Mom has been in the hospital and/or rehab continually since July 10. I have health Care POA. She is 83 and very ill. She gave then permission to do surgery and now she is in worse condition than before. She struggles to put a sentence together and sleeps most of the day. She hasn’t eaten in a long time. She has a DNR. I believe they are going to want to insert a feeding tube into her stomach. I feel she is at the point where she needs comfort care and no more invasive procedures. In her condition she may agree to anything they say. Any thoughts? She is constantly saying she is in pain and suffering and it’s very hard to see her like that.
Pinpoint her primary physician or surgeon (is she currently in rehab or in hospital?). Take your POA documentation to that person, and get agreement that you are to be present at all decision-making consults, and that given her physical state at the moment your mother's consent to any procedures cannot be considered valid unless you are there to witness it. That's your starting point.
From there, the question is whether your mother is able to give consent or not. If your argument is that, in her current condition at least, she is not able to then you're going to need to get that on record.
Let's assume for practical purposes, though, that your mother remains the decision-maker. These are difficult conversations to have with someone you love, but you need to talk to her about her options. You might find it helpful to speak to a hospice advisor first (you don't need anyone's permission to get advice). It is also perfectly reasonable to request a hospice evaluation on her behalf, provided she is free to refuse it if she chooses to.
With the immediate issue over the feeding tube, make sure you're in the room when it's discussed. Try not to take over the conversation or put words into your mother's mouth, but do ask questions on her behalf such as "what happens if we don't do this?" "is this likely to be reversible?" and "what outcomes are we aiming for?"
Of course I don't know what your mother's underlying conditions are or what the surgery was for or how long ago it was done; but try to keep an open mind. If the surgery was recent and the PEG tube is intended to be short to medium term, would you still be hoping for some improvement in her?
To make sure everyone is on the same page, call a Care Conference with the staff. You need the social worker, Director of Nursing, any therapists and as many other people who are responsible for Mom’s care to be there; even the dietician if she's available. If the facility has their own Hospice Agency, ask that they be there as well. Be polite but firm and tell them “no heroic measures”.
Ask about "Allow Natural Death".
Remember that hospitals do not care about your loved one the way you do. The hospital will get paid big bucks for every procedure they do, for every feeding they give, etc.
Inquire about taking her home for hospice.
Ask for a consult with the palliative team.
When the elderly go under it can make their worse mentally.
Tell them you want a hospice evaluation.
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