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?

It is February 2020... It's not locked :(

I am sorry for your loss.. This just showed up today from what I see...

Prayers are with you... Take care.

The OP’s husband has already passed away. This post is 5 months old. Time for it to be locked.

You and he need to have a serious sit down talk. It very much sounds as though he has had enough. If that is the case then if you love him you will listen to what he has to say.

The Dr saying his cancer is treatable but not curable means they can give him treatment to a point at which it will lengthen his life or put the cancer into remission but it will not go away, he will always have it and it will impact his life as it is doing, with a chance that at some point it will become untreatable and all that brings with it.

Hospice assistance is available in the home, he doesn't have to go into a specific facility as long as you and they can cope in the home with assistance available. If he is in agreement and you can get them to come and talk to you they are best equipped to give him the best standard of life available to him.

These are not decisions for you to have to struggle with alone - he needs to be open to you on his feelings. He is probably fighting to not cause you distress, but is succeeding in doing the opposite. He also may be struggling to accept his position and be one of those of us who don't want to consider paperwork as it feels like the beginning of the end - it is a pity we don't all do all necessary forms when we are fit and well, but we do tend to leave them and then they become somehow more final - hospice staff can help with helping him see what is good to put in place if he wants any wishes on his treatment taken into account.

Its hard to talk, and you have all my sympathies at such a difficult stage in your relationship, but for both your sakes you need to sit down and each say your piece and discuss.

Hugs and thoughts to you xx

This post is from August

For anybody in this situation, if the person has his own right mind they has the right to refuse treatment and that's that. If you doubt this, you can have him Baker acted for psychiatric evaluation.

What a horrible dilemma! I understand your angst!
I do not see a date on your post; I just logged on 01/13/2019. It is sometimes appropriate to refuse aggressive care, especially with a brief lifespan prediction. Doctors are trained to treat, regardless of a prognosis or age. My husband, 81, is a Palliative Care patient with PPO coverage. I know nothing about an HMO; however, a hospice will administer "comfort care" just as Palliative Care will. If you have not already, I encourage you to contact Home Hospice for a visit.

Wondering how Susie is tonight?

Sweetie - you are phenomenal.
You are going through so much and it really influences clear thinking. Thank you for reaching out for others’ perspectives. It is a good step to helping yourself.
As for your husband - it seems like he has made the decision already.
How fo you have the conversation about “the next step”? Just ask him his preference, then just listen. Your hopes are probably not his desires at this point. Pain is a ruling factor and he may not express it any other way than to refuse further help. It is his life, and his decisions will affect you, but keep focused on what he wants at this time. That is probably as far forward thinking as he can manage at this time. If possible, talk with his doctor about your concerns. His doctor cannot share any of your husbands medical info with you, but he can help settle your unanswered questions of how you can help, etc. That doctor has the inside track and may be your next best resource.

Just more reinforcement for hospice. My aunt "graduated" from hospice & went back to her daughter's home. Only to be readmitted several months later. Admission is based on the best prediction by the MD that the patient has less than 6 months to live. My sister-in-law's father was in hospice care & it was a comforting experience for all. And my mom had hospice during the last 2 weeks of her life. She made her wishes known to me months before when, moving to a new apartment in AL, she showed me the outfit she wanted to be buried in! I knew then that, after many medical problems, she was tired of the whole thing. She went into hospice after fracturing her hip & having complications. I guess my ramblings are to reassure you about hospice & that loved ones can help US thru THEIR transition. All the best to you.

Prayers for you and your husband during this most difficult time. Praying for comfort and strength.

Against Medical Advice

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

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

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

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

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.

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.

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.

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.

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

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.

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.

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.

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.

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

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.

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

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

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.

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.