My cousin went to detox for alcohol. He has liver cancer and an infection he had in his face from a motorcycle wreck and finally after a long search a doctor finally got an appointment to have surgery to fix his face issue. He went to detox and was looking forward to having his face fixed. When they transported him to the hospital from detox for the infection, he got combative because he wanted to make sure he went to the appointment to have his face fixed. He pulled his tubes out and they sedated him. At that time, they called his mother a day later and said they lost her information, and she needed come and get him. they then transported to hospice and now they are keeping him sedated and he has not been able to come out of that state since the first sedation. He was fine and coherent and up with life and wanting to do what was best for himself prior to the sedation. I am appalled at this time since my cousin is not the type to just want to end his life and now, he has no say in whether to go through with the suggested hospice care or not. He has not come out of their 24-hour sedation because every time he starts to come to, they administer more morphine and advocate. This is beyond belief, and I disagree totally with it all. I am hoping to get any feedback as to what I can do to handle this. as I believe the person who has power of attorney is not competent enough to decide any decisions for him as well as she may be trying to cause his death. I hope anyone who can help will respond quickly because I'm running out of time to help him live if it’s possible, please help! I’m scared for him.
So sorry for what you are going through...
1. The mother is beyond abusive to your cousin. (Awful). She is an addict herself.
2. The mother has taken out a life insurance policy on your cousin.
3. The mother has power of decision making because she is next-of-kin. I'm assuming that he has not signed over POA to her in a formal document?
4. The mother is making sure that he is sedated and denied food and water. So he is unable to advocate for himself.
This is terrible.
You have a choice to make. You can sit by and watch what's going on, or you can reach around behind you, grab hold of your spine, step up and advocate for your cousin.
Present yourself to the hospital. Demand an immediate face-to-face with the hospital administrator. Don't mince words - tell it like it is and demand that your cousin be taken off sedation and given food and water.
Remain calm but firm and don't be afraid of his mother. You may very well save his life. If you can't convince the hospital to chance course, then you'll know that you tried.
I have had to advocate for family members. I've stood up to nurses, doctors and EMTs when it was necessary. They always backed down and I have no regrets.
I do however have regrets about the times that I held my tongue - in order to keep the peace or not ruffle feathers - when I needed to speak up on behalf of a loved one, and they ultimately paid the price. (I'm thinking mostly of my dear sweet twin brother, RIP.)
Regarding holding one’s tongue…Not that it’s always true, but they say:
Your success in life depends on how many uncomfortable conversations you’re willing to have.
Relatives were in such chronic denial my father was dying, it wasn't until he was actively dying and the drastic change in his physical appearance did they THEN and only THEN begin to comprehend what was happening. And what did they do? Started acting out, treated me horribly all because they had guilt for not spending any quality time with their brother. It also had to do with none of them able to control the inevitable outcome that was looming, my father's impending death.
These same relatives also accused me of starving him when hospice had instructed me to remove food/water. So these relatives who insisted my father should not receive morphine also believed he'd turn into an addict! Then they panicked and demanded I administer morphine in large doses at a greater frequency than what was prescribed, which I could not legally do. My father was still communicating and according to his wishes, he received morphine to abate the level of pain he was in (he had end stage CHF, diabetes, coronary artery disease and hypertension). He was on 10 liters of oxygen and morphine helped him with his breathing. Morphine also helped in the final hours when he was twitching a lot from agitation.
These relatives also insisted dad just had to eat a burger and he'd be fine, make a full recovery. Or, drink Ensure (which would've put him into a diabetic coma)...Next they wanted me to force feed him, which is abuse. Of course I did not because I knew my father did not have the capacity anymore to eat, chew, swallow. He went from using straws, to sippy-cup, to dabbing water on lips with a sponge until that was removed, too. They did not have any general understanding why I was following specific protocols as instructed by the hospice team because they chose not to be informed. And guess what? I DID NOT HAVE POA!! The uncle who flat out refused to be involved in dad's care was the POA along with their middle sister. Yet none of them wanted any responsibility with hands on care, but were quick to dictate what they thought was best.
Accusations can come with consequences too. Your cousin's mom may not have all the power you think, or pull to have him on hospice. That can only be determined by the doctor who signed the certificate requiring hospice care (which is also required by insurance). Best you can do is try to speak to someone on your cousin's hospice team and learn for yourself his true state of condition. You are still family and they might be able to share enough with you to help you during this troubled time. Maybe once you're better informed, it will help you see what is happening and the medical necessities behind these decisions.
I posted earlier but I just want to say that I understand how you feel. I have addiction in my family. My oldest (deceased) brother was an opioid addict an had liver issues, Hep C.
My brother also had a horrific motorcycle accident and nearly died.
You cousin has many complexities in his life. All of these things may have caught up with him and there isn’t a way for him to survive.
My brother’s lifestyle eventually caught up with him and he died in a hospice facility.
It’s truly unfortunate that your aunt has mistreated your cousin. Obviously, she has her own issues with addiction.
I can understand why your cousin reached out to alcohol for comfort. Plus, you can’t overlook the fact that he was following his mother’s example. People will either follow their frame of reference or they avoid it.
Addiction is a disease. I have enormous empathy for people who are struggling with addiction.
I found Al-Anon and Nar-Anon to be very helpful to me. It helps to meet with others who have similar experiences in dealing with family members who are addicts.
No one wakes up in the morning and says, ‘Hey, I want to be an addict today.’ Addicts are human beings just like anyone else.
Some people are able to go into recovery and others struggle to make it to that point. Some make it and they go back and forth between recovery and addiction.
My brother was a great guy when he wasn’t using. He successfully ran his own business. Sadly, for one reason or another he kept slipping back into his addiction. Addiction will steal everything from a person, even their very life.
Again, I am extremely sorry that you are suffering. I spent many years crying over my brother’s pain. He accepted death when he entered his hospice facility and his restless soul is finally at peace. I take comfort in knowing that.
I hope and pray that you will find peace. I don’t think there is a way for you to help your cousin now. If you pray, now is the time to offer up a few prayers for him like I did at my brother’s bedside for him.
It’s hard to say goodbye to people that we love. I was the last person to see my brother. He died the second that I left his room.
Wishing you peace. I know that it probably isn’t what you want to hear but, for what it’s worth, I will say a prayer for your cousin and for you. I know that you would rather know that your cousin will pull through. I’m so sorry that I can’t tell you that he’s going to be okay.
Al-Anon was very helpful to me too. Your brother sounds a lot like my first husband. He was a great guy. He had the biggest heart and he would help anyone. He was a hard worker too. Never drank on the job and never missed a day of work for being drunk. He wasn't mean or abusive either.
He tried so hard to give up the booze. He'd get sober for a while then fall of the wagon again and again.
It wasn't his fault. He was an alcoholic. Most of his family were alcoholics. Leaving him broke my heart, but I couldn't live with a drunk anymore.
When he was sick I helped take care of him. I was married to my second husband at the time and he understood why I had to and was cool with it.
My first husband knew he wasn't going to recover. Addiction killed him like so many others.
My first husband was an alcoholic who died from alcohol related complications when he was a young man.
Your cousin's face infection had to be treated with antibiotics and cleared up before surgery for it could even be a possibility.
My first husband had extensive liver damage like your cousin and also had an infection that required antibiotics. His live was too far gone to be able to process the medication and he died.
Hospice is keeping your cousin sedated as an act of mercy. Anyone will pull at the tubes and get agitated. That is why there is sedation.
Your cousin has cancer and is an alcoholic. His cancer could have spread very fast. He likely also has cirrhosis and aeschites as well. These are painful conditions that require morphine and other drugs to help a person's suffering. These conditions can get very bad very quick. He may have been coherent and seeming fine to you, but he wasn't. He was having a good day.
The day before my former husband went into the hospital to die he seemed almost like his old self. Like he could rally and get better. He couldn't. He had to be sedated (a drug-induced coma) and then he went to God's mercy in peace.
I think the same for your cousin too. Go and be with your cousin in his last days. Ask his doctor to explain what's happening.
If what you say is true about your cousin's mom, sounds like something very sinister is going on. You're in a tough position though; how to prove what she's doing? Unfortunately the burden of proof will fall on you and time is working against you. How can you prove your cousin signed over POA to his mom without undue influence or coercive control?
I really do sympathize for you and can hear the panic in your writing. Just know if the hospice was truly torturing your cousin, they would lose their license. There are strict regulations/laws they must adhere to. Whatever was ordered for my father strictly came from the hospice doctor. If your mom's cousin has that much control over this situation, my guess is your cousin stated in writing in his estate papers his wishes for a time like this to act on his behalf as his agent......I can't imagine hospice not having his papers on file/in his records. During my father's hospice admittance, all estate papers (POA, Advanced Health Care Directive, including his POLST) were uploaded into his file. This is standard procedure, even when someone is admitted to hospital for surgery. The multitude of times I called 911 for an ambulance for my father, at each home visit, I'd show the fire-crew and paramedics my father's DNA/POLST document. This copy accompanied my father with him during the ambulance ride....point is, documentation is very important. Who is authorized amongst family to see these papers?
Because another obstacle you face is having access to see those papers. Due to HIPAA law, hospice has to adhere to patient rights to privacy. Unless your cousin specified information to be released to you on record, without the help of an attorney, this is yet another challenge for you.
It sounds like some key pieces are missing here. Either by design, or by choice you have not been informed.
I wish you peace during this difficult time. Please don't be so hard on yourself either. You really are in a tough spot, and I know what that feels like having been through something similar with my own nefarious relatives.
PSA: if you sincerely believe someone is being “murdered“, call the police. Don’t go on an anonymous internet forum to complain about a potential murder. Sheesh!
Hospice is comfort care. If keeping your cousin pain free means he needs to be kept in a drug induced sleep, then so be it.
I would say that when cousin was placed in detox it was found that his cancer had worsened and he probably had Cirrhosis and was in the last stage. Detox then would do him no good. His outburst at the hospital could have been caused by the liver toxins in his system. They effect brain function too. By the time toxins present themselves, he is dying. The pain maybe so bad that he needs to be in a drug induced sleep to have enough morphine in his system to stop the pain. Eventually, his body will shut down. First sign is the ability not to be able to swallow. At that point no food or water will be given because it will do more harm than good. The body no longer can digest. After that, its a waiting game.
Your cousin was a practising alcoholic. Not a candidate for a transplant. Maybe they felt by putting him in detox it would help lengthen his life but seems he may have been too far gone. So sorry.
I think you're spot on. You basically describe what the situation was with my first husband too.
They're too far gone to even be considered for a transplant.
For alcoholics to even be put on the transplant list, they have to have at least one year of sobriety. That's how it was years ago. I don't know what it is now.
Liver cancer is 100% fatal. Period. Unless the person qualifies for a liver transplant, which, based on your comments, your cousin would not qualify.
My SIL is a liver transplant doc and also a hepatologist. Most of his patients die. It's sad, but true. You cannot live without a liver.
The infection is a side issue, unrelated to the cancer. Looks doubtful that he can have any kind of surgery as he is so sick with the cancer.
Perhaps you can get someone to talk to you about what is going on with your cousin's body? The things that Hospice are doing are simply keeping him comfortable, they arent' killing him. The cancer will do that.
The POA can and should make the hard decisions. Take a step back and ask yourself IF your cousin could have chosen you as POA, why didn't he? This person is who he chose. I'm sure they are not enjoying this experience at all. It's awful to have to see someone suffer and Hospice can keep them from the excruciating pain of all his myriad health issues.
He's proven to be combative-and while you want him to get his face fixed, he may simply never be healthy enoough to do that. I'm so sorry.
Go visit him and be supportive of the POA, who probably feels as awful as you do, or more.
And, BTW, if he is 'fresh' out of detox, it would be hard to find a dr who would want to perform surgery on him.
Sorry--that's just the facts. Please take care of yourself during this time.
Dave, your cousin made many decisions in the past that didn't serve him well. His lifestyle has led him to this point. At the time he thought he was living his best life, but all of those decisions have come home to roost and put him into this present circumstance.
I understand that liver cancer is very painful and the survival rate is low. Hospice is there to help, not kill him. Cancer and infection are killing him, not hospice and his mother. Hospice is trying to keep him from the agony of the excruciating pain that goes along with his condition. If you were to witness such pain, you'd probably be even more upset than you are now with his being sedated.
You need to talk to his hospice team so you can better understand what's happening. I wish you peace.
People can get cancer and other illnesses and it's not because of their life choices.
No one ever has to hear that a person they love made bad choices and their lifestyle put them where they are.
No one in grief ever has to hear that because it's cruel and completely unnecessary.
~BC 8/12/23
Let me also say that hospice is only called in when a person has a life expectancy of 6 months or less. There are certain exceptions, but that it the norm. So if he has gone into hospice, you need to understand that it is not likely that they are just keeping him sedated because he is combative and needed care until his mother could come get him. Had they just needed someone to take care of him until someone picked him up - they would have discharged him to a rehab facility or something similar.
Hospice is end of life care.
They are sedating him and giving him Ativan - an anti-anxiety medication. Hospice care is explicitly for "comfort" care or compassionate care for people in the advanced stages of terminal illnesses. They don't typically do anything to prolong life, but they also don't do anything to bring on death. They do what they can to make patients comfortable.
They are there for both the patient, and their family and friends. To offer comfort and to keep the patient comfortable and ease their last days. They are not causing death. The person is already dying.
For some family and friends that is incredibly hard to process. That is another reason hospice is typically brought in, to offer comfort and respite for the family.
I know this is difficult. It was very hard on our family when hospice was brought in for my dad, and we knew it was coming. I can't imagine if you didn't know it was coming.
Liver cancer can be pretty aggressive. Is it possible that it has progressed and you aren't aware of how far? Are you allowed to get information from the hospice nurses? Will they update you on your cousin's situation?
It doesn't sound like your aunt is a very nice person. But your cousin did choose her as his POA. Typically people choose someone as their POA that will make the choices for them that they themselves would make if they were able to do so. It's unusual for someone to choose a POA that will not act in their best interest. If you think that she is actively acting against his best interest I suppose you could bring that up with the hospice nurses.
But honestly it is better for you to understand the entire picture about your cousin's health before you try to intervene. If you are unaware of his current cancer prognosis and he is genuinely end of life, maybe it is better to understand that first. This is such a difficult time for all of you. If they bring him out of sedation to make decisions, what does that look like? Is he in pain? Would he be able to make sound choices? Or would he be in too much pain? Or become combative again? Keep his ENTIRE best interests in mind as you move forward. Gather all of the information before you proceed. I know you have his best interests at heart and you love him and only want to do what is right. But you need the full story before you make any moves.
Sometimes even those we love and think we know well don't tell us everything. Take a deep breath. Reacting in panic sometimes leads us to do the wrong thing even for the right reasons.
Best of luck.
https://www.crossroadshospice.com/hospice-palliative-care-blog/2014/july/20/why-it-s-ok-for-your-loved-one-to-have-no-food-or-water-on-hospice/
He can’t be in hospice unless he is dying. There is no way to get him in hospice without that— Medicare, Medicaid and or his insurance won’t pay for it unless he has medical records showing he is dying.
What you are saying is his mother is trying to kill him. Ok go to the police then. she might be every terrible thing you say she is, but none of that means he isn’t dying from liver cancer.
If the cancer has metastasized (that means it's spread) to his liver, it can be deadly. And horribly painful.
His body can not absorb nutrients which is why he isn't being fed.
There is a patient advocate at the hospital. Also social workers and chaplains. That’s who you want to talk to in the morning.
Wishing you well.
Since time is of the essence, do something. Here on the forum you’ll get sympathy, but no one can actually do anything to help your cousin.
1. Maybe you’re wrong.
Maybe his mom/POA, hospice staff and all medical staff involved are doing the right thing, medically and morally.
2. Maybe you’re right.
Maybe there’s something fishy, immoral, even criminal going on. Since that’s what you think, contact the police…and/or go to the hospice staff physically, explain your worries face to face.
I have a feeling his situation is considerably worse than you realize. I understand your agony, as I had it, too, but please don't second-guess the very difficult decision his POA (mom?) had to make.
And no, hospice does not murder people. They're solely focused on quality of life -- in your cousin's case, managing his anxiety and pain, not dancing a jig.
It sounds like he lived hard, and now his body is giving out. I'm very sorry.
If he was in the hospital due to an infection, then that had to be treated before he could have any type of surgery on his face.
He pulled out his tubes and wanted to leave the hospital. He wasn’t thinking rationally. So, he was sedated.
I am a bit confused by your post. Was he through with detoxing? Or was he in the hospital for detoxification from the alcohol?
Your cousin has multiple issues, his addiction, his cancer and an infection.
Was he being treated for his cancer? Is it possible that it had progressed to a point where he cannot be treated? How serious is the infection? Those things are more important than having his facial surgery.
Can you find out more information from his POA or other family members who are close to him?
Wishing you peace during this difficult time.
Maybe you don't have all the medical facts, especially as you are not the MPOA.
I read your cousin has liver cancer - maybe it is more advanced than you believed?