Can enyone shed light on this for me?

itsme · Oct 21, 2003

Well I dont know about all states, but I do know here we cant force anything on anyone. Patients have the right to refuse. Sounds like maybe instead of a psyche ward, maybe they need to look into her meds, allergies to any of them? I am not a oncology nurse so I dont know how those meds can make one react. Has hospice gotten involved, or social services? Maybe this lady wants to spend her last days at home instead of a hospital? Hope i helped?? Good luck to you and your friend....

Lindasfriend · Oct 21, 2003

Thank you for responding!

We are in Missouri.

Who would declare her 'incompetent'... her doctor?? her husband/family?? Some lawyer?

I do not understand. She is paralyzed on the right side of her body, so if she goes home, she can't walk or get herself to the bathroom. Of course, she wants to go home... but there is no one there to care for her. Her husband has to work, and she has no children/family in town.

Lindasfriend · Oct 21, 2003

I am desperately just trying to understand where legalities come in here...

I mean, can't they force her to let them take out that port and then let her GO home?

oramar · Oct 21, 2003

Almost everywhere that I have heard it takes a judge to declare some one incompetent. Usually the same judge assigns someone to be the person caretaker and have medical power of attorney. The purpose of filling out a living will and assigning a power attorney is to take care of these things before that day arrives.

nialloh, RN · Oct 21, 2003

You need a psych Dr to declare her incompetent. Also the psych wards that I know won't take a pt who is not medically cleared. As to forcing her to take her meds, everyone has the right to refuse treatment.

Lindasfriend · Oct 21, 2003

Okay, I understand that patients have the right to refuse meds/treatment.

So the hospital has to just keep this patient in a bed and take verbal abuse? Until she dies?

If she could get UP, she would probably hit someone.

kids · Oct 21, 2003

There is a possibility it is a progression of the brain tumor rather than a side effect of the decadron making her "crazy". I have *never* seen a LTC evict an actively terminally ill person for behavior (but I am sure someone else has), same with admition to a Psych unit. Pretty much the only people who can be locked up and treated against their will are the truly mentally ill. Even if "incompitent" I do suppose her doctors could choose to treat her against her wishes if the POA insists...it certainly would put them in a sticky place ethicly.

You mention that family is paying out of pocket for her care in the facility her husband needs to apply for Social Security Disability on her behalf. I have seen SSA move very quickly to approve the application of someone with cancer (my brother was approved in 10 DAYS). It would likely qualify her for State Medicaid. Also, if her anticipated life expectancy is less than 6 months a Hospice referal is deffinately appropriate and Hospice care is covered (by Medicare I think).

santhony44, MSN, RN, NP · Oct 21, 2003

Basically, no, they probably can't. Her husband might be able to go to court to get a judge to declare her incompetent so that he can make her medical decisions, but the doctors and hospital are not going to touch her with a 10-foot pole if she's still legally competent. They could face both civil and criminal charges, otherwise. It may not make a lot of common sense, but that's how things are. Years back in the past, it was relatively easy to get someone declared incompetent, but because of abusive situations (get Grandma declared incompetent to get hold of her bank account and put her away somewhere, that sort of thing) that has changed. I've personally seen situations where the mother of a schizophrenic young man could not talk with his doctor regarding his care, and where a drunk diabetic with extremely high blood sugar could not be put into an ambulance because she refused.

As far as putting her on a mental ward, the basis of her problem is medical, not mental, so that's not really appropriate. It's a difficult situation, and there are no quick and easy answers.

Lindasfriend · Oct 21, 2003

Thank you all so much for your wisdom!

Her husband's company went bankrupt a year ago (the day she had a brain aneurysm--this woman has been through it!!!)

So, they lost all medical coverage.

She does not qualify for SS or Medicare, because the clerk at the agency told her 'she was 3 quarters shy(of work) of ever receiving benefits'

But she gets SSI, because she has Scleraderma (KREST) & Lupus, so how can she qualify for one and not the other?

Sorry to bother you all, but I have been reading many of the boards here, and you guys are very educated and helpful...

Lindasfriend · Oct 21, 2003

SANTHONY44:

I understand... that does make sense now. I guess all I can do is feel sorry for everyone involved here... including and particularly those nurses by her side day in and day out... and hope that the situation improves. Hope she gets well enough to go home...

sanakruz, ADN · Oct 21, 2003

If youre friend is not in a extended care facilty she needs to be transfered to one. All the facilities I know of have social workers on staff. Someone needs to advocate for this woman to receive state funded health insurance benefits, hospise care, etc.

here in CA one can be medicated against their will- If its an emergency and the person is screaming cussing threatening- An injection of some thing to calm this indiviudual down is definately called for at the time the actual "scene' is happening. It can't feel ok to be so out of control; this is the justification for taking away a person's choice. It does not mean your friend will continue to get medicated, even if that may be indicated.

Doesnt the hospital have some type of omsbudsman? This would be a good resource person and advocate for you to talk with. Laws vary so much from state to state. I can onlt suggest to you what I would tell some one from CA. Wish I could be of more assistance.Sounds like you are a good caring friend. Don't give up. One can learn to"work the system"