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windytown Asked October 2016

Sister-in-law's want my father-in-law to go back home on hospice to die but he's totally unmanageable!

FIL in respite care for end stage prostate cancer, bone mets, falls. Background: 85 year old father in law was diagnosed with prostate cancer 1 1/2 years ago. He was estimated 3 to 6 months to live. He is morbidly obese, on coumadin for 40 years and suffered a heart attack in August. He has a tumor in his spine and bone mets throughout his body. He has broken a bone just showering with no trauma. Edema in his legs has caused his flesh to break. He requires leg wraps twice a day and also is incontinent. He recently went on hospice and they are thinking he needs a catheter. He has had three falls in six weeks, once he fell hard enough to dent the sheet rock and make a hole in the wall. EMT's were called twice resulting in ER visits. Survived that, but extremely unhappy in AL. He has another week paid for in AL and is MAD about that. Just wants to go home to live alone! Huge mobility issues will make it difficult.

JessieBelle Oct 2016
His daughter's insistence that your FIL get his dying wish says to me that she wants to make sure that comes true for him. I am glad that she personally wants to come home to care for him. That is what I would tell her -- that he is welcome to come home as long as she'll come home and do the things that need to be done. I wouldn't be surprised if she changed her mind if she knew that was the only condition.

Katiekate Oct 2016
I would tell the SIL that he is coming home to her house or not at all.

It sure gets tiring dealing with all those family members who are so free with advice and demands....all the while being unwilling to actually do anything with their own hands.

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Countrymouse Oct 2016
Most people when asked will say they want to die at home.

But here's an odd thing. Many people who are actually dying undergo an abrupt change of mind, and want to get themselves to hospital in a hurry, or at least to a facility where every possible medical intervention is available. I'd call it panic except that it seems to me to be an entirely rational response to the ultimate crisis.

I got into a fight about this subject on my old school's Facebook forum. A well-known, long-serving member of staff had died, and her non-participating great nephew had posted criticisms of her health care team (professional - she had no close family) to do with her being taken to hospital against her will, what a sad end, how terrible that they didn't protect her wishes etc etc blah blah blah. I pointed out that she had been found acutely ill and in terrible pain, and her consent to being admitted had been given. He replied that I obviously didn't know his great aunt. Actually I knew her better than I'd wish on anyone and thought her a tyrannical and sadistic cow; but given that I therefore wasn't very objective I refrained from commenting further.

But Windy, in your FIL's case it is different because he himself wants to go home. Take that as the starting point, then "SIL meet FIL, FIL meet SIL, she agrees that you should go home and she will therefore be assuming full responsibility for your discharge arrangements, in-home care and palliative treatment. Best of luck!"

Rainmom Oct 2016
My brother was like that for a few years - telling me just how our parents and later just mom, after dad passed - should be cared for - calling the plays from his vacation home, based on what he saw on his - at best - twice a month visits that lasted an hour or two. It's enough to wind you up on an episode of Snapped! Last year, after brother retired and actually began visiting twice a week and actually helped out with a problem or two his attitude certainly changed. Tell your SIL to put up or shut up.

jeannegibbs Oct 2016
He wants to go home. His daughters want him to go home. Leave them to it. Depending on their skills and availability and with hospice's help, maybe they could make it work. Stranger things have happened. I hope before they make any definite plans they sit down with his care team and learn exactly what will be involved, and also discuss with hospice what they'll be able to do.

CTTN55 Oct 2016
I see from your profile that you are caring for your mother in AL. What's the previous situation been with fil? How long has he been in AL? Did you do care for him before he went to AL?

What is your husband's stance on all of this? He would be the one to make fil and your sil's "die at home" dreams to come true, right? Is he planning to move in with his father? What is his plan? How does it involve you? If he acquieses to his father and sister's "die at home" wishes, then it's on him to make it become a reality. NOT YOU. Of course, I know this is easier said than done (I have my own issues with boundaries with my mother).

windytown Oct 2016
For some reason lost connection. Anyway, FIL has one more week in AL. Absent daughter is adamant he gets his 'dying wish' to go home to die. She does not live here. Thanks honey from the people that have been here forever! Childless and oldpeopleness gives you a lot of freedom. You can be so f'ing CARING without wiping people's butts and pulling a catheter out of their penis when it's bleeding. So sick of the family.

JessieBelle Oct 2016
windy, your FIL's weight makes it nearly impossible for someone to care for him at home. It would be difficult if he was half his weight. I would not even attempt to care for my mother at home if she weighed 300. Moving him would require a lift and at least two strong people to make sure it was done safely.

I think your SIL's ought to leave well enough alone and just enjoy visiting him in his AL place. Given his weight and his history, bringing him home would be a mistake, IMO. He needs a team of trained professionals to help him.

windytown Oct 2016
Well, I have a very positive follow-up. FIL will be staying at the AL willingly. A longtime friend had a heart to heart conversation with him yesterday and my FIL had a meeting with a home care service.

Treasure the fact if your elders have long term friends available to them. I'm not so fortunate. Anyway, FIL's friend was able to get through to him about his many falls recently and he would not wish for him to be alone. Later in the day, a home care agency told him that his care is out of their range of abilities and responsibility. In short, he is beyond home care.

My husband told me it went as well as can be expected. His dad is upset but resigned. Told them to sell his place and settle his things. They all had dinner together at the AL and talked about settling him into his own little apartment at the AL.

HUGE sigh of relief as anyone can imagine! Thank you so much for your support AC friends. There will be rough days ahead but a least he will have a team there 24/7. I feel so fortunate for everyone involved having gone through my own dad's terminal cancer without that kind of care for two months. Hospice was a blessing but they are there rarely unless called and my mother wouldn't let us more often than not.

Prayers for all of you going through hard times with stubborn family. I'm sure ours are not over but a least this decision was made with not total angst and drama.

My thoughts are with all of you and again many thanks for your kind advice!

Rainmom Oct 2016
Ah yes, who's the most devoted and therefore the most deserving?!! I guess that in a way I was lucky - my brother is too self centered to have kept his devotion up for long. After about two months he was back to vacations out of state and extended stays at his "other" house - and out of my hair. At least, most of the time.

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