Thank you, Rena, for your response. You are correct. The physician/ Medical Director should be and was at the center of these discussions He told the son that he was not comfortable giving the orders he requested, explained the reason, and stated that he would bring this issue up at the Hospice Ethics Committee.
You also correct in terms of the son speaking as his father. My only concern is that the father had never made any statements Re: meds R/T his terminal illness before he became incapacitated, and that he has not been declared incapacitated. The son is now stepping forward with his fathers wishes, at a point were his father is really no longer able to voice his wishes. I believe that the resident would have voiced his preferences in this matter well before he was unable to do so.[EMAIL PROTECTED] wrote:
These are medical issues, and I believe the physician should be at the center of these discussions.
Regarding the question of the son speaking as his father, in many states, that is the case when an individual is no longer capable of making decisions and the surrogate decision-maker takes over. It is very important to know your state's regulations on this.
Rena
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]
Subj: End of Life Issues
Date: 1/9/04 4:22:05 PM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
Although not related to MDS, I have to throw this out to the group. Have a resident with end stage lung disease, under Hospice care. His son has POA, and is requesting that all meds R/T pulmonary condition, including O2 and neb TX be provided on a "as requested by resident" basis. His reasoning is that those meds would prolong the resident's life since they are used to treat the lung condition, and that is not what the resident would have wanted. The resident is not capable to request any meds, and the son is aware of this. He is requesting that the resident only receive Morphine and Ativan for comfort. When asked why he did not want all meds D/C, i.e., antidepressant, antiulcer meds, etc, he stated he would like to continue the other meds, as they were not R/T the terminal illness. The resident was admitted last April, was still alert with intermittent confusion. He is now no longer able to make health care decisions, but did never mention that he did not want the meds R/T his terminal illness since admission. He is not declared incompetent but the son is enforcing his POA. He states that he speaks as his father (not on his behalf). It was explained that the resident may experience discomfort if the meds are not administered, and that they would not prolong his life, the son has made his decision. He feels that the meds would prolong the resident's live because without them, he would die sooner. Any thoughts?
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