My mother has periods of lucidity as well as confusion since she had a laminectomy under general anesthesia. How can I find out what the specific diagnosis is that qualifies my mother for hospice?

This question has been closed for answers. Ask a New Question.
Find Care & Housing
Your mother appointed your brother DPOA of her healthcare, yes? It's always better if the folks with the documents feel they can discuss their reasoning with others in the family, however this seems not to be the case here.

Perhaps your mother asked him not to reveal her diagnosis. Perhaps he knows/thinks that you will be upset by whatever he reveals to you. Perhaps there is unspoken family baggage here.

I would suggest that you get in touch with the hospice social worker and chaplain and discuss your concerns.
Helpful Answer (9)
Report

~ I can't see a hospice taking on a patient, that isn't near the end of her life. They don't take people on, like a nursing facility.
My mother-in-law was transferred to a hospice, and she was physically fine. BUT she refused to eat, and her Health Care Proxy stipulated "no feeding tubes, or artificial means to prolong life, and a DNR". She did have dementia, but had given up her will to live.
I would definitely look into this, the way "Babalou" suggested. Speak to her nurses also. Hope this helps ... Good Luck and God Bless.
Helpful Answer (5)
Report

My guess is he will not tell you because he does not want to engage in a heated debate, as he had to with your father. Nor can he withstand further accusations of murder by hospice. He is protecting both the patient and himself by not telling you the details.
Helpful Answer (2)
Report

How do you know she had a heated debate about her father? I feel her mother's life is worth a heated debate. My experience with Hospice is they are very dubious and over eager to end life. They approached my elderly Mother to end my sister's life when my sister was in the nursing home. I brought my sister home after that. They nursing home and Hospice seemed very eager to end my sister's life. She has been living with me for the last six years. Find out what is going on before it is too late.
Helpful Answer (2)
Report

Hospice is either something that you have a good experience with or a bad experience with. It depends, much like other health care options, on the provider. My father was placed on hospice with no definitive diagnosis, just an "unidenified bleed". I have clients who have gone on hospice simply with a "failure to thrive" assessment. I have also seen people go on hospice and later come off of hospice. Hospice does not end a life, it makes a person comfortable and provides support as they face the end. Many people wait waaaaay too long to call in hospice, that is why we often see people on hospice pass away quickly. Also, Medicare pays differently on hospice and your mom gets alot more support. I know it massively sucks, but you may have steel yourself against the fact that you may not know until she has passed. Unless you have had a tense relationship with your brother, maybe not assume that he is "up to something"? Have you tried asking your mom during her periods of lucidity? Good luck, sorry you have to deal with this on top of your mom being sick......
Helpful Answer (7)
Report

manis1954: I'm not sure if I missed something or not, but how old is your mom, and did she have problems before the surgery? I believe a laminectomy is a procedure to fix the spine somehow. If she is very elderly, the anesthesia can make people confused for a while, then the pain meds can have an affect as well. I would want to know exactly what is going on, and why he wants her on hospice. Keep us posted on this if you can. Sorry you have to go through this with your mom.
Helpful Answer (1)
Report

My brother is also POA. He refuses to tell us or any of the family anything about my mom. Mom has dementia and she signed the papers because she said she had no other option( she was living with him at the time). She is in assisted living now. I live 300 miles away but visit her monthly. The staff knows me and will give me basic updates. Your brother might be a control-freak, like mine. He wants to hold the reigns tight no matter what the cost is to the rest of the family- makes him feel important. I know Karma will get him in the end...
Helpful Answer (3)
Report

IF your name is not on any papers to reveal/disclose information to, the hospice or anyone cannot give out info. we had that happen in my husbands family. the one son (some how) must have gotten their mother to sign over the POA to only him and removed the other 2, so when anything was being done, no one else had any say or anything. now at one point, even though it was HOURS later, when MIL went into ER, we finally were told why. to this day, we haven't heard from the one brother, he is greedy and all for himself (and I guess wife too). hopefully your brother can at least give you a reason why he won't disclose any information. good luck
Helpful Answer (0)
Report

Sounds like my brother. He has mother living with him, but won't reveal to the other 4 sibs ANYTHING. Sometimes mother "picks" one of the sibs to confide in if she's in the mood, but as far as her financials, end of life arrangements, the rest of us are in the dark. I know she has DNR, but I don't know much else. This brother is SUPER controlling and thinks he knows everything and has the answer to everything. The same could be with your brother. I'm trying to get him to loosen up a little--he has MPOA and the other brother has POA over finances. The women know nothing. This year's goal is to get all 5 of us on one page and in sync with mother's care. Don't know how it will work, since the controlling brother simply doesn't talk to us.
Helpful Answer (0)
Report

~ I have a question ... Was your mother lucid when she signed the DPOA? If she wasn't, you can contest it! I would look into this . . .
Helpful Answer (1)
Report

I'm sorry you have to go though this, and what I'm gonna say sounds cold & hard-hearted, please don't take it that way...your brother should know better if he is an MD. They take an oath of first do know harm.....how about turning the tables and putting HIM in the situation without consulting anyone. Maybe he needs an evaluation by a Hospice professional
Helpful Answer (1)
Report

I'm so sorry for your mother's condition and for your pain. If a family member told me my mother was in hospice, I'd certainly want to know why! I think I can imagine your anger, fear, and frustration. And it is hard to imagine a legitimate reason for your brother not to tell you. This whole picture is very sad,

I feel for you. I do. I think I would feel as you do.

But on a practical level, your mother is now on hospice. Medical personnel say she meets the criteria. One of two things will happen:

SCENARIO 1

1) Mother will continue to decline.
2) Hospice will do all they can to keep her comfortable.
3) Mother will die.

(This was the case for my husband. He died 5 weeks after enrolling.)

SCENARIO 2

1) Mother will improve.
2) Hospice will keep her comfortable but realize that she no longer meets the criterion of being close to death.
3) Mother will be discharged from hospice.

(This was the case for my mother. She was discharged about 3 months after enrolling. That was nearly a year ago.)

Whether you know the terminal diagnosis or not, one of the two possible hospice scenarios will occur. You knowing or not knowing will make not one fraction of an iota of difference to the outcome.

Your brother is empowered to place Mom on hospice, with her approval is she is lucid enough, and within the guidelines of the program itself. Accept that.

He is not telling you the exact diagnosis. I have no idea why, and I can understand your frustration. I join other posters who've suggested talking to the hospice social worker. If it is meaningful to you, also talk with the chapline. Get comfort from whatever source you can!

Do not let your conflicts with your brother interfere with your relationship to your mother. Please, continue to visit her, comfort her, love her, and be there for her without regard to what your brother does.
Helpful Answer (5)
Report

Retain an attorney. He'll have to talk to the atty or be in contempt!
Helpful Answer (1)
Report

For a patient to qualify for hospice they have to have less than 6 months to live. Medicare has special criteria and won't pay if your mom does not meet the criteria. Your brother should not be hiding this info from you. My brother wont tell us anything about my mom. It infuriates us but I do know he will have to live with this guilt the rest of his life.
Helpful Answer (0)
Report

To find more information about manis1954's situation. Go to the SEARCH BOX at the top right of this page and type in manis1954. A list will appear with prior questions that manis had asked.
Helpful Answer (0)
Report

manis, if you have time could you go back through your prior postings and answer some of the questions that the writers presented? Such as why did your Mom, at 92, have a laminectomy surgery on her back? After surgery did she go to rehab, if not, why not?

Please note that in order to go into Hospice your Mom had to be referred by a doctor [maybe your brother] but there is also a Hospice physician assigned to the Hospice group, and he/she also makes the call if someone is ready for Hospice.

Surgery is very difficult for an elder, it can send them into delirium and/or worsen dementia. Yes, there will be time when the elder sounds clear and alert, but that comes and goes.

Manis, are you a son or daughter? There are times when a woman your Mom's age doesn't want a son to know her medical condition if the condition is female in nature.
Helpful Answer (0)
Report

Thanks, ff.

manis1954, from your other posts, it looks like your relationship with your brothers is dysfunctional. I am so sorry. In previous posts you were given a lot of advice about pursuing a change in POA and/or consulting a lawyer, to bring you mother to live closer to you. Did you follow up on any of that advice? What was the outcome?

In any case, my previous answer on this thread stands. I do feel sympathetic to your situation. Talk to hospice personnel. Continue with a loving relationship with Mom.
Helpful Answer (3)
Report

I went to a seminar on Hospice 5 years ago. It was to explain to people that it isnt just for end of life anymore. My mom was determined eligible at that time but i waited. Got it 2 years ago and they were no help as shes a 2 person assist and they couldn't find an aide to turn her. Okay now my moms 94 going on 95 and could get hospice again but i wont get unless she is dying and needs morphine.They re-write their care plan every 6 months. They said people can be on it sometimes 2+ years because they need support and no one really knows when an alz person will die. So it doesnt mean she is dying. Why wont your brother tell you? You can call the adult protective services and they will investigate free. If he is using her money or keeping her from seeing you, they can take care of that too. Now, as far as her signing a POA while not in her right mind, forget that one. NO lawyer us going to say she signed it being incompetent because his reputation is on the line! Even if she was, the lawyer would NEVER admit it! know what I mean jellybean?
Good luck!
Helpful Answer (0)
Report

Some people when give the DPOA use it as a status symbol and become control freaks! It's nearly impossible to get that special power taken away from them unless the patient does it. Don't believe the lawyers who will tell you they can do it b/c is the end you end up paying thousands and thousands of dollars for nothing. Our lawyer advised us there was no guarantee and he was right. We spent alot of $$$$ to learn the lesson. The headache and heartache are not worth it.
Helpful Answer (1)
Report

Exactly megan, that would be a lawyer admitting he was wrong, no way!
Helpful Answer (0)
Report

I'm sorry "Reverseroles", but you're wrong in advising her NOT to look into her mother's state of mind, when she signed the POA.

What she has to do is, get records from her mother's doctor that states, the earliest dates of her diagnosis as to when the change in her mental health started. Also, get some follow-up records, showing it's progression. Compare these dates, to when she signed the POA.

DON'T go directly to the lawyer ... Of course he's not going to jeopardize his reputation. Adult Protective Services (APS) may be able to help you with this.

I don't know what your brother is up to, but there's obviously a reason, he's being so secretive. I also don't know what state "manis1954" is from, but I've been through this with two families I cared for, in both NY and FL. It split the family in half ... The POA in both instances was up to no good. The one POA, (in FL) wasn't even related to the person, and does this as a career.

Good Luck and God Bless.
Helpful Answer (1)
Report

~ If your brother signed the orders, as a doctor, to put your mother in a hospice, isn't it a conflict of interest, for him to be his mother's doctor?
I thought relatives, (that are doctors), can not treat family members?
What happened to the doctor that has been treating her, in the past?
I don't know if there's any legal standing, regarding this .... Something you might want to look into.
Helpful Answer (2)
Report

As long as I live - or maybe I should rephrase to: as long as my mother lives; I am her DPOA both financial and medical - I will NEVER understand all this secrecy crap! I am a self confessed control freak. I have a very volatile relationship with 1 of 2 brothers - yet I tell and show my brothers anything they ask about. Sometimes when something is particularly difficult medically I call them. What is the problem? I just don't get it! In truth I don't give my brothers passwords to access finances but that's just common sense - they are free to look at statements anytime they want to come on over. Am I the exception or the rule?
Helpful Answer (4)
Report

My mothers doctor said that just because a person is "forgetful" in the beginning years of dementia, it doesnt mean that they cannot make decisions. Its further into the diagnosis down the road when their reasoning goes. I have never read of anyone reversing a POA has anyone else? But if someone wants to spend their money to try, hey why not. I never said "not to" I stated using APS is free and may help her more without robbing her.
Helpful Answer (0)
Report

The OP states that even now her mother has "periods of lucidity." It would be just about impossible to prove at this time that she wasn't lucid when she signed the document. There is a huge gap between a doctor diagnosing dementia and a doctor declaring someone incompetent to make decisions. (It is ultimately a court that makes that decision, in any case.)

It is the hospice doctor who determines the eligibility for hospice, often with consulting the primary care doctor.
Helpful Answer (3)
Report

Please make sure that your mom had the legal capacity and was competent to sign the DPOA document at the time it was signed. The definition of legal competency is that your mom understood and comprehended the consequences of the actions surrounded by signing this document. You might also might to contact Medicare or QID if you have a reasonable suspicion that medical abuse is taking place. They will probably investigate the case if you have reported a good faith case and have the facts in order including the time, place and manner of the signing of the DPOA. Affidavits or a written report from the doctors, nurses, laymen or others that your mom was not competent when she signed the DPOA would greatly increase the odds of Medicare investigating the competency of your mom when she signed the DPOA and the probability of health care abuse. I realize that this will take a considerable matter of time to gather all of the above but you might need this information at another time such as when and if your passes. Good Luck and God Bless.
Helpful Answer (1)
Report

For a person to qualify for hospice and for medicare to pay for the services a patient must be certified by a doctor as having less than 6 months to live and a specific cause must be cited with evidence. In my mom's case I finally found out that her diagnosis was dementia with trouble swallowing. After getting another one of her chronic uti's last week my mother went downhill quickly and passed away.
Helpful Answer (1)
Report

Dear Manis, I'm so sorry for the loss of your mother.
Helpful Answer (2)
Report

thank you
Helpful Answer (0)
Report

So sorry - and now that you have found out, it seems very possible that the right things were done. There is not much that can be done for someone with dysphagia in the setting of advanced dementia that helps increase either quality or quantity of life. I'm praying for your comfort and for the family to be able and grieve together in a way that mends the hurts. I am sure you will miss her, and hope you have some better memories to comfort you too!! Hugs...
Helpful Answer (5)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter