Follow
Share

I have cared for 5 elderly people over a career of more than a decade. I cared for several clients until they passed away at home. My current client is 92. He has kidney failure, two large tumors in his bladder, 2 compression fractures in his thoracic spine, and end stage CHF. He is in agony. There is no other word to describe it. He cries out in pain throughout the night. His kidneys and bladder cause such discomfort that he wakes up 4-5 times an hour and slaps his abdomen hard. I asked him why he did this, and he said he wakes so frustrated that slapping helps. I wonder if somehow causing pain on the exterior of his abdomen helps the pain inside. I have reported to the family repeatedly that he is in pain that is no longer addressed by Tylenol. The daughter that he lives with sees the pain, and agrees with me. She contacts the other daughter who is the POA, and also has an associate's degree in nursing. She works in a cardiologists office. The daughter who is POA comes up with reasons that I find incredible for why her father "acts" like he is in pain, but really is not. She is concerned that Daddy will become addicted as well, although it is apparent to me that her father has perhaps 2 months left to live. The best I have been able to do is get Tylenol 3, but only after the bladder tumors were found 3 weeks ago. The POA refused a biopsy, as her father does not want to treat them even if they are carcinomas, so why bother finding out what they are! The home health RN spoke with the urologist about my client's obvious pain, and Hydrocodone was prescribed. However, according to the POA daughter, Daddy is allergic to it. Nothing else has been prescribed. Unfortunately my client is slipping into despair. He won't talk to me about his pain as of last week, because he no longer trusts that I will help him, as I have failed in every attempt. Please help. I can't stand to see him angry and withdrawn. The daughter he lives with will not override her sister.

Find Care & Housing
I don’t see why POA comes into play. He can decide for himself about what meds he wants for pain. His doctor can approve this
Helpful Answer (1)
Reply to Daughterof1930
Report

I hope the home care nurse or kind daughter gets through to the Doctor asap. Can the gentelman call himself? Can he ask for hospice himself?

I'm sure you are, but please document everything - every dose & keep copies. I hope not, but some people can lash out if crossed - the POA daughter may cause legal trouble. Especially if the gentleman declines rapidly & she is still in denial about this or suffering from grief.

Is he having kidney dialysis treatment? If so & he decides to stop, depending on his kidney function, he may have only one to a few weeks.
Helpful Answer (1)
Reply to Beatty
Report

What a horrible shame. He is dying and in pain. She should not be focused on addiction at this point. She should be focused on her father being comfortable and as pain free as possible. I am so sorry. This must be hard for you to see. Please don't stop being his advocate. He needs someone to help him. You have a kind soul. Thank you!
Helpful Answer (1)
Reply to NeedHelpWithMom
Report

If the man is competent, then he is in charge of his health and can request pain killers. He does not need POA approval. That only comes into effect if he can't make an informed decision. Get addicted? Who cares he is dying. How cruel of her.
Helpful Answer (7)
Reply to JoAnn29
Report
Judyscare Mar 30, 2020
Thank you. He has some definite cognitive issues, but he has not been diagnosed because, again, the daughter with POA does not see it. That is good for us. I am going to try to get through to the daughter he lives with Monday morning to see if her dad can speak to his doctor. Tuesday they have a video appointment due to the coronavirus. I spoke with the home health nurse, and she is putting in another call to his doctor on Monday as well. I will let you know how it goes after work tomorrow. I have to do something or I will lose my mind. I have never experienced this before with any family.
(0)
Report
The RN daughter is clueless. Report to the home health RN your concerns and have her speak to the daughter living with him. Your client should be on Hospice for obvious pain control. This needs to be addressed asap.
Helpful Answer (4)
Reply to earlybird
Report
Judyscare Mar 30, 2020
Thank you. I spoke with the home health nurse on Friday. She is calling his doctor again in the morning. I will post after work to let you know if I made progress.
(1)
Report
Give him 1000mg tylenol and 600 mg advil together. This should help with his pain. It is supposed to have the same pain relief as opiates. Obviously talk to his doctor to find out if he can have this and not his POA.

If this was my client I would be talking to the reasonable daughter about bringing hospice on board.

I would also call APS about the POA withholding comfort care.
Helpful Answer (2)
Reply to Isthisrealyreal
Report
Judyscare Mar 30, 2020
I have been talking to the reasonable daughter about hospice since the week after Christmas! I went to his last doctor's appointment as well, and shared my concerns with his GP. At that time, his TSH was 17, so the doctor said they would get that down first, then address the hospice subject. As of last week, his TSH was 5.97. Still a little high, but close to normal. I am meeting them at his appointment on Friday to bring up these issues again. I am honestly hoping that the home health nurse can make some headway with the doctor by phone tomorrow, so he doesn't have to wait until Friday for relief.
(3)
Report
Ask a Question
Subscribe to
Our Newsletter