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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.

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Folks, Trap hasn't posted on this thread for 4 months.
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Trap, your mother chose no more treatment, no more pain. A very wise, as well as courageous, lady. The NH followed her wishes, as was her right; your medical power of attorney did not override her stated wishes. It was your responsibility to inform yourself about the DNR, etc., nice if the NH sat down to explain it to you, but Your responsibility since you held the MPOA. You did right by your mom. No one killed her, it was the terrible illness, and now she is in a place so great we cannot even comprehend it. May we all be there someday!
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Going through the exact same scenario only my mother has COPD and it is not right the games they are allowed with lives. They sneak and lie and purposely don't inform families because they can. I feel so bad for our parents they are at the nursing homes mercy.its just not right.
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trapwhisk

This is so sad. I'm sorry. Vegaslady probably meant in her comment that you should have asked all questions and got all the information before the change.
NH is going to look out and protect themselves first and foremost. They were going on your mom agreeing to suspend any life saving measures. As some other members have pointed out, your mom was suffering and dying and it would not have been fair to her to prolong her misery any longer.

As far as the feeding tube they would have probably given her one that uses a continuous pump. In essence, she would be confined to bed.
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trapwhisk, sometimes the writers will try to use what is called "tough love". It might not set well at the beginning but after a month or so a person will realize that the writer was right. When I first came on the forums about 5 years so, I got the "tough love" answer which I really needed because I was in denial.

As for your Mom not being given food or water, it would have been MORE painful being given food/water as the body's organs sounded like they were shutting down. What would happen would be food would sit in the stomach as the stomach wasn't digesting food correctly.... and water would sit in the kidneys. That would be like filling a measuring cup of water and keep trying to put in more water with no place for it to go.
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Arwen31
with Vegaslady comment, it was a very harsh one; I thought that this person that made this comment was very unfair in presuming that I didn't know what was going on; I did know what was going on. Like I said in my original post! After getting diagnosed with this, she was doing good for some time. Then when things started going downhill she was in a lot of pain, especially with the headaches. She was in a lot of pain, because that dam tumor was pressing on areas of the brain that was doing a lot of things, her legs where cramping and hurting really bad. She was having stomach cramping from the Chemo that she was getting. She was on a medicine that was called Temadore. My brother did some research and found out that this particular medicine tears up the lining of your bowl's. When people like Vegaslady make unfair and inappropriate comments like that, well, in my opinion, they should not even be posting on a site like this. I am grieving hard; And I am going to be for a long time. But, what was done to my mom was an injustice. And further more, it is "Medical Malpractice", my mom died and was probably very hungry and dehydrated, whoever tells me that is dying in a comfortable manner is very wrong. Just think about it for a second, what if you where in that position, and you had to go without food or water for about 10 days would that be comfortable to you? "No" it would not. Like I said I did not know anything about the VSDE "Voluntary Stop Eating or Drinking" I still believe that they should have informed us about this because this would have never happened. And they violated the Law when they did not inform me of this decision. She was suffering by not having anything to eat or drink for several day's. This is cruel treatment.
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I can see an honest misunderstanding/ problem with information - if family does not ask, does that mean that they really don't want to know? Speaking for myself, I have found myself wondering how to communicate with a terminally ill person. Do they believe in an afterlife, if you talk about heaven to them, are you insulting their non-religious beliefs? Etc., etc. With all the goodwill in the world, this problem of how honest you should be can be quite hard to deal with. I think with medical people nowadays you have to be pro-active. Don't wait for them to open a subject - if you have questions, ask. I would have to agree that if you are asked to be medical proxy then you really need to do your homework - otherwise how can you be prepared to discharge your duties? Medically it is a different world than the one I grew up in.
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I feel that some people have been way too harsh in their comments.
She can't blame anyone, but Vegaslady, you can blame her for not "knowing enough"?
Not knowing is precisely what she's complaining about. It wasn't up to her to have all informations, she's not a doctor nor a nurse, it was up to the people in the Hospice to inform her.

Personally, I didn't feel she was "lashing out", but looking for some validation for her feelings, which are in my view fully undestandable, and not just as part of the grieving process.

Trapwhisk. While I do agree with others that suing the Hospice won't alleviate your pain, and that this is what is your mom wanted and possibly needed to go to the next world without suffering, I do agree with you too; the lack of information sometimes is just mindblowing, and I think this is what makes you feel frustrated and angry.
Lack of proper and full of information is not what caused your mom's death, still it's way too common, and yes, I do agree with you, it can be seen as a form of malpractice.
I think you are right. They should have given you the whole picture of what was going to happen, and how.

At the same time, it's possibly a blessing in disguise that you didn't know; it allowed your mother to die in a dignified and peaceful way, without suffering, and it didn't put you in that terrible position to anticipate what was going to happen and take perhaps wrong last-minute decisions.

The Universe sometimes knows what has to happen, more than us.
This goes beyond who's right and who's wrong and it's the only thought that can give us peace.

Close to you.
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So sorry, Yogagirl, for the loss of your dad.
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yogagirl

I am sorry for your loss of your dad. I just recently lost my mom, this is very hard to deal with. I am about at the same stage that you are at; A lot of second guessing, and grieving, it is getting a little less, and less, but no the less it is so, so hard. We, me, my brother and sister are still doing all the second guessing and all that. It is going to take some time. My mom grieved my dad for 10 years. I lost my dad when he was 28, I was 2 1/2 years old; So I did not know him. My mom raised the family and she did a wonderful job. But we just lost this precious lady December 19th, so as you can imagine how our holidays where! Not good at all. But yes yogagirl it is going to be very hard for a long time. I hope that you will heal with time.
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I am so very sorry for your loss.

I lost my precious daddy only one month ago.
I must admit that I am reliving his end of life moments and second guessing many of the decisions I made, even though I know better.
Hopefully, with time, we will accept that we did the best we could at the time and remember most the love we shared.
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Jacob-
We are all sorry for your loss. But lashing out at us, the people who are trying to help you to understand the process of dying (and your mother was terminal, with the glioblastoma, you know that--) and to accept that she did have a very tragic and terrifying end of life.

Your language alone says you are very angry, and I am sorry for that. Please try to get some help with dealing with your loss. Lawsuits can drag on for ages....and your mother was dying as it was.

Nobody from the hospital who took care of your mother is on these boards, I'm pretty sure. You're ranting and not getting to your "audience".

We ALL want a peaceful passing for our loved ones. We don't always get that. Would you have preferred for your mother to live in pain and misery for an extended period of time?

Give yourself time to grieve, and hopefully, get some grief counseling too.
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Jacob; I'm so sorry for your loss.
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Condolances on the sad loss of your Mom. Gliobastoma is a very aggressive brain cancer and frequently advances very fast. Once it is diagnosed it is often very far advanced so although tretment maybe done it is rarely if ever curative. Brain tumors are frequently only diagnosed after the patient has a seizure- remeber Ted Kennedy died from a Glioblastoma and he only survived a few months after diagnosis.
By all means consult a lawyer as most first consultations are free but if your case is taken you may be asked for a retainer of several thousands of dollars. Even if you win your case the cash reward may be quite small because of the age of Mum and the lawyer will take qpprox 30% of the award which will be taxable to the beneficiary.
Of course there are things that the facility should have done better but they may not have been negligent.
Going through court proceedings will be very stressful and reliving the events surrounding Mom's beth will be heart wrenching for you. For now concentrating on getting through your grief will help you the most.
Hubby is from a family who was very litigious and he has often threaten to sue over something. My advice is always to let it go because the case will take for ever and be very stressful for the family
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I completely understand your grief and pain at the loss of your beloved Mom, I went through something similar, we lost my Mom to uterine cancer 14 years ago at only age 75.

At age 65, my Mom had experienced some vaginal bleeding, not normal at that age. She had a D&C, and the Dr said she stopped counting the polyp's being removed at 100, again Not Normal!!! Being naïve of such matters, it never occurred to me to inquire whether or not biopsies were done at the time.

Fast forward 10 years, Our Mom had recurring problems, and this time, a uterine biopsy was performed, finding advanced uterine cancer, for which she had a Radical hysterectomy, followed by 30 straight days of radiation therapy. During this time, we lost our Dad to Pneumonia, it was a horrible and very stressful time for us.

On Mom went on to have spreading of the Cancer to her pelvic bones and probably to her brain as well, but by this time she was on Hospice ( a good experience for her and our family), and she passed away 5 months Carter our Dad.

I have always wondered had they done biopsies of the uterine polyps the first time around ( nothing was ever mentioned about biopsies), had found the cancer and she had appropriate treatment, would she have survived, and still been be with us all these years later? It is something we will never know, and our Mom was not the type would ever sue over something of this nature, so we had to learn to let it go, and accept things as they were.

I try not to think about, the unknown, the what if's, shoulda, woulda, coulda. It's not easy, but time does heal these things, and I have to remember that our Mom and Dad are together in Heaven, happy and healthy once again.

I'm sorry for your sorrows, you take care, and I think you are doing the right thing.
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I don't know if this helps but while every grief is unique, there is overlap. Crying in public, anger, sadness at what you and she lost before her death. You are not alone in these this, and people here will support you.
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Venting spleen can be very, very important in the healing process; and this forum is the ideal place to do it. I have nothing but sympathy for how you must feeling, huge hugs to you.
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Trapwhisk: We're relieved you're here so we can be your support and sounding board. {hug}
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I can understand you are shocked and saddened by the death of your mother. But a law suit won't restore her to life, cured of cancer.
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Be well, Trap. We all understand.
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Trapwhisk, of course, of course. We understand. It's all so raw and horrible. And unfair that all this happened to your dear mom.
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Here is an update on what action will be taken with this nursing home. I was just very dissatisfied with them because of the way that they had treated my mom, and use when everything was going well and she was not in that terminal stage. Before she was terminal, the nurses where not treating us right, nor where they treating my mother right, and I called them on a lot of their B.S. But, that was not the only reason I was mad, it was because the blatantly ignored the power of attorney (In my opinion) the reason we have decided not to file a lawsuit now is because my mother said that she did not want us to sue them. There was discussion about it, but I am going to go with her wishes and try to heal from this. I still miss my mom so very much though. I find myself crying out in public, at my house and other peoples house. I found myself crying today because of that tumor that she had, it made her so she had forgotten how to read, and even how to use the cell phone so she could even contact us. It almost mimicked Alzheimer Disease, the tumor was so big that it was pressing her brain to one side of her skull. This was a terrible thing to watch. So please don't be too hard on me for the other post that I left, I was upset very much and almost not in my right mind. Grieving, you are right, I am grieving hard core. It is going to take a very long time to be able to move on, that is because I was my mothers caretaker for the last 6 years and nine month's.
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trapwhisk I'm so sorry for the loss of your mom. It probably is best that you let this go and remember your mom the way you want to remember her.
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You asked "Can I Sue the Nursing Home?"

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!!
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trapwhisk, my heartfelt sympathy to you and your family for the passing of your Mother.

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
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Trapwhisk, you had the important conversations with your mother and you took her instructions. She did not want a feeding tube. She did not want to be resuscitated. She wanted, crucially, no more pain.

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.
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Trapwhisk I am very sorry about your mother’s passing. Unfortunately glioblastoma is a rapidly spreading cancer in the brain that is often inoperable. Chemo & radiation is grueling treatment. The body is immunocompromised from the chemo and skin frail from the radiation. 

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.
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Sounds to me like you are a very devoted daughter. You followed through with everything your mother asked. Anger is a very normal reaction, but it doesn't sound like she would have survived and the feeding tube could have made things a whole lot more uncomfortable for her. May you be comforted knowing you did all you could.
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Trapwhisk, I am so sorry for the loss of your beloved mother. Of course there's no good time for this to have happened but I would imagine it feels even more painful at the holidays with celebrating happening all around while you're in pain and grieving. God bless you.
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I would like to extend my heartfelt condolences on the passing of your mother. The pain you are suffering is horrible. We've all lost a loved one to very bad diseases. Their deaths seem untimely but everything is in the Lord's timing.

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.
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