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After yesterday I sure know what NOT to do. My mom had major surgery yesterday, a colostomy and debrinement of the infected pressure ulcer on her hip. My brother came up on Monday (he lives 4 hours away) to "help" us. He wanted to make all the decisions and have us deal with the consequences. He strongly was against the colostomy. He never changed her diaper, I do, I see all the fecal matter inside, sometimes outside. In the hospital, they saw feces on her bandage. That's the first strike. The anethesiologist called me to explain the risks, and they might have to intubate her for an unspecified period of time. He was just protecting himself should something go wrong. I stupidity let him talk to my brother and he was bringing up an advanced directive that I never sent in. I had to call him back to let him proceed. Then my brother went absolutely nuts on me. He wanted us to pull my mom out of the hospital when she was in pre-op. She was in the best cardiac hospital in the area. My brother kept shouting at me, "listen to me, you don't listen". My first mistake was doing what he asked and taking him to the liquor store on the way home from an early visit to see my mom. My second grevious error was letting him talk to the anethesiologist in the first place. Luckily, the surgery went well. I had to lock myself in my car to get away from him during the surgery. He almost polished off a full 1.75 liter bottle of vodka, in one day! Round 2 is coming up soon. He insists mom not go to rehab. His brilliant idea is a fentalyn patch and a shorter walker. I don't know at this point when she will be able to stand, or transfer to the wheelchair or bed. My mom is going to take a long time to heal, a shorter walker won't help. As to the fentanyl patch, she is in CHF with an unstable BP, hypoxia at times. It will kill her for sure. I'm not ready to take her back, I don't know what equipment I'll need, how to change her bag, none of those things. He left this morning and things magically fell into place. I talked to the discharge planner and asked if she could facilitate getting mom's rehab in the nursing home my niece works at. VH has a rehab unit, it's closer, my niece will be working on another floor so no conflicts. We won't be allowed to see my mom for 14 days due to Covid restrictions. It would be great to have my nieces eyes on her, possibly even to visit during the quarantine period. A Dr walked in and saw she wasn't eating. He gave us permission (more of a recommendation) to bring her anything she wants to eat. My 2 hardest problems as a caregiver were drawing out of her what she wanted to eat, and her spending all her energy messing with her depends. Thanks for listening to my tale of woe. After a few nights of rest, I feel recharged (my brother got me at at 4:30 to talk before he left). Right now I feel great, ready and raring the face the challenging times ahead.

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Who has POA to make medical decisions? That person is the ONLY person the doctors should be talking to and listening to when it comes to making decisions. Other members of the family can ask questions and voice opinion but they do not get to be the ones making decisions. It is difficult enough to coordinate care when someone other than the patient is making decisions let alone when each family member has a different opinion as to what should or should not be done.
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Whoa nelly, you’ve had one hell of a ride!

Now, I don’t know your brother, but it definitely sounds like the fear and the liquor talking. You can give yourself a good ol’ pat on the back that despite your OWN fears, you tried to make the best decisions possible for what she actually needs. Good on ya!

Remember these learning moments for next time, because with a mother with failing health, there WILL be a next time. Don’t get swept up in his fears, and DEFINITELY don’t stop at the liquor store!
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SnoopyLove Aug 2021
I think as a general principle all people should avoid taking other people to liquor stores! It won’t end well.
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CtyankeeinOR,

I joined this forum just to respond to your post. It hit close to home for me. When there is addiction there WILL be chaos. I realized recently that I have to limit association with my brother unless totally necessary. I have had peace ever since. I told him he has drinking problem and it has gotten worse. Apparently those were the magic words to keep him from harrassing. I feel free. We can deal with my father separately. He turned out to be more of a problem than father is. I wish you the best .
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CTYankeeinOR Aug 2021
Thank you so much. Wow, you joined this forum just to respond to me? I'm deeply touched. I'm going to keep him informed (he is my mom's son too), but he has no say anymore in making care decisions. I'm not sure if and when she comes home, he will be welcome here. I don't need his "help" cleaning out my liquor cabinet. I talked to my niece for about an hour. She told me what to expect in rehab, and how she will look out after her grandmother. PT will assess and push her, but not past her limits. My niece told me the rehab unit is very good where she works. My niece is already working her connections and friends. The hairdresser said she would cut and curl her hair because she likes my niece. Another mistake I made is I coddled both my mom and brother for far too long. Thanks again and peace to you.
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lost the post.
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My guess is he wants mom to be on fentanyl so he can get his hands on it too.
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SnoopyLove Aug 2021
This was my thought too, unfortunately.
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Hopefully she is going in rehab and then into placement after. You think her messing with the depends was bad wait until she starts messing with the colostomy bag.
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CTYankeeinOR Aug 2021
Thank you so much for the suggestion. I'm going to talk my CNA niece in a few minutes, I'll ask about that. My niece is coming with me for the Sunday evening visit. My niece and mom had a falling out years ago, now she is happy to see her. I plan to use every resource I have. I guess every cloud does have a silver lining, if you look hard enough for it.
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POA makes brother in charge of finances; Health Care proxy makes YOU and sis in charge of mom's treatment.

Have you read "Boundaries" by Townsend and Cloud? You need to get hold of it asap.

Your brother sounds mentally ill.
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LoopyLoo Aug 2021
(oops, double post)
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Do not ever allow a raging alcoholic to give input for critical care decisions for your mother unless he is stone cold sober at the time. His judgment would be impaired. Put up boundaries for your mother's protection and your own sanity. Who is your mother's PoA for medical? If it's you and not your brother then don't talk to him AT ALL unless he is stone cold sober. Don't allow him to converse directly with her doctors -- you are the conduit of information. Otherwise you will confuse the staff.
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CTYankeeinOR Aug 2021
Unfortunately, my brother has POA, but my sister and I are the healthcare proxies. I said I made a grevious mistake and won't do that again. He told me he stopped drinking, and even stone cold sober he is so arrogant because he was a volunteer EMT for 30 years. Guess what? my sister retired as an RT and ran a PFT lab. She's worked in hospitals most of her career. I only listen to her, I ignore what he says (that's what set him off). It was a very stressful day yesterday for all of us. Live and learn, I'm not going to repeat that mistake. I think the best thing I can do is to stay focused and positive for my mom. If not for my sister and BIL, I'd be a mess now. My brother knows not to tangle with BIL, I feared he would come over and knock him out. Not the best solution I know. Thank you for your thoughtful and caring response. Peace.
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