Can I refuse care?

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Can I refuse care?

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My mom lives with me but refuse to take medication, bathe and at times refuses to eat as long as she lives with me. She has verbalized to everyone she does not want to be here. We’ve had adult protective service in the home, social workers and doctor involvement.

If she ends up in the hospital, can I refuse to bring her back home with me?

Care Decisions Family Caregiver Refusing Care

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I think Jacobsonbob has put his finger on it. By "does not want to be here" your mother means she's had enough and is ready to go, do you think?

And you don't want to feel responsible for having allowed her to waste away and die.

I deeply sympathise.

If your mother were in reasonable health but depressed about her age, then a spell in hospital and rehab might well perk her up and she could enjoy a good quality of life again. But that's not the case. She is very ill with a chronic disease, she's already blind in one eye, and the brain hypoxia can only go one way. Your mother's outlook is not a good one, wherever she is looked after.

You say you are afraid that she will get so sick that eventually the doctors will be able to do nothing for her. But... dear loving child, with hugs to you, that IS going to happen. And it won't be your or anybody else's fault.

When my mother was at a similar stage, after a lot of denial and futile struggling I eventually realised that if she was not in pain and not afraid, that was good. We know that our very sick elders are not going to get better. What we have to aim for is a soft, gentle landing.

If your mother is not already being treated for depression, it would be worth asking her doctors to consider that. Depression would fit with her other conditions, and can be alleviated.

If she is already being treated for depression, and in fact that's one of the meds she won't take; and seeing that she is still considered competent to make her own decisions; how would you feel about trying to accept the choice she's expressing? Have you discussed that possibility with her doctors and care team?

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Countrymouse- I actually took a screen shot of this message you just wrote. It was a balm for me, and I pray it is for the original poster. Thank you for always writing heart-felt, genuine, straight-forward replies.

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Is it possible she actually wants to die? However, from your description it appears to be more of a "hunger strike". Does your mother say where she would rather be?

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Get her to the hospital. Tell them she’s not eating.

She may have new medical problems. There may be something causing food to taste different, or making her otherwise nauseous. Could she have a UTI?

Usually in in the hospital they push everyone toward nursing homes at discharge. That is the American cultural norm. You don’t even have to ask or answer questions. They will tell you automatically that your mom should be in a NH.

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Now I have Moms age and I read CMs post I can now answer ur question better.

My MIL did the same thing ur Mom is doing, but she was in a rehab. She had a very bad UTI. Was in rehab to get her strength back. I don't actually know what she was told by my BIL but I think they gave her more info than needed. But the jist of the conversion was, she was going to have to transfer from Fla to a rehab in GA. After that, she would need to figure out which son she was going to live with. Because, none of her sons lived close enough for her to remain in her house. One in Miss and us in NJ. My Mil was a passive-agressive stubborn woman and if she was not going to go back to her home, she was not going anywhere. The woman literally willed herself to die. Doctor agreed. So she was put on hospice.

Your Mom is 89. She is probably tired and just wants to go. I think an honest sit down with her and her doctor would be a good idea. Even just you and her. Ask her what she wants. Why are you not taking your Meds Mom. Where do you want to go? Call a Hospice agency ask if they have someone qualified to ask Mom what SHE wants. You may find she is ready to pass on. My Mom had Dementia, but in the end, she wanted to be left alone. She didn't want to be touched or be forced to do anything. Nurses couldn't even get her out of bed.

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Really good answer, JoAnn. I completely agree with what you wrote.

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Many people on this forum say you can. I’m not sure how you’d go about it, but your first step would be to contact the social services department in the hospital. They may send her to a geriatric psychiatrist for evaluation.

You can also file for Medicaid for her and find a facility.

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Unless there are unlimited funds I would leave it in the hands of the hospital social worker to find placement. We cannot get it both ways and if we are to continue to give signals we will continue to caretake, they will leave it ALL to us. It is honestly very overwhelming. I would leave it in the hands of the social workers.

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You can certainly decide at any point that her care is beyond what you are capable of providing, and since she doesn’t want to be there and is fighting your care it sure sounds like you’re at that point. You can take the route of her being hospitalized and then refusing discharge back to your home, or you can start immediately looking for a place for her to live that can meet her needs. If she can’t afford to pay for this the business office of the facility can help you through applying for Medicaid.

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Even applying for medicaid and medicare can be very expedited by hospital social workers. For the lay person it is a nightmare not easily negotiated. But when there is no family it is one two three and done.

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My father was in a nursing home at the time but decided enough was enough. If they state that, the facility has to accept it. It’s basically a DNR , He was kept clean and comfortable but no food or meds. Died 2 days later peacefully.

If your our mom isn’t eating she may have already started the dying process. It can last a few years from start to finish but looking back I can see when my stepfather started it. He slept a lot, rarely ate unless badgered, didn’t communicate. Reality is they aren’t going to get better.

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Yes, you can. There is no law to say you have to care for your Mom. If this is your intention, when she enters hospital, get Social Workers involved to tell them that you will not be taking her home again, and that you cannot do so either physically or mentally. This will give them the heads up to seek placement for her. She will not want to be where she is placed, either, and of course her verbalization to you likely comes of dementia, not of reality, but it does sound as though you cannot do this anymore. So sorry.Accept that you will feel guilty about it. When people enter care their families always do. But there comes a time when you cannot do it. The nursing home she is placed in, and you yourself can be involved in seeking palliative care for your Mom, or even hospice care. The refusing to eat is not at all unusual in the end stage of life. You will need to be firm and unwavering in this choice when you speak with Social Workers and Doctors, because they will do what they can sometimes to get you to continue your caretaking in the home. This is something to consider before you go--whether you could go on with hospice and or palliative care in place, or not. It does sound as though the decision is made already in your head.

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All the agency’s that have been to the house, are looking into placements for her, however, we are on hold until a Medicaid Wavier is approved for placement which can take up to 4 months. We considered an emergency, so from what I am told we are being pushed through.
However, placement is not my biggest concern here. It her health. I am being told be told because she is still mentally capable of make her own decisions, I can not force her to eat, wash nor take her meds.
With that all being said, she in essence is making her health decline rapidly and if she does end up in the hospital and gets healthy, I don’t want to bring her home and she decides to do this again.
Im afraid, she ultimately get so sick doctors will not be able to bring her back.
Shes 89 blind in one eye, has CHF and brain hypoxia.

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Well, if she ends up hospital bound, then maybe the Medicaid can be pushed thru faster. Because it will be clear then that for someone to do this to themselves, there is something wrong.

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Yes, if she is admitted to the hospital, you should explain that you cannot care adequately for her and will not take her back to your home. It would not be a safe discharge. Then the hospital social worker will have to place her. What other place does your mom want to be? Is she competent legally? If she is legally competent then you cannot force her - it would be abuse, but be careful to protect yourself by making it clear that food, medicine, etc. are NOT being withheld by you. It's her bad choice, not yours.

Can I refuse care?

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