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Mom wants care when she's ok, but when her CO2 levels rise and she's angry and sends them away only to go later when she's critically ill.She wants care when she is well, but refuses to put a dpoa in place because she thinks we'll lock her up in a home! She's always been angry but now she's more demanding and suspicious. she cannot seem to understand a need for a plan for her care either so we have these emergencies that cause havoc for 2 kids (other 2 live out of state.). One gets it but the other just seems to want to be done with her. I need to know how to get her to the hospital when she's getting sick. All the dpoa that I read said when she can't make choices for herself. She can function on co2 at 125!!!!

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Your mom clearly has end stage COPD. She has survived many near misses so she feels that she can survive many more. Hence the agitation while she suffocates. The high CO2 makes her sleepy and low oxygen impairs judgement. It is time for hospice but I suspect she will resist. Her desire to manipulate is because it takes her so much effort to move around.
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Well, I would just back away completely from her. The other siblings are there to help her, let them.

Tell them that Mom has been very clear about one thing at least...she doesn't want you involved with her care. So, after all the anguish, you need to concede to the only wish she has made clear to you.
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It sounds like in addition to lung disease your mother has some mental health issues. Could she have dementia? In dementia what appears as manipulation comes from fear, confusion, and desperation.

Could you talk to her doctors about Mom's mental health? Perhaps some screening for that would be appropriate the next time she is hospitalized.

If your mother would give you medical POA you would have authority to make decisions about her health when she could not, including sending her to the hospital.

Having Guardianship would authorize you to make all decisions for her. But that would involve having her declared incompetent and if any of your sibs objects to you being guardian that would be an obstacle. Then the court might appoint an outsider to be her guardian.
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She has stated very clearly that she wants care and what type of care she desires- bipap, no vent. We talked about it a week ago and the impact of her behavior in that state. She would not commit to an agreement or plan at that time.she has in the past but ems won't take her. She nearly died two times in the car so I won't take her in my car now.

While she did tell us what she wanted for her care then, She is much more confused. This started a day or so before the coversation. She can't stay on track in a. Conversation. She ties unrelated events together and gets angry when anyone disagrees. Also now forgets recent things. There is certainly a decline in her thinking but she now she's super manipulative for what that's worth. Everything is an argument with her now too and that's where the anger comes from. My husband says she's always had one emotion -we just see it all the time.

She lives nearby and my sister and I both help her. My sister does a lot more for her and my mom easily manipulates her into doing almost anything. My mom shows her anger and sister caves. I actively work to set boundaries and it makes me the bad guy to all my siblings, thanks to my mom's bad mouthing me.

My mom has had COPD for 12 years with countless vents, hospitalizations and I have been there for all but one. She's become increasingly more difficult to deal w trying to get her to the hospital and getting her to stay there. She acts out verbally toward nurse and doctors. Drs admit they have caved because she's so difficult.
I'm the bad guy cause I won't cave to her but I am powerless to make her come up w a plan. I told her it's too difficult to be her medical advocate because she won't do the paperwork and she treats me so badly while she's in the hospital along w what she says to my siblings. I know they are lies but they don't!. I am rambling here!

I have no idea how to get the authority to get her care when she gets sick and her personality becomes so extreme.
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How is she when she is not confused? Is her cognitive status fairly normal? When you talk to her in a relaxed state of mind does she agree that she needs treatment when these episodes occur?

Is your mother on oxygen? Has that been suggested for her? How is her lung disease being treated? Has her doctor suggested any steps she/you can take when C02 levels rise to get it under control at home? Do you have clear instructions on when she needs to go to the ER? Yup. You need a treatment plan! Perhaps if she agrees to a written treatment plan when she is well, specifying when paramedics will be called, she would be more cooperative in an emergency. (And perhaps not. It might be worth a try.)

Do you live together? Or does she call you when she has these episodes?

What do you mean that she's always been angry? This could indicate a mental health issue. I wonder if an evaluation and treatment for that might her be more calm.
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