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Hospital threatened to take guardianship unless I brought an advanced directive. I brought a living will, as there was no advanced directive. Mom is still in hospital, just over three weeks. I know they are buying time by keeping her here. I've taken mom to this hospital many times before. I don't know why other than their anger at my not consenting to some medicines she had known allergies to.

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Juju, not providing an Advanced Directive is to my understanding NOT a basis for guardianship. I doubt if any judge would entertain that kind of guardianship action.

However, I'm wondering what other issues are involved. Why was she admitted, what are her diagnoses, and what are her prospects for recovery?

I can think of a possible situation when someone might have threatened, trying to intimidate you, and that's if some medicine to which she has a known allergy might be the only life saving or appropriate medicine under certain conditions, and those conditions are a factor either now in her treatment or could be, based on her conditions.

Even so, only a temporary guardianship would make sense. Hospitals don't have the capacity to manage guardianships.

Could you explain why you "know they are buying time by keeping her" there? Hospitals don't do that; Medicare standards are strict and if a patient doesn't qualify to remain in a hospital b/c of a Medicare standard (s) , then the hospital isn't going to get reimbursed by Medicare.

I suspect there are other issues at play here.
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He spoke with a judge, ex parte? And the hospital supported this? I'm more than a bit skeptical that a judge would speak with one party unless it was at a hearing.
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Ah. There is family conflict over who gets to make decisions.

You say you are in charge. Brother says he is. Hospital needs decisions so they need to know which of you can make them. Hence the need to see the written documentation. Does the Living Will name someone as the person to make decisions? That is all that is needed -- it doesn't matter what the document is called.

In the absence of clear authorization for either of you, the hospital is apparently seeking some emergency authorization to make decisions for her. I'm not sure if that would be full Guardianship, but the intent seems to be to allow them to control the meds she gets.

Have I got this right?

What is Mom in the hospital for? CHF symptoms? Does Mom also have dementia? Is she unable to make decisions for herself?
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So your Mom has what is known as "expressive aphasia" where the person knows &/or understands what is being said to her, but is unable to express her thoughts or ideas or wishes clearly or coherently through speech or written word.

Did your brother ever get involved with your mother's previous hospitalizations? If not, then there was no reason for the hospital to ask for more information than your POA & Healthcare POA documentation. Now that he is involved the hospital is caught in the middle and they are trying to clarify who has legal authorization to make healthcare decisions for your Mom.

Where does you Mom live--at home alone, with you in your home, in assisted living? Lots of people don't want to go to a nursing home, but sometimes their health gets so poor that the best place for them is in an assisted living or long term care facility/nursing home.

When a person has lots of medication allergies or tends to have adverse reactions to many medications, it becomes that much harder to treat the person because they might be allergic to or have adverse reactions to the "normal" or regularly prescribed medications used to treat a condition.

Did your Mom have a stroke that caused her aphasia and does she have other problems such as weakness of her arm(s) or leg(s) so that she needs someone to help her get dressed, transfer, feed her, etc.? Is your Mom's CHF and aphasia (& other health problems) so bad that she could qualify for a nursing home or even hospice? These organizations do intake evaluations prior to accepting someone as a resident or client? If your Mom does go to a nursing home or into hospice care, who is going to pay for her stay? Is your Mom going to be private pay? Or will Medicare or Medicaid pay for part or all of her stay at the nursing home or hospice?

You need to talk with your Mom's lawyer ASAP and let him/her know what is happening so that he/she can assist you in doing what is BEST FOR YOUR MOM.
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Definitely get with Mom's lawyer. He should be able to speak for her on many subjects including who has contributed to Mom's care. That just may shake the brother up a bit.
I was granted guardianship when the DW's lawyer spoke in favor of me and no one contested my request.
Incidentally, the judge froze DW's savings account since she is living at home. I could only access her checking account until it reached a level of being frozen. So I have placed excess funds from checking to savings and I am only allowed to withdraw $250.00 on a monthly basis for DW's expenses and needs.
Those actions were in accordance with NV laws. It may be different in your area. If brother thinks he has found a money pit, he may be in for a rude awakening.
Best wishes and good luck to you and Mom.
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Hi Garden

Mom had dehydration. They said it was chf. Her bp has been good for the past week. From past experience, that's what they wait for to happen and then discharge her.

Adversarial brother somehow got involved with hospital and said he wants guardianship over mom. He has been trying to take her from my care for many months. He has never contributed anything towards her care. He just wants control of everything and to put mom in nursing home, where she doesnt want to be.

He told me he talked to the judge and the hospital is behind him. That i will be served.

Mom is being used as a pawn unfortunately.

The point of contention was always refusing certain medications that cause adverse reactions in mom.

When asking doc why can't she go home, I just get a different response each day. Nothing in particular or that makes any sense.

Thanks for your concern Garden.
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Any ethical judge would not speak to anyone about a case.
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jeannegibbs May 2018
But many a relative would lie about what has gone on.
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FIGHT. You don't needan attorney, the judge will want to see your fight. Who knows more bout everytging than you. Today I won guardianship of my mom, it was the hardest but most empowering thing I hav ever done it went on for 2 1'2 years 32 court appearance then the trial where I made myself the most educated person in the room, I made all of them look like the liars they are, but you need proof of everything. Tips for ya the regret of not fighting will haunt you till the day you die. Document everything call logs, pictures, save all emails, bank statements most important research every law, research everyone involved even judge. Court service center make a best friend there cause all documents you need there help. Have a plan tell the judge what u r goin do as guardian review and reserch every thing bout your parents disease and potential LTc facilitis, do reviews on all of them. This won't be easy there will be a lot of lies anintimidation and a lot of sadness, but never give up always remember your parent would have already been in the right for you. You got this and you have never experienced pride like this. Start the fight right now
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Why won't you give your Mom blood pressure medication?
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Your Mom would be a challenge to any doctor no matter where she is because of her unusual response to medications.

Coumadin 5 mg is a rather high dosage to start on unless there is a crisis. Many doctors start at 2-3 mg per day and work the dosage up after checking INR, clotting time or Prothrombin time (PT) daily or every other day.

Lopressor (metoprolol) is a beta blocker that has also been given to patients diagnosed with LOW blood pressure to INCREASE their blood pressure—so your Mom’s increase blood pressure after taking the medication can occur, it just isn’t one of the EXPECTED results of taking Lopressor.

Does your Mom take any NSAIDS (aspirin, ibuprofen, etc.) as they can interfere with hydralazine’s effect? According to Davis’s Drug Guide for Nurses 12th Edition: “80-90% of Eskimos, Japanese and Chinese are…at risk for decreased levels (of the drug in their blood stream which leads to)…treatment failure.”

Why did the Doctor discontinue pain meds? Did the doctor prescribe ANY pain medication at all? Or did the Doctor discontinue just the more potent pain meds? Has your Mom been taking pain medication prior to her hospitalization? If so, which one?

"for the first time in over a year, Mom was moving her right leg and arm" (she was writhing in pain)...Still, I hadn't seen her move that side in a long time...She follows commands for me", apparently your Mom has NOT moved her arm deliberately to hold a glass or spoon/fork, or uses her arm when eating or getting dress or performing any ADLs. This arm and leg movement might be caused by pain and physical therapy isn't going to help her arm or leg get better function.

Some doctors have a difficult time working with patients who do not have the expected results to medications and are not often willing to listen to the patient or their families which is SAD and counterproductive for the patient and the doctor. Is the doctor who is taking care of your Mom a “Hospitalist” or is it her Primacy Care Physician? You need to continue to be your Mom’s Advocate in this situation.
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