advice

caliotter3 · Jul 21, 2010

Unfortunately he did not provide any written provisions for you to get legally involved in his care. If you have concerns, you should bring them to the attention of his doctor or other providers, but do not expect that you can accomplish anything. Unfortunately, his wife holds the cards.

GHGoonette, BSN, RN · Jul 21, 2010

As his son you have rights as a close family member. I would think that in an ICU your dad's sister in law should not be allowed access to him, especially if she is upsetting him. You have every right to speak to his doctor, and, I should think, have the sister in law excluded from visiting him. And if your stepmom objects, ask her if she wants her husband to have the best possible chance of recovery?

fungez · Jul 21, 2010

If it were me, I'd talk to a social worker to see what rights you have for your dad's medical care. If she tells you what I suspect - you have no rights, his wife does - then you are going to have to kiss her butt. Otherwise, she can have you barred from seeing your dad, and that's not good for him or you.

So kiss her butt. Make yourself useful in a million little ways, and agree with everything she says. She has all the power, you have none. That's a bitter pill to swallow - I know how I'd feel if my dad were sick and my stepmonster was calling the shots - but it's reality. The more you kiss her butt, the more access she will give to you. good luck.

netglow, ASN, RN · Jul 21, 2010

Find out where you stand. Talk to the social worker/advocate. Even if you find you don't have the ultimate authority, it's possible that the social worker can help by facilitating the care planning discussions to include you, your stepmother, the docs and the social worker all together.

happy2learn · Jul 21, 2010

As his son you have rights as a close family member. I would think that in an ICU your dad's sister in law should not be allowed access to him, especially if she is upsetting him. You have every right to speak to his doctor, and, I should think, have the sister in law excluded from visiting him. And if your stepmom objects, ask her if she wants her husband to have the best possible chance of recovery?

This is my job as a volunteer in the ED. I speak with the visitors and tell them who can or cannot come back. I've had husbands say they do not want their spouse to visit or be in the room.

The OP has no right or say as to who can visit. The sister in law would only be excluded if the OP's dad stated so.

The card's for now are in the OP's dad's hands. If the OP's dad can understand his surroundings and make decisions, then it's his choice who is allowed in the room.

OP, you need to speak with your dad about this. You need to explain the situation and you need to ask about POA, because right now, the stepmom has the legal power over you. He needs to have a will as well. The hospital will contact a lawyer to have these things done right there in the room with him. You need to explain your concerns to him and I would even state that as an RN, you feel you have more knowledge when it comes to making good medical decisions.

If you can get POA, then you can decide who can or cannot come into the room.

Social work will not be able to do much only because the dad can function mentally. And if he gets to a point that he is not able to make decisions on his own, the wife will have the power.

mgh000 · Jul 21, 2010

I work in an ICU and sadly see a lot of this type of family dynamic issues. Your stepmom if legally married does hold the rights to the medical care for your dad, but you obviously have to be in aggreement with what she wants done as well or can go to court (but she does hold a higher right). I would talk to the nurses and doctors about the fact that you notice changes in your dads vitals/etc. when your stepmoms sisters are in the room and the fact that they are talking neg. things in front of your dad is not benefiting your dads progress. Def. talk to the social-worker at the hosp. because you do have rights as far as who is allowed to come see your dad and if you feel certain people are not helping with progress in his care you can have visiting restrictions. My mom and her sister had a similar situation, but it wasn't till after her dad died that they had issues with his estate.belongings etc. (he had no recent living will either) and her stepmom got it all and sold it.

Sorry you are going through this, wish you the best and your dad too!

annacnatorn · Jul 21, 2010

Difficult situation in every corner.

My Husband had the same situation with His Father, remarried a lady who claimed to be part of the family...Dad was DX with "Stage 1" esophageal cancer...under went chemo/radiation tx, 2 months later he passed away. She shared absolutely nothing with 4 out of 5 children and the one child told no one. My Husband would call to go over and told no, he would just show up and not be allowed entrance to see His father at His home. We get a call that "Dad is not doing well, we are at X hospital"..by the time we get there, He passed..sucks big time. My Husband who had POA could do not a thing because the Sister and Step Mom changed it without His knowing. The entire thing sucks.

Sorry you are going through this, my prayers will be with you and your fathers recovery.

Macbs4 · Jul 21, 2010

From your description, you father can answer yes/no questions. Find some time alone w/ him when he's alert. Tell him you'd like to ask him a few simple questions that require yes/no answers and ask him to nod "yes" or "no" in response. Make sure you tell him you are not asking him these questions to cause problems for anyone in the family, but that you want to make sure his wishes are being fulfilled.

Ask him the basic questions regarding his wishes for whom he wants for his (1) POA for financial affairs; (2) POA for health care decisions; (3) visitors. Depending on how he responds, take immediate action accordingly.

ktwlpn, LPN · Jul 22, 2010

I need some advice on what to do about family issues, My dad had a massive cva 2 wks ago. He is in icu..has a trach and peg placed last Fri. From my understanding he is going good from a medical standpoint.He is flacid on rt side.He trys to talk but has trach collar on.I think over all he is doing well. I realize he may never walk again,but he can follow comands at times and he will smile when spoken to.My problem is my stepmom and her sisters.My dad has raised me since my mom passed away when i was 7. My stepmom and me have never gotten along..she is very controling over him and has always been jealous of me and him.When my stepmoms sister visits him she talks about how bad he looks and he would not want this.She feels my stepmoms head full of negativity and also my fathers.I know he can hear what she is saying...I try and give my stepmom advice and explain things to her because i am a rn...she doesn't listen to a thing I say.My dad has no living will or poa...im not sure my legal rights to make any medical decsesions on his behalf...im thinking that my step mom has all the rights. My issue is she doesn't understand any of what really going on with him...she is actually had part of him having this massive cva to begin with..}i don't wanna go into details}...today i went to see him and my stepmom and her sister and my daughter were in the room, I noticed his resp were up to 28...i started to worry maybe something is going on. Then when my stepmom and her sister left my daughter told me that my stepmoms sister was talking neg about him. I started wondering if he heard was she was saying and was starting to become anxious. Now it seems as if my stepmom is not keeping me informed of anything going on with him.I just don't know what to do.If my dad was suffering and i knew he wasn't getting any better i wouldn't mind letting him go..i feel he is fighting this and that if he didn't want this he would give up. The pulm and neuro say it is a wait and see as to what will come back and what want. I just want my dad to be given an chance.My stepmom has already told on md that she felt i was stepping on her toes...i just ask the questions about labs and resp...stuff she doesn"t understand...If it was me and i knew nothing about the medical field and if i had a nurse in the family..i would want their advice..she is just soo jealous of me and my dad.Its getting to where if i visit and her and her sister are in the rm...i can't take it..i have you leave.While im with him..im always massaging his legs and moving his joints...her sister will sit there and say im hurting him and he doesn't like.I just wanna know if any of you have experienced this and can give me advice?

I believe that legally the spouse trumps an adult child.It's possible that your step mom and dad have had conversations about these issues in the past and she knows exactly what he wants. You have to be very careful and not step on her toes because she can bar you from visiting. I would try to do something with the sister in law and the things she is saying in front of him. I hate that-you have to always assume the patient is cognizant. I would take her aside and tell her how is vs seem to show that she is upsetting him,explain the r.o.m. and how it may be abit uncomfortable but is beneficial to him -but again, be very careful because if she goes back to step- mom then you are the one with the trouble. You have to try to be the adult child and leave your nurse's cap at the door because obviously they don't want that type of input from you. It's hard to seperate your feelings regarding her from the reality of his situation.You imply that she played a part in causing his cva-look up the risk factors of cva.I think you'll find her at the bottom of the list (stress?) This shows that you are not thinking really clearly right now. You are going to have to let go of your feelings for her so that you can effectively grieve over your dad's condition now. I've seen crap like this is both my immediate family and my in-laws,also families I have cared for.You don't want to get yourself totally shut out from your dad's bedside now and legally she can do it...Be very very careful...

Copper4 · Jul 22, 2010

I agree with a couple of the other posters- and also am sorry for your Dad- I do believe also that your step mother is the legal decision maker if no others have been defined-- i would suggest you speak to the doctor or nurse, and ask them to speak to your step mother about positive feedback, and the assumption a patient can hear all that is spoken whether he can respond or not. Maybe that will get the point across to the family members that are negative, and hopefully encourage them to speak to him in a more positive manner while taking the burden off of you. Good Luck!

leslie :-D · Jul 22, 2010

i hope my advice isn't inappropriate, and know that what i suggest, is heartfelt.

i do like the idea about questioning dad about his wishes, and get that settled asap.

in the event that the stress escalates, there seems to be a chance that she'll find a way to put you in your place.

so while you still have the opportunity, i would have a private 1:1 with your dad.

tell him how much you love/honor/respect/admire him.

thank him for being there for you, yesterday, today and always.

share with him what a profound impact he has had in your life.

because it's a wait and see situation, combined with the simmering hostility betw you and his wife, there just may not be a later time to talk with your dad.

so please, have 'that' talk with him, because if the worst happens, you'll know that he knows how you feel.

and there won't be any regrets, should the situation deteriorate.

i pray you work this out.

personally, i couldn't kiss anyone's butt.

being civil and courteous, no problem.

but i just wouldn't compromise my integrity for anyone.

perhaps you and stepmom should also have a 1:1...and hopefully you both can come to a truce.

that would be ideal.

just know all of you are in my prayers.

leslie