My mom was diagnosed with a terminal illness 6 years ago. During the time her and my sister filled out and got a POA form notorized. My sister was the first POA and I was listed as alternative. The POA stated mom wanted all life measures. However, during the first year my sister got into several altercations with my mom and mom asked to move out of state with me. I moved her out
of state and she had a few declines in her terminal illness but survived 5 years past the few months prognosis that doctors had given her after chemo and rad therapy. Earlier this year Mom's cancer metastizied to her lungs and she received rad therapy to shrink a large tumor in her lung as palliative rad. We, meaning me and mom and I relayed this to my sister too, were told to plan for the worst instead of the best. Mom's pain got too hard to manage with over the counter meds and scripts for morphine from her doctor were too complicated to get ordered and filled. I left out that mom moved from my home once she moved out
of state with me to an assistant living facility. So I asked would mom be a candidate for hospice because she was on hospice 4 years earlier which assisted her with pain management of the cancer. Although mom moved to assistant living I was still for 5 years her caregiver, going to and from doctor appointments and tests with her, buying her things she needed and wanted but couldn't afford because assistant living took everything, and I visited her and spoke to her many times per day. As these are things a daughter and caregiver should do plus she and I
lived in the same state. When mom was signed up for hospice mom understood she was on hospice and she spoke to the hospice admitting social worker, nurse, and doctor not me as they found mom mentally with it enough to sign
her own paperwork and make decisions despite I had told them mom had a head injury from when she was a child that the family thinks caused frontal lobe damage that causes her to verbalized and react without a filter in the things she sometimes would say and do. When it came time to decide on DNR status I was asked if me and mom would decide, but I asked if they discuss with her without me because I wanted her to tell them what she wanted. And she did eventually tell the staff of the hospice in bits and pieces of the DNR sheet at a time that she didn't want IVs chest compressions and tube feedings. Just wanted comfort measures. So a few weeks ago mom had a decline after she had been telling her nurse aid and hospice nurse she was ready to die and due to the rad therapy she couldn't tolerate food and had been suffering weeks of nausea and vomiting even though
she was given antinausea meds. I bought her
mashed potatoes and ensure and she tolerated them for
weeks but it wasn't enough. The last decline left mom transitioning and dead in a little over 24 hours. As she was transitioning I called and told my sister and she began yelling at me and the nurses at the assistant living and the hospice team that she was POA and she wanted mom to a hospital, but she didn't so
she claims realize mom signed a DNR and when hospice said mom was transitioning she was gurgle breathing in a trance like state passing secretions etc all things I was there to witness and clean and remember of moms passing. My sister has hollered at me after Mom's death that mom was mentally unsound (without any legal certification of that from any professional) and that hospice violated the POA. Did Mom's declaration of being a DNR on her own trump what was written in that old POA form? Did mom have the right to
change her mind as she had done? Then lastly my sister got
angry that the facility and me notified social sec and her pension of Mom's death
stating she was POA and no one else could do that. I paid for
Mom's final expenses without any help from my sister and organized a memorial for my mom. Since 2-3 days after Mom's passing my sister has not spoken to me or anyone else in the family. Hospice bereavement had tried to reach
out to my sister despite they never met or saw her and she will not respond.
Conversely, a POA has no control over end-of-life issues while by law, the DNR has to be honored. The DNR would trump the POA.
A childhood brain injury doesn't figure into this unless your mom was disabled by this injury and was under a Dr.'s care for this injury at the time of her death. A family story about a long ago brain injury affecting mom's reasoning abilities doesn't count.
Forget it. Your sister is armchair quarterbacking. It's a terrible thing to do in this instance. Put it out of your mind. You did the right thing.
Your mom's expressed wishes at the time trumps any POA or DNR in the WORLD unless she's been found incompetent by the COURTS.
form. And it was only for medical decisions and not
legal or financial POA. Yes, the medical doctor, nurse, and social worker from hospice evaluated mom and told me that mom was mentally with
it per their criteria and capable to make her own decisions as far as care and being a DNR or not. No one asked my sister to pay
for anything however she was aware that mom had nothing in place to pay for final expenses as I knew too. And she didn't offer anything was only concerned with the DNR and POA even after mom took her last breath. I had a memorial for mom in my city and I asked my sister if she would have one for
mom in her city because mom lived and worked there and knew more people there than here and she said no. I had even offered to help get it organized. She said that in her opinion mom died 5 years ago to many people when I moved her to my city. It's just sad. But it was nice to see how many people that mom had touched in life in living in my city for a short time at the memorial I had.
None of this is your fault. Your behavior was honorable.
Allow more time to pass. If Sister can gradually cope better with her grief you may be able to re-establish a relationship.
Please accept my condolences on your mother's death.
I'm a bit confused on the order of things.
I'm going to assume that you're referring to a Health Care Proxy, which your mother executed during the first episode of cancer, but never rescinded. Is this correct?
Then later during the second episode a DNR order was executed while your mother was in hospice, shortly before she died. Is this correct also?
If so, presumably someone as hospice witnessed the DNR. Was your mother queried by a doctor before executing the DNR?
Was your mother ever declared unable to make her own decisions, thus authorizing the holder(s) of the health care proxy to make those decisions for her? If so, was this before or after she executed a DNR order?
Was your sister present at your mother's death? If not, how was she able to make the determination that your mother was "gurgle breathing," etc.? If she was present, why didn't she raise the issue of the DNR at that time?
Why didn't your sister help with the funeral expenses, or was she not asked to help?
Sorry, but I got a little bit lost trying to follow the sequence of events and execution of documents.
memories and not cut people off. I am going to let my sister alone and see what happens. Yes, I agree the whole POA thing can be out of hand especially when people are not directly involved with the patient's care and not being realistic and not allowing a person to live or die according to his or her wishes. I get that my sister is reflecting her anger and guilt outward. I also think that the person that responded and said it seems as if my sister is still angry about Mom's move from 5 years ago is right. Thank you all for giving me more insight on the POA and DNR issue.