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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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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'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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I think that dying from sepsis brought on by an untreated UTI would not be a merciful ending. Something like pneumonia - sometimes called the old people's friend - is an example of a time to choose no antibiotics. I think you really have to just do your best to weigh the pros and cons of how any treatment will effect her quality of life, keeping her advanced directive in mind.
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I think you've just answered your own question in your latest post. Since at the time you hadn't seen the AD or read it, you weren't able to know the specific terms and directives. Assuming the hospital did, it presumably followed the terms.

W/o knowing the specific details of the AD, I would say generally that if an infection would be cured, it would be treated. If it was uncurable, that might be a stronger indication for hospice.

However, there's another issue. You wrote in the first part of your thread introduction that in 2001 the breast cancer was discovered to have metastasized to the bones. I am frankly totally amazed that she's survived so long with that kind of metastasis.

I would ask the doctors if any further metastasis has occurred, and if that was considered in the decision to recommend hospice. I suspect it was. And that's probably a stronger indication for hospice than a potential recurrence of the UTI. In fact the cancer may already have compromised other organs and made it more difficult to recover from the UTI.

You wrote that she's "ready to go." I would let that also be my guide; it is her life and if she's exhausted from the battle, it's time for her to find peace.

You might want to, or have a doctor, explain to your uncle the nature of metastatic cancer and how it can eventually compromise multiple systems.

The nasty fall she experienced recently makes me wonder if her entire spine has been compromised by the cancer metastasis.
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Since she is already being treated I think the ship has sailed for this round of illness, now that you have all seen her advanced directive you will be better prepared the next time. As for POA vs healthcare proxy... I assume the poa your uncle has is concerning her finances, your healthcare proxy should put you firmly in charge of all her medical decisions.
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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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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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Often times hospitals are between the rock and a hard place - the AD says no but the distraught relative at the hospital says treat. It's like the organ doaner notation on a drivers license. Be sure your loved ones are clear on your final wishes - or they may not happen.
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Her cancer has beem meticulously monitered. She began taking a iv drug in 2002 which stopped the cancer from being able to spread. The way it was explained to me before was it makes her bones like cement, which for an elderly person is a blessing. I did not however think to question any of those things. It is strange that she has fallen numerous times over the last few years...yet this is the first time she has broken anything. Thank you. I will be checking to see when her last PET scan was done (she has them annually).
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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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