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My 82-year-old grandmother lost a son to cancer 5 years ago. She requested all life sustaining measures even when the cancer returned and metastasized to his bones and brain. His brain swelled and she even had the doctors drill a hole in his brain to drain the fluid. He went to her home on hospice where he died a day later. She recounts the story today as if it were yesterday. She still doesn't sleep and is not over his death. He was 59.


Now, my mother is at the end of life at 59, multiple medical issues including cancer, but that is not the primary issue. She listed me as medical power of attorney. The youngest child of 3 age 39 and we discussed in detail what she did and did not want years before her sickness took over. She did not want all the life-sustaining measures her brother received and she did not want her mother to watch her die and carry the burden of her death like her brother.


My grandmother now wants to be by my mom's side all night in the event she passes away and she also wants to bring her to her home on hospice. All the things my mother did not want. My grandmother is angry at me saying I am keeping things from her and isn't really speaking to me.


How do I honor my mother’s wishes and still maintain a great relationship with my grandmother?

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First I want to say that I can't imagine what it feels like to lose a child. I can only assume it is the most difficult thing a mother can experience. So I get where your grandmother is coming from, however, your mom has voiced her last wishes and I feel like you need to honor that. Have a heart to heart with your grandmother and tell her you know this is heart wrenching for her and you want and need her involved in these last moments with your mom, but you have promised your mom what she has requested and grandma needs to respect that. Ask her not to make this any harder on everyone than it already is. Explain that you would honor her last wishes as well if she were in the same position.
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My family and I went back home yesterday to celebrate our daughter's birthday with her friends. We live out of state.
My daughter said it didn't even feel like her birthday because she didn't get clothes from her grandmother like she always does. I had already held mom's hand in the hospital so she could sign a birthday card and shipped a gift from mom to my daughter. She was so happy to see the gift and card, she wore the nightgown the same night.

GM asked the nurse again again if she could stay the night, so the nurse called me. They are well aware of our family dynamics now. I took some of your advice and allowed it. After speaking with a family member, it is clear that GM may have some mental impairment as she is aging.
Noone else has said anything about this as if it's a secret. I sympathize with her and based on our last interaction, I didn't even recognize the person that was being so mean to me.
I cried at the airport and called to check on mom before we took off. Being here has me so confused. What am I supposed to do next? I just want to care for my mom. I still can't sleep either and I'm afraid to take a sleep aide, fearful that I will miss the hospice call.
I'm really sad now, missing mom and not able to talk to her. I just can't be at two places and I need to get back to work, but I have no desire to do so.
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You are all going through so much. You seem to be the most level headed right now. Would it help to have the Hospice Chaplain, a Priest, or Clergy talk to your Grandmother? She has so much turmoil because she is going to see another of her children die. It has been said that a parent should never have to bury their children. Unfortunately, many parents do. Your Grandmother can only feel emotion. She should be allowed to sit with her daughter, but not override her end of life wishes. Your Mother doesn’t want to suffer any longer. Hospice has such a nice way of helping the final process. I will pray that God gives you strength and peace through this. Be selfish tonight and know that God has has your back. Find peace and sleep. It will soon be over and it will be okay. Hugs and Prayers to you and your family through this difficult time.
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Ignore your grandmother and follow your Mom's wishes. What she inflicted upon your uncle sounds incredibly abusive.
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SadlyYours: Without restorative sleep, your grandmother is not able to think clearly. I am so sorry that your mother is at the end of her lie. Love and hugs sent.
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Sadly, you need to let the hospice folks take over now. They've been advised of the situation and the danger to your mom. You've done your best.

Now, go home and sleep.
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After all of this, I'm almost ready to let my family do whatever they want. Just let GM stay the night with mom, and have them take care of everything. Even the funeral and burial when the time comes.

I'm heartbroken and so tired, I haven't slept in 2 weeks. I was up all night calling the hospice unit to make sure mom was OK it being her first night there and all. I made sure she had pictures of her family too.
No one else is showing that they care, they aren't doing any of those things. I'm the one that's following up with nursing staff to ensure she is treatied well, I clean her hair and moisturize it. I place warm towels on her head, I make sure her skin is moisturized. I clean her nails.
Why is everyone so angry at me and blaming me for everything?
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horticulturist Jul 2022
Many people think everyone should be saved and extreme measures to do so show how much you loved the person. I believe that following someone's expressed, last wishes to the letter really shows love. Sometimes love causes us to do selfish things, and I believe your grandmother is experiencing this, if your description is accurate. She is afraid of the loss of another child, and we can weep for her as well. I am so very sorry you are experiencing this. You may not be able to preserve a "great relationship" with your grandmother, but your mother is your first responsibility.
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An elderly mom who is suffering the loss of two of her children is close to the epitome of sadness. Dealing with an elderly mom who has suffered the loss of her children is super tough.

First thing that comes to mind is to get an Advance Directive pronto.

In the meantime, is your mom is able to write her wishes in her own hand? You may need a notary public to witness her signing it. This maybe helpful to show your g’mom.

It would be a great kindness to you and your g'mother if your mom could write her mom a letter.

Otherwise, perhaps a bit theatrical, but invite your g'mother to join you for maybe something warm and comforting to drink, like cocoa. 

Tell her that you not only want to tell her about a serious promise between you and your mom but that you also need her to help you respect it. 

With a photocopy of the document of your mom’s signed wishes nearby, tell g’mom that you can't imagine the heart wrenching nightmare of losing children. And that your heart aches not only due to the hopeless and painful anticipation of losing your mom but also knowing how insanely painful this must be for her.
 
Tell g’mom that you are holding up, and will hold up, but she has to know that it is difficult witnessing and managing her heartache and your own. 

Tell g’mom in your words - I love you, and I love mom, and when I think too hard about what's going on I’m short of breath by the thought of losing you both, mom by death, and you because of a rift between us. I'm afraid of losing my two moms when mom dies, and when you won't love (or talk to) me anymore. 

(Hold your mom's written wishes, and continue with), BUT I cannot watch my sick dying mom’s heart torn out as she watches her own mom's pain. I know you want to stop this from happening but it’s happening and I won’t let anyone, not even you, prevent me from not abiding by my mom’s dying wishes. 

Mom is not stupid or without a heart. She knows what the loss of uncle (name) did to you, she can’t endure seeing more pain in your face, and that she’s the reason for it. You are both important to me. She loves you. We love you. Help me give her what she wants. Allow her to just be, to feel gentleness, peaceful, dignified and in control.

SadlyYours,
Are your siblings supportive of you? Can you ask them for help in this.

I have to tell you that my sweetest and dearest friend, who died at 49, requested to receive hospice care at her mom's home. She wanted her mom to be with her and her mom, also a dear and calm person, wanted the opportunity to hold hands, to be present, to love her in-person to the last minute. This mom was a gentle rock for her daughter. Her mom is my closest friend now.

Maybe a palliative nurse or social worker can give your g'mom things to do to help.

Everyone handles great sadness differently.

You have my deepest best thoughts and wishes.
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sp19690 Jul 2022
Great advice but grandma is irrational. She has been told numerous times but she wants it the way she wants it. Posters mom shouldnt have to be subjected to this by her mom (grandma of OP). Its sad grandma is missing an opportunity to show love to her daughter by respecting her wishes.
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Well, it's a bit late, but your mother needs to tell her mother what she told you. Is she able to talk to her?

You are obliged to honor your mother's wishes by your MPOA. You don't have a choice, no matter what your grandmother says about it.

I think you owe it to your grandmother not to keep any information from her, if you have been doing that. She does at least deserve the truth, it's just that she doesn't have any right to overrule her daughter's wishes.

I think it might also be worth pointing out to your grandmother that you really don't want a second trauma, such as that she experienced with your uncle's death, finishing her off. But the red line for you is that every decision you make is about your mother's best interests and expressed wishes, and not your grandmother's.

I'm very sorry for all your family is going through.
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BarbBrooklyn Jul 2022
CM, grandma was in the family meeting when all of the mom's wishes were laid out on the table. She indicated that she understood; from what Sadly has written, it sounds like gma is either in deep denial or experiencing some dementia.
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From your last reply, it sounds as though grandma may be developing dementia.

The hospice folks should certainly be told that she's not dealing with the reality right now.
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SadlyYours Jul 2022
I told the nurse today.
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Sadly, I'm so sorry for this terribly distressing situation and the well-meaning but untutored folks surrounding your mom.

(((Hugs))).
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I went to visit mom today. She's still transitioning, not really able to communicate anymore. But she did hold my hand. Grandma was there, she hasn't been speaking to me. And was really mean, nasty today. She asked me what is hospice doing that she can't do?
I explained these are mom's wishes, that she did not want her mother caring for her at the end. She didn't want her to stress and be a burden to her in any way.
I explained that she would have to administer IV medication, catheter care, identify signs of distress, how to know what mom needs because she can't communicate very much, etc. She said they stopped giving her medicine at the hospital.
It sounds like all of the things are too much for her to process, they did stop all life sustaining medicine on July 3rd, but initiated comfort only measures including pain medication, but she's been so angry at me that she hasn't said a word to me, but want to hug me and tell me she loves like all is well.
I asked her, doesn't she think I would do everything to save my mother? I'm just doing what she asked.

I also found a syringe and cup in mom's room. The nurse was livid because she did not put that in there. We got to the bottom of it and discovered mom's friend told the tech that mom was asking for ice. Which is highly unlikely. So the tech gave her a syringe and cup of water. Mom's friend was giving her water. Mom is NPO and hasn't been able to swallow since July 1st.

The nurse was upset, educated the tech and all mom's guest on how mom could get aspiration pneumonia and choke. She made me remove all snacks and water from the room. She was so made she was considering asking me to cancel all visitation because the staff can't watch activity like this. They are not in the room 24/7. She was really nice allowing more than the allowed visitors, they are generally really strict about this.
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cwillie Jul 2022
Don't stress too much about the water, even though it's against protocols the possibility of aspiration pneumonia is moot at this point.
I'm sorry that it's so stressful and you aren't getting support in real life, but plenty of us on the forum have told you that you are doing good - believe us, its the truth.
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Talk to the doctors about your mom's wishes - if need be in a room away from grandma. Let grandma know that you love her AND you love your mom. You need to do what mom asked you to do as her POA.
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Hospice will not do "life saving measures"
As a matter of fact they strongly encourage a POLST be completed. This document outlines the specific treatment that you wish and that by it's nature excludes specific treatments. (this document may go by different names in different States)
Hospice WILL keep mom comfortable.
Hospice WILL help the entire family deal with what your mom is going through.
Honor mom's wishes.
At the same time help grandma through this time. It is difficult to watch one child die it must be torture to be witness to another.
If you can let grandma do what she can at the same time abide by mom's wishes.
If grandma wants to feed ice chips, if she wants to rub ointment into mom's skin, let her. But don't let her overstep her boundaries.
((hugs)) to all of you,.
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Be brave! Follow your moms wishes. You may have to stand alone but, you will have joy knowing you followed your mom’s wishes when she was able to convey them.
Say to them if you would give someone their final life request… would you not follow them? Regardless of what everyone thinks “you should do” you have a final request to complete … stay the course! Some family will understand and some may not… do what’s in your power to do… they weren’t given the task… you were!! Hold your head high, I’m imagining mom will smile🌹😊. Wishing you peace at this trying time❤️
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I told my mother that it was okay to pass on and that I would take care of Pa. We would all be all right. Then I left and she soon died. Not everyone wants a slew of people around for their last minutes.
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Bless you, essentially you promised your Mom to do things her way. Could other family members help you manage Grandma's wishes and comfort her? I think she must be frantic with emotions, and you have to subdue your own. If your Mom is not conscious, I would be tempted to let her mother be with her. But you are on the spot and responsible.
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Your GM sees her child dying and wants to do everything she can to save her. You are an impediment to her natural need. As a mother I totally get it. This is her baby, not the level-headed adult leader you know. "I must save my baby." She is desperate.

You are desperate, too, to honor your mother's dying wishes. Your grandmother is most likely incapable of honoring her daughter's wishes as her baby is dying.

You are right to do as your mother asks. These are her wishes on her life. Even though GM brought her into this world, your mother is a separate person with her own rights to makes choices about her life. GM dies not understand this because her baby is dying and she MUST do everything she can to save her. GM is reacting emotionally, while you are reacting both emotionally and logically. You may never get through to your GM, aunts and other relatives, but in honoring your mother's wishes, you will be able to live with yourself.

May I suggest the following mantra to be repeated every time you speak to GM and other relatives: "I love my Mom dearly and I don't want to see her suffer. We have thoroughly discussed her end of life care numerous times and I am doing exactly as she made me promise. I know you love her, too, and I am sure you want to honor her wishes, too.."

As for hospice, the hospice providers have very clear guidelines on what they are permitted to do and not do when caring for a terminal patient. Most hospices have only one family member they contact for the care plan. Sometimes there will be a second contact for the financial aspects. As your Mom's MPOA, they are required to contact you for all medical updates and medical decisions. Make sure you explicitly tell hospice that you are the only MPOA and provide them with the paperwork documenting this. They are legally bound to honor this, which will prevent your relatives from undermining your mother's wishes.

Best wishes fir you and may your mother find peace.
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Is it possible to meet the family members somewhere in the middle without actually doing harm to your mom's wishes? Maybe you are certain that bringing mom home under hospice care is not best considering her wishes and care that would need to be provided, but allowing g'ma to stay overnight so that mom doesn't pass all alone at a hospital (or wherever she is) is something g'ma needs. I know that I would have had a very hard time knowing my mom was alone in her final hours or minutes. If g'ma is not being disruptive, what is the harm.

It's not clear from this post if your mom is awake and talking at this point. If she's out of it, g'ma would probably just be in the room, sitting with the daughter she brought into this world. Grief and how we deal with dying is totally different from one person to another.

Another post said you sat with your siblings and g'ma to go over mom's desires and they had a better understanding. Just because you are medical POA does not mean you can't bend a little to help all of them 'let mom go' in their own way. And, of course, those who aren't privy to medical conversations that you have been involved with will have questions of their own. Help them to get these answers.

I think it's very possible for you to maintain relationships with all of the family and still carry out the things mom wants. It's also very possible that when mom gave these directives her wishes were to not burden these folks. Yet, if she could communicate now, knowing the family members want/need to be closer to her in the final days, she may understand they don't feel burdened at all and need this for their closure. Try not to be so 'in charge' that you can't see some of what they need, too.

Not being critical at all. Totally understand that you are trying to do what you were asked to do.
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SadlyYours Jul 2022
She was able to nod and say some words a few days ago and I discussed everything with her again including GM staying the night with her. She said no.
I needed to do it alone because I'm sad and her youngest and only daughter and I needed to pour my heart out from that place. I wouldn't be able to be that vulnerable in front of my family.
She confirmed her wishes again. When I told my family to speak with her, they refuse to do so.
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Your mother made you Medical POA for a reason and as hard as it is to go against your grandmother’s wishes. You need have the tough conversation with grandma and explain gently that you love her and your mother, and as much as it pains you to not go along with her, your mother had clear instructions on how she wanted her end of life to be handled. She trust that you will carry out her wishes. I would tell grandma that I need your support rather than the fight. Stick to honoring your mom. You are POA and it's your job.

Sorry about grandma’s insensitivity to your situation as this only makes it harder. I've been in your situation with siblings and mother, and was my dads POA.
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SLEEPER911 Jul 2022
Good answer...there is a reason the young lady was chosen as POA....honor your mother and HER wishes...
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I’m sorry you have to go through this. My mother passed just a month ago, in hospice care, and fortunately my sister and I were on the same page with mom’s wishes. You have to be strong in this; keep the focus on what your mother wants. Let criticisms from others roll off your back - it’s NOT about THEM. Hopefully these relationships will survive after your mother passes, but they may not. However, you will have a clear conscience because you honored your mother by carrying out her final wishes. Peace to you…
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Sounds to me that Grandma dearest has gotten everything she wants over the years. I'd sit Grams down, and discuss all your moms wishes and tell grandma you WILL honor your moms wishes and NOTHING will change your mind because this is the last thing you can do for your mom and it WILL be done, whether she likes it or not. Then see to it! Don't let someone try taking away what your mom wants. If she gets mad and refuses to speak, oh well. I don't want you to go to your own grave with regrets just because you were trying to keep someone else happy instead of what you mom wanted. Stand up, stand strong and do what legally you should do. Good luck!
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SadlyYours Jul 2022
I explained all of her wishes during the family meeting with the doctors. She didn't discuss death or her wishes with anyone but me. They said she never wanted to talk about it with them, she just kept telling them she was going to beat this cancer. She did, but the rest of her body took a beating while fighting and it just stopped. She's still alive, but can't move, talk, poop. Not even lift her hands.

My husband is now worried about me because of the stress. He said he refuses to tell my daughter something happened to her mom because of this. She would be devastated.
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I suggest that your Mom put her wishes in writing. Would having your Grandmother present as your Mom dictates her wishes, be helpful?
Best wishes to you both.
Sorry, I had not read previous comments before I responded.
So sorry that you're going through this. I can only imagine how hard this is on you.
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I am big on doing what a dying person wants, in writing or not. Several times I have been asked to do something involving money that was not stated in the will. In all cases I was the sole beneficiary.

I carried out their last wishes to a tee, no exceptions. I committed, I followed through. If someone did not like it so be it.

I am nor one to get all worked up if someone does not like it, sorry they need to accept it and move on. I have done my duty.
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Can you show proof of your discussions with your mother? I think Grandma has to be told that decision was made by her daughter, at least in part due to what she saw happening to her brother! Get support from other family if possible, and acknowledge the difficulty Grandma has in losing yet another child - this has to be terrible, not only for her, but for you all. The right decision is in your hands, I think.
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Sadly, how are things today?
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SadlyYours Jul 2022
Hi Barb,

I was hoping things were getting better, but they are not. GM upset that I didn't personally call her to tell her mom was going to inpatient hospice as the doctor recommended. She was in the family meeting so we heard it at the same time.

Funny thing is, I did call her. I guess it wasn't when she wanted to know.

My aunt has cursed at my siblings and I saying we're treating my mom like a pet, we don't care about her and we didn't bother to ask her to take mom home.

3. My oldest brother states he is moving him and his wife into mom's home. Mom is still alive so I am sad about this. How could he be thinking about a house at this time, but he was upset that I called a funeral home for pricing to know what funerals actually costs so we're better prepared.

Please pray for me y'all. I'm going back home for a few days to celebrate my daughter's birthday tomorrow. I live in another state. I am so hurt, that my body won't even let me cry.
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Sadly, is grandma's behavior typical of how she usually has acted over the years (wanting to be in charge, dismissive of what othrs think) or is this new behavior?
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SadlyYours Jul 2022
Barb,
This is typical of my GM, her sisters, & my entire family. No one in my family has ever had their affairs in order the way my mom does and this is so foreign to them. In death, everyone in my family has an opinion on "what the dying would have wanted". The mother takes charge and does what she wants with the advice of her sisters.
In this case, nearly 2 years ago mom told me what she wanted, wrote it down and made me POA to ensure it's done.

GM feels like she is supposed to make all the decisions and speak to all of the doctors. She interrupted a meeting I was having with a doctor saying "I have a right to know about what's going on with MY daughter."

I'm giving them lots of grace because they have never played the back seat before. Even my eldest brother who is adamant that he and my middle brother have a "say so". But this is really separating me from my family and not allowing me any space to grieve my own dying mother.
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The cackling peanut gallery arrived around 9:00pm with visitation over at 10:00pm. (My GM sisters and eldest brother) I spent the entire day with my GM, we all met with the medical team, went over mom's POA document, Advanced Directive and explicitly explained in detail her wishes. Everyone expressed understanding.
I told everyone goodnight, including my grandmother around 9:40pm. I didn't see the nurse for our nightly chat to thank them and remind them of no overnight visitors.

I called the nurse around 10:20pm. The nurse told me my GM asked HER if she could stay the night. She replied, "let me check with her daughter to see if it's okay".
Excuse me, I spent the entire day with GM, not once did she tell me about this burning desire to be by moms side all night, which I explained to her in the family meeting goes against what mom wants.

At this point I'm getting angry because it feels like they are being malicious about everything. Showing up when I'm not there to slither in.

My GM didn't say much in the meeting so now I'm feeling my great-aunts are feeding things to her or GM just cannot accept everything that's going on. I'm thinking she may have some form of early onset memory issues. Of which I would love to help her with, but I am deeply hurt by all of this that has transpired.
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Geaton777 Jul 2022
How old is your GM? If she's in her 70s it is not out of the realm of possibilities that she has ccognitive/memory impairment and others around her don't see it and are aiding and abetting her. But just the fact that she's calling anyone BUT you makes me think she is really just a passive/aggressive manipulator or has a personality disorder. This is beyond her "not accepting everything that's going on". You can tell her that if she doesn't respect your Mother's wishes that you will have no other option than to pursue a restraining order against her. See if she remembers this conversation. Just know that there will be family blow-back from others. Good luck!
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Even though your mother gave you medical power of attorney, if she is competent to make medically related issues, she can tell her mother herself with you backing her up.

It's not clear to me what your mom wants, though. Does she want to be in the hospital? Does she want to go back to her own home? Does she want hospice care in her own home rather than her mother's? It sounds like she does not want her mother by her side all the time.

Sit down with your mother and find out very specifically what she wants. If she has a living will, go over that with her. Ask your mother if she would like to talk to your grandmother about this. If she says yes, sit down with your grandmother and patiently and kindly explain to her what your mother wants and, if possible, why she wants it. You might want to say that the kindest thing she could do for her daughter is to honor her wishes.

If your mom is mentally competent and doesn't already have these documents, she may want a physician orders for life sustaining treatment (POLST) document, a DNR on her hospital chart and in her doctor's files, and to make sure it is clear that she doesn't want tube feeding or ventilation assistance.

This must be a very hard time for you. I wish you, your mother, and your grandmother the best.

(These are suggestions and not legal advice.)
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Sadly, consider asking the hospice social worker to arrange some grief counseling for Grandma. She is much in need of relief from her unremitting pain, but it's not up to you to do that. She needs some professional guidance.
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SadlyYours Jul 2022
I agree, I asked palliative care how we could best support GM. They gave the same recommendation for grief counseling. I've been searching, I hope she's receptive.
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