Can my sister have my Mother declared incompetent to make her own medical decisions?
Mother (age 85) has decided to have her 2nd hip replacement surgery in just under 1 year. The first hip was bone-on-bone, so having that done was very essential to her quality of life. She had a terrible time afterwards, didn't want to go to the rehab facility, moved facilities twice, refused PT, fought with all us kids (5 living sibs) and basically had a truly h*llish 8 months as she worked her way back from the surgery. It was hard on all of us who were trying to care for her....she FINALLY is now back to a kind of "new norm". She didn't need a walker pre-surgery, now she can't get around w/o one. Post surgery she fell many, many times, setting off her alert button and making life stressful for all of us. Even during all this, she was also seeing drs trying to get back surgery. Luckily, she was refused by every dr she saw, and she shopped around plenty.
Recently she saw the dr who did her knees and first hip. He approved her for surgery. We were all appalled, as A: he told us less than a year ago she wouldn't live long enough to need it done and B: the first one was so awful! 4/5 of the sibs are in agreement that this is a bad idea, given the last surgery, and though we are all on the same page as far as making sure she knows she HAS to stay in a rehab center until the doc lets her go and that she promises to be more compliant this time--my youngest sis is going to call the drs office on Monday and let them know she is going to fight them on this and try to stop it.
Mother is NOT incompetent, IMHO. She can take care of herself, manage her own bills and (sort of) take care of her apt. She's alert and aware of her surroundings, she gets out as much as possible. She lives in an apt attached to my brother's home, so there is always someone around to check on her.
I am not thrilled with the idea of her having another surgery, esp as her recent one was such a difficult and stressful process, and she will not be able to walk ever again w/o a walker, but she is relatively pain free and her dr is now allowing her pain pills for "palliative care"...so the pain isn't the issue. She just loves surgeries and all the hoopla that goes along with them. (She's had nearly 100 since she was about 30 years old).
My question is: can my sister have her declared incompetent to make her own medical decisions? I queried her as to why she's doing this (the sister) and she said she was afraid Mother would die from this surgery. Well, Mother does want to die and she has often said pre-surgery that she'd love it if she just didn't wake up. I don't think my sis has a chance in the world of stopping this surgery and she should just make peace with the fact mother is still in charge. None of the rest of us sibs are worried that Mother will die--we're actually shocked she made it through the past year. Sis is the youngest (50) and quite attached emotionally to Mother, also Mother slips her money as sis asks for it.( She is actually not even in Mother's will at this time, as she has taken well over $100,000 from Mother as "loans".) Speaking for the 4 sibs who think her surgery is a terrible idea, we still support her in it. Sis thinks if she stops this dr Mother will be OK. Not so--she will shop around until she finds a way to get what she wants. I want the sibs to all be one cohesive unit and not split into factions like we were about the last surgery--not the actual surgery but the post-surgical care.
Mother's basic health is atrocious, we're all shocked the dr okayed this. BUT, she's not unable to make decisions. Good ones? Probably not, but I feel that legally taking her autonomy away will just cause her to cut this sibling out of the family and cause more grief.
Any ideas?
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I did ask my son (who is an attorney, but not in our state) about this and he basically said the same thing. Sis has no money to "waste" and actually, no support from the rest of the sibs on this. I am GLAD that it's that hard to have someone declared incompetent. I am not that many years away from this scenario myself! I know sis is just very upset that Mother is doing this against all of our "wills" so to speak. But, Mother is not incompetent, and no court nor dr would find her so. Wacky? Surgery crazy? Attention seeking? Yes to all 3, but not incompetent. Our hope is that she gets this done, behaves herself for the weeks following and is at least able to be as mobile as she is now, not worse off. She knows if she becomes wheelchair bound, she will have to go into assisted living. None of us has a home set up for that dynamic. Deb--yea, If she picks out her own rehab center maybe she will do better. She picked the "bad" one last year, based on a photo of one lovely private room that didn't even exist in the facility and was furious when she got there and was stuck with a semi-private room. This time she will tour a bunch of them and make a decision. Gives her and her BFF something to do, I guess.
Ironically, the sister who is kicking up the fuss is the youngest of the bunch and the least attentive to mother by far. My brother does the lion's share, I pick up the slack and the 3 other sibs show up every once in a while, when they think about it.
As a family, we have decided to simply support her in this and let the chips fall where they may. Last year was absolutely horrible with her 1st replacement. I expect no difference this year, except maybe all of us kids are on the same page and she won't play us off one another as she did last year.
Deb-don't take the blame, sounds like you had no choice. It's really hard caregiving to our parents, we often second and third guess what we could or should have done differently. As long as they are calling the shots, we have to be respectful, but we don't have to LIKE what they choose.
Last year, on the day of her first hip replacement, her dr told me and my sis that she would not live long enough to need the other hip replaced. I'm sure she hasn't walked 150 miles in the past year, she's so sedentary. No way that hip is as worn out as the first. But it must be bad enough that the dr will do it. SIs told me that Mother is spending some time this week with her friend scoping out rehab places. She hated the one she was placed in last year, so she's making sure she loves the next one. It's all quite depressing to me.
Well, thanks for your input. Did you read my whole first post? Mother has had nearly 100 surgeries--so obviously talking to her about NOT having a procedure isn't the way to go with her.
She lives with one brother. He does benefit somewhat financially from having her live there as she pays some of his bills. As she should! He takes her to drs appts now she can no longer drive. He is the one who gets ALL the "crap" thrown at him--so for him to have her away for 6 weeks will mean a lovely summer for him and his family.
I live a mile away. I go over as often as I can. I clean, shop and do what she asks me to do. Other brother, and 2 other sisters call once in a while or drop a card in the mail. Easy peasy. SO for my youngest sis to be so frantic about this upcoming surgery is a mystery to me. She literally does nothing for mother. But, she's her favorite kid, now my oldest brother has passed--and she knows it. Talked to my brother who does have POA and he was upset with her, but after we talked for a little bit, he agreed that if he did anything to stop the surgery, Mother would be furious with him. And he is a huge "Mr. no-shot" meaning he NEVER stirs the pot. Mom will have this surgery, no matter what we think or do, only if her dr changed his mind. Dr is out of the country until 2 days before mother's surgical date. It's going to happen.
Yep, if she winds up in a wheelchair, then she moves into assisted living. If she doesn't wake up from the surgery, then she gets her "wish".
I do not mean to sound callous, but I am nearly 60 years old. I have dealt with mother and her emotional manipulations for my whole life. I'm not going to be held captive to fear that she might die-she's wanted to for 40 years.
Oh, her first surgery was a success, actually. She did wind up walking with a walker and will use one for the rest of her life, but the surgery itself did away with the pain. I think she pursued THIS surgery as her 6 month attempt to have another back surgery didn't pan out. This is def. a woman with a plan. I personally am going to support her, but be firm about her compliance with the drs and rehab facility.
I hope that your mother will be compliant with the after-care requirements.
I think it's probably b/c she's the youngest, and as you wrote emotionally attached to your mother. To me that suggests she'll be more if not hypersensitive to any possible danger to your mother. I'm not suggesting she cares more but she might be more anxious because apparently she is somewhat financially dependent, but she also seems to have some anxiety for your mother's safety if the surgery goes forward.
I've seen that in my family - my father tells me repeatedly "QUIT WORRYING!" But I'm the only one taking care of him, so of course I'm going to worry. And he does take chances. He's quite determined to do what he wants, much like your mother.
I think the only things that moderated my anxiety were (a) sleeplessness and recognition that it was harming me, (b) I couldn't change anything and (c) he's living his life the way he wants to, and it's better that he should go that way than in a hospital or hospice.
No problem, I appreciated your thoroughness in your answer! My sis is going ahead with the "intervention" but after talking to both of my brothers, I know she can't do anything to change the surgery. I will try to be sensitive to her, something is off that she can't accept that Mother is aging (and the past year has aged SO rapidly)---I am grateful that in this surgery, we all know what to expect and will all be on the same page as to Mother's care and such.
I do know that there are unscrupulous drs who will prey on aging people and this is terrible--but as I said, this dr is a "repeat" one--my one brother had a sever car accident and this dr put his legs back together several times. We totally trust him.
Thanks for the words of support. I do hope Mother gets whatever she wants/needs from this. Attention, friends surrounding her, family, I don't know--she's a pip. for sure.
After reading your second post, especially the laudable compliments for the doctor, I think it's fortunate that she does have such a good physician if she is determined to have the surgery.
I see that you really have a good assessment of the situation and will do whatever you and your siblings can to make it workable for your mother after the surgery, which is the most positive attitude I think anyone can have, given that your mother is intent on the surgery.
I wish your family the best outcomes for this pending event, and do hope that everything goes according to plan. Sounds like your mother is still pretty tough at her age! And in many ways it's admirable that she is still intent on determining her own course of action.
Mom's dr is a very well respected orthopedic surgeon with NO sanctions, NO malpractices, nothing negative in his file. Been in practice over 35 years--is actually retiring very soon. I have ultimate faith in him. She did go through a thorough vetting process for this surgery. She is "qualified" to have it. He is not a quack--and I am very aware that there are many not-so ethical drs out there who would do this surgery if her chosen dr wouldn't.
He does prescribe the pills, but 5 mgs of Norco 3xs a day for pain in someone her age is NOT abuse. She cannot tolerate Tramadol, she hallucinated on it and that was a major issue from the last surgery, which took us months to figure out. Ibuprofen has rotted her stomach lining. She's 85....I personally think that many drs under-prescribe pain meds for geriatrics --mom is addicted, for sure, but she's not abusing them. She needs them to function. He's NOT a pain pill dr, he wouldn't give her anything stronger than the Tramadol after the last hip surgery, and as I said, it caused her a lot of misery. hence the very recent re-introduction of Norco in her life. Nowadays that stuff is so highly controlled, she cannot possibly get more than the dr gives her. Why should she have pain and misery day after day at age 85? That's cruel. None of us kids has an issue with that---it's only one sibling who is terrified Mother will die on the table. That's always a concern, even in younger, healthier people. She is NOT incompetent, she can and does make decisions regarding her finances and her life. My sister just has this issue with trying to stop the surgery from happening for her own personal reasons.
Without question, Mother is and always has been a hypochondriac. She doesn't get a cold, she gets pneumonia. She turns her ankle and wears a boot for months. My husband commented that he has never known a time when my mother wasn't in a sling, a cast, neck brace or wrapped in ace bandages. Again, at 85, she's not going to change. She did abuse many prescription drugs all the years we were kids at home and long after. That takes a toll on the body.
Her cardiac condition is the one area where she is probably the best. No heart attacks, HBP is under control. Diabetes is under control, Cholesterol under control. I KNOW her dr would have denied her if he truly felt she was a bad candidate. (And he knows she would shop around until she found someone who would do the surgery.) I think he is making a difficult call here.
OF COURSE she loves the drama and attention of the multiple surgeries. We've all known that for the last 40 years. She is who she is, and again at age 85, she is NOT changing. We just want the best care she can get and if she wants to die, of course one day she will get that wish.
I think you might have mis-interpreted what I said. I am supportive though not happy about this latest surgery. All 5 of us sibs have spoken to her and we all say the same thing: If you want this, then do it. BUT, you must be compliant and act decently towards the PTs the nurses and all of us. Also she has to be aware that this may lead to further decline in her health, and if she is wheelchair bound afterwards, she is going to be placed in long term care. Her apt is NOT set up for that dynamic. She has agreed, and only my youngest sister is going behind mother's back to try to get her surgery denied. I doubt she can do it. She does not have POA over mom's affairs, my brother does and he is on board with the surgery. After thinking this through, I think my sis is terrified my mother will die--she handled dad's death terribly. A lot of guilt, I think, but that is her problem.
I appreciate your reply, but I have complete faith in this dr. I can't control my mother, I can only support her. Trust me, if I thought she was not competent to make this decision, my lawyer son would be on the case. I really think the problem is my sister's and I am sorry for her unease.
Check with your state's list of doctors who've been reprimanded, or faced some other kind of action because of incompetency, unethical practices, etc. It may be that this doctor is a quack.
When I worked for one particular medical malpractice firm, I became aware that there really are doctors who do operate without justification, just as in the movies! In this case the doctors were preying on indigent people, doing experimental surgery. ... straight out of something I might have thought only the Nazis did.
You could also check with the hospital with which he/she is affiliated to inquire as to the same issues. If the hospital gets inquires on a specific doctor, they may become suspicious and do their own investigation.
As I was reading your post, I was wondering if your mother enjoyed the drama and attention she gets during surgeries, and I think you've already suspected this. Alternately, with over 100 surgeries in 55 years, there may be an issue of hypochondria. I say this not to be cruel, but only to suggest some influences. I think most people her age would not be enthusiastic about a surgery.
I do NOT know if hypochondria, if diagnosed, is grounds for consideration of mental incompetence - perhaps just an imbalance.
Is this the same doctor who's "allowing" pain pills for "palliative" care? This raises a red flag right away. If they're narcotics, you might see if there's a way to determine as well if this particular doctor is one of those who freely prescribe narcotics.
I don't know if the AMA or the state licensing board or even the DEA could go after him if he's a "pain pill doctor", but it's worth a try, even if your mother would be furious with all of you if you do this. However, if it he is a pain pill doctor, he needs to be stopped before someone is seriously compromised.
You state her health is atrocious - what about her cardiac condition? That assessment will be made before surgery. Are their other factors that could influence the surgery? Have you contacted anyone in the administrative department or the head of surgery in the hospital where the operation will take place?
Sometimes working around the periphery can produce results that a direct approach can't.