My mom would benefit from the smallest dose of otc inflammation reducer/pain medicine and anti anxiety medicine but my dad won't agree to it, for reasons I have no idea why. One of my sisters is in agreement with me and we have tried to have three family meetings with the executive director, nurse director and doctor on staff.
The other sister is in my dad.s side which makes no sense why they wouldn't want to keep my mom comfortable in her final stage of life.
I have met with the executive director which was futile because all she does is avoid the issue and play head games to deflect the real issue. I believe she and the Dr are not pushing for it because my dad is paying the bill and they don't want to cause waves. When I told the exec. Director That it seemed fishy and I would get to the bottom of it, she got very upset and said the conversation was over. I want to call the ombudsmen but I am mentally and emotionally worn out. I have the names of two mediators but every time there was a meeting my dad displayed irrational, nasty, and embarasding behavior because he has an an explosive temper. I visit my mom later in the day when she is showing pain in her hip and shoulder that she broke last July and her back and legs. Her anxiety and agitation is shown in comments like I want to die, I hate it here, I don't want to live.,is that normal behaviour for sundowning? My dad only visits in the morning when she is usually feeling okay and he refuses to go any other time of day. He is a stubborn, mean and nasty man and always has been. And is preventing my mom from being comfortable. What would you do?
I have written my dad several letters asking for an explanation to these points as well as why he wont sign the paperwork that would allow me to take mom out of facility for ice cream or to a geriatric dr for a second opinion on the issue, and he never answered me by phone nor letter. So frustrating.
The only reason i have requested otc pain meds is because that is what the dr on staff prescribed her after breaking her hip and then her shoulder a week later after moving into this MC facility. any pain or anti inflammatory med is what my ine sister and i are asking for, at the smallest dose.
Her last stage of life means that she is in late stage alz and not going to get better. Not talking much, extreme anxiety, confusion with food, parkinsons getting worse, making it hard to hold silverware and eat.
Hospice is an,option but i dont know where to start and again my dad has all the control over that decision.
She was put in this MC facility bcuz it was,the only one thst accepted his insurance at that time. thank God he has now changed it to medicare and the other on. as well, along with long term care insurance, which he told me a few days ago will run out in one and a half years. He thinks he will lose his home and car and belongings if he she lives that long and has no more i,surance. He is. Veteran and i suggested calling usaa or va or whoever to find out if he is eligible for any of his military benefits. He disregarded it by saying unless he was in world war 2, which he wasnt, he was in korean war, and was injured or has a disability, he doesnt, that it wont help mom. Is that true? I checked the vfw and american legion websites but didnt have enough info.
Thank you again everyone. Will follow up with yr suggestions.
Good luck.
Second, you state your mother is in the last stages of her life. Was this metaphorically speaking or actual? If the latter, perhaps she'd be better off in hospice.
Third, was there a specific issue why she was placed in this nursing home? Did she fall again?
Fourth, is your father sole proxy, or is anyone else named as a co-attorney-in-fact?
I could see myself saying, "Dad, I'm thinking mom's pain isn't as controlled as it might be. Can we talk to the doc about upping her pain meds?" What I can't picture myself doing is fighting tooth and nail with him and the nursing home to give her aspirin or some other OTC remedy.
Nevertheless, I would ask to talk to the doctor and tell him your thoughts about mom's pain control. If he cannot or will not speak to you about it...if nurses on staff agree with you that mom's discomfort can be lessened with more pain meds at little cost to 'the rest of her," then I would write him a letter, signed by whatEver other siblings agree with you, clearly stating that you believe she is getting inadequate pain control and ask for a brief meet next time he's at the NH to discuss it.
Please remember that you are not an MD. You may or may not know what other meds mom is taking, whether or not the pain CAN be controlled and still give mom safe mobility, etc.
I'll give you this -- it's pretty apparent to me that dad isn't doing anything to assuage your concerns. If you have any question that he is of sound mind, then I most certainly would report this to APS. You'll get one shot at that, in my opinion, and then you'll be notorious as the cranky family of that sweet little old lady.
The thing is, if you were the doctor in this MCU, this is how you'd go about it. Your elderly patient, lacking mental capacity, sustained serious injuries last year and now has chronic pain. So you would prescribe pain relief. If the patient's POA then objected and refused that medication on her behalf, you would at the very least want to know the reason why, and you would not lightly allow your patient to remain in pain without a satisfactory explanation.
I can see and agree that the "he who pays the piper calls the tune" aspect does interfere somewhat; nevertheless ethics are ethics and it seems unlikely to me that any doctor would just shrug and go about his business. There are mandatory reporting responsibilities placed on these professionals, after all, and as Babalou points out withholding minimal care would probably amount to an abuse of your father's POA.
So I conclude that either there is something you're not being told about your mother's pain management, OR that there is some good clinical reason why she can't be given NSAIDs or standard otc remedies which you are also not being told about. I hugely sympathise. It would drive me up the wall.
The anti-anxiety clinical decision-making process would be broadly similar, if slightly less clear-cut. There could be generational prejudices against "psychological voodoo" at play, for example, which would make the argument with your father harder to win.
But I also agree with Babalou's recommendations about advocacy, and her suggestion that you support your mother's remaining capacity to state her own wishes (which could not easily be ignored), and that taking advice from APS would be a good and straightforward start. Best of luck, please let us know how you get on.
I would not think that calling Adult Protective Services would be too strong an action here; you seem to feel that the facility and your dad and keeping your mom from what would seem like minimal care. Has anyone talked about Hospice as an option?