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My Mother is POA and my father has stage 4 cancer and has done 3 rounds of chemo. Has lived with cancer for 2 years. He was in the hospital because of a related brain issue. The hospital had to discharge after a month and we found a care facility. He is going to do sub acute rehab. My Mother hopes to have him strong enough to try a new immunotherapy treatment recently FDA approved. My father can barely sit. Soils himself, can't feed himself, and is racked with pain from the cancer. We (siblings) have said perhaps it is time for Home Hospice. To keep him comfortable and ease his pain. My mother is in denial saying that she hopes that he gains his strength and will be able to do the treatment. But the siblings want Father to have some quality of life, however much is left. Mother is saying she is waiting on the Drs to tell what to do. The thing is they gave them two options to continue or stop. We even had a conference call with the Doctors who kindly took time out on a Sunday Morning to do so. She said she doesn't remember. I don't know what to do. She says she doesn't want to give up on Father, we don't want to but the siblings don't want him to suffer needlessly. Is there anything the siblings (all adults ) can do IF we fear Mother is putting Father needlessly in pain, thinking she is doing if for the best intentions?

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BTW I can't edit my original post. The immunotherapy would extend his life 3-4 months in his current state. Would not "improve". More of a stopgap.
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What does your dad want? Is he competent to express his wishes? Unless he is unable to express them, POA does not get to be the decision maker.
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Does your dad have any kind of living will or advance care directive about his wishes for his end of life care? Is there a friend or a pastor who could talk to your mom about coming to terms with what his happening, since it sounds like she's not listening to you children?

And yes, what does your father say in all of this? Is he at all able to make his wishes known? I feel for all of you - it's a tough situation to go through. If the best hope with the experimental treatment is an additional three months and he's in terrible pain now, I don't see how it makes sense to prolong the inevitable.
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P.S. You can bring in hospice and if he improves, they will leave. That's not going to happen, but you can tell your mom that many people recover enough to go off hospice (which is true). The hospice people can work with her to accept what is going on.
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He is somewhat cognisant at times. Other times confused. Simple questions are answered but the answers make no sense in relation to the question. It's very tense, when our hand was forced to look for a care facility and we just wanted to bring Father home. She did say she "was the POA and her she will make the deicision" I don understand she would be the one at home taking care of him. BUT my spouse and I and siblings are there at the facility taking care of him and changing him when he needs his undergarment changed. As for a living will the problem is we advised him and Mom when this all started to please get it all in writing, I even suggested a local attorney to write up a living will. We never heard if they went through with it. You all are right we need to ask him directly while he is able to reply.
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You MUST do whatever you have to so that your dad is kept relatively pain free. He doesn't have to be on hospice for that to happen. If the doc says he/she can't prescribe enough of the good stuff unless he's on hospice? Then you MUST move on your mom if she blocks it. Whatever it takes.

Just imagine being in intractable pain 24 hours a day. Tell your mom she is being cruel. That you will take better care of her than she is taking care of your dad. Whatever it takes.
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I doubt that your mother can give up on your father; it takes a tremendous and agonizing effort to recognize that further treatment isn't going to be beneficial, as well as tremendous will power to make the decision not to continue treatment.

It's very difficult to accept that further "treatment" will not in fact change anything, and could in fact prolong the agony. But I think it's human nature to want to try whatever might alter the course of the cancer.

You might ask the doctors about the new immunotherapy treatment, its success, and the probably of changing anything for your father. If it doesn't provide either but also isn't able to ameliorate his suffering, it doesn't seem like a good option.

I agree though that what your father wants is important. It doesn't seem as though he has any quality of life now.

A close friend offered a very beneficial way of viewing end of life decisions. When the cancer can't be cured, or if additional treatment only prolongs life but doesn't improve it, the family's decision to discontinue treatment is an emotional challenge, but also allows the loved one to avoid continued pain, agony and suffering.

That's the key issue: when the end is inevitable, you save your father from more misery and pain.

I wish you and your family peace as you face this very difficult and emotional issue.
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I guess I didn't answer the question re what Father wants. We asked him in a moment of clarity and he did say " I don't know"
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Try to talk to you father about his wishes with the social worker or doctor present. When you ask of course he is going to say "I don't know", he doesn't want to die, but he doesn't want to suffer either, and he must be aware of the conflict in the family so he doesn't want to pick sides and further the rift.
The health care team are used to talking about DNR's and such with patients, and they can present the options to him realistically. "If this happens, do you want A or B, and if that happens should we do C or D", specific to his needs and diagnosis. I expect a hospice provider would be versed in this as well.
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Origin, your mother is not about to hand over any control to you. I know this is agonizing, but you have to step back unless she is showing some signs of dementia herself. If you bring in Hospice now, while she is against it, she will call you a murderer for a long long time. Like forever. Sending prayers for all of you.
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Origin, my instinct - no more than that - is that if your father could bear no more treatment he wouldn't have said "I don't know." He would have said "stop." He may yet do that.

You could perhaps put it to your mother that he must be allowed the option of admitting defeat and not forced to be heroic. The imperative of "not giving up" can cut both ways - she doesn't want to give up on him, he doesn't want to give in while she still needs him. Their situation is heart-rending, and must be agonising for all of you to witness. I'm so sorry for it.

But Pam is right, and I'd add to it that in the pain that she's going through your mother might naturally latch on to anyone who was remotely blameworthy for the sake of simply releasing emotional tension. Keep your heads down, whatever you do.
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Well we had to take him to ER from the care facility. There he has been diagnosed with pneumonia. Ironically the attending oncologist is a former classmate from hs. We spoke and he def said father is not a candidate for continued treatment. Of course when the oncologist came mother wasnt present. We will tell her of the recent evaluations. Now it isn't a choice but a def answer of course of action. I want Father home. That's all he's been asking for the past week. He said " I just want to go home" It's frustrating. I hope now that we received the lastest news. We can finally move on to making him more comfortable in familiar space and have him ease his mind.
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Even if mom still insists on the immunotherapy and no hospice - and I'm hoping it's not standard chemo that will only make him feel worse - you should be able to insist on better pain management, and absolutely get him home. Mom is scared of being a widow, and scared of the grief, too scared to think it though and come to grips with what's really best for dad, but all you can do personally is be there for her and let her know you will be there before, during and after for her in any way you realistically can. Maybe the SW attached to the oncology service would spend some more quality time with her too on this.
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I called in hospice for my husband. It was a very, very difficult thing to do. I did not consider it giving up on him. but trying to make the inevitable less gruesome. He died in our bedroom, holding my hand.

My sisters and I put Mom on hospice, in her care facility. After a few months she "graduated out" of the program. She had gotten much better (thanks in part, we think, to the extra care and attention of hospice.) So telling your mother that hospice will bow out if Dad gets stronger is the truth. (It's the "if" that is not realistic.)

I hope Dad can go home. I hope hospice can be involved. Even if it does nothing for Dad that couldn't be done without hospice, it can be such a comfort to your mother and to all of you, gently preparing her for the inevitable.

She is in charge. Don't try to force anything. But it sure would be wonderful if she can accept the help of hospice at this time.
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Origincyclist, how did your mom take the news that your dad is no longer a candidate for the treatment?
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Origincyclist, we were in the same boat with my parents, Mom refused to sign the DNR, and thankfully in the end, she didn't have to, the Pneumonia took him peacefully, thank God. At nearly 60 year's together, it must be an agonizing decision, and hopefully your Mom will come to understand that it is now about quality vs quantity of life, and keeping him as comfortable and pain free as possible. Just continue to show her that you all will be there with her now and forever! Prayers and hugs to you and your family! Stacey B
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Thank you to all. For all the answers. Any procedures they would do would be too much for his condition. He's coming home. We are making plans for hospice. Father is saying "Let's go!!" Very animated in a good way. I'm happy he will be more comfortable without another scan,mri,ct he wants a bonfire in back yard. Thank you. What ever time we have left we want to be together.
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Origincyclist, I am so glad Dad is getting his wish!

Do pop in once in a while to give us an update. My heart goes out to your mother. Hug her for me, please.
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I think she is finally coming to the conclusion of accepting it. She wants to know the results of the thoracentesis if it's cancerous. But I let her just ask. siblings were just saying what is the point, to me since we know his cancer is wide spread. We just went to a funeral home to make arrangements according to Father's wises. Meeting soon with hospice coordinator. I am scared for Mother. But we will be here for her. I just got her a new laptop to deal with the inevitable paperwork,etc after Father dies. They have had a desktop since the early 2000's. Will need to help her with that in my own way.
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Can your father speak for himself? I am does he have his wits yet? My mother is dying with heart failure to due her main heart valve being clogged, renal failure and recently diagnosed with lung cancer 1.5 months ago during a work up to unclog her heart valve. Needless to say she didnt get the procedure. It went from that to you have lung cancer and there is nothing we can do all in a day. She is receiving hospice care at home. My point is the docs asked her what she would like to do. Despite what my father (her husband), and primarily me telling her well maybe you could try to have the heart surgury. She wanted quality of life for her time left here verses quantity if she would have even made it through the heart surgury. It was/is very difficult for me, my father and everyone to have to accept that there is nothing being done and that it is a waiting game. Ultimately this was her decision and we hd/have to accept and respect her choice. If your father has his wits and is able to speak for himself ask him what he wants. Take care, I know this is difficult.
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He took a turn for the worse this the past two days. Spoke to Pallative care Dr at hospital he is to fragile condition to be moved even by ambulance. He cannot go home even if we want to. We are now being moved to he Hospice wing. It's not what we wanted or planned. At this point we can't turn back now.
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My mom's on hospice. They are a great help effort-wise. Mom gets an extra bath, they wash her hair. The pastor visits. Music therapy visits. The nurse visits a couple times a week in addition to the normal care she already gets. The social worker is there for ME.

I can't say enough good things about hospice. Death will come when it will and there is nothing your mom can do to stop it. Why deny a man comfort measures and kind people's care in the meantime?
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Please have your mother read "Being Mortal" (Medicine and What Matters in the End) by Dr. Atul Gawande. It may help her understand that everything can't be cured and that hospice can help provide quality of life and pain control.
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Just a FYI he is now on Hospice but at the hospital. He is too frail to move.
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How is your mother handing this development?

I wish you and your family peace as well as the consolation that you've done as much as you could for your father. And I hope that your mother is able to find some relief for her emotional pain, with the knowledge that hospice will address your father's comfort and pain issues.
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Origincyclist: Since your mother is in denial and won't listen to family members, try a social worker. Your father will die. The golden years are anything but, sadly.
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Origin, good thoughts and prayers your way. I hope they can keep Dad happy and comfortable and give you support too.
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Father died peacefully with all who loved him so dearly around him. We knew it was coming and dreaded it. But now it is done. We had the wake and funeral last week and many came out to honor him. I truly thank you all for your input.
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Bringing in Hospice is a good idea. Is your father able to make decisions for himself? Does he have a Health Care Proxy in place? If so, hopefully he has addressed what his wishes would be when he came to a point where he has little or no quality of life. If you pose to your mother that keeping him out of pain is the best thing for him, maybe he will regain some strength.
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Origincyclist, I'm sorry for you and your family's loss, but hope that each of you were able to express your love for him during the last final days. And I hope that you and your family are able to comfort your mother, as from your previous posts, this was a really difficult experience for her to accept that his life was ending.

I wish your family peace and only the most pleasant thoughts as you remember your father.

GBlackwell, if you read the post immediately above yours, you'll realize that Origincyclist's father has already died. The issues you raised are moot.
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