I am not young or untrained. I asked if it was legal. I thought or assumed that most if not all of you were probably your loved ones health POA and might know the answer. I have talked to the daughter and her family and suggested pallitive care or hospice. I'm not trying to take over nor am I condemning their feelings or wishes. My client is in a state that investigates any deaths in the home where the person hasn't been seen by a physician within 36hrs prior to death. Hospice and or pallitive care would qualify. I have license to protect. The daughter was not aware of that and doesn't want to have to deal with that at a time when she will be grieving. She has taken her mother to the Dr. And hospice is scheduled to meet with them. Thank you to all for the help it was much appreciated.
Is the mother prepared to go for medical treatments? If this is the daughters own decision rather than the mothers it would be considered elder abuse and Adult protective Services should be consulted. if you are close to the family you could do this anonymously.
Does the daughter have legal responsibility for medical decisions? Is she the healthcare POA (medical proxy?) Is the mother able to make her own decisions? Has she ever been declared incompetent by a court?
The question of "legality" might be complex.
And then there is the issue of "the right thing to do," which might not match the legal answer exactly.
Can you explain the background to this question a bit? What is your relationship to this mother/daughter pair? What do you think should happen?
Tracey, is this lady already receiving medication?
If the TIA's or related diseases have never been assessed by the lady's doctor, then I agree it's high time they were - there are things that can reduce her risk of something more serious. But if she's already being treated, then I can see the daughter's point of view that there's not a lot of point in going to the ER about a TIA - by the time anyone does a CT scan it will likely have vanished without trace.
But in any case, if the lady is of sound mind you don't need the daughter's permission to seek medical attention, the lady can agree to that herself. Have you tried asking her if she would like to see a doctor?
I don't know enough about the situation (how can any of us claim to?) to judge the daughter or her reasons for her decisions. I can't judge whether the caregiver is acting out of a sense of duty and compassion or high-and-mighty righteousness. I tend to assume that everyone is acting out of genuine concern unless there is evidence to the contrary. "Genuine concern" doesn't always translate into "doing the right thing," of course, but the right thing can be very difficult to judge and nearly impossible to judge by outsiders who don't know the full picture.
Tracey3, if you feel that what you are being asked to do -- ignore symptoms that you think should have medical attention -- goes against your principles and is unethical, then I wonder if you would be better able to live up to your own standards in a different caregiving position. You have reported the situation to the visiting nurse. You have explained your concerns to the medical POA (the daughter). Perhaps it is time to move on, having done what you can do.
I can relate hypothetically to the daughter's situation (without knowing the background) and to what NomadSE says. It can extremely difficult to make decisions for a loved one when other people don't approve of those decisions, even when you firmly believe your decisions are in the best interest of the loved one.
I knew that my husband had VERY strong feelings against prolonging his life after he developed dementia. If he were having a heart attack I think I could abide by his DNR wishes. But he had a different kind of medical emergency altogether. Do I ignore the symptoms and hope he dies? He was conscious. I was holding him. I said, "I'm going to lay you down and call 911." He said, "OK." Turned out he had a bleeding ulcer. I don't think anyone at all would have the right to judge me, whichever way I made that terribly painful decision.
Client has appointed Daughter to make medical decisions. Daughter is doing that. Caregiver is disturbed by those decisions. None of this seems worthy of name-calling, in my opinion.
I am this woman's caregiver. Her daughter has power of attorney over her health. I have told her that her mother needs to be seen by a doctor. Each episode that she has had (5 in the last week) I tell her to take her to the ER, her response is they won't do anything and puts her to bed.
If daughter won't take her, I would call an ambulance the next time this happens.without telling daughter. With TIA's there is not anything that can be done. But it might be something else.
My mom exhibited stroke symptoms, I called an ambulance, EMT's thought it was a stroke, so did doc's in ER. It wasn't it was a UTI. The first of seven over the next year.
When my Mom was having mini-strokes....the situation was quite clear.....without any followup medical remediation, there is no point to doing the tests to find out.
Yeah...you can go ahead and do I...but, insurance won't pay and Medicare won't pay. With no treatment options, no point to doing expensive tests.
Mom was already on the medication to do the best they could to control it. That is that
I will admit to not having read all the replies to this post. TIAs present the same way as a stroke but the symptoms resolve in less than 24 hours. The danger for any one is that they can evolve into major life threatening stroke. This lady is 90 and is going to die of something in the near future so heroic measures would not really achieve anything. From the description Tracy gives of the episodes I would also consider that she might be having seizures but once again so what. I would assume the daughter is acting on her mother's previously expressed wishes which is very reasonable. Tracy may not be a very experienced or untrained caregiver and feels everything possible should be done for her patient which is a very laudible sentiment. Having hospice come in would be a good idea and provide extra help and support but if the lady is being adequately cared for and does not need things like aggressive pain control it is not really necessary. Nice but not vital. Those who are not familiar with end of life care can find it hard to just let things be which seems to be what the daughter has decided and not put Mom through distressing tests like MRIs. I don't think Medicare would not approve the tests but I could be wrong. She certainly would meet the requirements. The amount of stuff they have approved for me is mind boggling and I am ten years younger and able to tolerate these procedures.
If this is the daughters own decision rather than the mothers it would be considered elder abuse and Adult protective Services should be consulted. if you are close to the family you could do this anonymously.
The question of "legality" might be complex.
And then there is the issue of "the right thing to do," which might not match the legal answer exactly.
Can you explain the background to this question a bit? What is your relationship to this mother/daughter pair? What do you think should happen?
If the TIA's or related diseases have never been assessed by the lady's doctor, then I agree it's high time they were - there are things that can reduce her risk of something more serious. But if she's already being treated, then I can see the daughter's point of view that there's not a lot of point in going to the ER about a TIA - by the time anyone does a CT scan it will likely have vanished without trace.
But in any case, if the lady is of sound mind you don't need the daughter's permission to seek medical attention, the lady can agree to that herself. Have you tried asking her if she would like to see a doctor?
Tracey3, if you feel that what you are being asked to do -- ignore symptoms that you think should have medical attention -- goes against your principles and is unethical, then I wonder if you would be better able to live up to your own standards in a different caregiving position. You have reported the situation to the visiting nurse. You have explained your concerns to the medical POA (the daughter). Perhaps it is time to move on, having done what you can do.
I can relate hypothetically to the daughter's situation (without knowing the background) and to what NomadSE says. It can extremely difficult to make decisions for a loved one when other people don't approve of those decisions, even when you firmly believe your decisions are in the best interest of the loved one.
I knew that my husband had VERY strong feelings against prolonging his life after he developed dementia. If he were having a heart attack I think I could abide by his DNR wishes. But he had a different kind of medical emergency altogether. Do I ignore the symptoms and hope he dies? He was conscious. I was holding him. I said, "I'm going to lay you down and call 911." He said, "OK." Turned out he had a bleeding ulcer. I don't think anyone at all would have the right to judge me, whichever way I made that terribly painful decision.
Client has appointed Daughter to make medical decisions. Daughter is doing that. Caregiver is disturbed by those decisions. None of this seems worthy of name-calling, in my opinion.
If you work through an agency, I would talk to the supervisor.
Have you asked the daughter if she has considered Hospice or Palliative care for her mom?
My mom exhibited stroke symptoms, I called an ambulance, EMT's thought it was a stroke, so did doc's in ER. It wasn't it was a UTI. The first of seven over the next year.
Yeah...you can go ahead and do I...but, insurance won't pay and Medicare won't pay. With no treatment options, no point to doing expensive tests.
Mom was already on the medication to do the best they could to control it. That is that
I would assume the daughter is acting on her mother's previously expressed wishes which is very reasonable.
Tracy may not be a very experienced or untrained caregiver and feels everything possible should be done for her patient which is a very laudible sentiment.
Having hospice come in would be a good idea and provide extra help and support but if the lady is being adequately cared for and does not need things like aggressive pain control it is not really necessary. Nice but not vital.
Those who are not familiar with end of life care can find it hard to just let things be which seems to be what the daughter has decided and not put Mom through distressing tests like MRIs. I don't think Medicare would not approve the tests but I could be wrong. She certainly would meet the requirements. The amount of stuff they have approved for me is mind boggling and I am ten years younger and able to tolerate these procedures.
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