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LoneStarGuy Asked March 2019

What should a health care proxy do when and elderly parent refuses 'treatment'?

My mother is in assisted living. Yes, she's a crotchety person. Diabetic, COPD from among other issues. My sister is health care proxy. The issue for this moment is that my mom's oxygen level gets low and is supposed to be taking oxygen but refuses and 'doesn't want it in the room'. Have heard that kids can get sued by the state if they don't 'take care of their parents' but what is one supposed to do when the parent absolutely refuses to do what they should be doing? Apparently, the caregivers can't get her to take it as well.


Thoughts on how to proceed or what are the legal ramifications if something bad happens due to a directly related care issue that the health care proxy can't handle due to the individual refusing care?


Thanks

Llamalover47 Mar 2019
Document it through an elder law attorney.

rovana Mar 2019
Posters who recommend "document, document" are spot on here. Basically I think this whole area is still an uncoordinated mess from a legal standpoint.  Possibly because there has long been the assumption that people want to live as long as possible. Had an elderly neighbor with heart and other health problems. He went to a lot of trouble to consult physician, lawyer, and took notarized copies of his wishes for DNR, etc. to the local hospital, all the ambulance companies, the local fire department, everyone he could think of. He was tired of living, morally could not commit suicide but absolutely did not want any treatment beyond palliative/hospice care. Some people cannot seem to understand the concept that long life is not necessarily a good deal. And some of these people are in positions where they can prosecute (or persecute) people who do not agree that we should do everything to extend life. The legal situation is in flux here, but to be safe, DOCUMENT!

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Harpcat Mar 2019
It may make her feel better, you know that, staff knows that and we know that. But bottom line is you can’t force her to wear an O2 cannula in her nose. I would quit fighting the battle that can’t be won. It doesn’t make sense to us but it is what it is. Document. Even take a video her ripping it out and saying she doesn’t want it.

JoAnn29 Mar 2019
If the NHs can't force someone to do something by law, then why doesn't that same law cover caregivers. If an ambulance comes for a person and the refuse to go, they cannot make them. So what is a caregiver suppose to do.

I guess, call the ambulance and allow the person ur caring for turn it down. Then get a copy of the EMT report showing the person refused to go. Call APS or Office of Aging to evaluate the situation. No, they can't force either but they can document it too. Document, document. Then when something happens you can show you did everything you could and even the powers that be could not force the issue.

LoneStarGuy Mar 2019
I am in TX, but thanks 97yroldmom, you got me to look this up regarding FL law. So, apparently a person can refuse medical treatment whether competent or incompetent. That helps. I don't know about more medications, but she should have been taking antidepressants for the last 40 years, LOL. :-) Nevertheless, it is something to think about.

https://flayld.org/2016/08/right-to-refuse-treatment/

AnnReid Mar 2019
Along with the documentation of day to day functioning including periods of both compliance and resistance, be sure to document input from her medical advisors as well.

The burdens of care management are difficult enough without feeling as though you have sole responsibility for her life and death, and knowing what her caregivers and medical personnel see about her refusals can help clarify what you’re seeing yourself.

In our caregiving situation, a minimum does of an anti-depressant was very useful in helping our LO become slightly less “crotchety” without becoming drugged out. That may not be possible with your mom’s other limitations, but it has sometimes helped me (a little) to brainstorm potential small changes that may shift the landscape a bit.

One of the kindest things one of my mother’s caregivers ever did was to tell me that I should stop trying to get her to eat, when in spite of a previously healthy appetite, she began to refuse anything by mouth shortly before her 95th Birthday.
Counterintuitive as that was to me, I complied, and found that she was much more calm and content.

97yroldmom Mar 2019
My MIL (86, dementia) while on hospice and in her final days, was on oxygen. She would pull the cannula from her nose. Her daughter would gently replace it. One day, MIL pulled it back off immediately after daughter had replaced it. MIL said “If I die, I die”. That was one of the last things she ever said.
Here is a guide for guardianship in Texas.
The way I read it is that even if your mom were a ward of the state, she would have the right to refuse the oxygen.

https://hhs.texas.gov/sites/default/files/documents/laws-regulations/legal-information/guardianship/pub395-guardianship.pdf

EDIT;
I just read that you are in Fl. The LoneStar made me think Texas. However, I’ll bet you can find something similar for Fl.

worriedinCali Mar 2019
Health care proxy doesn’t mean you can force someone to do something they don’t want to do. It gives you the power to make decisions when they can’t make them. Your mom has made the decision not to use her oxygen so there’s nothing you can do. Your sister can document everything but your mothers refusal to comply isn’t going to get your sister in to trouble.
LoneStarGuy Mar 2019
One can hope. I have heard of a case in FL (from a lawyer) that a child was prosecuted by the State because they didn't force their parents to go to the hospital when they needed care. Don't know the whole story of course, but it was said the child TRIED but they refused. They said the State basically said 'you should have done it anyway'.
cwillie Mar 2019
She's resistant. Staff can hook up the oxygen and she can tear it off, so even if there is a effort made to get her to comply what do you expect to happen when she doesn't? Even though it's in her best interest she can't be forced to accept treatment, it's that simple.

LoneStarGuy Mar 2019
This is in FL if it makes a difference. Sometimes it does.

LoneStarGuy Mar 2019
Well, actually she HAS been declared incapacitated, by two doctors... unable to make her own health care decisions and 'placement' decisions. I appreciate the input, especially about documenting her refusal, both by my sister and the doctor and hopefully the caregivers have been doing it as well.

It's hard to understand what 'rights' a person has once they are declared incapacitated because they are no longer able to properly exercise their God-given rights, i.e., make proper decisions.
AnnReid Mar 2019
This is one of the reasons why it may be better for you to give more of the responsibility for decision making to the people you’re paying to do her ongoing care.

Have you asked the social services staff staff about your responsibilities concerning management of her compliance in her care?
Isthisrealyreal Mar 2019
Document, that is what she can do. Get a day calendar and everytime mom refuses make a note, whether it is caregivers or sister. You can't make anyone receive treatment, it is against their rights.

So sorry that she is refusing something that would help her feel less distressed and tired but unless she has been declared incompetent she is free to make these decisions.

I would ask her doctor to discuss it with her and have her tell them that she refuses it, then make sure the doctor puts that in her records, don't assume it will make it in there. This will ensure that your sister will have no trouble because mom refused co2

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