Mom is 93, has dementia and lives in a memory care facility. Quality of life is poor and we're looking at the end of funds and transfer to a medicaid facility which might be beyond visiting distance. I have full power of attorney and pay all bills. ( son ). I'd like to transition to comfort care only. The POLST form has been updated to reflect that. However the doctor states they need to meet with both of us before considering a medication stop order. I've set up the appointment but not sure what I'll do if mom is questioned and says she wants to keep taking the meds. I could stop paying the pharmacy, and have told them not to send any more. This morning mom said " have you seen your parents lately." So I'm not optimistic about a meaningful Dr. consultation.
By the way, though. If the doctor disagrees that it is in your mother's best interests to stop this px, be sure you understand the clinical reasoning before you fire that one and get a second opinion. Blood pressure problems can make a person feel terrible, so there could a quality of life issue to stopping them.
There is no guarantee her current home will keep her if she goes on Medicaid and I have to consider the possibility of locating her somewhere to far away to visit.
I'm sure the doctor will give you good advice.
Yes, we are discussing hospice and as I mentioned, her current memory care unit can accommodate that.
Of course nobody wants to see their parent in a h3ll-hole. But there is "undesirable" and then there's "rather be dead."
Are you having a lot of trouble with Medicaid? Any specific problems that people (not me, not my area) might be able to help with?
(and just to add, I am pro death with dignity)
Medicaid is there precisely to provide for people once their own resources are exhausted. Your mother trusted you to act in her best interests when she gave you the substantial authority of POA. How is it in her best interest to avoid a benefit to which she is entitled?
You should be seeking agreement in principle from her current facility that they will accept her, as an established, settled resident, once she transfers. You say there's no guarantee they will; that doesn't mean it can't be negotiated. Better get to work on it, eh.
Slowing this down, needing time to reconsider motivations that are NOT insurance, financial, or convenience related.
I am not accusing you of faulty motivations. However, who is qualified to judge anyone's quality of life? Get a second opinion. Patients have actually improved in hospice once all the meds are removed, then they are graduated from hospice as death is not imminent.
Peace to you and yours.
You are in a difficult situation, and I am so sorry you are suffering loss of your Mom.
To repeat: an experienced doctor will give you good advice, and certainly will want to remove any px's that are of no further benefit to your mother.
Judging your mother's quality of life by what you would or wouldn't like is a schoolboy error in terms of ethics. Bear in mind that with age and experience you may come to a very different point of view. What matters now is what is best for your mother: if she is content, unafraid and not in pain, it doesn't matter whether she knows who you are and it doesn't even matter if twenty or thirty years ago she'd have said "shoot me if I ever go gaga." Or not unless she wrote it down and signed it, anyway.
I'm sorry if this seems harsh, it's just that you have rather given the impression of working to a schedule, and being in a bit of a hurry about it at that.
Thanks for the input.