On 3/18/2015 8:14 PM, Someone wrote:
Mr. Luddite wrote:

I feel badly for my wife and her sister. Both have been the primary
care givers for their elderly parents for many years. Their father
passed away a little over a year ago and the demands of taking care
of their mother have been ever increasing since.

The mother is *very* old school Italian and doesn't trust doctors,
hospitals or social workers. She is 90 years old now and has
adamantly refused any suggestion of moving into assisted living or a
nursing home. She wants to remain in her house but my wife gets calls
from her constantly day and night complaining about something or
demanding that my wife go to the store for her or help take car of her
dog.

They have arranged for professional social workers and nursing help to
visit daily (their mother is also diabetic) but the mother keeps
kicking them out, accusing them of stealing things or simply
complaining about them.

Two weeks ago something happened and the mother called 911, was
transported to the hospital but then refused any medical services.
One of her legs had swelled up and was bleeding. My wife requested
a psychiatric evaluation and the psychiatrist declared that the mother
was fine and was capable of making decisions. So, she was released.
The medical docs can't keep people against their will.

Then, two days ago it happened again. This time my wife called 911
and the mother was whisked off to the hospital again. Same thing
after she arrived ... refused treatment. Again, she was evaluated by
a psychiatrist who determined her to be "fine" mentally.

Then the medical docs called and reported that the mother was
experiencing hallucinations. They also, despite the shrink's
evaluation declared the mother as being "incompetent" regarding making
decisions which now puts the onus on my wife and her sister to
determine what's in her best interests.

At my wife's and her sister's insistence, they convinced the mother
to stay in the hospital and allow a few tests to be conducted.
The docs quietly sedated her to make her more cooperative. A CAT scan
followed by a full body MRI revealed she has a brain tumor the size of
a golf ball in her head and a life-threatening clot in the swollen leg.
The docs have given her 3 months, max.

So, one of the two issues is going to do her in, the clot or the
brain tumor. A procedure to minimize the clot threat is available but
it involves risk and all it will do is buy a little time for someone
who doesn't have much time left and who's quality of life is dismal.

Tough decision for the kids. It's not my place to advise, but I know
what I'd do.





That's tough. I lost my mother to a blood clot in her leg that moved to
her lung. She waited far too long to see a doctor about the clot -
three days earlier and she might still be around. Her mind was solid
but she procrastinated when there were hard decisions after my father
died. When she was in the ICU different doctors gave us different
opinions. There also seemed to be a lack of communication between the
doctors, specialists, and ICU nurses. I really wanted to move her to a
bigger, and hopefully better, hospital but that wasn't an option in her
condition.

It's a shame there is nothing they can do for the tumor. It probably
has everything to do with her behavior. If she is otherwise healthy, a
second opinion couldn't hurt. One thing I've learned is that medicine
is far more subjective than I ever thought.



It seems to be becoming more subjective with more knowledge.

My wife's mother is 90 years old and in deteriorating health. She's a
diabetic and requires daily insulin shots. We were also told today that
it appears her kidneys are starting to fail. All things considered, it
is obvious that she is entering the final, end of life stages. The
question on the table now is where should she go ... home, nursing home
or should we take her in at our house.

The hospice people are excellent in educating family members who are not
familiar with the signs and symptoms of impending death. I learned a
lot from them with both my father and my mother as they went through the
process of dying.

One of the conflicting issues in our health care system ... be it
hospitals or even nursing homes ... is the objectives and mission of
health providers (doctors, nurses, etc.) and those trained to make the
dying process natural and as comfortable as possible (Hospice). The
medical people's objective is to save lives and respond to any life
threatening situations. The hospice people provide comfort and care
to allow the process to proceed.

All a doctor can do ethically is to "recommend" hospice when he knows
the time is drawing near.