My father is 85, very frail (99 lbs) and has been in hospice care for eight months since moving from one assisted living facility to one closer to me home.
He is unable to eat and only can grunt to talk about his needs. I was taken in recently (COVID-19 lockdown) and sat with him for over 1 1/2 hours. I watched as staff spoon fed him shake and woke him up for meals in which he wanted to sleep through.
I have his Durable POA and the Main Hospice nurse has decided with the facility doctor (not the hospice dr.) that he be taken off all drugs (he has Schizophrenia). I disagreed and they said they are doing it anyway!
He has an Advanced Directive stating basically that he does not want prolonging life saving measures to take place at the end but also states that end of life is a vegetative state.
How long can my father live this way. I know it is not what his wishes are and feel the facility and the attending (and the associated) hospice are just prolonging his life to get another monthly check.
I spoke to the Director who says he has the right to decide and doesn’t care about POA or Advanced Directive.
I worry about the uncomfortable feeding or forced drinking and did see a suspicious red circle in vein on hand. Hopefully it was blood drawn for checking and not an IV.
What can I do now with COVID-19 restrictions and having his final wishes honored?
Hospice Chaplain or Social Worker will help you deal with "your suffering". Hospice always honors final wishes.
Hospice is a separate entity that has nothing to do with the AL. I would think taking him off off these meds would make things worse for him, but then I am not a doctor. And the Hospice Nurse should not be taking orders from the ALs doctor but the Hospice doctor, I would think.
I would call the Hospice doctor and question what is going on. I would also consult with a lawyer and have him write a letter telling the Director that your POA is in effect and as such you not him makes decisions for your Dad. I would also find another Hospice agency if ur not happy with this one.
And like others have said, once Hospice takes over, the facility Dr has NO say in your fathers care, so make sure he/she steps aside and let Hospice do their job. If you're not happy with the Hospice agency your father is with, maybe it's time to switch to another. Not all agencies are created equal. You need to feel confident that your father is receiving the best possible care in his final chapter of life. You both deserve that much. Best wishes.
You could talk to the lawyer that drew up the POA and ask about taking the facility to court for violating Ethics.
Hospice generally does not do IV's
It is very easy to develop what I called a closed skin tear it is brighter red and more just under the surface of the skin than a bruise might be. This can happen if the skin is bumped even a little bit. (I used to say about my Husband, if I used the razor a bit firm he would get one, if he slightly bumped the back of his hand on the table he would get one) And a blood draw would also leave a mark.
You could also talk to Hospice about what his wishes are. Generally as soon as you are on Hospice they have you sign a POLST (not required but encouraged)
As far as stopping medications, Hospice will encourage discontinuing all medications that they feel are not necessary at the time. The Hospice nurse does not suggest taking a person off a medication if it has not been discussed with the Hospice doctor. (a Hospice nurse, unless they are an APRN can't change or prescribe medications)
Hospice holds a team meeting at least weekly where each person is discussed and medications are reviewed and recommendations are made. So the Hospice nurse is following the orders of the Hospice doctor.
You can contact Hospice and talk to the supervisor if you think your dads wishes are not being followed and discuss the ethics of that.
My dad was in hospice care at home, and I fired the first hospice agency after a couple of weeks. I inquired about a couple of things in relation to visitors coming to say goodbye to my dad, and the social worker told me "This is not about you." Excuse me?? I fired them the next day and hired another company. The change between the two companies was seamless, and to the credit of the first company (a well-known national company) they helped make it that way.
The facility doctor is treading on very dangerous legal territory, and you might remind him that your dad is not his patient any longer. He could get in enormous trouble if he persists with his attitude. Communicate with him through emails so there's a record of your conversations. Talk to the hospice doctor and ask his opinion of taking your dad off his meds. If he's close to the end, he probably doesn't need to be taking them.
I doubt the AL place gave your dad an IV -- they usually aren't certified to do that. My mom's skilled nursing facility couldn't even do IVs.
As for waking him to eat, that's ridiculous. I found hospice care to be very compassionate. Call the agency a express your concerns. Telling you "they're going to do it anyway" is unacceptable.