We finally get mom/gramma to the ER, and one day later the oncologist, after some tests, find she has lung cancer, stage 3. We talked about doing a biopsy to confirm, but since one of two masses found, left and right lung area, it's a no go. Reason being, the left side mass is imbedded within mom's aorta they said the c.t. scan has revealed. May go ahead with radiation treatments to only they say "buy mom some extra time, because she has very little time". I am, also the family that knows, at a loss for where to go from here. We can begin with some basics, like finance (paying bills). Question is: going forward, do we need legal advice, because I can see now that dissention, anger, fear, etc. is coming fast as sadness has already. Thank you all for your guiding lights of information also. We'd love some more input upon putting things in context since this position have never made our aquaintance, if you will. Thank you.
"Don't give up' needs to be weighed with the quality of life.
My client, 65, was in incredulous pain for at least 2-4 weeks.
Hospice has 24 hour supervision and empathy for the patient as well as the family.
Hospice (maybe Medicare too and Medicaid if she qualifies) can provide some equipment. If she qualifies for Medicaid, they often can cover limited hours of care (Medicare, I believe, can also help with covering some cost of outside help, if the person qualifies.) The SW at the hospital might be able to answer these questions, and perhaps help you to get the help you need. Hospice at home generally isn't a full time coverage.
If anyone can provide part-time care for her, it would reduce the amount needed to hire outside help. Just thinking she might prefer to be in her own home, with family, than stuck in a hospital.
I've not had experience with hospice, but being on this forum, I've read about the experiences of others. Like any business, and even employees within the business, these can vary widely. My understanding is that if you are not having a good experience/relationship with one selected, you can terminate them and switch to another. Try the one sent to you privately (if you don't know how to access that, ask!)
Given she has dementia as well as the lung cancer, forgoing treatment might be the best path. As much as we don't want to give up on our LOs, we also don't want to see them suffer. My mother just turned 97 and is past halfway through year 4 in MC. The only treated condition she has, besides the dementia, is high BP, which she's had for a very long time (has taken medication for years.) While I'm doing everything I can to manage her affairs and see to her needs in MC, if she were to get a terminal Dx I would'nt want to put her through any extraordinary measures. She did request DNR during the first round of EC atty documents and specified what she would and wouldn't want for treatment too. She's had UTIs in MC, but those are easily treated and treatment is'nt invasive. She had knee pain about 2 years ago (knew, and said many times, she should've had knee replacement done.) Rather than continue with large doses of ibuprofen and Tylenol, as suggested by her doc at the time, I took her to orthopedic. They did xrays and confirmed that she should've had it done. He said if she were 20 years younger, we'd be talking surgery. There was no way, even if he suggested it, that I'd put her through that, given her age and condition. What I requested he did - injection in the knee to help reduce any pain. So far, it hasn't come back.
As to finances, whether she can sign any documents is highly dependent on her dementia status. Mom was deemed capable by our EC atty although she was in the early stages. He was used before, to set up everything for mom when dad wasn't well, so we knew and trusted him. He chatted with her alone and was satisfied she could sign. If your mother has assets AND can be determined competent enough to sign documents, you should try to pursue that. IF she is willing to do this, I would include at least one other family member to witness the decisions and signing. Select from those who are most opposed - it might ward off any contention later that she was coerced or incompetent.
Signing over the house to a trust or those she'd want to have it would be good. Getting access to her account so that you can process any bills/payments she needs to make would be good too. The bank may insist you use their forms, but obviously she can't go to the bank! I had no problem with ours when using the POA to assume control of mom's finances (YB and I were also on her primary acct, which likely helped - I brought her with me, but she said nothing and just rifled through her purse and wallet, at both banks!) A good EC atty, if you can afford one (with her assets hopefully) can usually push the bank to work with you.
Technically in order to use her SS funds to make payments, you should sign up as Rep Payee (their rules!) However, that process can take some time, first to get appt to file and then waiting for it to complete review. I wouldn't stress over that at this time.
If no atty considers her competent, guardianship is the next step, but it's often expensive and time-consuming - sometimes they can process it as emergency, given the situation, but at least start with getting atty to work with you and her. It's much easier and quicker to honor her wishes if it's managed before. Certainly it can be done via probate, but that takes time, and with some contention within the family, it could get dragged out longer!
All the best to you, your mom and family in this difficult time. :-(
I had a neighbor whose mother kept falling, had stroke, heart problems, and she had hospice in her home for 5 years. A daughter was full time caregiver, but hospice was there every day till she had to be hospitalized due to a stroke.
You are bettr off getting hospice now and be sure all the papers are executed in case she gets worse. There is nothing worse than watching your loved one struggle with eating (mine refused all food the last month), or do anything other than lay there. Consider hospice as soon as you can-for everyone's sake, not just yours or your loved one's. Your loved one will be comforted by very nice people.
Just in case you didn't see my answer to your question underneath my original post, I sent you a private message with all the information you requested - names, phone number etc. along with their background. I've already called them as well this morning letting them know about your situation and that you might be calling them. Just remember, there's no harm in just seeing what they have to say. I hope all goes well!
My birth father had Alzheimer’s, then suffered a massive stroke that left him brain dead but very much alive. Hospice helped him pass within two days, when he may have stayed there, in that condition for months or even years.
Since your Mother has terminal cancer, and the aorta is involved, she cannot survive, I’m sorry to say. You’re time left with her may be very very short. Hospice may be a blessing to her. It would save her unnecessary pain and breathing difficulties, and a possible painful demise.
I hope I have explained the purpose of Hospice a bit better. I’m sorry that this terrible situation has happened to your family. I wish you the strength and courage to help your Mom and your entire family to the end of her road, and the recovery that comes after.
Are they nurses or wha? the ole' saying goes 'man or a mouse'. Not to be critical, as in this case, no finesse, care response etc niece said quietly, etc. I assume it's "no icecream for you kid, if ya wanna act like that!" mentality.
So, we come to HOV care and for comfort. Fine, she/Mom goes there, takes the same books to that class, what'll they do? Also, family is concerned about mom and all of her health issues, as families do, going on the ride with her to hospice, wholly unaddressed. Do they massage her, read at night to her, bring in family counselor for a group meeting once a week, help her to stay cognitive etc before the lung cancer have its way? Never did this with brother at all. By the way, his pain was never about any cancer, it was an auto accident early in 2016 that lingered as he had a legal battle ongoing same year. Lastly, the claim of phentynal/morphine doses hour on hour till one Odose, then revived him just to do it again at another HOV three blocks away, totally not justified, don't see it. Because if I have a terminal illness pain free as with even Mom/Gramma does now as the Dr. and staff tells us, then by all means care and comfort then, w/o the doggone dope such as those they never asked for. We trust hospice very very little at best. Let the person pass on thru here, if dope is needed then Kiley down or up the street may suffice. Kavorkian couldn't do it, even with pts. ok to him. Hospice sad to say is no diff.
Thank God, which many aren't ashamed to say, has us clumping together now, in order to benefit Mom/Grandma etc back to her home, for some icecream plus cake. She deserves it, ya think? God bless all. Any input is certainly welcomed. Firm and direct is no problem. Take care...
Does she have a will? If not, is she the type of person who would want to have this conversation right now after learning she has cancer - would she think you all have thrown in the towel while her mind is still set on getting well? If the conversation would just add to her fear and anxiety, leave it alone. Probate can sort things out later according to the rules in your state. I would suggest that you talk to her to determine what her wishes are at this point and see if she wants someone to carry the medical wishes out by having her designate a person to do that. Then get the paperwork done. Many people are agreeable when you put it to them as - what if you couldn't tell the doctor that you want this procedure or that one, who would you want to speak for you.
Absolutely do a pre-arranged funeral or cremation because funeral homes will gouge you while you are grieving -- with pre-arranged funeral/cremation you are in better control and also have discounts.
Me, not big on Chemo if not guaranteed to cure. Lost an Aunt at 80 to lung cancer. I really think she did the first bout of Chemo for my Mom. She refused the second bout. My sister died from an aggressive breast cancer. She was on chemo 8 months, only to pass about 4 months later because the cancer had spread to her brain. Would she have lived just as long if she hadn't done Chemo?
Chemo does a number on our bodies. It effects the heart. You have no immunity. You are sick and throwing up. Personally, I would not put someone suffering from Dementia through this. They will not understand what is going on.
Sorry that Hospice didn't seem to work for a family member but this is how I look at it. The person on Hospice will eventually pass. Morphine is given to elevate pain and ease breathing. A person on Hospice should not experience pain. Its suppose to keep the person comfortable so they can pass comfortably. Overdose or not, the person passed peacefully. You have to look at the quality of life.
I know I would want to be in my own bed and die at home.
Have her put on Hospice Care where she will be kept as comfortable as possible.
They will send a Nurse to the home, she'll get meds to help relieve her pain and an Aide to come 2-3 times a week to give her a bath.
All of the above, her Insurance will pay for.
Of course, depending on her condition, she'll need someone to come by and check on her daily to someone being with her 24 7, dividing up the time amoung family and friends or paying for a Caregiver to be with her a couple hrs or more a day.
My sister died of Cancer 7 yrs ago and I had her living with me the last 3 months and tho it was sad and hard, I would do it all over again.
My 96 yr old Dad is still in his own home where he wants to be and I have Caregivers 24 7 for him which is expensive but Dad has money to pay for at least 3 yrs and after that I'll hire a Live In to care for him, which will be less than half the price.
Prayers.
Just some comments on your post, and my experience that might offer some insights:
1. Radiation as stated is hard on a patient, especially one who's older and is already in Stage 3. With dementia, radiation will be brutal. She won't understand it and think she's being tortured.
That's what my sister looked like after every radiation treatment. It was emotionally painful beyond description, for both of us. In the long run, it didn't do any good; she died anyway and the last several weeks of her life were nothing that I'd ever want to see someone else endure. And she was still fighting to live.
So I'd opt out of the radiation and focus more on the end of life comfort.
2. Are there any religious hospice organizations in your area? I'm not at all a religious person, but I found that they're far better and more stringent in compliance than any of the several hospices I called when I was selecting one.
Some asked personal questions which I learned when interviewing with the Catholic hospice (first for rehab, but Dad segued quickly into hospice) should NOT have been asked. The nonreligious ones, including ones recommended by a good home care agency were pushy and demanding wanting to get us signed up quickly. I really resented that. There was no compassion at all.
3. The rehab then hospice facility we chose had very compassionate staff. As Dad grew closer to the end, the DON arranged for a pot of coffee, pitcher of water, and snacks to be brought to the room when I stayed with him. One of the chaplains also brought food; another found a tv channel with soothing music.
I was very, very impressed.
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I'm not entirely clear on the legal issues. Are you asking for assistance on that aspect as well? If, so:
4. Whether or not your Mom needs a will depends on what assets she has to convey, and whether or not they're jointly titled with the heirs. If everything she has is jointly titled, with rights to the survivor(s), assets will pass directly w/o the necessity of probate.
5. If she has no transferable assets, she won't need a will.
6. If she has assets but isn't able to create a will now, she would be passing "intestate", subject to the intestacy laws of the state in which she resides. These are statutorily prescribed levels and orders of succession.
As to legal advice, it would depend on the answers to question 3 - 6. And as to taking over care, you mention paying bills. Would your family be able to agree on someone to handle this? As asked above, are her accounts held jointly with another family member who could assume this task now?
Does Mom have a home? Where is she living now and where will she stay? Are there enough family members in the area to provide 24/7 support at her home, or one of the family member's homes? In terms of meals, is she able to eat anything? Her desire to do so will begin to wane as time progresses.
You mentioned that dissension, anger and fear are coming fast. Is this over treatment options, how to get acceptable hospice treatment, asset management?
I'm so sorry that your family is going through the devastation of mom/gramma's diagnosis. That alone is hard enough but, to deal with dissension, anger, fear and more on top of it only makes it that much more difficult.
I can't imagine her having to go through radiation treatments for what could just be a couple weeks or months. When my husband's father was diagnosed with cancer, he was only in his 40's. He was a big, strong man but let me tell you my husband, who was 16 had to drive him to a hospital two hours away for his chemotherapy and he would always get extremely sick in the car after each treatment.
In my own case when my dad was diagnosed with Stage 4 Pancreatic Cancer in 2004 at the age of 82 even though surprisingly he told the Oncologist he would try the chemotherapy, it would have only kept him alive for a very short time. I knew my dad well - I just couldn't see him being able to handle it. We had a long talk and I told him I didn't want to see him suffer and that I would like to have hospice come to our home (my parent's home where I grew up) and have them do an assessment. He trusted my judgement and that was the route we took. He remained home until he passed away three weeks later. They took such good care of him. It was my first death of a loved one and to this day, I have never been more grateful and thankful for God's mercy. Honestly, it was meant to be - I never heard of hospice before and while I was desperately trying to figure out what to do I heard a radio commercial for a hospice company. I called right away to have them send me their information packet and everything fell into place from there. The strange thing was I never heard that commercial again until many years after my father had passed away and I had listened to the same station, at the same time everyday.
May God give His strength, wisdom and mercy upon mom/gramma, you and your whole family in the days ahead.
P.S. I just read your reply to someone who commented. I think we live in the same city and I just got a great hospice company for my mom now. I'm sorry you had a bad experience with a previous one here.
Where is the disension coming from? Are there family members who want a second opinion? It's probably pretty easy to have her CAT scans sent to another hospital, but given the advanced state of your poor mom's dementia, I m not sure I see the point. Cancer treatment is brutal; do you see the point in subjecting her to more suffering?
Im pretty sure that hispice is the correct answer in this situation. You want her to be in no pain and free from anxiety and agitation.
(((((Hugs))))))
Ok, the social worker option I, we can begin with for sure. It is in Mom's best interest first and foremost, and not so much ours. Except she/mom isn't cognitively aware of even her lung cancer diag. let alone can make any decision's to fanancial/medical issues. Wouldn't be fair to her either, I feel, to bombard her, along with as someone commented about going thru radiation/chemo subjugation or process. Makes sense. I will soundly firmly handle any rift within the family ranks, as I am going through medical issues myself, to meet with the social worker Monday, to have a better perspective in regards to Mom/grandma, as I or life's God had me step forward for our loved one, army veteran bravo Co. cadet, etc... 'bout four years ago. We though as a family unit, the one's here, are and shall be eternally grateful to all of the input/advice/recommendations etc. you all have made through this, I stumbled upon, site for forum time. Shall not subject Mom to anymore pain or sickness through chemo or radiation neither as was suggested from the oncologist, no way. Shall keep all of you commentors, 'natural avocates for truth and love', I'll say, in our prayers and may have, of course I shall, input to help to guide someone else which may be going through similar situations, directly or indirectly. And, the hospice option is not, for me, off per se, the table in no way. I today can say I have no room for hate or anger, which made me very sick in 2017, for anyone who may be harboring that stinkyness I call it, but I am human and still perplexed to a degree, as to what were they thinking when the obvious was so very obvious. And with that, May the God of all life, however presented or accepted to one, be there up front in any of life's roadways ahead for all of you and all of life that's helpful and never hurtful. Peace.
Unfortunately things will happen within the family as they have always happened.
May God grant you all strength and wisdom during this difficult time.
Your profile says Mum has dementia, so if her paperwork, Will/POA documents are not in order, that ship may have sailed. If Mum does not have a Will, you need to find out what happens when someone dies intestate in your Province/State.
Talk to the social worker at the hospital about what services are available to your family.
In your post you say no discharge from the hospital. Do you mean to home, but perhaps to a nursing home, or she will stay in the hospital?
Talk to the doctor about Palliative Care, ask lots of questions and take notes.
Has Mum discussed in the past what she wants for a funeral? Covid-10 has changed how we mourn, but there should be some way to include her wishes and or cultural practices.
You are worried that your family is going to break, do you have a trusted advisor to whom you can speak? There are a great many posts on this site from people whose families have broken over caregiving and the death of a family member. It is a sad situation.
My step father died 6 weeks after getting a cancer diagnosis 2 years ago. He has been diagnosed with dementia a couple years before. For him it was a blessing in disguise. He stayed in the hospital, a couple times he was scheduled for discharge, but the doctor realized that there was no way Mum could manage him at home. He had 24/7 professional care, family had unlimited access to him (before Covid-19), and Mum was able to catch bits of her life at home.
It was not easy for the family to have him go from being healthy other than the dementia, to being deathly ill. But during those weeks, his daughter was able to visit several times. Mum was able to get support from the Minister, Hospice, family and friends. Even the lawyer who prepared David's documents was an incredible help and a true friend to Mum, helping her enact the POA documents, deal with banks that did not want to accept them, and after death he helped to settle the estate.