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My mom also had compression fractures from osteoporosis. They put her on hospice for her COPD, but at the time that was not the problem. They gave her morphine and Ativan (with my sister encouraging it). Long story short I was told my mom was dying twice, she didn't, I stopped it.


Eventually she moved out of her home to a home where she was encouraged to eat and get out of bed.
They limited her Ativan and stopped morphine. My sister got a new hospice. She moved to independent living and was doing great! In 8 months living in independent care my mom gained 30 Lbs. She was going on field trips, managing her dentist appoints, and even a facial peel.


This July my mom got a new compression fracture. My mom get's very hysterical and is a terrible patient. My sister again encouraged a certain level of inertia in regards to her care. Encouraging her not to get out of bed, and she did not provide the extra aides to help with eating while in independent living. Hospice RN mismanaged her pain meds too. My mom starting walking, but had several set backs N/V, poor appetite. I encouraged aides and kept telling them about the N/V, and diarrhea.


This took weeks for the RN's to adjust meds, and diagnosis c-diff. My sister felt my mom was suffering and encouraged my mom not to received antibiotics for UTI, (after c-diff) flu shot, and to not get out of bed. I talked to the RN and my sister was allowed to make those choices for my mom. Eventually after 3 weeks and talking to the nurse, and doctor she received antibiotics. I was told the DPOA can do this. Is the true? and I asked the doctor why he put her on Hospice in March when she was doing amazing. Better then when she lived all alone two years ago. He said his experience has been that patients live longer on hospice for maintenance care.


During my experience under his care the RN's have mismanaged her medicines, and caused my mom unnecessary side effects. Basic important things were over looked and took weeks to get the correct action.


I communicated with the doctor my experience with the last hospice and my sister's mindset of my mom is she suffering and she has a poor quality of life. I communicated to everybody that mom my gets emotional and very hysterical when she gets fractures and to just give her time to heal. Just recently, after her last fractures she was most sad that she can not drive. I told my mom that people think you are dying. I asked her if she wants to die, and she said some days I want to and other days I don't.


The California health department found 3 violations in regards to my mom's care with the first hospice. I sent the current hospice a copy of the violations hoping they would listen to my concerns. Its disappointing to me that the MD renewed her hospice 3 times....knowing our story. And the RN manager listened to my sister refusing my mom an UA (she got confused) and I had to fight for this.(my mom eventually got antibiotics after 3 weeks of confusion, and the antibiotics helped) It was a constant power struggle with my sister, but to me regardless of DPOA there is standard of care, that would dictate the care my mom would receive. When asked to speak to the RN Supervisor the RN case manager said she would call me back....after 6 weeks I realized she was not being honest. I called the doctor and the Owner eventually called me and answered my questions. The RN was not always honest with me avoiding questions, and deflecting. My moms hospice clients are about 70% dementia patients and 20% cancer patients. My mom was mentally with it to make her dentist appointment , get a ride, and be on time, all without my sister knowing about. She called all my kids on all their cell phones, and remembered over 25 names at her independent living home. Is this the new normal? Is this the new direction of hospice? Is it normal for a DPOA to be able to refuse appropriate medical intervention under managed hospice care?

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So the MDs are not right. Your Sister who was given POA by your Mother is not right. The nurses are not right. But you are right?
I don't think any of us here are in a position to judge the right and wrongs in this matter. When a patient is in hospice comfort care is rendered, palliative care, not curative care. Yes, the DPOA will act now when your mother is unable to secure the kind and amount of care she believes your mother would wish to have were she able to make her own decisions. She will do the best she can in this matter. I hope.
You say that your mother is quite competent in making her own choices. Do allow her to make them then. She could appoint another POA were she to wish to.

Wishing you good luck.
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Also, compression fractures are painful. There is not much to do while healing except to promote comfort and *maybe* light physical therapy exercises to maintain some muscle tone.
Hospice & palliative care can provide pain management without your mother having to see a pain mgmt specialist, which for her would be very painful traveling to & from on a monthly basis.
I think you should take another look and may find what your mother is getting is exactly what mom needs.
I agree with others in that hospice doesn’t mean death is imminent. In my area, there aren’t many certified palliative care centers but there are, fortunately, enough hospice organizations to meet the community’s needs, so often patients have to be admitted under hospice.
Maybe it is time to offer to have a heart to heart with your sister so you can understand her plan. Both of you want the best for your mother but it sounds like you two don’t communicate well.
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From what I understand, people can and do get better under Hospice care so I do agree with the doctor you talked to. It's not a death sentence and it doesn't mean someone has 6 months or less to live, although that is generally when they take over care for a patient. I think patients are reevaluated every 6 months and can go off of Hospice. Hospice is about comfort care and sometimes giving Antibiotics is part of comfort care so they are not withheld unless a family requests they be withheld. That was my experience with our Hospice when my mother was moved into that level of care.
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If your sister is not acting in accordance with your moms wishes then she is in violation of her fudiciary duties. From my understanding only the MEDICAL POA can make health care decisions. And ALL decisions are required to act in the best interests and in the exact manner as the person would if they were healthy and of sound mind.

I would go to www.nelf.org and meet with a certified elder law attorney and find out how you intervene to protect your mom. This may be as simple as her changing her POAs to you seeking guardianship. An attorney would be able to help you understand what your choices are, how they affect your mom and what your responsibilities would be.

I hope that your mom is well taken care of no matter where she is. A good hospice will encourage her to continue with the course that keeps her healthy and comfortable.
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MyThreeSons Jan 2020
A fiduciary POA does not handle medical decisions, only financial. (https://dictionary.cambridge.org/us/dictionary/english/fiduciary)

A healthcare proxy handles medical matters. I'm not sure where a medical POA exists. Do you mean a healthcare proxy?
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And that what concerns me. My mom was on hospice without cancer or (terminal) disease. My sister refused antibiotics for a UTI and (she got confused after having diarrhea) and for. 3-4 weeks I had to fight for antibiotics. My mom got them, and became less confused. So, I just don't think it was appropriate for the hospice nurse to withhold them for my mom. It should not have been an issue. So, that s why I am concern. My sister believed in/and tried to euthanize my mom(I stopped it twice) and I told the current hospice the whole story, my sister never denied anything. But the current hospice thought it was my sister's right to refuse basic medical care for my mom on managed hospice care. So, its really not managed care, just basic hospice care. Therefore, if my mom was doing great , going shopping, and day trips why did the doctor continue on hospice? So, I think this is a new mind set ....and its concerning to me.
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worriedinCali Jan 2020
Your mom was on hospice with terminal disease—COPD. There is no new mindset, there appears to be a lack of understanding of what hospice is. It’s not euthanasia.
your sister didn’t try to have your mom euthanized. Good luck to you.
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It sounds to me like you girls love your Mother very much and are trying your best to care for her.  It also sounds like she's getting very good care.  Caring for an elderly parent is challenging, to say the least, and it is SO important that those involved work together when making decisions.  Your Mother is blessed to have such caring, concerned daughters - please don't allow this to come between you.  There are many here who can give you great advice, but going straight to the source is always advisable.  Hugs to you - you're so stressed (and believe me, I understand).
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Rowdyd Jan 2020
Your very sweet. You made me cry. My family did not agree to a mediator, counselor, and does not think my mom has a good quality of life. My mom is scared, doesn't want to be a burden, emotional ,and has pain. I know my sister is doing the best that she can with her perspective, and mindset. She has stayed true to that. But as DPOA she was given this honor to care for my mom, and to work with all of us. In the process of this sad story our family ...has been divided, and I don't recognize them. In their attempt to stay true to their ideas, the grandkids are not in each others lives. My mom does not want that . My siblings created a situation of a no win, no win. I had to agree with the situation or your out of our lives.(21 months later my mom is still alive!)

Thats the very last thing my mom would ever want. All for their perspective of "quality of life," end her suffering. What makes me concern is that under "hospice" good intentions can actually causes more suffering. If your under hospice for "manage care" some care depends on the knowledge and leadership of young and inexperienced nurse making medical decisions. The doctors are not as accessible . The system allows for things to get overlooked, and these things that get overlook can be costly to the patient. Thats why, I think if you are on hospice for "maintenance care" the patients should be managed differently. I think sometimes patients get pigeon holed, and its hard to see people differently .
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