I need help ASAP!! My mother had a stroke a year ago that took 3 months to diagnose because her symptoms were not “Classic”. Her symptoms then were loss of coordination, confusion/disorientation, severe memory/cognitive impairment & extreme blood sugar fluctuations; no physically noticeable symptoms. Doctors initially said it was sudden onset dementia caused by uncontrolled diabetes. I argued with my father/siblings to request a CT/MRI for 2 months (to the point of being pushed away). Ultimately, my dad caved & said “just go to the doctors Appt with me & you’ll see”...(please don’t judge for overstepping here). I did go to the appt & witnessed my dad downplaying all that was happening at home - so I took the opportunity to tell the doc my concerns; long story but doc finally agreed to an MRI & guess what...CVA.

Fast forward to yesterday. My father (still in denial) was determined to take mom on a cruise vacation (which everyone thought was a bad idea, but he insisted on “one last time”. He did ask my sister (an elder law attorney) & me (the only person that Mom will cooperate with) to go with them to help out.

Yesterday was travel day. Cognitively, Mom was having a great day & excited to go, so we headed to the airport. This was the most lucid I had seen her since the stroke; major status change (signal #1 to me). She walked to the car, but agreed to use a wheelchair at the airport. She even “allowed” a TSA agent to do a pat down. We got her to the airplane entrance, where she suddenly complained of severe leg pain; said she felt like she was going to pass out; began sweating & lost all function in her legs. Between myself, sister & 3 airline staff; we got her off the plane to a quiet area to be checked by paramedics- BP 134/96; blood sugar 79; she felt much better after some cookies & juice. Paramedic thought we should go to ER, but dad refused & made arrangements to get us all home. Again, she was completely lucid & had no anxiety throughout the event (to me, that was signal #2).

While waiting for our ride, My sister went to speak with airline, leaving Dad & I with Mom. Mom said she needed to go to the restroom. No family restrooms in the area, So I took her to a large stall in the women’s room...while transferring her to commode, her legs began to give out & she c/o same symptoms as earlier. Somehow, I was able to lower her to the floor (thankfully she did not fall during either event). We recalled paramedics who did not give dad a choice about going to ER.

Upon arrival - blood sugar dropped to 44; she briefly started slurring her words (doc said she was “just very tired”);. Blood sugar then jumped to 112, then back to 60, then back to 120...all in1 hour time frame - again, no one batted an eye. All bloodwork came back as normal; EKG showed minor afib (which she’s had in the past); & exam showed that she had feeling/movement in her legs; so ER wanted to discharge. I overstepped & asked if she had stood up/walked since arrival - answer “no”, so they got her up & saw the exact symptoms that brought her in + now she could not pick up her feet. (Signal #3 to me) Ultimately, ER doc admits her for “observation” & a Physical Therapy consult. I asked for imaging - Dad quickly shut me down.

SO, she is safely in a hospital this morning; & I am going back today. I am horribly fearful that she has had another stroke; but can not convince Dad, her medical POA, or my siblings to request imaging. The change in lucidity; brief slurring; loss of coordination/leg function, blood sugar fluctuation & loss of bladder/bowel control (forgot to mention that)...same symptoms she had last year. Dad refuses home health.

How can I request imaging/plead my case to hospital staff without medical POA, sounding like a “drama queen” or being the “family b****” (sorry for language but that’s what I was called last year). Dad has been in denial through all of this & medical POA is my oldest sister who will not stand up to him. WHAT CAN I DO??? HELP

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Update: nothing new on the MRI (YAY!!), but docs pulled her previous medical records because they were unaware of her full history. They believe a bad combination of medications caused her collapse & instability. Hospital doc & neurologist agreed that she had been prescribed way too much insulin & they were both “very verbal” about the negative effects of Ativan in people over age 60 (mom is 81)!! She is doing much better today & is being discharged to an acute care rehab center tomorrow. They also had a social worker meet with my father & sister & set up classes/groups to learn how to be a caregiver! So happy right now!!
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Isthisrealyreal Feb 2020
Wonderful news! Thank you for letting us know.

This is how things get sorted out, Well done!
Great news indeed.

Do come back and let us know how mom is doing and to get support for yourself during this trying time.

I hope that it shows no changes.
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Diane, great news!    And the doctor's explanation of "ruling out" is a good approach if a similar issue arises again.

Thanks for sharing, and I hope your day today is much better than it has been; same for your family!
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Thank you to all! Great advice & information. I spoke to my dad privately & he didn’t understand how an updated mri could help treatment & diagnosis; he’s wants to fix it, but denial is getting in the way. I went ahead & gave info on her history of atypical stroke to the nurse & stated my concerns...attending doc came in 20 minutes later & explained that he wanted an mri to “rule out any brain injuries”. Dad questioned it, but ultimately agreed. MRI was completed this evening, so we should have results in morning. Hoping it shows no changes, but feel better being safe.

Thank you again!!
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I would ask to speak privately to the Charge Nurse or attending physician and share your concerns.     I've done that.

I don't know the protocol for overriding someone with authority pursuant to a heath care proxy, but the medical staff, if they agree with the need for further testing or other treatment, can certainly take your father aside and explain the facts to him.   If he refuses, it would be charted, especially if he goes against medical advice ("AMA"). 

From what you write, he's not performing his responsibilities well, and is in fact negligent and interfering with your mother's health.

I believe the hospital could take legal action to take control of your mother's health and decisions, but it would depend not only on the issues but on how strongly the medical staff feel your father's resistance and noncompliance affects your mother's health.  

Your father is in denial and that could cause permanent and irreversible consequences.
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The primary question is, would whatever diagnostic imaging showed make a difference in mom's treatment?

Maybe mom, dad and POA sister have decided on palliative or hospice care. They are no longer in "fix-it" mode, which is where you seem to be (not saying that's wrong, but mom and dad may have other wishes).

Tall to them about why they are following the course they are. They may be afraid to tell you that they are no longer desirous of treatment.
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You can tell the hospital that she had a prior stroke with the same symptoms as she is displaying now.

I would be insistent that they get this diagnosed to implement proper treatment.

Personally I would be telling everyone at the hospital and going to administration and tell them that you have been through this before and what happened. Beg them to please do whatever they can to help your mom.

They may not be able to tell you anything, but your persistence could be what gets your mom the proper treatment.

So what that you are the family b. This is your mom's wellbeing that is at stake. Your dad is showing indications of lack of executive function, maybe telling the doctor that will open their ears.

I hope that someone listens and your mom gets the proper treatment.
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I see no problem in asking the Dr. to offer the test to Dad. Giving passed medical info has nothing to do with POA. Its info she already knows. No, dr cannot discuss Moms treatment with her.
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Sorry to say but other than answering questions about past medical history there really is not much you can do.
Are you listed on medical forms (HIPAA authorization) as a person that information can be given to? If not the doctors and nurses can not give you any information. You can provide information but they can not comment on it.
Unless POA is enacted your father is the spouse and he has the right to make decisions for his wife. And unless I am mistaken since your father has no cognitive problems his decisions take precedence.
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If you request a Medical Information Release form your mom will need to sign it and designate you as her representative. This form needs to be filled out for every doc, clinic (and hospital?) that is attending to her. They don't volunteer this form. This signed form naming you will allow her medical teams to freely discuss with and receive info from you, BUT I'm not sure it gives you any legal authority to medical make decisions in her best interest, UNLESS you get your mom to create a new medical PoA overriding the one that is currently in place. Also i've never had luck requesting labwork or testing unless my doc agreed with it. Others on this forum with real legal backgrounds will answer more fully. Good luck!
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