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Natmarie Asked April 5, 2024

My mother is receiving hospice care at home for the second time. She suffers every day from pain and depression, but my brother won’t let her pass.

My mother had her first stroke a year ago and has had TIAs and another stroke. She is a type 2 diabetic with all the risk factors. She is with hospice at home for the second time. They have her on pain medication, antidepressant, anti-anxiety, and blood pressure meds, and finally stopped all the diabetes and cholesterol medication. My father helped cared for her, though his was older and had a lot of health conditions including a broken hip, a stroke, a feeding tube for over three years, and then was in a coma for over 2 months because my brother didn’t want to take him off of life support after he was rushed to the ER and they spent almost 2 hours resuscitating him (barbaric). He passed last November after I was able to have a majority of his 3 other children, older, agree to let him pass. Now my brother cares for our mother, I come 1 to 2 weeks a month to help. My brother has lived with them 49 of his 52 years and has not had a job for over 25 years. He has no mental or physical conditions except for my parents supporting him and my younger sister (she is 55). It is heart reaching for me to see my mother suffer as she does, in pain and crying, pleading with me and points to the sky. She never put anything in writing, neither did my father, but she has always told us not to let her suffer like her mother did with dementia. I know that my brother’s life will be changed forever once she passes as he will need to move from the home he has shared with them most all his life. However, I feel he thinks of himself versus the suffering of our parents in trying to keep them alive with pharmaceutical drugs, now my mother with blood pressure medication that hospice has her on to prevent another stroke. So much more to the story but I need advice not just for my mother’s care but also how to help my brother do what’s best for our mother.

Grandma1954 Apr 5, 2024
There is no way your brother is in control of when, if or how mom dies.
Mom will die when she dies.
the Hospice Nurse, social Worker and Chaplain can talk to your brother about how important it is that mom be kept comfortable.
If mom is in that much pain request that she be placed in the Hospice In Patient Unit for Pain and symptom management. (A stay like this for these reasons IS covered by Medicare/Medicaid and Insurance. It is also not considered Respite so a Respite stay could be utilized at a later time)
It is the goal of Hospice to make sure a person is comfortable so there should be no problem with this request.

Daughterof1930 Apr 5, 2024
When you say your mother “never put anything in writing” I assume she never named anyone to act in her best interests for a time when she couldn’t do so for herself. This is POA, or power of attorney. If she doesn’t have this, would she be able to soundly answer questions asked by her hospice nurse of what medications and treatments she does and does not want for the remainder of her days? If she is capable of doing this, even in a simple way, you need to set this up with the hospice nurse as soon as possible. Then the meds mom doesn’t want or need can be removed from the home entirely. She also needs to sign a form called a DNR if she hasn’t already. My dad had to sign one to enter hospice care,, so this is likely done. Be sure that form isn’t lost and follows mom if someone takes her to the hospital. Your brother is lost in his own emotions and fear of the future, you simply can’t depend on him to act responsibly. He definitely needs to take advantage of the grief support and clergy services offered by hospice

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AlvaDeer Apr 5, 2024
I am assuming that brother is living with and doing caregiving?
I am assuming that brother is the POA?

Hospice is involved. That's a good thing. They should be providing pain medication.

However, there is now way to simply withdraw everything if that is what you are asking.
You and your brother disagree on caregiving. As he is the primary caregiver, and I am guessing is also the power of attorney, his word on these issues is the one that matter.

It sounds to me like the end is coming. I would simply remain as good a support as you are able to in the caregiving. It is not unusual in these end stages for the siblings to disagree. That hospice is there means that your brother is facing this as end of life care.

I agree with Peggy Sue that Hospice being there, their goal and mission SHOULD BE to relieve the pain and anxiety. I hope your brother is agreeing to relief through medications and is willing to provide sedation as per Hospice instructions.
olddude Apr 5, 2024
Her mother is still capable of telling the hospice people to stop administering all meds except the pain meds. There is nothing the son can do about it.
PeggySue2020 Apr 5, 2024
Whether there are bp meds on board or not isnt the issue. The issue is that her pain and agitation obviously isn’t controlled.

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