What do people do when their marginally dementia parents / in laws resist necessary medical procedures?
- Thread starter PandaBear
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They aren't technically supported by us other than living in the condo we provide, so we can't really make financial decision for them. However, my father in law was basically living off cash out refi of his own house and have been in the past ask my wife to be on the loan, then my brother in law, etc. This got my brother in law into some financial trouble and they no longer talk to each other (brother in law and his wife are both on the deed of the father in law's house and get refi complicated with father in law's attitude, got into a verbal fight, and missed the low interest window and cost brother in law to miss a good refi). I told my wife we absolutely would not do that at the beginning of our marriage, but I was ok with her sending her parents cash allowance instead, to avoid the complication (I envisioned I need the credit for our own investment home or bigger home in the future).
Father in law also loves to spend a lot of money buying expensive toys to our kids that we have to throw away (not age appropriate or takes up too much space at our home). He gets upset if our kids don't take them, so we told our kids they can throw them away after he left the house.
Wife got into argument with her dad a lot, but her mom was not really the reason usually. Her mom does not take care of finance nor did she invest, got into trouble, etc. She usually just forgot things or ignore medical symptoms until my wife demanded her to see a doctor.
And I have witnessed the direct polar opposite to what you have seen…
Older adults who have a whole lot of money and HAVE ZERO clue that they have that much money.
My lady’s grandmother was just like that. Ms Betty had several hundred thousand dollars in a couple of different accounts. She had no idea the last years she was with us. And my step fathers good friend Frankie who has early signs of dementia had enough money to pay for his new truck… With all cash… He had no clue he had any money.
Can't believe this on the day of surgery:
Right before surgery nurse ask mother in law if she had oatmeal this morning, she said yes because father in law said just a small bite with milk. Nurse said no surgery today. We had to explain to the nurse that it didn't happen and she had memory issue, and mother in law said don't lie, she really did.
Edit: looks like Kaiser is concerned and they don't want to operate today
Edit: The procedure is cancelled
Right before surgery nurse ask mother in law if she had oatmeal this morning, she said yes because father in law said just a small bite with milk. Nurse said no surgery today. We had to explain to the nurse that it didn't happen and she had memory issue, and mother in law said don't lie, she really did.
Edit: looks like Kaiser is concerned and they don't want to operate today
Edit: The procedure is cancelled
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Unfortunately the state of healthcare has changed. Not all that long ago someone in that situation might have spent the night before in the hospital to ensure everything was ready and pre-op rules were followed.
There's a 5 day prep so you can't expect to be staying for that long.
Unfortunately all it take is a false memory to cancel the procedure now.
I Feel bad for you. I do.
Were you there? Was your wife there ?
Being that the staff member wasn’t there and they can’t trust possibly one guaranteed and possibly two people who may or may not be accurate historians… The staff member was in a bad position there.
It is a bad deal…
Maybe hire a temporary home health agency to stay with them for 5 days prior into that am of the procedure.
Or maybe the next time either her or you need to be with her for the 5 days prior or at a minimum she can stay the night before into the next am.
Kaiser shenanigans. My experience with them is a procedure delayed or canceled with the patient subsequently passing is a win for them. Raising hell is sometimes the only way you can get something scheduled or performed. You have to not take no for an answer with them.
Went through this with my mother who had stage IV breast cancer. Great oncologist, everything else associated with Kaiser was terrible.
Went through this with my mother who had stage IV breast cancer. Great oncologist, everything else associated with Kaiser was terrible.
That’s not it at all. This is major surgery. Whole GI tract has to be empty to reduce risk. It’s protocol. It’s standard of care.
Failure to follow standard of care, or protocols, gets Kaiser sued if something happens to her during surgery.
So, patient fails to follow pre-op instructions, surgery rescheduled. Simple. And every hospital does it. This isn’t a Kaiser thing.
How is the nurse supposed to know which answer is true. “Did you do what we told you?”
“No”
Family - “she means yes!”
You just put the nurse, or the medical person, in a horrible position, which answer is true because if they guess wrong, the patient’s at risk - patient could die.
You would not believe the number of patients that come what, in tell the truth, realize they made a mistake, and then lie about it.
How is this nurse supposed to distinguish the difference between that kind of lie and this lady’s dementia?
No , a big risk is not being NPO. If stomach contents are aspirated during intubation or extubation, lung damage can be unrecoverable in some patients, and or the subsequent infection from that. Anesthetic agents can temporarily impair lower esophageal sphincter tone. All sorts of problems can arise such as post operative ileus.
You want the upper GI tract empty, and for some surgeries, the lower as well.
You have a point, but I stand by my assertion that for Kaiser, a procedure delayed is money saved if the patient passes in the meantime. I've seen it too often with them.
In this case to prevent this from happening again (and if nothing changes, it will) you need to execute a power of attorney for health care to be the single point of contact to talk to medical personnel, then have her dementia documented. If the administrator or nurse chooses to get her information from a patient with dementia, then you will have recourse.
Im just waiting for the day with my mom. hasnt been a fun last 11 years with her.
Yep…. I’d there any doubt… It is a clear no go.
I loved when people came into the hospital I worked at and when asked how much alcohol they drank daily… They routinely did not tell the truth about that. The rule was amongst us staff.. Double or triple that amount they told you… Then it would likely be much more accurate to the real daily total. Some people completely lied and when it became apparent something was wrong… Boy it was not fun to get them straight once that happened.
For some people who “ under reported “ how much alcohol they drank and we at least doubled that then it put them on a etoh protocol… Fun times there.
Kaiser has been exceptionally good to us. As soon as mother in law was diagnosed and flew back to US, they see her within a week and schedule the operation within another week. We couldn't have ask for a better schedule. They also did a phone appointment to make sure we follow all the prep work (no asprin, for example) 5 days prior, and mother in law was also remembering the wrong thing and took an asprin already. We took away her med so she couldn't make the same mistake again, we make sure she went to the hospital with an empty stomach. What we didn't anticipate is that her memory is wrong within the morning and insist she ate breakfast, when in fact she didn't (we verify with 5 phone calls with father in law), all because she felt "full" in her stomach because the tumor was pushing her internal.
Not being sued is money saved. I think Kaiser knows how to deal with risk like that.
Wife was there next to her mom, and double checked with father in law at home (only 1 family member companion allowed). Mother in law insist despite her bad memory. We probably have to video record the same question before she left the house to play back to her at the hospital next time.
She came home blaming father in law, and told him not to lie and be honest, saying that he force her to eat a small breakfast before leaving. Father in law had to open the fridge to show us there was no oatmeal (they usually prep breakfast the night before to save time).
Also at the hospital, mother in law asked why we were at the hospital and not see a doctor after just 1 or 2 questions, she forgot she was there to do a surgery, and she forgot because of her answer she was cancelled.
Triple_Se7en
$50 Site Donor 2024
If you are absolutely sure the parents want further medical treatments, then apply for executive control thru an attorney - who often times will suggest medical specialists they've worked with prior.
Lots of times, parents want to maintain medical privacy and not show / admit to other family members that they've accepted the fact they are not immortal - don't want to live remaining lives in pain and are not interested in leaving a mountain of debt to their children, when they pass.
Many faith-driven folks turn to who they thought created them - raise their hands high in the air (I give up Mode) and tell that supernatural being that they've given up - putting the supernatural creature in charge of their future time, while still walking the earth.
My brother-in-law recently surrendered at 85 years old. He quit eating, drinking and wouldn't allow anyone to force-feed him..... even after being admitted to the hospital. He wanted no intravenous...... nuttin whatsoever!
He passed quickly and visited me five times afterwards. The last time I had collective energy with him in my twilight sleep, he used his right fist and pounded the section between his left-side collarbone and top of his shoulder 4-5 times.
If you contact a well respected local Psychic-Medium, he/she will tell you that the fist pounding at those key points on the body represents the departed family member admits to committing suicide.
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I understand what you mean.
Wife and I had a discussion yesterday about this, we aren't on good term in many aspect of live but for her parents' health we both agree we would do our best for them. Mother in law is not giving up on life for sure, just that she basically lost her short term memory yet she is rational and remember things long term. The nurse at the hospital was able to get answer from her like her name, birthday, address, etc, but when my wife told her to ask things we just talked about, or day of the week or which month, which day of the month it is, she would not be able to answer. She is not religious nor she wants to give up living or treatment. She does not even remember she has a giant tumor or why she went to the hospital yesterday (she though it was a regular check up when her gets back to the car, and totally forgot she was going to have a surgery).
Regarding to finance. They are on Medicaid / Medicare, not too much assets but enough to live probably another 10 years (then maybe move back to rural Taiwan or something by then, they have no plan what so ever). They can survive without putting financial burden on us other than the condo they are living in.
If I have to describe, she's like Dory in Finding Nemo.
