Recently, my mother was diagnosed with a Gleoblastoma (Cancerous Brain Tumor). There where no signs that this even existed up until 2 weeks until we found out. She was life-flighted to a Neurosurgeon in a nearby town, about 120 miles away. They did an MRI and found out that it was one of the biggest tumors that they had seen yet. She got surgery, but they where not able to extract all of the tumor. They would have been cutting into healthy brain tissue other wise. Well, after the surgery she was doing very good but had some short term memory problems, and right side peristalsis because the tumor was on the left side. After the surgery they where going to send her to a rehabilitation center in the area with intense physical therapy, but my mom decided to come back where we live and go into a nursing home/Rehab center. She was doing good for a longtime, getting stronger, and they even had her walking about 20 feet. She was doing radiation and chemo therapy, and things seem to be going well. Well, after this course of treatment she had a 3 week break from the chemo because they said that they had to do this because they had to give her time to recover from it, so they could re-start the chemo a different way. She was taking the drug called Temadore, very rough on the system. Well, she had went back for another MRI to see how things were going and they were not going well at all. The tumor had come back, and it was larger than it was before, so they were going to recommend hospice. Now here is where it gets tricky. My mom's advanced directive was a full code, that means to Resuscitate her and do CPR if necessary, and to put in a feeding tube in her. Well, when my mom was awake I had talked to her and I told her that she had a full code on her, she asked me what that was and I told her. I then asked her if she wanted a feeding tube if she could not eat, she thought about it and said no, then I asked her that if her heart stopped if she wanted them to do CPR she then again thought about it and said no, then I asked her if she wanted me to change her advanced directive to a do not Resuscitate, she told me yes, and said no more pain. So I did so, but before doing so, they did not explain fully what I had changed this to. They did not tell me that they would not put in a feeding tube, they would take away all food and drink once it became more difficult to eat, and take away all medication while she could not swallow. They could have in my opinion explained all of this that way I could have changed it back to a full code with a feeding tube. Then when we finally did decide to have a feeding tube put in, they said it was too late, the dying process had already started. I told them that we had wanted a feeding tube put in, and they ignored a full medical power of attorney. Not only that, they never got my permission to put an NPO on her (No Food or Water) they did not notify me that they where going to do this. I would have objected, and told them to once again get a feeding tube into her. That is not all, my mother had a very massive seizure at 6:00am Sunday morning, and we did not know about it until 10:00am that morning, they had all of our phone numbers and should have called us immediately. The NPO is how they murdered our mother, because they took her off of all food, medication, and drink. And like I said earlier, they should have informed us about what this, and a DNR meant. If there are any attorneys or people that know attorneys please let me know if you think we have a case, and other people of this forum, please let us know what you think. Word to the wide, do not get a DNR because this is what they will do to you. Any help in letting my know if you think that we have a case where we can sue this nursing home please let me know. I want to contact an attorney before 180 day's that is what it is in the state of Montana. Any help, or advice would be appreciated.

Trap, I'm sorry for your loss. For what it's worth, my brother died at 43 from glioblastoma. He had chemo and radiation but was not a candidate for surgery, and he lived approximately one year after his diagnosis. He spent his final weeks in a very nice hospice facility - his choice because he had small children at home and didn't want to burden his wife. I never saw him awake at all during his final weeks, he wasn't eating or drinking but I'm certain he wasn't craving food or drink. Heroic measures like IV's, feeding tubes and CPR/defibrillators would not have prolonged his life, at least not by more than days. I have researched this extensively and I can assure you that these measures CAUSE pain and suffering, they do not alleviate it. God - or nature - is merciful in that way, the dying are focused elsewhere and the body no longer wants what it has no use for.
Helpful Answer (24)
Reply to cwillie

And telling them heck no would have brought suffering to your mother. And now you would be blaming them for not describing in detail what would happen when they followed your "heck no" decision.

Since you were named as full medical power of attorney, do you think that perhaps you had some responsibility for finding out about end-of-life options, long before this came up?

And BTW full medical power of attorney ONLY applies if the principal cannot speak for herself. If the medical staff asked her the questions you asked her and she gave them the same answers that she gave you, those are the decisions they had to follow. Even with medical POA, you could not override your mother's decisions unless she was clearly incompetent (delirious, for example.)

Your mom died from a hideous disease. No medical intervention could have prevented that. You feel hideous about this. You feel that there should have been a way to intervene. There wasn't. I think you might find more comfort in seeing a therapist than in seeing a lawyer.
Helpful Answer (23)
Reply to jeannegibbs

Trap, Im so terribly sorry for your loss.

A very aggressive cancer killed your mom. Your mom wisely told you " No feeding tube, no code, no more pain".

Feeding a dying patient causes more, not less pain. You did the right things; you did as your mom asked.

I hope you can find peace.
Helpful Answer (22)
Reply to BarbBrooklyn

In 20 years of working in healthcare I have seen elderly patients who are full code and I have seen them go into cardiac arrest. It is the most barbaric and gruesome thing I have ever seen. Taking paddles to their bony chests with their thin skin, getting burned by the paddles because their skin is so thin. And if CPR is done ribs will break and puncture a lung as a result. The person is much worse off after being coded than prior to the code. In healthcare we call it "flogging". It's a spectacle and I can't imagine any elderly person who would want that done to their body. It's violent and shocking.

However, people have the right to choose this if they're competent enough to do so. These procedures should be explained and explained and explained until everyone understands 100% what it entails. And by the same token, a DNR should be explained and explained and explained until all involved understand what DNR means.

I'm very sorry about the loss of your mom. If you wish to pursue litigation you'll need a malpractice attorney. The attorney will be able to tell you if you have a case or not.
Helpful Answer (22)
Reply to Eyerishlass

I worked in a hospital as a ward secretary and one late night I witnessed a full code response on an elderly woman. I vowed that night to never have that done to anyone I love. There were so many people in the room, which was blazing with light. Pounding on the poor woman's chest. It was horrible. That was over 20 years ago and I remember it like it was yesterday.

I agree with the others who say a very aggressive form of cancer killed your beloved mom. She was ready to go when she said no feeding tube, no resuscitation, no more pain. I had my mom on hospice for a week and near the end, she didn't want any food or liquid. Her body was shutting down and didn't need it or want it. It's hard to accept, but it's a part of the circle of life. We'll all be there someday.

I personally think you should concentrate on grieving and let your mom rest in peace without pursuing a malpractice lawsuit.
Helpful Answer (21)
Reply to blannie

Here is an update on what action will be taken with this nursing home. I was just very dissatisfied with them because of the way that they had treated my mom, and use when everything was going well and she was not in that terminal stage. Before she was terminal, the nurses where not treating us right, nor where they treating my mother right, and I called them on a lot of their B.S. But, that was not the only reason I was mad, it was because the blatantly ignored the power of attorney (In my opinion) the reason we have decided not to file a lawsuit now is because my mother said that she did not want us to sue them. There was discussion about it, but I am going to go with her wishes and try to heal from this. I still miss my mom so very much though. I find myself crying out in public, at my house and other peoples house. I found myself crying today because of that tumor that she had, it made her so she had forgotten how to read, and even how to use the cell phone so she could even contact us. It almost mimicked Alzheimer Disease, the tumor was so big that it was pressing her brain to one side of her skull. This was a terrible thing to watch. So please don't be too hard on me for the other post that I left, I was upset very much and almost not in my right mind. Grieving, you are right, I am grieving hard core. It is going to take a very long time to be able to move on, that is because I was my mothers caretaker for the last 6 years and nine month's.
Helpful Answer (20)
Reply to trapwhisk

"The tumor had come back, and it was larger than it was before, so they were going to recommend hospice. Now here is where it gets tricky. My mom's advanced directive was a full code, that means to Resuscitate her and do CPR if necessary, and to put in a feeding tube in her. Well, when my mom was awake I had talked to her and I told her that she had a full code on her, she asked me what that was and I told her. I then asked her if she wanted a feeding tube if she could not eat, she thought about it and said no, then I asked her that if her heart stopped if she wanted them to do CPR she then again thought about it and said no, then I asked her if she wanted me to change her advanced directive to a do not Resuscitate, she told me yes, and said no more pain. "

They were going to recommend Hospice. Tumor came back, larger than before. Mom said " no" to further interventions. You asked if she wanted a Do Not Resussitate order and she said " yes".

It seems to me that what happened is that your mother was allowed to die on her own terms. She made a choice not to pursue heroic measures which were only going to prolong the pain. Hospice was recommended because the cancer she had was incurable.

Please read the Gawande book, recommended by Surprise. And be comforted by your good memories of your mom.
Helpful Answer (18)
Reply to BarbBrooklyn

Atul Gwande's book, Being Mortal, goes into all the end of life issues, including the brutality of a total code on a dying cancer patient. Since the author is an accomplished MD, you might want to read the book before approaching an attorney. Any judge looking at your case will have this information. A bad malpractice attorney will ignore the book's info and try to get you to pay him out of pocket, knowing you don't have a strong case.

The book is important for all of us to read as we confront death and prepare our own advanced directives.
Helpful Answer (17)
Reply to surprise

I'm very sorry for your loss. It is still too fresh in your mind and heart right now.

Your mother had a terrible form of cancer. She was not going to live much longer, no matter what they did, treatment wise. SHE made the changes to her DNR, and you have nothing to be sorry for.

Trying to sue an NH for doing exactly what they told you they would do (and a sad lesson learned for you that DNR's can look scary to the uninitiated) your mom CHOSE this.

A dying person who isn't eating or drinking? That is part of the body shutting down, and it's PAINFUL to eat or drink.

Was your mother receiving pain meds? If so, she was not in pain.

I'm very sorry for your loss--but ask yourself..WHY would you have changed her DNR back to full code and feeding tube? To prolong an already terminal life? THAT is cruel.

Right now you are in full grief mode. Please don't focus so much on getting is very unlikely that you have a lawsuit on your hands, and really, do you want to go down that path? It's horrible. It won't bring your mother back and it will rob you of any peace.
Helpful Answer (17)
Reply to Midkid58

I would like to extend my heartfelt condolences on the passing of your mother. The pain you are suffering is horrible. We've all lost a loved one to very bad diseases. Their deaths seem untimely but everything is in the Lord's timing.

I have been a nurse for 39 years. I have been on hundreds of Code Blue's (when you resuscitate the patient). It doesn't look like its portrayed on TV. I have had doctors try to intubate (put in a breathing tube) to have it accidentally pass into the esophagus (food tube to the stomach) instead of the trachea (breathing tube to the lungs). The stomach inflates with air and everything the person ate comes spewing out like Mount St. Helens.
I've seen ribs shatter, puncturing lungs or other vital organs, the nurses can't find usable veins so the patient is poked multiple times with a large bore IV to try to give blood or IV liquids. I've seen defibrillator paddles burn the fragile chest skin. This is brutal stuff. It's like a war zone in the ER.
IF the patient makes it, they are whisked off to ICU with more painful procedures. Many wish to die to escape the "hope" of staying alive!!

There is a pink DNR form that specifically spells out what is entailed. You are EXPECTED to read it before you sign it. That task is given to the patient themselves providing they are of sound mind. Even a medical POA can not override the patient's wishes if they are alert. They are supposed to be a spokesman for the patient IF they can't talk.

Your mother chose what she wanted to happen.

When the body shuts down in preparation to die, it rejects food and fluids. My dad had a feeding tube after a stroke left him without the ability to swallow. Then came another 2 disastrous strokes. The liquid food in the feeding tube wouldn't absorb into his GI tract. It just sat in the stomach. To force in more food would have blown up the stomach! The only conclusion was to withhold food and water orally (he would have aspirated and died of aspiration pneumonia) and withhold food from the G tube (blow up the stomach). There are no other options left except to let God intervene and take them to Heaven. As much as I wanted him alive, at that point, it wasn't up to me (the medical POA) anymore. Nor was there ANYTHING you could have done.

Calling you in 1 or 4 hours after a huge seizure really is of no consequence. YOU could not have done anything (except pray). Do you understand how much work goes into stabilizing a seizing patient? They weren't going to pick up the phone while trying to start an IV, run to the pharmacy to get emergency anti seizure drugs, taking vitals every 5 minutes, making sure she didn't bite her tongue (off), possibly cleaning up urine or stool that is let loose during a seizure, getting the lab to do blood tests, possibly off to a CT scan, dictating to the chart what just happened so other doctors can know, transporting her to ICU, etc., etc.
You really have no idea what's involved.

Let your emotions calm down, grieve, mourn and consult a lawyer if you really believe there was foul play. Most probably you will not have a case.
I'm sorry. In time, you will
see that there was no other outcome to be had.
Helpful Answer (16)
Reply to SueC1957

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