My 90-yr old cousin has Alzheimer's, she has stopped eating, became very ill with a UTI, and now she’s weak and cannot walk, and needs adult diapers. The hospital cured her UTI and sent her back to the mem care center. She signed dnr papers when she was in her right mind years ago. The very expensive mem care center she's in is now having hospice help with her care, they have prescribed appetite enhancement drugs, and they increased her antidepressants. My question is this: is this congruent with her wish to not be kept alive...?
A DNR simply means Do Not Resuscitate if her heart stops by using CPR. Increasing antidepressants is intended to keep her from feeling miserable!
Such as it is, they're following the rules of hospice care. There's not anything you can do about it. Visit your cousin and see for yourself how she's doing.
I highly disagree that a memory care that is high end would keep someone alive for profit. At least in my area they have long waiting lists. It is not my experience of at least the ones I am familiar with and my best friend is a DON at one in San Francisco.
That's what is important at this time.
If you are the POA discuss with the MD the withdrawal, now she is on hospice (who will help with the withdrawal of unneeded medications) all medication to promote long life should be removed. The goal now is to understand that the loved one is actively dying and that comfort is an issue. If the anti depressants are on board for some time now then an abrupt withdrawal of them is NOT A GOOD THING. They can stay and they provide comfort.
Again, this is for the POA or next of kin to handle, to make it clear that the goal now is comfort EVEN if this comfort care and medication does cause death early by some moments, hours, days or even weeks. The POA needs to discuss medications with the Hospice personnel in charge and the MD in charge.
I am so sorry for the coming loss.
I'm not sure what you're trying to accomplish with questioning the care she's getting. She's at end-of-life, and she planned for it. Let those who are helping her keep doing what they're doing - it's not up to you to change things at this point. It seems like she's getting thoughtful, expert care. I am very sorry for your coming loss.
If she is eating then the medication is working
If she was at EOL (end of life) the medications would NOT work as stopping eating and drinking is part of the natural way the body shuts down.
IV's and feeding tubes would NOT be permitted on Hospice. (a feeding tube is ok on Hospice if the person had one prior to getting on Hospice.)
A DNR is a document that states that no resuscitation is to be done. And if it is a newer form that states no feeding tube or intubation they are still following that directive.
He has Parkinson's and was in a deep sleep as he sometimes does. They felt his neck and said it was stiff... duh he has Parkinson's which causes stiffness. I found out later they thought he might have meningitis. Fortunately within an hour or so later he was wide awake and no spinal tap was needed.
I had a friend say her father was not given O2 even though he was gasping for breath while dying. They told her it was because of his DNR. O2 is comfort, it does not prolong life.
I have been taken back at other instances that have happened with my father, my husband and friends regarding health professionals not understanding the simple purpose of a DNR. I am always there to advocate for my husband to be sure it won't be used before the proper timing. I told my doctor that I would like a DNR but I don't have any one person I feel would understand they need to step up to advocate for me in similar situations so I am concerned I will be denied proper care. She said she would make a note in the chart. I only hope someone will see when it becomes an issue for me... yes I know it is best to actually have one. However, I have talked to my family about it.
Hoping your loved one has a decent end of life.
Neither of these will keep an actively dying person alive.
Beneath your post is a link to DNR. Click on this and read the articles for a better understanding. Also click on Hospice if you would like more details.
Hospice Care is suppose to keep her comfortable. I am sure your cousin's memory care is also charging for enhanced care even though she's in Hospice Care too. It's a racket. It's exhausting to advocate, but you must. Sorry for your situation. I am battling for my mom's care everyday. Staff and Administration is not on the same page.