Aware of advance directive but not the details. Should the hospital have even treated our grandmother in the first place?

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My Grandma is 84. She was diagnosed with breast cancer in 1999. Went under surgery and treatment only the find that on 2001 it traveled and become bone cancer in her pelvis. Since then , she has had a pacemaker put in (2004), had a knee replacement, suffers on and off aging severe bouts of vertigo, which leads to falls. Most recently Nov 26th, she suffered a horrible fall resulting in 2 broken cervical spines in her neck, and multiple fractures through the back. She is in a C spine collar and back brace currently still. She was hospitalized for a few weeks, including 10 days of intensive rehab. Became well enough to be discharged to go home. She was to go home Monday December 26th. On Friday December 23rd, we received a call from the home that they found her unresponsive and slurring words and we're calling a ambulance (original thought was a stroke). Came to be that she had a UTI. For 3 days she was delusional. We watched and waited. Christmas day, we were told to consider hospice, which was a shock since we were told by drs that it was just a infection and she should.come around in a few days. We came to find out that her Advanced Directive had no antibiotics or IV fluids on it. We were already 2 days into treatment at that time, and decided to continue forward. She is slowly coming around, but we have .outlying put her back at square one as far as rehab goes and I feel horrible. We were aware she had a AD, but unaware of such detail to it. My uncle insist that she wasn't aware either, my aunt says yes she was. I live near my grandmother and am very close with her. I KNOW that she has been ready to "let go", and now I feel that we went against her wishes. She is still not well enough to have the discussion with, and I fear it's going to happen again, sooner rather then later. My uncle says if it does we will treat again, I say no let her go. The wOman has suffered enough through her life and I know she's ready. My question is mainly, in a case such as this:
1. Should the hospital have even treated her in the first place? Her AD was on file there and we also gave then another copy again that night
2. Is a UTI severe enough means for a AD to come into play?
My uncle says no...we're all "dying", it's a infection that can easily be treated. I say yes, if it requires her to be hospitalized for treatment and rehab her AD should come into comsideration. He is the POA, so ultimately I have no "say" although we are a close family and try to make decisions as one. If and when she gets well enough to discuss this matter with a clear head, I honestly have no doubt that she would have not wanted us to do anything. I fear that he will talk.her out of it. He lives a state away and is not here to be the one taking care of her and talking to her like I do. Anyone else ever faced a issue such as this?

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If you have medical proxy, then AD should stand. I would have conversation with care team and demand they honor proxy. Let them go ahead at this point with 1st antibiotic trt but that is it. No more bags of potassium, artificial feeding, stronger antibiotics. Let grandma pass in peace as she wished. Make copies of AD and literally tape up over her bed at hospital, her home or residential care. Having on file is not enough ive learned --gotta have it visually posted so everyone that touches grandmother can see. I also carry my moms will, AD, POA on a zip drive in my purse. A good tip from others on this website.
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Last summer I had a UTI with hallucinations. I argued with my husband that I wasn't Sandra, I was our boxer dog, Sallie Mae. I ended up in an ICU unit for 7 days and another 7 days on a critical care floor. I am not as old as your grandma, but when I came around and got really alert, I didn't ever think that advance directives should have come into play. I am sure glad that my husband was there to speak for me. I am a retired nurse and we had long discussions as to what we both thought about our AD long before then. He had a long talk with the doctor and they were very sure that I could be healed of the infection without any further damage to my mind or body and that came into play with me. I am really glad that they gave me the IV antibiotics. If I had another stroke or my kidney functions had gone down, then everything would have been called off. When I got out of the hospital and fully recovered, my husband and I both tore up our advance directives after consulting with an elder care attorney and making our thoughts known to our 3 adult children. When these things get so technical that your family has a hard time knowing what you would want done and things seem so questionable, then that patient has not completely talked to the person that is to make that decision. All 3 of our adult children admitted that they could not be the one to say no to the treatments. Of the 3 kids, one is a social worker. My husband could not do it, either, so we made the decision that our death would come on God's calendar, and no one else. It is a personal choice that everyone has to make for themselves. I am a cancer survivor, also with many other health problems. Hang in there, Lorilassick, pray and meditate about this and have a long heart to heart talk with grandma when she feels a little stronger. Hugs! Sandra.
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Lorilassick, I don't think Sunnygirl was accusing YOU of ignoring her ... just surprised that the hospital acted as it did without consulting you.

POA grants authorization to handle finances and legal matters, not health issues. If Gramma chose you as her healthcare proxy, then you have the responsibility to make medical decisions when she cannot. It sounds like you know her best and will act in her best interests. If your uncle tries to interfere, tell him to ask an attorney. Your role is not an easy one, especially if your uncle disagrees with you, but it is you that Gramma trusted with this responsibility.

Are you bringing in hospice for an evaluation?
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Let me make it very clear, she was not "ignored" by her family intentionally. We were not aware that her AD had such specifics on it until 48 hours AFTER the hospital started treatment. At that point, we were told after another 24 hours she would be "cured", or at least grom the delirium part of the UTI, which she was. My question, in the original question, was that i didnt understand how the hospital was allowed to treat her with them having a copy. They did NOT come to us before treatment and say...heres what it says, what do we do. They just did. Thus leading to the 2nd part of my question, is a UTI considered a severe enough life threatening infection that her AD would even come into effect? Believe me, shes not being ignored. She, as a matter of fact was discharged this evening, to her house, under my care. I have a husband and 3 teenage boys, but this is where im at caring for her, because thats what families do. So, please, do not ever accuse me of purposely ignoring her. Im only 37, ive never had to deal with these things yet, ive reached out on here bc its seems like a caring site, not an accusational one.
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Lorrilasik, I'm not sure what more anyone needs than a written AD AND the patient telling you what they want. What's to wait and see about? People who do the rights things regarding their wishes regarding their treatment should have them followed. I've never heard of anyone being so ignored. It's very bizarre, imo. If you have questions, I'd consult with an attorney who can advise you the law in your jurisdiction.
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The first thing to consider is Gma's quality of life. From what you have described it is now very poor and filled with pain. To me that would be a good indication for bringing hospice in if Gma agrees. Treating an infection does make a patient more comfortable but does not necessarily extend life. On the other hand failure to treat does not garuntee certain death. At this point I would continue with the treatment she is recieving but if she is not responding do not get into the realm of exotic antibiotics.. Her wishes were quite clear so as always be vigilant when dealing with the medical profession and question everything.
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I'm going to suggest that you hang onto that AD and ask Grandma to have a talk with her son. And get Hospice to evaluate her WHILE she's in the hospital.
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Who signed her into the ER with permission to be treated? That person overrode the advanced directives. Now you have heard her opinion, now you call Hospice and let her talk to them. You know what she wants, now you gather the strength to carry out her wishes. Not easy, but it's what she wants.
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I spoke with my grandma briefly this afternoon. She is still not 100% "with it" but after explainimg what happend and what could have happend she very simply said, "i am not going through this again." I told her it would be revisited once she gets a little better and clearer , but im pretty confident that i knew that was her answer all along...just didnt know we had that choice. I am also very shocked that the hospital did nothing about it until we were 2 treatments in. Like i said earlier, we had the paper, just never read it entirely. They were given the paper before the first round of antibiotics were even administered.
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A while back my mother had a fall that landed her in the hospital. While mom was there it was discovered that she had cellulitis on one shin. Cellulitis is an infection of the skin that is usually easy to treat and cure but if let go it can become septic. To my surprise the doctor approached me for permission to treat using antibiotics, citing moms very specific and strict AD. I gave permission. Later, when my mother had a clear moment I asked her if I'd done the right thing. Mom said "oh yes, I meant things like "pneumonia".
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