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Mother has multiple brain tumors and has declined. She can't hold a meaningful conversation or make decisions. I am an RN and her POA for healthcare. She has lived with a man in his house for several years. He is in denial about her declining health and is very adamant that we don't bring in hospice care. My sister and I are not physically able to care for her. He insists that she isn't that bad. He insists that she is not having pain. Do I have the right to force hospice or to put her in an inpatient hospice?

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I already posted but wanted to add a few more thoughts. Your mom’s feelings are influenced by her partner. The fact that she was upset when he was upset about his experience with hospice for his dad shows me that she isn’t truly independent. She may not be able to separate her feelings from his.

There are things that may bother my husband and it won’t effect me. The same with him. Something could bother me and it does not effect him.

We care about each other’s feelings but we are capable of making our own decisions. While we are a couple we respect each other as individuals.

So, he doesn’t want her to have hospice because his dad had a bad experience. She doesn’t have to go along with that and she has. I was wondering if you ever spoke to her without him. I think that’s important. I still feel since you have accepted the medical power of attorney for your mom that it is in her best interest to have hospice.

You have said that you, nor your sister can care for her so in reality why should she even be offered a choice. She gave you the authority to do what is best. So, she may be relieved if you state calmly and in a reassuring way that you are preparing for her to receive the best care for her needs. Why should she suffer because of her partner’s desire to follow his ideas? She deserves medical care that is best suited for her needs and not according to her partner’s past experiences with his father’s experience with hospice.
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Does your Mom currently express her wishes? Is she able to make her wishes clear? Did she recently make them clear? I think it is what she would wish, and what would keep her pain free and in good care that is important here. Only that.
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When my MIL went on hospice, her boyfriend was her caregiver. That was their choice. And he was not at all supportive and did not want hospice at all. I don’t know your family’s situation and how well you all get along with your mothers boyfriend/partner/whoever but I cannot recommend allowing him to be her primary caregiver if he is unsupportive and against hospice. If at all possible, I would have someone else take care the role of caregiver. My MIL suffered a lot, more than she should have, because her partner had her convinced that the morphine & Ativan would kill her. She had pulmonary fibrosis and she was never in any pain but she was on a high level of oxygen and had difficulty breathing and unfortunately one of her end of life symptoms was anxiety. And since he refused to give her the medication, she suffered through it. My SIL did get her to start taking the Ativan toward the end but unfortunately she couldn’t be there regularly and MILs partner wouldn’t even offer it to her when she had an episode. And he would tell us things like “she had a real rough night last night” because of her breathing, she struggled to breath. And we would ask him if he gave her any of her meds and he would say nope! He just sat and held her hand while she suffered! It was awful, it was heartbreaking, it caused me personally a lot of emotional distress, it put me in a bad position, it put my husband in a bad position and worst of all, my MIL suffered needlessly! My first through when I was read your post was wow I can relate and you really need to remove this man from the situation. My MIL wanted to die at home too so there was little we could do.
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NeedHelpWithMom Feb 2020
Cali, what a tragic situation. Great advice for the poster.

Your MIL deserved better! You and your husband deserved better. He was not trustworthy, simple as that.
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Have you spoken with your moms oncologist to see what prognosis he/she offers? If she has brain tumors and shes having trouble communicating and is so weak she cant stand up to shower, then yes, its time for hospice. She will receive the care she needs. I have personal experience with hospice, both in a personal and professional setting. I cant say enough about the care my husband received while on hospice during his battle with pancreatic cancer.
and i have to ask....if her caregiver/boyfriend is refusing help for her, do you believe him when he states she is not in pain?? I sure dont, not for one minute...,
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NeedHelpWithMom Feb 2020
I was reluctant to say this as well because I was hesitant thinking it may upset the poster. I am glad that you brought it up though.

This poster is going through a lot. Since you brought it up I am going to back you up on this. I wholeheartedly agree. I don’t feel her partner is trustworthy.

This man is basing everything on his father’s experiences and won’t even share those experiences. Why? Something doesn’t sound right.

He has his partner’s daughter there to help him. Who could ask for a more competent person? She is a nurse and he clams up. Doesn’t add up to me.
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Your mom is dealing with enough. She shouldn’t have to console him. If he is in poor health too maybe be will see how hospice can tremendously help with the right organization.

I am sorry he had a bad experience with his dad in hospice. Reassure him that you will select the best place. Make an appointment for him to speak to a social worker. Be present at the meeting if possible. You don’t want him to upset your mom. Imagine her anxiety dealing with all of this.

There is a reason why YOU are medical power of attorney. She is trusting you to be responsible in this matter. What is your gut telling you?
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Donna2765 Feb 2020
Thank you for your thoughts and insight
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I agree that hospice would be appropriate. However, daughter saying mom can't hold a meaningful conversation or made decisions is not necessarily the equivalent of mom not being able to offer an opinion about hospice. I understand that daughter is the agent for the POA but that doesn't mean the mom has been determined incompetent to make her own health care decisions.
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NeedHelpWithMom Feb 2020
Fair enough but who would turn down hospice or palliative care? Her children can’t care for her. They are being sensible. Her mom’s partner is not being sensible.

Mom isn’t going to recover. This is going to get bad. It is never a good idea to wait until the last minute for palliative care or hospice.

Responsible health care professionals will tell families to use hospice. Hospice can always be discontinued. I don’t know why anyone would discontinue it though.

It’s foolish not to prepare for proper care for her mom if she suspects her mom needs it. Obviously, she does. She isn’t dealing with a sprained ankle. We are speaking about a brain tumor. It’s so sad.

This is why a living will or POLST is a good thing to have in place. Then there is no guesswork and the partner and children are following her wishes.
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You have medical power of attorney. Yes, use it to set up proper care for your mom. They are not married. No legal bond. Brain tumors? You see the decline. You are a nurse. Not trying to be rude but what exactly is stopping you from using hospice?

Do you have an in house hospice available? Do that. My brother was in an end of life hospice facility. They were incredible. The nurses were so kind to him and the family. The clergy and social worker were a huge comfort.

Please don’t delay any longer. Who says, “She isn’t that bad? He is aware of the brain tumors and opposed to hospice? Sorry, that makes no sense. None!

Your mom isn’t able to speak for herself anymore. You have the authority to be her voice.
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Donna2765 Feb 2020
He had a "bad experience" years ago with his father and hospice. Won't tell us what the problem was. Both of them got agitated and angry with just mentioning hospice when she was diagnosed in August. I'm not sure how much she understands now but she doesn't make sense at all when she tries to communicate. He gets immediately defensive and angry when we bring it up. He is her caregiver and he is not in the best of health either. We feel like they need help. My sister helped her shower a couple of days ago and mom could not stand up to wash herself. If we bring in hospice then we are going against his wishes and it is his house. Our other option is to put her in an inpatient hospice setting and definitely against both of their wishes. He keeps saying it is too soon as she might still be here a year or two from now. We have talked about it several times and we get nowhere.
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I am sorry about your mom's illness and decline. Have you asked her what she thinks about getting hospice care? She has the right to decide until she is no longer competent to do so.
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NeedHelpWithMom Feb 2020
She has stated that her mom can’t hold a meaningful conversation. So sad. The partner is in denial. Her mom deserves proper care.
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