What do we do...

deeDawntee, RN · Sep 30, 2007

These are my first impressions from reading your story:

#1) You are entitled to all the medical records there are for your mother-in-law, you do not have to worry about making the Doctors mad, it is your legal right to have them.

#2) If your MIL is non-compliant with her medical regime, and she is in bad health, I can understand that no Surgeon would want to touch her. Having a total hip replacement entails following hip precautions so that the hip doesn't constantly come out of its joint...it does not sound like she would be able to handle it to me. If she has severe osteoporosis and is putting herself in situations where she is constantly falling, it doesn't surprise me in the least that the hip has not healed. There is not an ethical surgeon I know who would take her into surgery.

#3) Why is she calling the fire department and not her family for help? It sounds like she is in a state of total desperation and needs to be supported in her living and health situations, like Assisted Living or some senior support services, like Homecare... I think she is crying for help but is not able to ask for it in a mature way. There are so many red flags in this situation, she just can't manage anymore.

Good luck to you, your family and your MIL.

TazziRN, RN · Sep 30, 2007

Why would she be entitled to her MIL's records??? Is MIL not entitled to privacy the way anyone else is? Unless MIL gives the doc permission to speak to the family, he legally canNOT say anything.

OP, I feel for you but I don't see how you can get the info. The doc may speak with you about her, but he would be violating her right to privacy.

babynurselsa, RN · Sep 30, 2007

Ask you MIL if you can sit in with her meeting with the Dr so that you can help her.

If you have her consent and you have both people in the same place at the same time then you can hear both sides and get in on the big picture.

If she declines then there is not much you can do.

llg, PhD, RN · Sep 30, 2007

I agree about the information issue. Unless you MIL gives express permission for you to receive information, it is illegal for her health care providers to tell you much of anything. Ask your MIL to be included and/or sign any papers required that will give you the information you seek.

If she doesn't want you to receive the information, then there is nothing you can do about that -- except to notify the health care team that you are willing and able to help. They can take that knowledge of your willingess to help into consideration as they make recommendations to your MIL.

ktwlpn, LPN · Sep 30, 2007

Please help! My MIL fell and broke her hip last October. She opted to have pins inserted rather than a total hip replacement. She's 63 years old by the way, suffers from severe depression, osteoporosis, and a ton of other things. She is a retired nurse who does have a tendency to self medicate, often, heavy smoker, etc. Now that you have a background here's the dilemma.
Her hip never healed from her fall last October. In the past three weeks she claims that she has fallen 3 times and had to call the FD to come pick her up, (she lives by herself). Her Orthopedic surgeon will not perform surgery on her due to her health. She called 911 on Friday b/c she stated she was in so much pain. She's in the hospital now awaiting some sort of surgery. We don't know if it's total hip replacement or just taking the pins out.
We need help getting information from the doctors w/o making them mad. According to the MIL the Dr's are against her. We all know there are two sides to every story. On the other hand, we don't understand why it's taken almost a year to repair her hip. How do we get this taken care of? Do we get a social worker, patient advocate???
Thanks for reading and for any advice you have. Let me know if you have questions or need more info in order to provide feedback.

You are NOT entitled to any information.Has she appointed anyone in the family her power of attourney? You may only get information with her permission. You -actually your husband can contact her social worker at the hospital and convey your concerns regarding what you feel are unsafe conditions in her home but don't expect much info from them. He can also call the office of the aging and have them assess her situation.If you all feel she is not capable of understanding her rights and responsibilities due to her depression your husband may be able to persue gaurdianship.He needs to consult a lawyer-one who specializes in elder care issues...No MD with any sense is going to give you info due to her right to privacy...

deeDawntee, RN · Sep 30, 2007

I saw nothing in the OP that stated the MIL didn't want the family to be involved...I certainly didn't say that the family had the right to the records without the MIL's consent....the MIL thinks the MD's are against her, and the OP thinks that getting info will make the MD's mad at them. My point is that, getting the info is the pt's right and no MD will be "mad" ....

DTCC PreRN · Oct 1, 2007

Thanks to all who replied. My MIL is more than willing to give us info and have us seek info from the med team. The problems we're running into is getting info from the med team. And not b/c they won't provide it. We live 800 miles away and any info we do get is diluted.

My hubby flew up on Saturday to try to get a handle on things and has since spoken to one of the MD's. He was able to get some really helpful information from him. He also said her house was in a bit of disarray. He counted about 15 cigarette burns on the floor around her chair where she fell asleep while smoking. One cabinet and a counter were full of meds.

I'm having a terribly difficult time convincing my husband that his mother needs to be in an assisted living facility. He feels like she's this way b/c of her hip and will bounce back after hip replacement. I disagree. I have the utmost amount of sympathy for him and his relationship with his mother. However, I feel like he's thinking more with his heart than with his head. Normally he's a very logical person but in this situation he's just not able to do it.

While she does have family, (one brother, two sisters and my BIL) who live near her, all are exhausted with trying to care for her. I feel like she uses the FD to come pick her up as a way to get attention. Any one of the family members would have done so but would have lectured her on why/how she fell. She doesn't want to be held responsible for her actions or lack thereof.

She also has a hospital bed and a lift recliner in her home which she will not use. Instead she has decided it's much easier to stay in her wheelchair, where she also sleeps. A CNA comes in daily to do minimal services. She declined the majority of services the agency provided.

All these reasons are why I'd like to get a third party involved. She's already told my husband and BIL that they can not make her stop smoking, can not make her leave her house, etc. We need someone else to take a long hard look at the situation and help her understand what she has to do.

One last thing...my husband and BIL both have POA privileges. We just need someone to say they can use them. I believe an earlier post indicated what needs to happen in order to be able to use it.

Thanks again to everyone who's replied. It's reassuring to know I'm not the only one who thinks she's needs help.

leslymill · Oct 1, 2007

Did she receive home health care or PT after the pinning? Did she receive any gait training besides be careful? Even if she is a nurse, they knew she was high risk for re-injury. Seems like a bad situation from hindsight and it sounds like she has re fractured her hip.

DTCC PreRN · Oct 1, 2007

Did she receive home health care or PT after the pinning? Did she receive any gait training besides be careful? Even if she is a nurse, they knew she was high risk for re-injury. Seems like a bad situation from hindsight and it sounds like she has re fractured her hip.

Yes, she did receive care after the surgery. She went to a rehab center who specialize in orthopedic rehabilitation. It was a nursing home/rehab center so she actually lived there. She received gait training as well as training on how to maneuver her stairs. She had to be able to climb stairs before she could be discharged.

She was there a little over a month and did not want to leave. When she was told she was being discharged she threw a fit. She stated that she couldn't stand on her own to take a shower, etc. She as living the life of Riley and it was great for her. I've never seen her happier. The insurance co. sent a social worker in to check on her to make sure she was okay to be discharged. She went through her routine of not being able to stand on her own etc.

When the social worker left her room my MIL got off her bed, walked over to the table that was in between her bed and her neighbors bed, retrieved the remote control for the tv, and got back into her bed. She was discharged.

leslymill · Oct 6, 2007

I am on your side. She has fallen too many times, she is gonna burn down the neighborhood and sleeping in a WC is not good on the hip. I don't know what is wrong with her hip and what surgery they plan on doing. That could change everything. My grandmother just passed away at 94. It sounds like the same thing only she didn't smoke or sleep in a chair. She just insisted on unsafe positioning of furniture and rugs, refused her walker. she didn't fall but her lower extremities were black from the bruises or bumping into things. She had all kinds of options but she insisted on living alone. It is hard to make decisions against their will if they are coherent. If the family that live near her are not gonna side with you, I don't know how or if if you can convince her or your husband.