My mom is 79 and has COPD - a conglomeration of various respiratory conditions all lumped into one name. It encompasses so many diseases....I guess it's just easier to lump them all into one lump. I sure as heck don't know which one of these other formerly-named diseases Mom has, but I do know that asthma runs on her side of the family.
- Chronic bronchitis
- Chronic obstructive airway disease
- Chronic obstructive lung disease
- Emphysema
Mom has a POLST Form on file, which her doctor walked her through verbally in 2008, and he checked off her choices. Apparently he didn't explain it well enough, because she had him mark what SMC, Southwestern Medical Center, Vancouver, WA, is now calling conflicting wishes and IT'S A PROBLEM FOR THE HOSPITAL.
The POLST, "Physicians Order for Life-Sustaining Treatment, is a legal document and must be filled out by the attending physician, and signed off by both doctor and patient. If you've never looked at one of these forms, please do.
The POLST should be illegal. I'll try to explain why.
It is full of medical chicanery, lying in stealth, beneath the medical terminology & jargon & subtle nuances that many who are not medically sophisticated, and especially those with either mental, language, or other comprehension deficiencies are not going to fully understand.
It's confusing, conflicting, complicated.
It can be interpreted subjectively.
I'm sure it covers all the LEGAL bases, EXCEPT ONE: PATIENTS RIGHTS.
It fails to give any Disclosure that it is a legal instrument, and the patient should be afforded the right to seek legal counsel.
Therefore, the patient, oftentimes, is not making a fully informed decision, nor is advised the document is a legal instrument, nor is the patient offered the suggestion to seek legal counsel for full disclosing of the legal ramifications of the document.
Simply put, the POLST Form is a CYA legal instrument that works in the best interests of the medical community, andagainst the best interests of the patient.
How can this be legal?
A criminal has more protected rights than a 79 year old woman, with a POLST Form on file, when she is admitted to Southwestern Medical Center of Vancouver, Washington.
The precipitating scenario:
Early Monday morning Mom had a coughing fit and expressed she was having difficulty breathing. She was admitted into SMC, and they intubated her, why I do not know, but they said her stats were good, and she was stable. They try to remove the ventilator tube as soon as possible because the body will get lazy and let the ventilator do the work for it. The nurse says if they cannot get her off it by Day 14, they will put in a tracheotomy tube.
By Friday, DAY 3, they had Mom on very little sedation and she was doing well with that. They keep a patient sedated because the ventilator tube is in the throat, is painful, and the patient's reaction is to tear it out, potentially harming themselves. They weren't able to successfully remove the ventilator on Friday so they will try again the next day and the next day, until either it is removed or it is Day 14.
Also on Friday was the first time the nurse informed me of the POLST Form Mom had on file at Dr. Larry Lee's office. I knew nothing about it, so did online research, had the hospital email me a copy of it when I was unable to locate one online.
THE PROBLEM. SMC claims that Mom, on her form, checked DNR-Do Not Resuscitate, but checked YES on every other kind of medical care: IV fluids, antibiotics, cardiac monitor, feeding through a tube, intubation, advanced airway interventions, mechanical interventions, and cardioversion, among others. SMC CLAIMS this is a PROBLEM for the doctors because the information THEY CLAIM, is conflicting.
Mom didn't fill out the POLST, her doctor did.
DO YOU UNDERSTAND WHAT SOME OF THESE TERMS MEAN? Are you medically savvy? Get plenty of oxygen to your brain? In good health? Are you on mind-altering medications? How old are you? What is your level of education?
My Mom has an 8th grade education.
I'm leaving out all the caveats and other misleading information on the form.
It is HIGHLY SUBJECTIVE AND SUBJECT TO SUBJECTIVE INTERPRETATION!
The PROBLEM, in more detail, according to SMC, is that Mom had her doctor mark in section A, DNR, "Do Not Resuscitate" but in sections B, C, and D, yes, she wants full care. I suggested that perhaps Mom meant she didn't want to live as a vegetable, but otherwise, it's very clear that she wants to live.
(I'm just wondering why the doctor did not fill out the form accurately, or at least that's what SMC is telling me. Initially Nurse Amy & Lynn Crawford led me to believe that Mom had made the errors, UNTIL I READ PAGE 2, and saw the doctor is the one who fills it out, at the instruction of the patient.
WAS HE COVERING HIS ARSE on this form because he KNEW Mom's medications and medical conditions, and her lack of medical sophisticatication prevented her from being a FULLY INFORMED PATIENT of her rights? Or does he secretly have a problem with the form, too?)
Who's suggestion was it that Mom even fill out this form, because CONTRARY TO HOW IT IS MARKETED to the medically unsophisticated, it is not about the patient and IS ALL ABOUT CYA FOR THE MEDICAL COMMUNITY.
I'm questioning, too, could it be that with RISING HEALTH CARE COSTS, and the implementation of government ENFORCED medical insurance for almost all Americans, and the attendent costs associated with it, that this legal instrument may be being used as a means to an end? An ending of a life, an old life, a sick person, someone who is using valuable resources?...
What got me to thinking like this was Lynn Crawford of SMC kept telling me that Mom had lived a good, long life, that she IS 79.
I bristled about the third time she made that statement. So now we make decisions to end a person's life because of their age?
Mom is stable. She's doing fine.
WHY THE PRESSURE?
WHY THE HARD PUSH from SMC??? To get a "consensus" among ALL SIX OF HER CHILDREN TO AGREE TO SELECTING ONE OF US AS OUR SPOKESPERSON & GETTING MOM TO ASSIGN ONE OF US AS HER POAHC, Power of Attorney over her health care (this POAHC terminology was Lynn Crawford's language, not mine).
Lynn Crawford is with SMC's dept of Bridges Palliative Care. She is a former Critical Care Nurse.
Lynn would NOT BACK DOWN off attempting to pressuring me to agreeing to over-riding Mom's wishes via having us kids make the decision. I kept reiterating that Mom is stable, she's doing fine. There is no need to change the form, or assign a family spokesperson or a POAHC.
"Can't we just wait and cross that bridge when we come to it?" No, that's not good enough for Lynn Crawford. I asked her repeatedly why she was pressuring me. She denied do so....a thousand times (denial doesn't mean she wasn't), but one lame excuse she gave was that because of the conflicting information on Mom's POLST, the doctors at the hospital did not have clear instructions on what care should be given Mom.
I asked her, well, what would you have done differently, when Mom came in, if there were no POLSTForm on file at all? Full medical treatment would have been administered. As soon as the patient was extubated, ventilator tube removed, and patient was off the sedation meds, they would sit down by the patient and tell them all about this wonderful form.
"While the patient is in ICU, on mind-altering medications," I asked? Yep!
I asked pointed questions, got obfuscated answers, and a whole lot of BS. By the time we got off the phone, 1.25 hours later, I was so worried I looked up the COO's office and put in a call asking that Lynn be removed.
I am feeling very pressured, and cannot get a straight answer out of hospital staff about my questions on their hard push to supercede Mom's POLST Form. It isn't affecting the level of care she's getting.
So, WHY?! WHY?! WHY?!
Further, Mom has resisted all pressure from some of my siblings who've never stopped trying to become her POA.
If this is such a "PROBLEM" (again, Lynn's words), with Mom's POLST, why would a doctor, a medical professional, allow Mom to request she be given conflicting care?
My sister is a nurse at SMC. From DAY 1, she has been saying we kids need to over-ride Mom's POLST. Is she using her position as an employee in any unethical manner? She has been pushing hard on my two youngest siblings who are under-educated, and medically unsophisticated. Her new claim now is she says Mom is in End-Stage COPD. Really? Funny, all the people, nurses, head nurses, I've talked to, not one said Mom was in End-Stage COPD, but that she is doing well.
So now we over-ride Mom's wishes, trample on her medical rights? What's next? Tell the hospital to withold life-sustaining support, effectively, and LEGALLY MURDERING MOM?
No medical rights.
Yes, that's the way my sister and two brothers see the issue. My sister, the RN, says I just don't understand because I don't work with patients like Mom all day long and I'm not a medical professional, and (perhaps I'm not as calloused about sick people as she is) and I don't have knowledge of COPD. Partly true, but I have personally observed miracles, and known doctors to be wrong on multiple occasions.
My grandson Christopher was supposed to be born with a severe form of spina bifida, a vegetable. Doctors told his parents to abort that black baby. Fortunately, they didn't. He was born PERFECT. So many other instances I could document where doctors have been wrong. It happens every day....
My baby brother, Mom's sixth and last child was not able to come home with her from the hospital. He was born with pulmonary problems. Mom cried as we picked her up that day, without her baby, 54 years ago. That brother has just come through a near death episode caused by an infection & his organs were shutting down. Legacy Hospital professionals did not expect him to live through the weekend. 5.5 weeks later, he's off the ventialtor, off pureed foods, and has a trach tube which will be replaced with a smaller one tomorrow, and is ahead of his progress schedule. I 'm 63, have COPD, never smoked, but drove inner city buses for 20 years, so I injested a lot of diesel fumes. I'm what my RN sister says the medical profession calls "A Difficult Patient" because all the doctor prescribed drugs I am supposed to take, made me literally too sick too function. They reduced my immunity severely, so I chucked them and never went back to the doctors. I don't have time to be sick! Mom's sister has had asthma as long as I can remember. She is 7 years older than Mom, and just went to church last Sunday. My son was born with asthma, but he's never missed a day of school or work over it. He's 36. Think there could be a GENETIC PRE-DISPOSITION IN THE FAMILY?
Are we going to start denying medical care based on a genetic pre-dispositionS?
Three of my siblings all believe Mom should also be cut off medical care because
"She's just going to go back to the nursing home and keep smoking and drinking Cola!" A very big sin in their religion!
Never mind that some of these same siblings are sex predators, pedophiles, adulterers many times over, alcoholics, and, obese by choice. Is their hostility towards Mom's so-called sinning is a conflict of interest, or a hardened heart from years of sinning themselves? They don't know that Mom will go back to sinning...er...drinking Cola's & smoking...
Hmm...
Using these siblings logic, the RN sister, who full well understands the dangers of obesity, shouldn't get any more hip or knee replacements until she loses 200 lbs, and another sibling shouldn't get any medical help when he develops pulmonary problems from years of smoking, or any care for a bad liver after years of drinking like a fish, and the middle son? Well, he'll get his reward in the next life for what he did to another sister, myself, and ALL FOUR of his wives, whom he married for their money. Based on his extremely immoral life, I'm thinking he shouldn't get any medical care at all, because of all the lives he's damaged with his sexual deviancy.
BUT! WHERE DOES IT ALL END? This playing G-d? It's common for medical professionals, with all their expertise, to get "The god-Complex." Doesn't make it right. Anyone of us can come up with reasons why people should be denied appropriate medical care. Still doesn't make it right to play G-d with other's lives through their medical care.
Mom's wishes are absolutely clear. She WANTS TO LIVE.
Why my siblings are getting hung up over Mom's COPD, her drinking Colas and smoking cigarettes (which she never did while raising us) and in spite of the fact this is her FIRST INTUBATION, and that she is doing well, inspite of the FACTS, and INSERTING THEIR OWN PREJUDICES as a rationalization and justification for over-riding Mom's medical rights to receive full medical care, as stipulated by her POLSTForm, that I cannot answer.
I am angered, bewildered, very hurt, and sick deep down in the pit of my gut. Between my siblings and Southwestern Medical Center, my Mother is a goner... She's not being given the dignity she deserves to die when the Creator calls her time, not MAN, nor the respect of her clearly obvious wishes.
Off topic, FOOD FOR THOUGHT:
If the powers that be, can manipulate the elite, the educated, the medical professionals into selective application of medical care, for whatever reason, and if the powers that be can fan the flames of religious bigotry, and racism, how far off will America be from having our own Holocaust? It just takes LEADERS who understand the human dynamics that Stalin, Hitler, Castro and Mao did, leaders who have crediblity and social status, leaders in medicine, leaders in religion who build up their members at the expense of and by putting down those of another religion, add some class and race envy to the mixture, add some evil people that don't need an excuse to be evil, add some hard financial times where people can no longer get living wage jobs....
Is it just me seeing that MEDICINE is already on THE SLIPPERY SLOPE?
My Mom refused to be a victim of an emotionally abusive, unfaithful, alcoholic husband, but she will end up becoming a victim of corrupt, evil children, and a "system" designed to ensnare & ensure the end of many lives. My siblings will not protect our Mother. They have already judged, tried, and sentenced her as unfit to live because she smokes, drinks Cola, and has COPD. They have lost their way... and our Mother will lose her life. She may not even have the joy of being with these children, on the other side.
She was a good Mom, and I will write some wonderful, amazing stories about her in the upcoming days in my attempts to cope with my grief.
Please pray my siblings will see before it is too late, they are being sucked in, ensnared, not only by their own evil, but that they are being used by a corrupt SYSTEM, to legally murder people against their will.
Jon Huntsman tells graduates to follow their hearts, but we Jews read Jeremiah 17:9 "the heart is most deceitful of all, and fragile..."
