The calls have been from the AL nursing office. Please don't tell me he has rights, because my dad can't tell what is his health risk...what are my rights to tell the ambulance service to take him? They told me they can't if he refuses. Do I need a doctor's note to state he cannot make medical decisions to show them!?! He does listen to me and my younger sister...but who's to say that we may not be available!!!
Standing, on the other hand is in effect always. My mom's was standing but had the requirement for two doc's to find her incapacitated. Doc's hate to make that call when not obvious.
The kind of dementia associated with Parkinson's usually has wide fluctuations in cognitive ability. Sometime when Dad is in a particularly lucid state, discuss with him what kind of medical care he wants.
My mother who has Alzheimer made it clear when she still had capacity that she wanted nothing medically done, unless it brought her mind back to it's normal state.' She did end up in the ER, because the ALF policy was if they fall and hit their head they had to go to ER, even if no neurological changes occurred nor the force at which the head struck the object taken into consideration. The ER visit was quite upsetting. I have been questioned about the lack of intervention, as I told them unless it is an event that cause pain or mental anguish I do not want her taken to the hospital. I have been questioned if she made that decision while she was depressed. I took her to a psychologist and reasonable care while she was very functional. But as I told ALF, the reality is inevitable and depressing, so it is difficult to say she was just being realistic or made the decisions under depression.
As someone has mentioned a POLST; it is a great document to have. It will be more likely followed than a living will, although the 2 should match.
Another thing, someone mentioned hospice, when the time comes they are wonderful, but it sounds as though his status would not yet qualify him for hospice. Some hospices, however, have a palliative care component, for those who don't qualify, but do not want life extending care.
It is difficult to manage what could be life altering care for someone you love. In the end you have to make decisions you feel you can live with, and even then you may feel you could have done some things better.
As others have queried, what is the ambulance for? Our mom has fallen a few times and they sent her to ER in ambulance (she tried to refuse, but she eventually went, and is not currently combative) just to be safe. Would it be better if they call you and have you take him to be checked? There is only so much they can do without worrying about charges of neglect or abuse.
I do not know if it will post, but try this or I will list my query and you can find the site:
allnurses.com
Query: what to do if patient with dementia refuses ambulance
I read through all the posts and it is enlightening. I can understand how difficult this is for the care-gives (nurses, etc). The original poster tried multiple ways to get compliance and then is written up when it fails. Consider this from THEIR perspective!! Again, work with them. If it is a concern to get him checked for whatever the issue is and he refuses to go in the ambulance, you should consider taking him yourself, unless you are not within a reasonable driving distance - then you have to decide how to handle this another way.
Anyway, the ambulance can be sued for not listening to his wishes. Perhaps a NH would be in his immediate future.
It would also depend on why the ambulance was called? My dad used to fall and he would have refused an ambulance if called just because he fell. My DH would do the same thing. You can spend up to 12 hours in the ER room and that really bites.
But I have witnessed paramedics asking these basic questions to someone who can't answer them and the paramedics took the person to the ER over their objection.
If you wish to declare him incompetent you would have to go to court and become his Guardian.
Does he have a DNR or a POLST? The POLST is more detailed than a DNR (Physicians Order for Life Sustaining Treatment).
If he truly wants no more treatment and does not want to go to the hospital you might want to contact Hospice and see if he would qualify. The good thing is he would get a Nurse that would come in every week to check on him, he would get a CNA that would come in a few times a week to bathe him and help get him dressed. Even though the facility where hi is does this it is a good thing to get an extra set of eyes on him to make sure all is well.