Help! I'm lost. The ER last night said my husband needs to be hospitalized, but he left AMA. I don't know what to do. Do I let him die?

Does California have physician assisted suicide law?

Call hospice to get him evaluated. He certainly has the right to refuse treatment.

I’m very sorry to hear you’re going through this. It sounds extremely difficult. I don’t have any advice. As long as he is of sound mind, it’s true that he can refuse treatment. I’m sure he’s sick of hospitals. Speak with his doctor today and find out the options. *hugs*

I should demand hospice. They will ensure that he is made comfortable, and not only that but it is also part of their role to enhance his quality of life as far as possible.

So then:

EITHER he will receive the best possible comfort care while exercising his right to refuse treatment for his cancer;

OR an improvement in the care he's receiving will help restore his motivation to resume treatment, in which case he can choose to discharge himself from hospice and return to active therapies. It can't possibly be the wrong move!

Treatable not curable = we can slow the progression of the disease, we can mitigate its effects, but we can't get rid of it.

https://www.verywellhealth.com/what-is-stage-4-lung-cancer-life-expectancy-2249420


First off, big (((((((((hugs))))))))). And deep breaths.

Read the above link. Adenocarcinoma is treatable, meaning that it is life-limiting but life can be extended a bit. It sounds like DH doesn't want that.

It sounds like he wants treatment to stop and to get on with things. Making him comfortable should be the goal now, treating symptoms and not the disease.

It sounds like he would be eligible for hospice. Have you asked his doctors if he is hospice eligible? That won't give you much at home help, but it will provide some assistance and access to a social worker, chaplain and those kinds of supports.

I think you need to make a list of his day to day needs, sit down with him and figure out who is going to do what. Do you work? So who is going to prepare lunch? Get him dressed?

Do you need to hire outside help? Does he need to go to an Assisted Living facility?

Start by calling his doctors today about Hospice. He certainly made his views clear by leaving the hospital last night.

Thank you Barb. Those are all great questions. I retired in 2014 to take care of him since this is the 3rd cancer since 2011-2012 but I'm now under a doctor's care for depression from burnout now since having all the doors shut in my face what with not qualifying for Medicale for AL or NH and and spending each day with medical appts, unexpected symptoms, chemo side effects med management, etc., etc., I have scheduled an appointment this AM to demand a hospice evaluation though.

My husband had cancer for 12 years, he finally gave up and refused treatment. It was his choice, and I accepted it. His battle could not be won, we were both worn to a frazzle, it was the right decision for both of us. Sending hugs your way!

Good luck and hugs. I know that scheduling the appointment with hospice is a terribly difficult thing to do, but I think your DH is saying that this is what he wants by leaving the hospital. Having the end of life discussion is HARD, but I'm glad hospice will be able to help you through it. My heart goes out to you!!

Susi, were you able to get in touch with Hospice today?
(((Hugs)))) and know that we're all thinking about you.

I am so sorry you and your dear husband are going through this. The MD told you correctly that stage 4 cancer cannot be cured. He hopes to treat it to buy more time, but that treatment, as you and your husband are aware, can be grueling, and I can assure you that people at times die of the treatment before they do of the disease.
Have you and your husband spoken about the cancer, the stage, and what he would want the end of his life to look like. Please try to get support now from hospice personnel to put his wishes into writing, so that you can carry them out for him when he is not able.
Does he want palliative care with medications for comfort only, and in home hospice to administer pain medications? Do you believe he is ready to "go" or is he just over the treatment. If you haven't discussed any of these things in these last years of treatment it will be hard to face them down all at once, but Hospice can be very helpful.
Do you have friends or family for support in this heartbreaking time?
So many of us thinking of you now in this hard time for you both.

Saying in a caring way so please take it that way.............. Calm down. Have honest sit down discussion with husband (you may need to brace yourself for his answers) find out what he wants, and do your loving damnedest to follow his desires no matter what you would prefer. You have been together 37 years, its a long time and a loving time, but maybe his illness has become too much for him to want to carry on. In which case the hardest and most loving thing you can do is support him in his choice, contact hospice to come and visit and advise you on how you can care for him, and thank God for the time you have had together and how fortunate you are in being able to support your husband in whatever his choice(s) are.

Many prayers to you. My mom was 92. Had cancer of mouth. Had operation to remove tumor but no radiation or chemo. When she was finally in pain I called her doctor to ask for hospice. At first he refused. I had to explain we were not treating anything and she is in pain AND she is 92 why make her suffer. He finally agreed. Best thing we did . It does sound like he is ready for hospice . Just love him, read to him,show pictures of your wedding, kids etc Enjoy what time he has left.

Honestly, I would stay focused on what he wants, not on advice from hospital. They do their job, which is to "treat" the condition. Just remember that "treatment" might just keep a person alive only to become sicker and weaker and more disabled. He has had so much "treatment." It seems that he does not want more. Hugs. this is the toughest.

He grew up in a different time, men were men and he is apparently declining to give up his dignity. Just as Inkandpaper said... so he can live the last of his life in a body that’s sick and in shambles? I will say 1 word... DIGNITY. Let him have his dignity please, forcing him to continue treatments is not ok and he’s probably dying inside every time someone has to help him wipe his hiney or dress him. Let him die? No dear, let him pass with his DIGNITY. It’s about keeping him comfortable and that’s what hospice does. No more, he doesn’t want it so you’re not doing him a disservice by allowing him to go comfortably and naturally with a little help from hospice which I believe is free if he’s indigent. He’s your husband, help him stay as much the man you married till he goes. This is just my opinion, I hope you decide on how to proceed soon. Hugs from California

Hi Susie,
Just checking in to see how you are doing. We are here and care!!

A person has the right to refuse treatment if they are alert and oriented with their own cognition. If a nurse or doctor gives him medications against his will that is called assault and battery, and if they hold him against his will in hospital that is called kidnapping. The medical authorities can be charged with those crimes. Contrary to what many doctors and nurses think, insurance will still pay for AMAs due to patients' rights to refuse treatments.

The only other alternative is the Baker Act if you feel he is a danger to himself, especially if he is confused. Actually if he has documented confusion the doctor should have Baker Acted him for medical and psychiatric evaluation. If both are clear and he is of sound mind, he has the right to refuse treatment and leave the hospital. You can call 911 and let that happen, but like I said if he is of sound mind and is cleared he can indeed refuse treatment and he has that right.

He knows i ti Time to Go, love, Let him Die at Home. You have Not even Made yourself Anything Here, Dear, To entitle You to his Last Wishes, Such as HCP or POA...God bless, It is in God's hands now

As gladimhere said - call hospice. Not sure of your state, but hospice will likely do their own assessment anyway. With the HIIPA forms they can get all the medical records they need. We used them for four parents in five years.
Hospice takes over all medical care and provides supplies like wheelchairs and hospital beds. The hospice nurses we had were amazing.
If the patient decides to treat the main condition again, then hospice needs to be discontinued. It is fairly easy to jump back and forth if needed though. For example when a "miracle cure" fails.
Hospice provides care and comfort for the patient. For us it absolutely took strain off of the rest of the family so we could just concentrate on our loved ones instead of fighting doctors, appointments, and bills. We could talk about the good times rather than the hospital.

It really is the patient's right to accept or refuse treatment of he or she is mentally competent to do so. My husband accepted treatment to mitigate some symptoms of his incurable, metastatic cancer, but refused the chemo which would have prolonged his life but would have made him sicker during that extended time. I would have liked to have my husband live longer, but he is the one who would have had to endure the treatments and he had the right to refuse them. I believe I would make the same choice for myself.

They never tell us how much more suffering there will be with more treatment. Maybe he has had enough. He is dying, it seems. Not a question of living or dying. Question of how much treatment can be tolerated before dying. Some know when to stop. You suffer also in this process either way. Hope you can talk to him and accept his wishes to stop treatment. To be loving and supportive is all you can do.

A book that has been very helpful to me as a caregiver is new from Crossway and titled: Between Life and Death by Kathryn Butler, MD. I am sure it is sold on Amazon. I will say that it is written by a Christian surgeon who works in trauma and critical care. She has seen when medicine is helpful and life-giving and when the same treatment can be devastating and life-removing. There are 3 sections and a total of 13 chapters in the book, and you can easily pick and choose the ones that are most important to your needs. Part 3: Discernment at Life’s End, was very helpful to me as I recently helped my cousin whose mom—my dear aunt—92, with Alzheimers and an unrepairable fractured femur due to a fall in her AL and was hospitalized. We were able to get her on hospice and moved to a hospice house. She was given comfort measures and sweet, compassionate care. She passed peacefully several weeks ago.

Hospice has had a huge part in my family’s life. My mom who had Parkinson’s was on and off hospice several times (she improved with their care). When she developed pneumonia and I knew she was coming to the end of her life, I requested hospice and the ER doctor who diagnosed her pneumonia was kind in quickly getting hospice ordered. My dad had prostate cancer that spread to his kidney and his hip bone (probably many other places too). We had been told that my dad would have a “speedy demise” which didn’t happen for him. He chose not to go through any cancer treatments or surgery and survived with hospice care for nearly 3 years. The comfort measures at the his life’s end were truly a blessing for him and for us as we sat with him.

I pray that you and your husband will have a great hospice team to come beside you and help you at the most difficult “life-test” the two of you will ever face.

He may have decided that the time of being poked & prodded is over - there is an old saying 'he turned his face to the wall' in other words he has no more wish to live like this - extending life isn't always the best thing for the person rather it is so others don't feel bad that they suffer on - prepare yourself & take what his wants are into account

I don’t have direct experience but I have heard again and again that hospice, with its nurturing, palliative measures, can be more life-prolonging than the usual medical interventions. It certainly offers more support for loved ones. Peace to you and your beloved husband.

Better be contacting an attorney that specializes in emergency guardianship.  That AMA will not be paid for by your insurance company.  Get control NOW and the attorney can help you with this.  Also, join a support group just to have people that you can see and speak with rather than unknown people in the internet world.

Just sending my best wishes to you and your DH, Susie. My mom left the hospital AMA when she had cancer, but she was already enrolled in hospice when it happened. (She collapsed suddenly due to a UTI that had become septic, and she was admitted to the hospital, but after 24 hours she refused to continue receiving IV antibiotics and the constant poking and prodding in the hospital). I didn't know for sure if she was going home to die, and neither did she. We just took it one step at a time. Since she was immobile, we brought in a hospital bed, and hospice workers came to check her vitals and to bathe her every day or two. After a few days it became clear that she was entering the dying phase.

I'm glad you now have hospice because an in-home caregiver needs the moral support as well as the physical help with bathing, changing linens, etc. May your husband's passing be as easy and peaceful as possible, for both of you.

I hear your heart breaking. You want the best care for him and he seems to "not" want this. You need to have a heart to heart talk with your hubby with maybe somebody from his care team present.

Ask your husband
What does he want his life to look like in spite of all the medical problems?
What kind of palliative care would he and you be comfortable with?
What kinds of care would his cancer treatment require and how would this impact his life: pain, loss of energy, loss of appetite...?
How does your husband want to live and die with dignity?
Tell your husband
What scares you about his current condition.
What you need to feel more comfortable with his life decisions.

Try to formulate a plan together that honors his wishes and alleviates your anxiety. Ultimately, your husband has the right to reject treatments that he sees are not according to his wishes. He needs to know that you want to know what his wishes are.

😐I don’t have an answer for you but want you to know my heart aches for you.
Prayers
eloise

Susie I'm very glad you have Hospice on board. Let us know how you and DH are doing. We care!

susiencalif: Now that you have Hospice, please let us know how you and DH are doing. Praying for you.

Will someone please explain what AMA is??????????????????????

Against Medical Advice