Extremely frustrated caregiver, STILL frustrated!

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Several months ago, I posted about taking care of my husband's difficult landlord. He is still alive, and things have only gotten worse.
Sitting here tonight, (it's after 2:00am), I felt the need to update and just get some things out! I apologize in advance if this bounces around, my tiredness is to blame.
In June, after a ruptured colon, he had colostomy surgery. We (doctors included) didn't think he would bounce back from that, but true to form, he hung in. He was (is) still weak, barely eating, and having lots of all over pain. We convinced him to let home health come in, for nothing more than to help control his pain. The nurse comes in twice a week, changes his colostomy bag, and manages his pain meds. He started with percocet every 6 hours, then a stronger dose every 6 hours, and recently went yo the strongest dose possible, every 4 hours. For the last couple of weeks, it hasn't been enough to control his pain. He was wanting another pill no longer than two hours later. After much debate (on his part) he agreed to try some morphine. He took one dose, slept better than he had in months, and then promptly decided he wouldn't take it again, because it made him sleep. So he went back to the percocet, and suffered through the pain. He is horrible! I know he's in pain, but dealing with him had become almost unbearable.
So let's go to what happened Friday night. His girlfriend called, and said he was having bad stomach pains. He had called the local hospitals asking a diagnosis over the phone, but refusing to actually go to a hospital. When hubby and I showed up, he was screaming at the top.of his lungs to the poor nurse at the hospital! We got him (somewhat) calmed down, and I begged him to try the morphine, since he refused to go to the hospital. He finally agreed, but an hour later, he was still in extreme pain. Finally, he said, "well, take me to the hospital, something is wrong". Ya think?!?!!
So at midnight, we headed to the hospital, 45 miles away, because the one here in town wasn't good enough. Once there, he refused pain meds, ordered the nurses to " do some damn tests", and was belligerent until a doctor came in. The doctor ordered blood tests and a CT scan of his abdomen, and urged him to take something for the pain. He refused again, and the doctor told him that they couldn't do the scan unless he could hold still. He agreed then. Two and a half doses of dilaudid, and he had his scan...which came back clear! His blood work was relatively normal, considering he has stage IV cancer that's gone untreated, and the doctor suggested they admit him to further investigate. True to form, he promptly refused. Once again, he signed himself out, against medical advice! The doctor did urge him to take the morphine, (he refused), so the doctor gave him a fentanyl pain patch, with a prescription for more, and a muscle relaxing pill. We took him home, and left him with his girlfriend, and at 5:00am, went home ourselves.
At noon, the girlfriend called and said he had been throwing up green liquid. We sped down to see what was going on, and found he was throwing up, and had removed the pain patch, claiming that was what made him sick. We were then told that he hadn't had any food for 24 hours, and hadn't had any bowel in his colostomy bag for that long either. We begged him to go back to the doctor. He refused, and told us he would be fine, and to go home.
This afternoon, girlfriend called and said he had thrown up all night, hadnt been out of bed at all, and she was beside herself.
(Let me say real quick, that we haven't been in the house with him much in the last couple of weeks, as school has started and we have kids at home, and Friday night we had called grandparents to come sit with them.)
So my hubby came down to see what was going on, and called and told me that it looked bad. We called grandma and grandpa back in, packed an overnight bag, and here we are.
This man is SICK. He is crying out in pain, and dry heaving so hard he has tears in his eyes. He has urinated himself twice from heaving so hard. Yet, he is refusing morphine, and absolutely will NOT let us take him to a hospital! In my 21 years of nursing, I've NEVER seen anything remotely like this man!
His girlfriend said he hasn't eaten in 4 days now, and he barely sips water. He hasn't been out of bed other than to the bathroom, because he won't try a urinal. I cried tonight because it's heart wrenching to watch this! I begged and pleased with him to do SOMETHING, we all have, and he flat won't. He sleeps in between retching, and is so weak he can barely walk. Hubby talked about taking over, as he is supposed to become power of attorney once this man is incapable, but he's NOT incapable! The doctor Friday night said he is clearly still sound of mind!
So I sit here, now at almost 3:00am, waiting until I hear him heaving, so I can hold the trash can, and get him to the bathroom of needed!


I am so sorry you are going through this. Hugs to you and to your husband. This has got to be beyond frustrating and disturbing!

I am wondering why you are called in? What does his girlfriend think you can do that she can't do? The appropriate call to make is to to paramedics. It the man refuses this, what are you supposed to do for him? It it that the girlfriend does not want to experience this alone? (Who can blame her, poor dear!) Or that he wants you there while he is dying?

I am so, so sorry you are in this position. Not only watching him suffer, but being powerless to do anything to stop it. I'm just trying to figure out what your role is, here. If he becomes unconscious, will somebody be calling for an ambulance, or will you respect his apparent wish to die naturally, at home?

What a position to be in! Hugs again to all of you!
Hi jeanne, to answer your questions, I am a dementia care specialist/nurse. My hubby is this man's heir, and has been chosen as executor, trustee, and would have power of attorney if and when this man is incapable. He is a lifelong bachelor with no family. My hubby is a farmer/rancher, and has rented this man's land for over 15 years. In his estate planning paperwork, will, trust, and living will, it is clearly stated that his wishes are to remain at home as long as possible, as long as he is capable of making that decision, with no life saving measures.
Good news is, I just convinced him to try the morphine again. Hoping for the best at now 4:30am...
Will he accept hospice care?
Catty, has anyone had the blunt discussion with him that this is really the end, and he can choose to go out screaming or choose to save himself all the suffering, but either way the results will be the same?
You are doing the work of angels, I hope you can convince him to accept help.
This is my experience: When I start to call my ex my "husband" instead of my ex, I know I have lost sight of my own boundaries of detachment and self-care. Hope that helps.
Catty, oh my gosh, that poor man must be scared to death thus the reason why he keeps refusing help. Could be he's afraid that if he goes to sleep he won't wake up, thus the reason he keep refusing meds that would be more calming for him.

The man's girlfriend must be terrified herself not knowing what to do to help him, and her boyfriend will only allow you and hubby to help out. It must be comforting for her to know you are there.

Do you think the meds might be making him sick or do you feel that the cancer has reached its final journey? If the latter, apparently this man is going to fight this all the way. What a sad way to go :(
Babalou, he absolutely will NOT except hospice. Hospice means he's dying, even now, he will not face the reality of the situation.
Cwillie, like I said above, he will NOT accept the reality of this situation. He is a narcissist, control freak, and a chronic liar. The life he has chosen for himself is evidence of that. He called a hospital this afternoon while he was awake for a few minutes, and asked if he came in, if he could be in control of his own meds, even if it was by IV. Needless to say, we are still at home.
Freqflyer, you nailed it. That is exactly what part of it is. And he's at the end of his journey, we are sure of that.

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