Can my MIL's guardian override her living will?

UPDATE -

Good news is, the daughter has come to grips with the fact that her mom is dying. She asked her brother (my DH) his opinion and he told her that they needed to respect the living will - no feeding tube, DNR, etc. She then agreed. We are contacting Hospice today and will proceed. It will be sad to lose her, but also she is a shell of herself, that's not my MIL in that bed - it's what's left of her after this series of strokes ravaged her.

The more interesting news though, in talking with the nurse, she said that though the Living Will is important, the family had the ultimate decision -- YIKES! They would try to steer the family to follow the LW, if they know about it, but can't override the family's decision.

Bottom line - make sure your family (or at a minimum your POA or potential Guardian) are willing to abide by your wishes.

I'm sure "enforcement" of Living Wills vary from facility to facility, but this is how it would be handled at our local hospital. It just underscores what we say on here all the time -- have those talks with your loved ones, find out what their wishes are, make a plan, and make sure everyone knows the plan -- and do it now, while they are able to make these decisions and articulate them.

I have never gotten a tattoo or piercing in my life, but am tempted now to have "DNR/NO HEROICS" tattooed on the left side of my ribcage where a medical person would have no way of NOT seeing it. I asked my sister to hook me up with her lawyer so I could do a POA and Advance Directive, because I absolutely NEVER want feeding tubes, amputation of limbs, intensive surgical intervention, etc. Leave me the flip alone, let me go if I am on the way out the door!

Do the doctors have a copy of the Living Will? I can tell you that they will do their BEST to talk the guardian out of doing the above.
Then it may go one way or another. As you have to understand the doctors do not want to deal with hysterical guardians claiming that they are allowing death when they should have/could have treated.
I think that the important thing here is that you make certain Doctor has the Living Will and that you THEN stay well out of it. If the guardian is FIGHTING and feels backed into a corner by you, then he/she will continue to flail madly without thinking on this. They will have an enemy to fight instead of the grief of facing this painful loss. The doctors and social workers and clergy can do much more good than you can.
You understand that this guardianship holds a lot of power. The guardian is free to say "Look, I spoke to her right before this happened and she told me 'I want to make out a new living will because I want to live, and I want everything done; my friend Hulda just had a feeding tube and she was right as rain in weeks'."
Leave it to the doctors and Social Workers and other staff to make the facts clear in a very kind and gentle way. I wish luck to all and and sorry for these circumstances. Hope you will update us.

Thank you AlvaDeer -- always the voice of reason and good ideas!

I feel for the doctors, they get stuck in the middle of trying to do what's best for their patient and appease the family members as well. It's a no-win situation.

In my call to get the update last night, the nurse read from the chart that the daughter said "She doesn't want anyone talking about end of life, none of that!" and I'm picturing that it involved raised voices and a little hysteria already :(

And you are so right about me being the enemy - as an in-law, I'm already a second-class citizen to her. DH will make sure they have the document, and then we will step back (and I'll be two steps behind him even, lol.)

I expect it will be like you suggested, much flailing and fighting - and I understand, it will be coming from a place of fear and pain for my SIL, and I have great compassion for her. Any of us who have lost a parent know how hard that whole situation is, and how it breaks your heart no matter the circumstances.

Thank you for your input, it was really helpful!

I’m pretty sure a guardian can override a living will. Hospitals and doctors will ultimately defer to the person who has the ability to sue them instead of the person lying in a coma

No, she shouldn't be allowed to override it.

My daughter, RN, would not even recommend a feeding tube at this point. Its only prolonging the inevitable and can do more harm then good. Especially if the body is shutting down. I would ask for Hospice at this point. From what you wrote, this child should never have been guardian. She is letting her emotions override common sense.

I think this is a matter if timing. Is your MIL close to death? Is it imminent? Or are the feeding tube and vent interventions to help her recover? You say she's recovered from strokes before. If death isn't near, I think the procedures could be worth doing. If the doctors think she is close to death, then why would you want to deny your MIL her wishes? Sure, we all want our LOs to hang on but at what cost? Realize death is a part of life and we all have our druthers. Some of us will declare how we want to spend our last hours, some would rather leave it up to fate or burden the family with the final decsions. If these are her last days, how would it benefit her to prolong her death? How would it benefit the family?

If the family decides to override her wishes, you may have to live with the consequences of that decision, added expense, knowing you went against her wishes, watching her on a vent and other emotional scars you may acquire. Of course honoring her wishes could also result in "what ifs" by the family. I would want my children to honor my wishes.

First, the big question in my head is: do you want her to do that? Seems that other readers assume you don't. But maybe you do want her to. Knowing your goal affects how I think about your post. But I'll stick to the question asked.

Every time dad was admitted to the hospital the staff asked him about DNR and health care directive. His directive says no DNR but they ask whether he wants recessitation. He would always hem and haw about it; that he wanted recessitation if he could expect to recover fully. The doctors would then say there's no middle ground. If you don't say DNR then you get full recessitation.

In other words, the document is not the final story; not the final word.

It's good to have the document. But people need to be on board with what it says.

Also, the daughter seems to be denying the reality that her mother is dying. She's not ready to let go. That's unfortunate considering her position. Hopefully she will find the strength to let go.

YES.
Living wills are not written in stone and can be changed.

If she has a Living Will she probably has an Advance Directive, they are usually done together if an attorney was involved. Find out what it says in her Advanced Directive. A guardian or power of attorney should never willing go against the wishes of the person they are representing.

When they do it is often not because they think their loved one would be better with the feeding tube, clearly that is not what the doctor is saying. The problem more often than not is that the guardian or power of attorney can not let go of their loved one so they are insisting on the feeding tube. They are making decision based off what they want NOT what is best for their loved one.

I would contact a Elder Law Attorney and talk about challenging the guardianship so that your MIL shes are honored.

I am sorry you are having to go through this, keep us updated on any progress.