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My mother lives with me. She has been ill for over 15 years. Within the last month she dropped a starling amount of weight (possible medication/vaccination issue). She struggles to even drink without vomiting. I bring up the hospital every chance I get but she refuses to go. We are extremely close and I want to give her dignity and respect her wishes. However, I don't want anyone accusing me of not taking proper care of her. She is a very strong willed woman and she still has all of her faculties.

She sleeps on the floor (and has for years), only showers occasionally (and has for years) and likes being alone (except for me, but sometimes not even that). On the surface it could look strange but we've lived this way for years. The only hiccup is this drastic weight loss. Who is to say what the right thing is to do? If she goes to the hospital she could die (they nearly killed her once before), or she can stay home and try to get better herself and be comfortable.

If something happens while she's home, though, could I be blamed for neglect? I'm fulfilling her wishes the way I see it. Is this wrong?

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I worried about this with my father. He didn't want to be around any people and it was nearly impossible to get him to the doctor. He had what we would now call Asperger's and wanted to be left alone to die. He never wanted to bathe, but we made him do it at least once a week to keep his skin healthy. We got him to doctors twice, but he went into melt-down both times.

He sat in the same chair looking out a window for 20 years. He was content doing that, just waiting for God and ordering a lot from catalogs during the last years. He didn't want to eat much, but he did like sweet things like ice cream treats and little cakes. Even though he seemed content, it was torture for me to see him sitting there slowly dying. And I worried that it could be considered neglect, even though I tried.

I do believe that anyone knowing how hard it can be to get some elders to take care of themselves will know it is not neglect. If your mother does the same as my father, she will stay on the same path until she ends up in the hospital. You will know when to call 911 to come get her, even though she will try to tell you she doesn't want to go. My father spent his last four days in the hospital. There is no way we could have handled him at home, so I'm glad I called 911.
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It's perception, not reality, that's important. A hospital is for acute emergencies. Have one? Transport her there. She's in your care. You should make the call.

Is your mom under a doctor's care? I hope so. Is hospice appropriate? Is she eligible for in-home nurse or doctor visits? Personally, although I understand your desire to honor her wishes? I would not even ENTERTAIN the possibility that I aeared neglectful. After all, it is only your little self voicing those wishes.

Get the medical community involved -- even if it's just to ask their counsel on what to do in light of mom's resistance.
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What I agree with here, is the "appearance" that someone was being neglected. And if someone pushed the fact that "she rarely bathes and sleeps on the floor," it wouldn't look good.

Where will she be, if she outlives you?
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I would call Hospice and ask them to do an evaluation. They will speak to her privately and if she is determined to have no medical intervention, they can independently document that, which will protect you.
On the other hand, let's say she dies, and you call 911. They find an emaciated body with vomit, lying on the floor for a bed. I guarantee you the homicide crew shows up, takes pictures and finds it all very suspicious. The body goes to the coroner who will find malnutrition and dehydration. You are booked for criminally negligent homicide or maybe just manslaughter.
Now go make that call.
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I think you need to get your mom professionally evaluated and make sure someone hears from her that she prefers to sleep on the floor and that you're doing what you're doing because you're honoring her wishes. Do you have other relatives or friends who know the both of you and know that you're honoring your mom's wishes? That would help. If it's just the two of you, I'd be worried.

The vomiting is troubling along with the weight loss. Even if she's near the end of her life, it's good for you to have some understanding of what is going on with her. And it's good to protect yourself. I don't know if I'd go as far as Pam in saying you'd be booked, but someone outside of the two of you needs to understand what's going on and that it's not neglectful on your part.

If your mom is of sound mind and you approach it from the standpoint of needing her to go to the doctor to protect you, would she consider that?
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It is such a big question when a caregiver gets caught between a person's right to die as they choose and the law. The weight loss and vomiting does point to a serious problem that might be treatable. My father didn't want to go to the doctor, but there were times we gave him no option. He had to go. Period. She doesn't have to go to the hospital. I suspect the doctor will order some lab work and maybe some endoscopy. (I wouldn't envy you the latter.)
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I'm also concerned about the vomiting and the weight loss. Something's amiss here, and it may be correctable.

If you can't get her to the ER, take her to a PCP, internist, GI doctor, even if you have to be a bit dishonest and not tell her where you're going until you're there.

Alternately, there may be some doctors that perform home visits; there is one group here in the SE Michigan area, and I'm thinking that this service may exist elsewhere.

Since you're inquiring about the possibility of neglect, I think you're concerned, but need some encouragement to get help even if your mother doesn't want it.

If you have to, call EMS with a report of weakness and repeated vomiting. I'm guessing she's probably dehydrated too. That way they can at least assess her and take her to the ER.

Actually, I think that's the best way because they're used to dealing with a variety of people and will know how to assure her that she needs to get help.

The fact that you called 911 will reflect on your concern, but be prepared to explain to the doctors that your mother hasn't been willing to get treatment and you've called EMS against her will.

Good luck; I hope you learn that the weight loss and vomiting are correctable.
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When you say the vomiting is a ned I cation issue, does that mean she's on meds.
? From a doctor?

In your shoes, I would call 11 and let them evaluate and talk to her if she refuses transport, ask for a hospice organization to evaluate her.
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CALL HOSPICE. If not for her sake, for your sake. They have a wonderful group who will help spiritually, emotionally for her and you both. just talk with them. They are there to help guide both patient and caretaker to the end, if that is best. Mom was on hospice for a long time. They graduated her !!! In other words, she stabilized, no better, no worse. But I can call if she starts failing again....What a wonderful backup to have in the time of need. You need now. Maybe not so much your mom, but you need to be assured that you are ok to make ok decisions on behalf of your mom...
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It is exhausting to be dragged to ER all the time. Your mom doesn't want it, I havent read much other than the little paragraph, she sounds like she may be in her 80 range. I certainly don't want to be dragged in or drag mom in, it is physically exhausting on both of us..Now I have her on a DNR, and getting mine ready too.
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Simple test first: Urine, does she have a UTI? Has her foods changed? Put her on a mattress at least. If you get her on hospice, they will most likely help to get her a medical bed that is adjustable. That may help in circulation etc.
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The legal definition of neglect depends on the laws of your state of residence and how those laws have been interpreted by the courts in your state. In my state, Florida, adult children have gone to jail for allowing disabled parents to die in their care, and conditions like dehydration and untreated infections have been major factors. If I were you I would insist your Mom see a doctor if you have to drag her there. If she dies, you may need to prove that you did everything in your power to get her medical attention.
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Thank you all for your answers. Even though some were quite blunt, it was the push I needed. I brought up the neglect thing to my mom and told her what it may look like for me as her caretaker if something happened to her. She fought me but then relented and she's now in the hospital. Her creatinine level was 9 and she's dehydrated. Her creatinine level has come down to 7. Still vomiting and can't eat but it's only day one.
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I absolutely 100% agree with Pam here. The situation is not normal by anyone's standard, the mer fact you're asking the question tells you that you think it might 'appear' to be neglect and in fact because you recognise there has been sudden changes to do nothing is neglect, so get it documented to protect your mum and you. hell she may not like it but then the alternatives arent good either.
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Jillie brilliant well done you - didnt see your update until I had posted sorry about that. You did absolutely the right thing and now they opefully will be able to give her some anti emtic to stop the vomiting and give her nutrients by an alternative method if needed. I am so pleased for you both and we are only blunt because we are trying to help not because we are nasty... well OK I am nasty but seriously we just want to help make the difference xxxx
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I feel like we need to give Jillie a standing ovation. Good job! You have made me feel better. I hope the nurses and doctors make your mother feel better.
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(Clapping while standing and shouting "well done"!)
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Standing ovation from me too! Kudos for getting the job done Jillie and getting your mother the medical attention she very clearly needs. Glad we were able to help point you in the right direction.
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