Mom has been in the hospital and/or rehab continually since July 10. I have health Care POA. She is 83 and very ill. She gave then permission to do surgery and now she is in worse condition than before. She struggles to put a sentence together and sleeps most of the day. She hasn’t eaten in a long time. She has a DNR. I believe they are going to want to insert a feeding tube into her stomach. I feel she is at the point where she needs comfort care and no more invasive procedures. In her condition she may agree to anything they say. Any thoughts? She is constantly saying she is in pain and suffering and it’s very hard to see her like that.

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Sounds like you are doing the right things. Hospice will help her be more comfortable and you will have the assurance that she is being cared for . Let us know how things are going for her and for you.
Helpful Answer (1)
Reply to golden23

Just step up & say you are now enacting the P.O.A. she gave you but bring the papers with you in case they want to copy them - when I did this with my dad in his NH the response was "THANK YOU" - the health care professionals rather have a clear notification than guessing - if she can't stay awake for more than a few minutes at a time then she is unable to fully understand what is being said to her
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Reply to moecam

GI doc would stand to make big bucks with feeding tube.
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Reply to shad250

Thank you everyone. Today we were told by the Palliative Social Worker and nurse that mom is not “fixable” and they feel that Hospice is the only thing left. She will be going to Hospice House tomorrow for several days and will be assessed as to whether she can be moved to a long term care facility under hospice care or has to stay at Hospice House. Thanks for all your advice.
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Reply to Billyyank1865
Ahmijoy Oct 18, 2018
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As POA, you are her agent. You should have given the hospital and her physician a copy of the POA when it was notarized.
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Reply to Llamalover47

Assert your medical POA.

Ask about "Allow Natural Death".

Remember that hospitals do not care about your loved one the way you do. The hospital will get paid big bucks for every procedure they do, for every feeding they give, etc.

Inquire about taking her home for hospice.

Ask for a consult with the palliative team.
Helpful Answer (3)
Reply to NYDaughterInLaw

My daughter is an RN in a nursing home. One thing she told me was not to allow a feeding tube in my 89 yr old Mom with declining Dementia, Doctors will allow nature to take its course but once a feeding tube is inserted, they won't take it out because then its consider starving them.

When the elderly go under it can make their worse mentally.

Tell them you want a hospice evaluation.
Helpful Answer (2)
Reply to JoAnn29

It would help if you could get her to sign a Living Will which outlines what extraordinary care services she does NOT want (like a feeding or respiratory tube). A few sentences are all that's required and the docs are available online for free. But she will have to agree and sign it. Ditto with a DNR (which she also has to sign and some facilities have their own you need to sign). Then, with the Healthcare Surrogate (POA) authorization, you share these documents with all her doctors (hospital and/or extended care facility) and you will be able to control her care. The lesson is---get these three documents signed while your senior is still lucid and able to sign off on them!
Helpful Answer (3)
Reply to Spankiedoodle

Does the hospital have a copy of your POA on healthcare on file? If not give them one. They will have to speak to you before her.
Helpful Answer (4)
Reply to Glendaj2

Time to assert yourself as your mother's advocate.

Pinpoint her primary physician or surgeon (is she currently in rehab or in hospital?). Take your POA documentation to that person, and get agreement that you are to be present at all decision-making consults, and that given her physical state at the moment your mother's consent to any procedures cannot be considered valid unless you are there to witness it. That's your starting point.

From there, the question is whether your mother is able to give consent or not. If your argument is that, in her current condition at least, she is not able to then you're going to need to get that on record.

Let's assume for practical purposes, though, that your mother remains the decision-maker. These are difficult conversations to have with someone you love, but you need to talk to her about her options. You might find it helpful to speak to a hospice advisor first (you don't need anyone's permission to get advice). It is also perfectly reasonable to request a hospice evaluation on her behalf, provided she is free to refuse it if she chooses to.

With the immediate issue over the feeding tube, make sure you're in the room when it's discussed. Try not to take over the conversation or put words into your mother's mouth, but do ask questions on her behalf such as "what happens if we don't do this?" "is this likely to be reversible?" and "what outcomes are we aiming for?"

Of course I don't know what your mother's underlying conditions are or what the surgery was for or how long ago it was done; but try to keep an open mind. If the surgery was recent and the PEG tube is intended to be short to medium term, would you still be hoping for some improvement in her?
Helpful Answer (7)
Reply to Countrymouse

Because you have Health Care POA, I believe the medical staff should be coming to you for these decisions and not her. They suggested a feeding tube for my mother, too. I had to put my foot down and say no way. Mom always ate like a bird and I told them that. Sometimes facilities want to do all they can so they won’t be blamed for not doing enough.

To make sure everyone is on the same page, call a Care Conference with the staff. You need the social worker, Director of Nursing, any therapists and as many other people who are responsible for Mom’s care to be there; even the dietician if she's available. If the facility has their own Hospice Agency, ask that they be there as well. Be polite but firm and tell them “no heroic measures”.
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Reply to Ahmijoy

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