need some advice on getting family member medical attention against their will

ktwlpn, LPN · Aug 28, 2004

I fail to see how recognizing and honoring a patients right of self-determination makes me a "bad "nurse or unsympathetic ...Even if the PATIENTS ACTS are not what I would choose for myself or my loved ones we still have to realize that we don't have control...We also have to realize that our resources ARE limited-do you force expensive health care on un-willing patients just because you think you the right to do so? And comparing and confusing this situation with "assisted suicide" is a darn BIG mistake IMHO ....Would you honor any advance directives? it sounds like some of you would second guess every patients intent and call codes on them all...I would say that this guy's alcoholism has advanced to the terminal stage-after years and years.....I see no problem with calling the office of the aging...Bring someone in for an unbiased assessment of the situation to assuage your conscious....But be ready to jump in and help with some of the aspects of care when it is determined that the grandmom has the right to let her adult son drink himself to death and ooze yellow wound drainage all over her house....I TRULY believe that in many of these situations as soon as the concerned loved ones find out that THEY will have to put up or shut up-they often SHUT UP....Once they find out that their loved one won't be wisked away at the government's expense...Recognizing that people live in all kinds of situations and standards very different then mine and accepting their right to do so and without trying to control their actions and NOT MAKING JUDGEMENTS about them isthe most important aspect of GOOD NURSING...IMHO-that's what it is about-Non-judgemental acceptance... Hopefully the OP will update us soon......

mscsrjhm · Aug 28, 2004

Excellent KTWLPN!!

leslie :-D · Aug 29, 2004

I fail to see how recognizing and honoring a patients right of self-determination makes me a "bad "nurse or unsympathetic ...Even if the PATIENTS ACTS are not what I would choose for myself or my loved ones we still have to realize that we don't have control...We also have to realize that our resources ARE limited-do you force expensive health care on un-willing patients just because you think you the right to do so? And comparing and confusing this situation with "assisted suicide" is a darn BIG mistake IMHO ....Would you honor any advance directives? it sounds like some of you would second guess every patients intent and call codes on them all...I would say that this guy's alcoholism has advanced to the terminal stage-after years and years.....I see no problem with calling the office of the aging...Bring someone in for an unbiased assessment of the situation to assuage your conscious....But be ready to jump in and help with some of the aspects of care when it is determined that the grandmom has the right to let her adult son drink himself to death and ooze yellow wound drainage all over her house....I TRULY believe that in many of these situations as soon as the concerned loved ones find out that THEY will have to put up or shut up-they often SHUT UP....Once they find out that their loved one won't be wisked away at the government's expense...Recognizing that people live in all kinds of situations and standards very different then mine and accepting their right to do so and without trying to control their actions and NOT MAKING JUDGEMENTS about them isthe most important aspect of GOOD NURSING...IMHO-that's what it is about-Non-judgemental acceptance... Hopefully the OP will update us soon......

who are you addressing this to ktw?

who called you unsympathetic or a bad nurse?

caroladybelle, BSN, RN · Aug 29, 2004

this is not the same.
these conditions you describe take years to manifest themselves. Now if a person who had smoked for years, suddenly had an asthma attack, ......you could watch this person w/o intervening?
Same with diabetics or anyone else that abuses their bodies and ends up with cad....could you watch someone having a heart attack w/o intervening?
and i'm not talking about someone with a terminal condition, or that's 90yo.
i'm talking about someone who is very depressed and just wants to die.
we don't have any responsibilities in this type of situation?

I repeat, that I do not like the situation and no one thinks that it is good or right.

And, yes, a Chronic drinking problem, quite bluntly is the same as a diabetic/smoker/cardiac patient that refuses to care for themselves. And presumably, this has gone on long enough that the patient has oozing wounds - that takes time and indicates a chronic condition.

If a CAD patient has chest pain and wishes to die, so miserable is s/he with their condition, and they refuse to complain of the pain or distress, I am not responsible for their death. If I, as the health care practitioner, have provided ALL the information/resources necessary to correct this condition, and they chose not to live...that is on their head.

If a smoker, continues to commit suicide by smoking (which is in essence what smokers are doing), and I have provided repeated assistance in stopping, and they choose to keep smoking, well I may be able to take care of the symptoms for a limited period of time, but they are still killing themselves by smoking...and I have no control over that ....no I am not responsible for their death.

This is a free country. And as long as it is, if someone is oriented and rational, then they can legally do with themselves as they wish. I don't like they insist on harming themselves, but No I am not responsible for it.

Agnus · Aug 29, 2004

In the United States an adult has the right to refuse treatment. He states he wants to die. Even though that is very difficult for the OP, he has the right to deside that. He is an alcoholic. Research show that forcing an alcoholic to get treatment for anything does little good.

The only option you have of forcing anything is to force him out of your house if that is where he resides.

It is sad that there are people in this state. And I feel for the OP. However, from what the OP describes there is little likely hood that if by some miracle he consented and agreed to comply with treatment that at this point in his disease there is probably little that medicine can actually accomplish. That is the prolonging or life will be limited anyway.

We can not control the actions of others only our own.

leslie :-D · Aug 29, 2004

I repeat, that I do not like the situation and no one thinks that it is good or right.
And, yes, a Chronic drinking problem, quite bluntly is the same as a diabetic/smoker/cardiac patient that refuses to care for themselves. And presumably, this has gone on long enough that the patient has oozing wounds - that takes time and indicates a chronic condition.
If a CAD patient has chest pain and wishes to die, so miserable is s/he with their condition, and they refuse to complain of the pain or distress, I am not responsible for their death. If I, as the health care practitioner, have provided ALL the information/resources necessary to correct this condition, and they chose not to live...that is on their head.
If a smoker, continues to commit suicide by smoking (which is in essence what smokers are doing), and I have provided repeated assistance in stopping, and they choose to keep smoking, well I may be able to take care of the symptoms for a limited period of time, but they are still killing themselves by smoking...and I have no control over that ....no I am not responsible for their death.
This is a free country. And as long as it is, if someone is oriented and rational, then they can legally do with themselves as they wish. I don't like they insist on harming themselves, but No I am not responsible for it.

this is my exact point.

the uncle has NOT being to a doctor yet.

drinking is chronic-yes.

NEW onset of unable to keep food down....

he is clearly deteriorating as a result/sequelae of this 'chronic drinking'.

so YES, let's get this uncle some INFORMED consent into him refusing tx.

let a doctor INFORM him that he has xy and z and this is going to happen if he refuses treatment......then the uncle's refusal will be INFORMED.

you keep on referring in your post, "if i has a health care practictioner"....that's all i am asking, is to let this man make an INFORMED decision.

leslie

mscsrjhm · Aug 29, 2004

this is my exact point.
the uncle has NOT being to a doctor yet.
drinking is chronic-yes.
NEW onset of unable to keep food down....
he is clearly deteriorating as a result/sequelae of this 'chronic drinking'.
so YES, let's get this uncle some INFORMED consent into him refusing tx.
let a doctor INFORM him that he has xy and z and this is going to happen if he refuses treatment......then the uncle's refusal will be INFORMED.
you keep on referring in your post, "if i has a health care practictioner"....that's all i am asking, is to let this man make an INFORMED decision.
leslie

I hear what you are saying. However, I still disagree. You cannot FORCE someone to a Doc just so that they can be informed of what they are refusing.

It seems that you are saying it is okay to refuse, but only if you are fully informed of what you are refusing??

He has a right to refuse to see a Doc, and to refuse to be informed.

Pretty safe to say, with weeping wounds, he knows things are bad.

Ignorance is also a right.

leslie :-D · Aug 29, 2004

I hear what you are saying. However, I still disagree. You cannot FORCE someone to a Doc just so that they can be informed of what they are refusing.
It seems that you are saying it is okay to refuse, but only if you are fully informed of what you are refusing??
He has a right to refuse to see a Doc, and to refuse to be informed.
Pretty safe to say, with weeping wounds, he knows things are bad.
Ignorance is also a right.

chrisco woman-

the way ladycarolebelle was answering, she was talking as "if i were the md/np/pa and known that i had done everything i can...." yes, i agree with that, totally. then it's their right to refuse.

my problem is that as an md/np/pa has not seen the uncle, i, as an observer, would do what i could to get him med'l help.

my biggest concern is that he's depressed; and i do find problematic, people making such decisions when that depressed.

it doesn't make sense, if every depressed person successfuly committed suicide because everyone said "well, that's his right".

susanna · Aug 29, 2004

my uncle is a alcoholic for many years now, he has began swelling up face and legs, his legs now have 10 inch diameter open wounds on them 1 1/2 inch deep draining and yellow, he also has a hernia almost to his knees. he lives with my grandma and of course is not employed, won't sign for medicaid or any help, says he wants to die. my problem is i do not want my grandma too find him dead soon. is there any way we can get him medical attention without his consent? he can't keep any solids down, he's started throwing any food up. any info would be greatly appreciated
thanx

Hey Rhonda,

What I'm thinking is OF COURSE there us some way to get him medical attention without his consent. The problem is that I don't know exactly if I am right or how u'd go about doing this: I'm not familiar with the process. But he is obviously QUICKLY degenerating and unable to take care of himself and unable to even recognize the urgency of his own degeneration. If he does not even notice his own physcial degeneration, this already indicates that he is not in a healthy mindet and not fully capable of making decsions for himself. In my opinion, I think this gives you guys every right to find him and subject him to medical help and maybe commit him to a psychiatric unit(I don't know if that would be the right place but I am trying to think of somewhere he can get immediate medical attention for all of his physcial and psychological problems and escape from his surrounding environment to someplace where people can care for him for a while so that he can rehabilitate and that is what came to my mind).

I hope the people here can give you useful advice on how to go about doing this. Good luck.

mscsrjhm · Aug 29, 2004

Hey Rhonda,
What I'm thinking is OF COURSE there us some way to get him medical attention without his consent. The problem is that I don't know exactly if I am right or how u'd go about doing this: I'm not familiar with the process. But he is obviously QUICKLY degenerating and unable to take care of himself and unable to even recognize the urgency of his own degeneration. If he does not even notice his own physcial degeneration, this already indicates that he is not in a healthy mindet and not fully capable of making decsions for himself. In my opinion, I think this gives you guys every right to find him and subject him to medical help and maybe commit him to a psychiatric unit(I don't know if that would be the right place but I am trying to think of somewhere he can get immediate medical attention for all of his physcial and psychological problems and escape from his surrounding environment to someplace where people can care for him for a while so that he can rehabilitate and that is what came to my mind).
I hope the people here can give you useful advice on how to go about doing this. Good luck.

Don't we have a constitution to prevent this???

ktwlpn, LPN · Aug 29, 2004

who are you addressing this to ktw?
who called you unsympathetic or a bad nurse?

I pm'd ya so as not to high-jack the thread... :)

susanna · Aug 29, 2004

Don't we have a constitution to prevent this???

I don't know exactly what they are but there must be tons of consititions and laws that let people not get medical help if they do not want it or if they refuse it. I think this is what the OP is worried about.