Recently, my mother was diagnosed with a Gleoblastoma (Cancerous Brain Tumor). There where no signs that this even existed up until 2 weeks until we found out. She was life-flighted to a Neurosurgeon in a nearby town, about 120 miles away. They did an MRI and found out that it was one of the biggest tumors that they had seen yet. She got surgery, but they where not able to extract all of the tumor. They would have been cutting into healthy brain tissue other wise. Well, after the surgery she was doing very good but had some short term memory problems, and right side peristalsis because the tumor was on the left side. After the surgery they where going to send her to a rehabilitation center in the area with intense physical therapy, but my mom decided to come back where we live and go into a nursing home/Rehab center. She was doing good for a longtime, getting stronger, and they even had her walking about 20 feet. She was doing radiation and chemo therapy, and things seem to be going well. Well, after this course of treatment she had a 3 week break from the chemo because they said that they had to do this because they had to give her time to recover from it, so they could re-start the chemo a different way. She was taking the drug called Temadore, very rough on the system. Well, she had went back for another MRI to see how things were going and they were not going well at all. The tumor had come back, and it was larger than it was before, so they were going to recommend hospice. Now here is where it gets tricky. My mom's advanced directive was a full code, that means to Resuscitate her and do CPR if necessary, and to put in a feeding tube in her. Well, when my mom was awake I had talked to her and I told her that she had a full code on her, she asked me what that was and I told her. I then asked her if she wanted a feeding tube if she could not eat, she thought about it and said no, then I asked her that if her heart stopped if she wanted them to do CPR she then again thought about it and said no, then I asked her if she wanted me to change her advanced directive to a do not Resuscitate, she told me yes, and said no more pain. So I did so, but before doing so, they did not explain fully what I had changed this to. They did not tell me that they would not put in a feeding tube, they would take away all food and drink once it became more difficult to eat, and take away all medication while she could not swallow. They could have in my opinion explained all of this that way I could have changed it back to a full code with a feeding tube. Then when we finally did decide to have a feeding tube put in, they said it was too late, the dying process had already started. I told them that we had wanted a feeding tube put in, and they ignored a full medical power of attorney. Not only that, they never got my permission to put an NPO on her (No Food or Water) they did not notify me that they where going to do this. I would have objected, and told them to once again get a feeding tube into her. That is not all, my mother had a very massive seizure at 6:00am Sunday morning, and we did not know about it until 10:00am that morning, they had all of our phone numbers and should have called us immediately. The NPO is how they murdered our mother, because they took her off of all food, medication, and drink. And like I said earlier, they should have informed us about what this, and a DNR meant. If there are any attorneys or people that know attorneys please let me know if you think we have a case, and other people of this forum, please let us know what you think. Word to the wide, do not get a DNR because this is what they will do to you. Any help in letting my know if you think that we have a case where we can sue this nursing home please let me know. I want to contact an attorney before 180 day's that is what it is in the state of Montana. Any help, or advice would be appreciated.
A very aggressive cancer killed your mom. Your mom wisely told you " No feeding tube, no code, no more pain".
Feeding a dying patient causes more, not less pain. You did the right things; you did as your mom asked.
I hope you can find peace.
However, people have the right to choose this if they're competent enough to do so. These procedures should be explained and explained and explained until everyone understands 100% what it entails. And by the same token, a DNR should be explained and explained and explained until all involved understand what DNR means.
I'm very sorry about the loss of your mom. If you wish to pursue litigation you'll need a malpractice attorney. The attorney will be able to tell you if you have a case or not.
nolo.com/legal-encyclopedia/what-the-statute-limitations-filing-medical-malpractice-lawsuit-montana.html
I echo the recommendations of others to contact a med malpractice attorney.
We went through a med malpractice/wrongful death lawsuit. There are many preparatory steps before the actual filing of the lawsuit. In our case, the firm's medical consultant (may have been a nurse?) read through the information, and then an MD was also consulted. All medical records were gotten.
Once it was determined that we had a viable case, we signed a contract.
I agree with the others who say a very aggressive form of cancer killed your beloved mom. She was ready to go when she said no feeding tube, no resuscitation, no more pain. I had my mom on hospice for a week and near the end, she didn't want any food or liquid. Her body was shutting down and didn't need it or want it. It's hard to accept, but it's a part of the circle of life. We'll all be there someday.
I personally think you should concentrate on grieving and let your mom rest in peace without pursuing a malpractice lawsuit.
The book is important for all of us to read as we confront death and prepare our own advanced directives.
They were going to recommend Hospice. Tumor came back, larger than before. Mom said " no" to further interventions. You asked if she wanted a Do Not Resussitate order and she said " yes".
It seems to me that what happened is that your mother was allowed to die on her own terms. She made a choice not to pursue heroic measures which were only going to prolong the pain. Hospice was recommended because the cancer she had was incurable.
Please read the Gawande book, recommended by Surprise. And be comforted by your good memories of your mom.
Your mother had a terrible form of cancer. She was not going to live much longer, no matter what they did, treatment wise. SHE made the changes to her DNR, and you have nothing to be sorry for.
Trying to sue an NH for doing exactly what they told you they would do (and a sad lesson learned for you that DNR's can look scary to the uninitiated) your mom CHOSE this.
A dying person who isn't eating or drinking? That is part of the body shutting down, and it's PAINFUL to eat or drink.
Was your mother receiving pain meds? If so, she was not in pain.
I'm very sorry for your loss--but ask yourself..WHY would you have changed her DNR back to full code and feeding tube? To prolong an already terminal life? THAT is cruel.
Right now you are in full grief mode. Please don't focus so much on getting revenge...it is very unlikely that you have a lawsuit on your hands, and really, do you want to go down that path? It's horrible. It won't bring your mother back and it will rob you of any peace.
Since you were named as full medical power of attorney, do you think that perhaps you had some responsibility for finding out about end-of-life options, long before this came up?
And BTW full medical power of attorney ONLY applies if the principal cannot speak for herself. If the medical staff asked her the questions you asked her and she gave them the same answers that she gave you, those are the decisions they had to follow. Even with medical POA, you could not override your mother's decisions unless she was clearly incompetent (delirious, for example.)
Your mom died from a hideous disease. No medical intervention could have prevented that. You feel hideous about this. You feel that there should have been a way to intervene. There wasn't. I think you might find more comfort in seeing a therapist than in seeing a lawyer.
Are you just really upset because she passed before you were ready? That is a common feeling. Death is individual and private. I'm sorry for your pain.
You got your mom's permission to discontinue care. You did what you were charged to do as her MPOA. You could not cheat death. None of us can
My deepest sympathies and condolences. I am very sorry for your loss. I know the pain and sorrow you feel is deep. I know you loved your mom and wanted to keep her here on earth for as long as possible. It is so hard. This is an extremely painful time and it is only natural to wonder and go back on every detail and think if only.
I did this too. I hated the doctors. I hated the hospital. Why couldn't they save my dad? Why couldn't I save my dad?
Your grief is deep. I am so sorry you felt that the DNR was not explained properly. I can see how this hurts your deeply.
If you want to consult an attorney and purse a lawsuit, it is purely your choice. Do what you need to. Talk to more than one attorney if necessary and I hope you can make a decision from there.
Thinking of you. Sending all my thoughts and prayers.
I have been a nurse for 39 years. I have been on hundreds of Code Blue's (when you resuscitate the patient). It doesn't look like its portrayed on TV. I have had doctors try to intubate (put in a breathing tube) to have it accidentally pass into the esophagus (food tube to the stomach) instead of the trachea (breathing tube to the lungs). The stomach inflates with air and everything the person ate comes spewing out like Mount St. Helens.
I've seen ribs shatter, puncturing lungs or other vital organs, the nurses can't find usable veins so the patient is poked multiple times with a large bore IV to try to give blood or IV liquids. I've seen defibrillator paddles burn the fragile chest skin. This is brutal stuff. It's like a war zone in the ER.
IF the patient makes it, they are whisked off to ICU with more painful procedures. Many wish to die to escape the "hope" of staying alive!!
There is a pink DNR form that specifically spells out what is entailed. You are EXPECTED to read it before you sign it. That task is given to the patient themselves providing they are of sound mind. Even a medical POA can not override the patient's wishes if they are alert. They are supposed to be a spokesman for the patient IF they can't talk.
Your mother chose what she wanted to happen.
When the body shuts down in preparation to die, it rejects food and fluids. My dad had a feeding tube after a stroke left him without the ability to swallow. Then came another 2 disastrous strokes. The liquid food in the feeding tube wouldn't absorb into his GI tract. It just sat in the stomach. To force in more food would have blown up the stomach! The only conclusion was to withhold food and water orally (he would have aspirated and died of aspiration pneumonia) and withhold food from the G tube (blow up the stomach). There are no other options left except to let God intervene and take them to Heaven. As much as I wanted him alive, at that point, it wasn't up to me (the medical POA) anymore. Nor was there ANYTHING you could have done.
Calling you in 1 or 4 hours after a huge seizure really is of no consequence. YOU could not have done anything (except pray). Do you understand how much work goes into stabilizing a seizing patient? They weren't going to pick up the phone while trying to start an IV, run to the pharmacy to get emergency anti seizure drugs, taking vitals every 5 minutes, making sure she didn't bite her tongue (off), possibly cleaning up urine or stool that is let loose during a seizure, getting the lab to do blood tests, possibly off to a CT scan, dictating to the chart what just happened so other doctors can know, transporting her to ICU, etc., etc.
You really have no idea what's involved.
Let your emotions calm down, grieve, mourn and consult a lawyer if you really believe there was foul play. Most probably you will not have a case.
I'm sorry. In time, you will
see that there was no other outcome to be had.
You referred to your mom’s repeat MRI after her first course as showing no improvement. I interpret this to mean the tumor had grown instead of being stemmed by chemo & radiation. That is probably why she had a seizure- which is common with brain tumors.
I do think there is a responsibility of the patient/family & the MPOA to understand the paperwork they signed, in this case a DNR. Talking about DNR is frankly a conversation about end of life.
As far as a lawsuit I do not think you have one. Can you prove neligence in her care? If you do find an attorney to take the case, it will have to be determined what the patient’s quality and quantity of life was prior to the event, and if the staff’s action led to her death, as compensation granted, if any, will also take into consideration what you “lost”, ie earning power of the patient if her death had not occurred. Courts rule on facts, not conjecture, or not what we feel the compensation should be. Could you sue for pain & suffering? In light of mom’s diagnosis I am not sure you can prove pain & suffering. Wrongful death? How so? The NH staff knew what she wanted. From your conversations with her about resuscitation your mom appeared to be able to make sound decisions.
Your mother herself told you “no more”. She gave the directive to be a DNR. So you would have subjected her to more aggressive treatment (CPR, defibrillation, intubation) that her chances of recovery from were small and who knows - she would be intubated during the “code” and maybe never regain consciousness. Then you would have to be the one to decide to take her off Medical life support, which would have been very hard for you to do.
They followed your mother’s end of life plan that she herself verbalized.
I do not think it was anyone’s “fault” that your mother passed away - the cancer took your mother’s life - not the NH staff.
You are going through an emotional time. Take some time to grieve for your mom. Celebrate her life.
As stated above quite succinctly performing CPR on your mother would have been catastrophic. Just thinking of doing compressions makes me cringe, as well as using the defibrillator on person sick with a malignant cancer, immunosuppressed from the chemo, as realistically no quality of life was ahead for her. You’d have had her intubated against her wishes so you so you’d be able to direct a MD to insert a feeding tube.
Every procedure performed on your mother has risks of its own. She is susceptible to MRSA, UTI’s & pneumonia due to being immunosuppressed from chemo.
No one took her life. Her cancer did that.
It’s very hard to lose your mother, I know as I lost mine almost 5 yrs ago. My mom had several mini strokes before the last debilitating CVA. I certainly wasn’t going to put her through CPR. We put her in hospice.
I am so very sorry about your loss. Losing your mother is devastating. I hope you find peace.
The experience you and your family have been through over the last few months has been dreadful, and I am so sorry to read of it. But one thing I hope you will soon begin to take some comfort from is that you did listen to your mother and you acted on what she told you. I wish it had been gentler on her and on you, but you did the right thing.
You have six months to think where to go from here. Give yourself time to come to terms with everything you have all been through before you even try to make any decisions.
It is quite normal to want to blame someone for the passing of a love one. There are all the "what ifs" such as, why didn't I take Mom to the doctor's sooner, or if only we had a different doctor, etc. Again, very normal to think that way.
I believe in the after-life, where a love one can look down to see how we are doing. And their spirits can appear to us in different ways. If this was my Mom, I wouldn't want her to see me wanting to sue the nursing home believing that the nursing home had "killed" her. The nursing home was following Mom's wishes. Now Mom, in the after-life, will think she did something wrong. She wanted to pass peacefully, and now everything has been disrupted.
One thing I would recommend is to talk to a "talk therapist", especially one who is older and has taken care of his/her elderly parents. Talking is so very helpful. I went to such a therapist, and it gave me a better insight on the circle of life. If you are on Medicare, Medicare will pay for the sessions, if the therapist takes Medicare
The answer is yes, but......
You cannot PROVE what you are saying, and as a result, you will lose in court. And you will not find an attorney to take the case on contingency, so you will have to pay $300-$500 per hour to hire an attorney. In the end you will have spent a ton of money AND lose the case. It's time to let go!!