MIL had to be moved out of her house out in the country to a house that we bought in town. We built on a handicapped accessible apartment for her so she has her space but is close to our son/dil/grandkids until we are able to move back. We are currently living in Norway with my husband working for NATO. She got diarrhea about a year ago and I took her to a GI doctor who told her she had to have a colonoscopy to figure out what's going on. She refused. He said he can't help her then. She said fine. She hates doctors and believes that they kill people. She is over weight, slow moving and falls quite a bit. When she needs to go, she just goes where she is. In the grocery store as she's walking around, in the car on the drive home. She's pooped all over our sidewalks. Doesn't care. We refuse to take her anywhere now and she's mad. Her keys were taken away from her last year. We told her if she wants to go to the grocery store instead of someone picking up her groceries, she needs to fix this. She said she's lost 75 lbs since it started so she has no desire to have it stopped. We have someone come in and clean for her twice a week (really needs to be everyday but can't find anyone to come for an hour everyday just to clean up poop) and on Tuesday last week they found her laying flat on the floor. She slipped in poop, her feet went flying up and she slammed her back into the floor and couldn't get up. She has a life alert but doesn't like wearing it so no one knew. She also doesn't like to take showers. She is being FORCED to shower twice a week because the smell is horrific and she's very upset about it. I'm at my wits end. She was in a hursing home for a week after a surgery for an impacted intestine and we really hoped it would fix the problem but it hasn't. After the surgery, her apartment wasn't quite ready so she was in a nursing home for about a week. The nursing home said she does not "need" to be there so she had to pay out of pocket. I'm at a loss. If someone goes to her house, sees poop everywhere, smells how bad she is, I'm afraid social services (or whoever does that) might show up and accuse the kids staying with her of elder abuse. She thinks they meddle too much (taking out the trash, trying to clean up the messes) so she locks her doors and will not let them in. They pick up the meals on wheels for her everyday and she won't even let them in to deliver it. Has anyone had something similar to this happen? If so, how did you take care of it? Oh ... she REFUSES to wear diapers because she's not a baby (even though she acts like one)
I think the time has come for someone in the family to contact APS or the Department of Health; don't you think it's unhealthy for your adult children living in the adjacent building to be exposed to her unsanitary and unhygienic conditions?
1) Worse case scenario is that she has colon cancer. Get her to a doc STAT!
2) Get a colonoscopy.
3) Knowing that she needs a mental assessment
4) Why can't the son/dil/grandkids get her to a mental assessment? they don't want to take very ill granny to ER? In no circumstances is it normal to just go to the toilet in your pants! THIS WOMAN NEEDS HELP DESPERATELY!
You kept saying we needed to take her, so I was just trying to show that it’s not possible when even the ambulance driver says that he can’t force her to go as long as she has the ability to say no.
At least with my mom, her vascular dementia has not affected her memory much, or her ability to know what day of the week it is, etc. But she can't REASON anymore. If she sees a spot on her skin, she thinks she has leprosy, etc.
Oh, and I'd give her back the Immodium. If she's not going to follow doctor's orders, she should at least get some relief from this ordeal.
Who has POA should the original POA be unable to fulfill his duties? I have no idea. I’ll try to find out. The POA was done over 10 years ago so we may have known at one point but just forgotten.
You don't mention how old MIL is but a geriatric psychiatric evaluation would not be out of the question. She is 76.
As others stated, should she slip and fall again and can't get up, have the EMTs take her to the hospital "to get checked over". We tried to do this once but she refused to get in the ambulance. Ambulance driver said there was nothing he could do if she refused.
A huge concern I would have is c-diff if there is bad diarrhea. The home health care aid said she doesn’t believe she has c-diff. She said that there is a smell that is undeniable with that.
How does your spouse feel about all this? My husband is the oldest. Ever since he was small enough to talk, his mother has told him that he is responsible for taking care of her in her old age. She even had that talk with me before we were married to make sure I was onboard with that if I was marrying her son. He also promised his dad before he died (he died from multiple myeloma) that he would take care of his mother after he passed. He feels like it is his responsibility to keep her out of the nursing home.
What we do know is that she must be scared out of her mind: that is why she refused the colonoscopy, that is why she is pretending that there is nothing wrong, nothing to see here, and biting anyone who doesn't agree with her. She HATES doctors. She had only been to doctors for the birth of her children (no prenatal care) before she had her stroke in 2010. And she refused to even go to the hospital after her stroke for 48 hours. We received a call from her neighbor that something was wrong. We called her and couldn’t understand her as she was slurring her words. Called neighbor back and told them to take her to the hospital. She refused. The neighbor didn’t want to do anything else about it. We called the “sibs” and they said “if she doesn’t want to go, she doesn’t have to go”. The next day we called again and told her she could either 1) go with the neighbor or 2) go in an ambulance. She went with the neighbor. They said her blood sugar was almost 400 and that she had indeed had a stroke. She was in the hospital for 2 weeks. Now it’s a major ordeal just to get her to go to her diabetes appointments every 3 months. She said the doctor is the one that gave her diabetes because they want to take her money. And she hasn’t been to a dentist since she was a teenager. Dentists just want to take her money as well. (she hasn't bit anyone)
I think she needs an aide at least twice a day, to clean up the poop, for starters. She has an aide 2 times a week. That is the most she would agree too. We live in a very small town and the aide has to drive over 30 minutes to get to her. It took almost 2 months to get anyone that would even agree to come 2 times a week.
Why can't the son/dil/grandkids get her to a mental assessment? She is refusing to even allow them in her house. Keeps the doors locked. Son and DIL are in a real hard spot. Even if they could get into her house, she refuses to go to the doctor and the ambulance crew said they can never force her to go with them as long as she is capable of saying no.
Part of the problem is that we have brought these symptoms forward to her regular care doctor, her GI doctor (that she refuses to go back to), the doctor that did the surgery for the impaction, the social worker that came for 2 months after she returned home from that surgery, the home health care aide that is there 2 times a week and the company that the aide works for. When she was in the nursing home immediately following the surgery awaiting for the apartment to be finished the nursing home said that she had to pay for it herself as she did NOT belong there. She was there for our convenience. We bring it up to everyone and they all said that as she is competent there is nothing we/they can do as long as she is refusing. My husband said the only good thing about that is he thinks we have some sort of protection from any claims that she’s not being taken care of as we have documented in all of her medical records our concerns. We also built her an apartment onto our house to take care of her that is 100% handicapped accessible and the plans were drawn up with her social worker’s guidance on what she needed.
We go home a week from today so I’ll look into the what else we can do while we are home. Thanks for all the answers and help!
#1 She is very dehydrated
#2 She is very anemic
With these 2 things against her, she may not have long!!!!!!!!!!!
For precedents, there are all kinds of interesting cases which concern people with learning disabilities: can they consent to carry on a pregnancy to term, can they consent to a termination, can they refuse treatment, can they consent to sterilisation, can they refuse sterilisation. These people being physically healthy adults with all their lives ahead of them, and therefore their quality of life at stake for a considerable time, the courts become quite animated when it comes to these discussions in a way that they don't seem to when the patients are in their eighties or nineties. But the ethical principles are the same.
I do know from a close, informed source that even when patients are deemed to be mentally incompetent their preferences, fears, phobias, anxieties and beliefs are certainly considered, and taken into account if possible. Considerable lengths are gone to, and it can be extremely time-consuming. Do you remember Tom Cruise as Rainman in the film trying to get his brother onto a flight? That wasn't a bad example. In the case of my source, while she will take great trouble to persuade rather than force compliance, if she believed something to be clinically desirable she would get it carried out. In some of her colleagues' cases, they draw the line at essential, rather than desirable; and let more go by.
My question would be who would go to the human rights with this issue because I suspect that if incompetent they wouldn't be able to instruct anyone. It would only be when relatives got involved that that could become an issue
What, just like that? The OP is in Norway. The MIL is in the States. How, precisely, is the OP to get her MIL to a doctor "stat."?
If the MIL has a partially obstructed bowel, what is coming out is probably more leakage than diarrhoea as such. The MIL may not be feeling normal sensations of urgency. This is not typical incontinence. Therefore, the MIL is not necessarily as nuts as she sounds, as nuts as she would be if she were just merrily pooping in the ordinary way, apart from its being all over the place. She is behaving in a crazily dangerous way in her determination to deny the issue, but she isn't necessarily demented.
She is quite possibly also anaemic; and she may have the other problems associated with being extremely sick. What we do know is that she must be scared out of her mind: that is why she refused the colonoscopy, that is why she is pretending that there is nothing wrong, nothing to see here, and biting anyone who doesn't agree with her.
Until she has been assessed and declared lacking capacity, to conduct the colonoscopy without her consent would be criminal assault and no doctor would do it. Even if she had been so declared, a doctor would still hesitate. A colonoscopy is an ordeal for a consenting, informed adult. What would it be like for a frightened, resisting, sick old woman? It isn't the operational difficulty - that's what sedatives are for - it is the ethics of it that would trouble a responsible practitioner.
Then you would need to think it through, to what are you expecting to find, what will you do if you find it, and what is the potential benefit to your patient? Unless you have a reasonable expectation of a measurably improved outcome, you do not conduct painful and intrusive investigations.
So this isn't a scenario with a one sentence solution to it. I hope the OP hasn't been put off coming back to update us.