Dad has type 2 diabetes, has been in the hospital twice within 2 weeks, had a stroke which he fully recovered from but mom is refusing to give him care. She hasn't picked up his meds in 6 months, won't get a test kit to test his blood sugar, gives him candy and high sugar foods, refused the ambulance to take him to the hospital after he had a stroke when his sugar was at 600. Their Dr. is furious. At their last appointment he told her she is incapable of caring for herself or him. His sugar was back to 600 and he was very lethargic barely awake. Dr. suggested assisted living. She refused. He then strongly suggested a home health care nurse to provide their meds every day and test his sugar. She reluctantly agreed. After the nurse came for the interview she told mom she can refuse the care if she doesn't want it! She did. The nurse called the Dr. and he is 1000% behind helping dad. How can she refuse? Isn't that an abusive caregiver? What options are out there?
Have you considered a call to Adult Protective Services?
I once, when very angry, pointed out to her that if she'd taken even the slightest notice my father might have received life-saving treatment before he dropped dead on a squash court at 71. I apologised immediately, because what I'd said to her was cruel and pointless. But the reason it was so cruel is that it was also true.
Stop wishing that your mother would turn into a capable, willing nurse. Are you geographically close enough to supervise their care? What did their doctor mean when he told your mother that she was not able to look after herself, either? - what are her medical/care needs?
When it comes to diabetes, it is a complex illness, so your Mom may find it too confusing to understand, so she sweeps it under the rug. Thus if she ignores this, maybe it will go away.
My own Mom I believe was still under the impression that my Dad was still in his 40's instead of being in his 90's. She would still do a "honey-do" list for him which would include climbing ladders and doing electrical work. Dad use to be able to do those things quickly but no longer at his age.
One time my Dad fell on his driveway and got a huge bump on his head. Mom thought an ice pack and a good lunch would do the trick. Once I found out about the fall, noticed that Dad was too wobbly to take him to urgent care, I called 911.
This is so tragic. I take it that this was not a functional marriage before Dad got so ill?
Is mom mentally ill, or does she have dementia?
In terms of decision-making and refusing care:
- Patients have a right to refuse particular medical services (although if they do so when it seems obviously a bad idea, clinicians and others should start to wonder whether the patient is impaired and lacking the needed decision-making mental capacity to legitimately refuse).
- When a patient is ill or unable to make medical decisions, a healthcare proxy/surrogate is generally allowed to do so on their behalf.
- A healthcare proxy can be appointed via a durable power of attorney for healthcare document. However, in the absence of such documentation, virtually all states allow for the next of kin to make medical decisions. In practical terms, most providers will accept the decision of a spouse who lives with the patient, unless the situation is extremely high-stakes and there is obvious family conflict (e.g. ending life-support).
- State law governs healthcare proxies and also defines elder abuse. Generally, the proxy is expected to act to serve the best interests of the patient or to make decisions in accordance with what the patient had previously specified. If they aren't doing so, in most states there is presumably a mechanism for removing the proxy from the decision-making role and finding a way to protect the patient. But getting there can be messy.
In terms your situation, @jjFlorida, one thing that is very good is that your dad's doctor is involved, concerned, and upset by your mother's actions. Things to consider and that you might do:
- Is your dad incapacitated and unable to make decisions? Or can the doctor specify to home health and the others that he should be making decisions, and not your mom?
- How does your dad feel about the decisions your mother is making? Is he able to voice preferences? To sign legal documents?
- Is your mom making decisions because she's named in a durable POA for health, or is she doing it "by default"? If she is DPOAH for health, does your dad have the mental capacity to name someone else?
In terms of next steps, you can try calling Adult Protective Services and you can try getting help from your dad's doctor in exploring options. I am pretty sure your mother doesn't have the right to refuse care that is in line with your dad's medical needs, unless he has previously been quite explicit about why this would be in line with his goals and preferences for his medical care.
You can also consider talking with an experienced elder law attorney in your state. Sometimes legal representation is needed to get what is "right" to happen.
In short, it's a tough messy situation. Your dad's doctor may certainly be able to help but it might take a while for the two of you to figure out how to do so. Good luck!
ps: I have not even gone into whether your mother has the capacity to be managing her own affairs and healthcare, but that's a whole other kettle of fish that you may have to deal with eventually...
You might need to contact your state's Adult Protective Services and file a report. I would do this after talking to the social worker... It's entirely possible that, after visiting your parents, that the social worker is willing to contact Adult Protective Services, in order to compel your mother to allow care for your father.
You might want to have a regular health and welfare check done on your parents. The social worker from the Council for the Aging can arrange for this. Do keep an eye on them, especially your father. If he doesn't sound right, you can call the police department non-emergency line and ask for a health and welfare check be done.
If you don't know where to turn, call your state level legislators. Most have a constituent services representative, who will help you determine who you need to talk to. A lot of people in your situation don't think about contacting a politician's office--they are there to help. If you don't know where to turn, calling them is well worth it.
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