I am the medical POA for my father. He has trouble swallowing, but refuses to see a doctor. Am I culpable if he dies?
I am 1 of 4 children in my family. One of my siblings committed suicide 18 years ago, but my other two siblings haven't bothered to stepped up to help. I guess they don't think that it's any of their responsibility. So I am on my own, taking care of my dad. I do all I can to try and make him happy. It's hard because he's so angry about everything, and always has been. He doesn't have dementia or anything like that, so I can't force him to go to the doctor. He has a DNR in his will...
After my mom passed away August of 2019, my dad didn't know what to do, so I offered him to come stay with me. He moved in with me in November... It has been mentally draining taking care of him because he's soooooo angry about everything! I just agree with him when he's talking about all the negative stuff that he seems to need to go on and on and on and on about, rather than argue with him; that would be pointless. He talks so loudly, almost shouting, about all of the injustices in his life. I don't think he even knows how to have an actual conversation with anyone. It's always a lecture about how horrible people are... I always laughed about how he's not prejudice, because he hates everybody... But with him living with me, his abrasiveness is breaking me down.... I just say to myself, "Just keep smiling."
There would be no way any outsider could care for him, or talk to him. He's so bitter. All I can do is try... He hates doctor's. I would have to physically fight with him to get him to a doctor. He's always been very angry, never letting go of things that have happened to him in his life, dating back to 77 years ago. He is 84 now.
I just don't want to be the one who gets blamed if he dies because he refused to go to a doctor to find out why he can't swallow. He has so much trouble swallowing anything, solids and liquids alike. I am just at a loss and I can't force him to see a doctor. I just need to know if it's going to be my fault if he dies.
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In any event, the next time he starts choking or having a particularly bad rant or gets violent, I'd call 911 and have him taken to the hospital for a full work up and evaluation. Trouble swallowing can easily lead to aspiration pneumonia where he inhales fluid into his lungs and that normally requires hospitalization.
It won't be your fault if your dad dies, so don't spend time worrying about that. Just plan to send him in an ambulance to the hospital as soon you possibly can. He can always refuse to get in the ambulance, of course, but that won't be your fault either. You may have to wait for something bad to happen to him FIRST, before you can get him to the hospital. That's often the case, unfortunately, with stubborn elders who refuse to do the right thing and burden US down with their issues.
I don't know how you're able to deal with this, frankly. My heart goes out to you in a big way.I am sending you a big hug and a prayer that this issue resolves itself SOON, somehow, and that you can find some peace.
Competent adults cannot be forced to accept medical care. Ever. By anyone.
The following is from Vermont. I suspect it is the same for every state. You can google the question for your State.
QUOTE: "Every competent adult has the right to refuse unwanted medical treatment. This is part of the right of every individual to choose what will be done to their own body, and it applies even when refusing treatment means that the person may die." UNQUOTE.
The problematic area is when parents try to refuse treatment for a child that is dependent upon them, say for religious reasons as in Jehovah's Witnesses refusal of blood for a child. The hospital will usually go to court on this. Also parents who use Christian Science Teachings to deny care for critically ill children.THESE will end in court, and often with the prosecution of the parents for withholding care.
You cannot prevent an adult from seeking care; neither can you force them to do so.
All of that said, if at any point you are uncomfortable and your father unable to make his wishes known in a coherent way, you can call 911. Have the copy of his DNR drawn out of his papers and present at all times so you can show it to the EMT and the ER folks. In some states, which don't allow POLSTS, the EMT will have to try to revive a patient if you call; but the ER will stop at once with the DNR papers presented.
Your POA does not override your father's choice.
Joann's advice is excellent about getting a POLST done, but as Dad will not go to a doctor that's unlikely (It is done with the doctor, is a doctor's order, and says exactly what you want and do NOT want.; it hangs on your refrigerator or where EMT can see it on arrival to home)
EMTs will not attempt to resuscitate a very dead person (as in cold) either.
I don't know if you mean his DNR in the will is an attachment he did when he had his will done. If so, you can pull it out, copy it, and keep it handy. It would make his wishes known.
States differ in what is required of EMT when called to home.
It is rare that EMTs called to home when person is deceased already are any help in any case; death is the expected outcome.
As his medical POA you can fill out a form and have him sign it. You can download your States form from the internet. A doctor's signature will be needed. A copy should be given to the doctor for his files, EMTs and staff in the floor he ends up on. Do not expect ER to make sure paperwork goes from them to his room. EMTs should be giving paperwork to ER but don't trust that either.
The swallowing is now serious. If he tries to eat or drink it could be aspirated causing pneumonia. I think for this problem, thickened liquids are required. I would have him go to ER but if he won't, then not much you can do.
No, ur POA does not make you responsible if he is considered competent to make his own decisions. It only comes into effect when he is declared incompetent or he is unconscious or in a coma where he can't make his wishes known. My Moms POA read like a living will. What she wanted and what she didn't want. If yours reads like this have it handy. Make copies and give them to doctors and hospitals to keep on file.
Because you stated that your father has a "DNR in his will" (which is not how that is legally arranged) I want to confirm some information from you:
When you say he doesn't have dementia...how do you know if he won't go to a doctor? A doctor administers the cognitive exam and is made official as it is then included in his records. You can't act on your father's behalf unless you know he is cognitively compromised.
A DNR is usually put into a Health Care Directive. Does he actually have one made out and signed? FYI a will only is active AFTER a person dies, so a DNR would be of no use then.
You say you are his PoA...do you actually have the legal documents that you have both signed? Or are you going by what he has only TOLD you?
If you don't have the properly signed paperwork you are not his PoA.
You may be able to get him to a doctor by using a "therapeutic fib" like, "Medicare now requires an annual physical so you MUST go in order to keep receiving your benefit" or something to that effect. When there pass the doc or his staff a pre-written note asking to perform that test, and also request a test for a UTI, which can cause behavioral changes in the elderly and is cleared up with antibiotics.
FYI do not fret about what the non-caregivers in your family think about how you are managing his care. If they don't like it then resign your PoA and let them deal with him. And no, you are not liable for his demise unless you were abusing or neglecting him. His anger is a sign of cognitive decline. You trying to make him "happy" is pointless. Please provide answers to the questions about the legal paperwork as it is critical in being able to move forward with any future care or plans for him. Thanks.
For your concerns about being held responsible, start a log / journal and document your attempts to help him and his responses and actions. Include past actions too, being as specific as you can.
Best wishes to you all.
I went through something similar with a relative who had every age-related ailment you can imagine. Every day I heard "I don't want to be here on this earth! I've got nothing left to give. I want to die!"
So I called her bluff and had hospice come and evaluate her. She qualified. She went under hospice care. She lasted 2 weeks with them and started whining "Nobody CARES about me! Everyone wants to just let me die!"
Pick a nice fall day when the weather is lovely. Try to get your dad outside on a porch or somewhere that the weather and sunshine will lift his spirits a bit and have the conversation with him. Let him know that you wish to RESPECT his wishes and more than anything, you want him comfortable and at peace and hospice can help achieve this for him, but he needs to agree to let them come evaluate him.
Have you contacted Council on Aging in your area? Please contact them. They will conduct an interview to see what his needs are. They offer help with sitting, bathing, light housekeeping in his room and preparing light meals.
Also call the doctor to explain your situation. What about hospice? Have you considered having hospice help?
Finally, is he on Medicaid? What about a nursing home?
So sorry that you are struggling with this on your own.
Others will offer more advice on the topic so stick around to hear more.
Thank you for your reply. My dad would never talk to anybody else about getting help. He hates everybody... I know that sounds a bit extreme. But if I were to get anyone in here asking ANY questions about his health or what he might need. He would have a conniption fit... Then he'd be so angry with me, it would not even be funny... I wish I could do that. But he's been wanting to just go be with mom... But he's not going to do anything to end it himself on purpose. He just doesn't want to do anything to prolong his his life, even though some medical attention and maybe some pain killers for his horribly painful feet and legs would improve the quality of what's left of his life... There's just nothing I can say. He's just so angry all the time about everything... I found this website when I was just looking for some light at the end of the tunnel. And so glad I found it, and that it's free.
It has been so hard this past year. I don't really have any friends, not anybody that I can talk about this to. I tend to internalize my private thoughts, especially negative ones. Because I askew conflict.
I have been so worried about him the last couple of days... He has had a bit of trouble swallowing the last few years, but since yesterday he hasn't been able to swallow anything at all and I am so worried that this is it... He WON'T go to a doctor or even want to talk to anyone about his problem...🤷♀️ I am at a loss... I just want to know if it's going to be my fault, cuz I didn't wrestle him to the ground and put him in my car and take him to the doctor. I believe that borders on kidnapping...