Capturing the Wishes

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Capturing the Wishes

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wishing-well-76869_640On Tuesday morning, I woke up grateful that Monday was over.

Until my mom called mid-morning with an update. "My hemoglobin dropped a little bit," she said.

And so did my heart.

Her hemoglobin drops when she starts bleeding. We just moved her back to the community hospital from the university hospital and endured nothing less than a battle between the siblings about where my mom should be. Two siblings wanted my mom to remain at the university hospital, which has a longer scope to detect internal bleeding, in case she begins to bleed again. Another sibling and I wanted her moved back to the community hospital.

I started to worry that we had a huge problem on our hands until I reminded myself: Every worry needs a plan.

I decided we needed to document my mom's wishes about her care. I texted a sibling who I knew would be visiting my mom at the same time as my dad that afternoon. I explained my idea: Let's talk about what Mom wants going forward so we can avoid future fights.

Before I headed to the hospital, I double checked my mom's durable power of attorney for health care decisions. My dad steps in to make decisions when my mom can't. If my mom and my dad both cannot make decisions, I step in. Another sibling steps in to make my mom's medical decisions if my mom, my dad and I can't.

When I arrived at the hospital, I asked my mom if she would be okay discussing her wishes in case she begins to bleed again. She agreed. So, with my dad, a sibling, the sibling's spouse and I, my mom shared her thoughts about her future care. (The sibling present was not one of my mom's medical powers of attorney.)

If our mom begins to bleed again:

1. She wants the doctors at the community hospital to do everything they can so she can remain at the community hospital.

2. If she requires an intervention not available at the community hospital, she wants to be transferred to a downtown hospital which also has a longer scope.

I asked her about the university hospital where she just spend the weekend in a few different ways: If the university hospital has the only treatment that can help, would you want to be transferred back? If the university hospital has the only treatment that can save your life, would you want to be transferred back?

Her answer to both questions was "No."

We also discussed a process to ensure my mom makes informed decisions going forward. She will discuss decisions with
her medical powers of attorney, who will act as her sounding board that she uses before she makes any final decision.

I emailed the details of my mom's wishes to all the siblings the next day. We'll continue to have these discussions with my parents as their situations change.

Thankfully, the drop in my mom's hemoglobin was just a dip; her number increased the next day. She continues to be stable and we're now working on her discharge to rehab.

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Hussy

<a href='http://www.caregiving.com/members/denise/' rel=\"nofollow\">@denise</a> well done! Thank you for sharing how you and your family communicate about these and other issues. I'm learning a great deal from you that will doubtless come in handy when the time comes for my family to tackle sensitive topics.

Heidi

That is good news that your mom's numbers improved and that she will be moved to rehab. Are you familiar with POLST? It is more detailed than an advance directive.

Jean

Denise, I'm glad it was only a brief \"dip\". I know you must be overwhelmed (to say the least) with all you've been through.... and all the communicating! But I want to say THANK YOU for continuing to communicate here... I certainly hope you get some relief from blogging.... as you continue to share with us valuable info of how to navigate rough waters. The way you have handled all that has transpired in your \"caregiving\" life during the last few months have been valuable lessons in so many ways. Hugs!

jan

So glad your mom is stable and there are plans in the works to move her to rehab. Your calm and no-drama approach to your parents' care should be a model for everyone. I realize there are many reasons why families can't do this; sometimes even their culture and ethnic background would interfere with this kind of approach. But there is no place in this equation where we could say the Shoemaker's children have no shoes. You, Denise, the Shoemaker, have taught us all how to make shoes.

Thedogmama

I hope everything says on an even keel this weekend for you and the family Denise. I'm sure you are tired of being the family mediator, but am so glad your mom is able to voice her wishes to you and the family. I am keeping your Mom, Dad, you and the rest of your family in my prayers. Let's hear it for a steady hemoglobin and a successful transfer to rehab.

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