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Cassie1026 Asked February 2021

How do I get my stepmom declared unfit to make her own medical choices?

My Stepmom is 60 years old. In 2018 my son and I, he was two at the time, moved in with my step mom so that she can have surgery. She has lymphedema and had two large lipoma that needed to be removed from her legs because they were causing her walking issues. At this point in time she weighed about 550 pounds but was still able to walk around. Most of her weight is in her lower body, her butt area her thighs, like I said she has extreme lymphedema, both sides and in the saddle bag region. She’s very large so she did really great postop and was walking by herself, didn’t need assistance. She used her walker but I didn’t have to be there for her to get in the car. She was doing great and in January 2020 she climbed into her bed and never got up again, no explanation, no nothing. Every time I asked her you know hey what’s going on I’ll get up tomorrow, I got up last night, and flash forward to October 2020 she was up doing some thing and I noticed that she had a little sore on her bottom and I asked her about it she said I don’t worry I’m taking care of it and I asked her about it Weekly since then. She showed me pictures and it looked like it had gotten better and the other day I found blood soaked towels under her bed and she told me that the wound on her butt was leaking so I called the nurse that helped us the last time postop and asked her to come and she help me get her cleaned. The sores are horrific and she has been acting funny and we called 911. She refused to go. We called her doctor they called the family and she refused to go. I believe that she is just waiting to die. She’s miserable and doesn’t wanna live but she works and she was taking care of her self and incredibly well up until this past year. She’s not mentally incompetent. Is there anyway that I can get medical decision making taken away from her so that she can go in the hospital and get the treatment that she needs for these ones, she has two now apparently? She isn’t mobile at all anymore like she used to be able to stand, toilet herself and she can’t anymore. She lies to me about her condition and capabilities of caring for herself. I just don’t know what to do anymore. I can’t care for her on my own, she’s too big. She weighs over 600 pounds now. I can’t turn her or move her alone. We do have a medical air mattress but it’s obviously not enough with her never moving out of the bed I just don’t know what to do.

BarbBrooklyn Feb 2021
In my experience you can call a hospice organization and have THEIR doctor do an eval for hospice. This might not be true in all states, but I think it is worth a shot.

If mom wants no treatment, I think the best response is "okay, mom, then we will call hospice". I think in some cases, is shakes folks out of their "I want to die" state of mind.

Geaton777 Feb 2021
Have you considered she may have a UTI? Or a another condition that's new to her, like a thyroid problem, which can cause changes in personality and behaviors? She is only 60 but UTIs can be caused by physiological changes, aside from hygiene issues. It may help to discount these treatable health concerns if at all possible.

I also affirm along with the other responders that you and your son are a priority and that no, you cannot help her by yourself anymore. It is not actually possible. May you be blessed for sticking with her and doing all that you've done so far. Like Ruth and Naomi (the Book of Ruth) in the bible.

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Sendhelp Feb 2021
Depression can be treated. You are right to try and get her help. Lymphedema can be treated, but not cured. The bed sores do need to be aggressively treated, and the infection not spread to others in the home. Did she have cancer? Did she recover? Then just give up on the serious pursuit of healing over the years? You did right to call in the nurse. Is your stepmom willing to have help come in? The nurse is obligated to report these conditions, required by law (mandated reporter). Adult protective services should be coming out, so this is the time to share, not hide anything on Stepmom's behalf.

It is obvious that you cannot do the care yourself. What did the nurse offer as a possible solution?

Your stepmom is not listening to you. Time for an intervention, calling APS.
Are there some other resources of family she may have?

You may need to remove yourself and your 5 year old son from this environment. He is your first priority. I read in your post that you have a good attitude and want to help/get her help. That is so much better than having an attitude of wanting to punish her for being ill. But you do need to protect your son 1) from the infection, 2) from the hopelessness of your stepmom.

It may not be that she is legally incompetent, but depression can get her admitted on a hold so that she can be evaluated. Hiding soiled and infectious materials under the bed- - -with a child in the home---
How aware are you about the spread of infection? You can safely get advice here.

Her room should be off limits to the 5 y.o., imo.

Love demands a response for all concerned. My heart goes out to you, your son, and your very ill stepmom.
Cassie1026 Feb 2021
Hello. First thank you. Thank you for understanding that my son is priority #1 and that his well being should be first. For understanding that I can’t do this alone and that I shouldn’t have too, I’ve had much guilt. My son has not been allowed in her room/with her/near her since she started acting weirdly last week. I thought it was the beginning of an illness. She didn’t hide the linens she through them in a garbage bag and didn’t seal it properly, still it’s gross and disgusting. Will not be tolerated. She has stage 4 lymphedema and we’ve gone for treatment they custom fit pumps for her and she just refuses to use them. This is an ongoing battle. The nurse did report and they called her primary who called ambulance transport (not bariatric though) she refused 2x 2 different days to go to hospital and signed AMA. I’ve spoken with social workers and they say she is “sound” Truthfully, I think if I make it known I’m moving out, that will be the only way she will get into a facility. Only because she has no choice at that point.
Countrymouse Feb 2021
Call APS and get them involved: there are two issues to address, your mother's *self-neglect* (it's her neglect of her own best interests that's the problem and that poses a serious threat to her) and her mental capacity right now while she is (or at least may be) extremely ill.

You see, although you have been told (?) that your mother is legally competent, with that risk of infection I would say that your mother's mental capacity is very much open to question - bear in mind that this isn't by any means a permanent situation, you're not saying it's forever, you're saying that right now her physical condition is such that she is unable to make the rational decisions that she herself normally would.

Also bear in mind that we don't know how much of those 600lbs is water. This is treatable, surely? Poor lady, I'm so sorry for her despair - as well as for what it's putting you through.
Cassie1026 Feb 2021
We have treated the lymphedema for years custom fit pumps for her. She never used them. Not more than 2x everything I’ve done since moving here to help her has been met with resistance.
Martz06 Feb 2021
If she’s eating herself to death and all she wants to do is die, has she ever tried therapy? It sounds like she is very depressed 😕
Cassie1026 Feb 2021
She is depressed. She isn’t eating herself to death. She doesn’t have great eating habits but she is bed bound due to lymphedema.
AlvaDeer Feb 2021
Hospice will not work with someone because mentally they wish to die. It isn't yet allowed in our country, though in some countries it is. No doctor would say that she has 6 months to live.
She also is competent to make her own decisions.
She is 600 pounds, so if not bedbound now, then she soon will be either because of breathing issues or a simple inability to move weight-wise.
Who is bringing in and cooking all the food? How is she getting an unhealthy diet would be the questions asked of all families of patients in this condition. The answer is always "We bring it because she gets mad if we don't".
Beatty says "There will be no solutions as long as you are all the solutions". I believe instead of trying to get control and step forward you should be stepping back now into your own life. She is 60. She is competent. Leave her all the numbers to call. Let the choices be hers.
If death is truly her wish, then surely she is headed there all on her own. I am so sorry. I can't imagine how difficult and sad this is to see, but I doubt there's little you personally can do about it.
Cassie1026 Feb 2021
No one brings her unhealthy food. She weighs what she does due to the lymphedema. I stopped bringing her home food and now she orders it for delivery. Her groceries. She knows I won’t bring home junk. The lymphedema plays a huge part in her weight and is the reason she is immobile
BarbBrooklyn Feb 2021
Call Adult Protective Services in her area. They may be able to help you get emergency guardianship if she is endangering herself.

BUT, if she is of sound mind, she IS able to make decisions for herself, no matter how bad.

Perhaps you should offer to call Hospice for her? They will make her comfortable if all she wants to do is die.
Geaton777 Feb 2021
Does she have to be assessed to qualify for hospice?

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