Does an 85 y/o have the right to refuse going to ER after a fall (again)?

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WHISTLER1 Asked September 2015

Does an 85 y/o have the right to refuse going to ER after a fall (again)?

Does caregiver need to respect her wishes?

My LPN sister is my mother's health adviser. I'm the oldest daughter and live out of state. I was visiting my mother when she fell the first time,which was four years ago .When I first walked in and saw my mom, she didn't even know where she fell, or what happened. She refused ER, but I loaded her up anyway. She needed over 50 stitches in her head and they kept her for observation overnight. The MRI showed she had been having mini strokes. My mother has fallen several times since then.The last one was about two weeks ago. bout a week later My sister sent me an e-mail about the fall. She kept my mother at home giving her pain pills (from where) and oxygen for a week before taking her to the doctor . But she said they had good news.......the x-rays showed no broken bones. I sent her an e-mail asking why she waited a week before taking her any where (very upset I would question someone so qualified) She said mom didn't want to go to ER and she needs to respect that. I asked about an MRI? "no MRI ordered just PT".They live in a very small rural town and my sister had worked for my mothers docror. My father died five years ago and about a year after my sister moved in with my mom, (because her boyfriend kicked her out.........only after my mother paid off his mortgage when it went into foreclosure, with no paperwork) Since then the will keeps being rewritten. Original will everything was to be divided equally between 4 children. Quess what,new will the sister gets everything. My sister has allready accumulated over 100,000 worth of debt to my mom. The other night when I called my mom about her fall, she was only all cosumed with the over 100,000.dollarsworth of debt of the oldest brother She forgot any of my sister's debt,plus gave her everything.("no,no you have misinformation. Where are you getting your info? " "from you mom!" I would think if you were the sole heir, you would not be playing Doctor at home and take her to the ER. Do, I call doctor and ask for an MRI? My mother wants to stay in her home, so I can't do alot where my sister would get replaced etc... Do I just sit and let whatever happen or, talk with the doctor. I'm pretty sure I know why she is not pushing for a new MRI. My mother would not want to live after having a severe stroke. ( Probably what is next) Am I right? I need some advice . Obviously,I don't have as much trust in my sisters capability as much as she does! or my mother!?

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score 2 · Answer 1

Well first of all I agree that one should not wait so long before taking X-rays in case you observe she has problems with using her legs, arms, or is in severe pain. Also one has to consider how she fell. As a home caregiver for many years, I once found a man lying down on the floor when I came in and I called emergency. You never know what is broken (or not) and when you lift a fallen elderly person you can cause additional damage to neck, spine etc.. Luckily this man had only a broken hip, but you can not judge that when you have not had sufficient education in this respect. An X-ray shows defects to bones, whereas an MRI shows defects to soft tissues, such as muscles, arteries, brains, etc.. So when no broken bones were found on the X-rays, and your mom is acting normally, an MRI is not necessary. On the other hand it is not normal that your mom keeps falling an such regular basis. Is her blood pressure okay ? Does she have these falls after her strokes ? May be it would be better to investigate this matter. Also the place where she is living is important. Is there enough space between the furniture, are all carpets removed , are there no electrical cables over the floor, does she ware closed shoes, etc... This seems rather not important, but it causes hundreds of falls every day to elderly people. Also the use of a walking device could be very very helpful (we call it a rolator - it is a small, very light car, mostly in aluminum, on 4 wheels, with handles and brakes, on which you lean and have stability during walking. This device is a miraculous invention for people who fall easily and certainly worth its money. In Belgium (Europe) you pay approx Usdoll. 175.- And it is much better than a walking stick, which is always forgotten or falls down.
As far as the other matters are concerned, I strongly advice you to take an independant person who is familiar with those kind of things. May be a social assistant can help you already. A lawyer of cause may know better, but it is a costly matter. First try to find someone else and let him/her find out what is happening with the financial issues. Hope you can come to good terms again with your sister and wish you all the best.

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score 0 · Answer 2

GardenArtist and JessieBelle you're not crazy, LeastFavorite DID have another thread. I guess she didn't like the answer she got there, so she started over two days later on this thread. Here's the original one:

https://www.agingcare.com/questions/mother-fell-becoming-a-frequent-occurrence-187514.htm?cpage=1

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score 1 · Answer 3

I think this is the first time I've seen the thread.

I do think sister is being rather lax with her treatment, but since she's with mom all the time, she may have a better idea of her condition. I don't get why you leave a senior who just fell alone or give them pain pills. That's really odd.

Is sister the Durable Power of Attorney? Is mom still competent? Who made the arrangements for a new will? Can you prove it was done under coercion or trick by sister? You may need an attorney to get on board with that.

The doctor will need to state a reason for the MRI for insurance to cover it. Maybe there's a reason and maybe not. I would ask what will the MRI results show and how will that help the situation. If they show marked increased damage, then how will you and sister respond? If they are the same, what will you do? What will the doctor do as a result? I would answer these questions and then see if I wanted to fight for another MRI.

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score 0 · Answer 4

GA, you're not losing your mind. I just saw the same question with some very good answers. We all seem to be saying pretty much the same thing.

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score 3 · Answer 5

My father and mother have fallen a few times since I've been home. Half the time I called the EMTs for help getting my Dad up. The other times my mother and I were able to manage without the EMTs. We used our best judgment on if an ER was needed or not. Only once did we take my father to the ER and my mother has not needed to go.

I had a friend who fell twice and hit her head. In those instances I did have them take her to the ER to make sure there was not brain trauma. Brain injuries may take a while to show up.

We have to make judgments on each individual fall. Your sister may have felt that the ER was not called for. I have been in that position a few times myself. Sometimes we can be wrong, but we do the best we can.

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score 0 · Answer 6

So the real issue is the will and inheritance, right? We caregivers are addressing the medical side of the equation from our own personal caregiving experience. And we agree (so far) with your sister's care.

I can't help you on the will side, as I have no real interest in that piece of it.

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score 2 · Answer 7

The MRI may show multiple infarcts, but that in in itself does not give a diagnosis of dementia, it would take a comprehensive cognitive exam to determine that. When my mom was under the care of a neurologist specializing in stroke prevention he never once told me that all those little spots could one day lead to vascular dementia. My mom was treated with statins, anti platelet drugs and multiple blood pressure meds and was FINE for many more years.

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score 0 · Answer 8

Another MRI would show the extent of dementia which my sister knows would make all the new revisionsof the will void. My mother was never had a definite dementia diagnosis. She has been taking the meds for about 5 years now.

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score 0 · Answer 9

I must be losing my mind. I swear I saw this post several days ago. Leastfavorite, is this the second time you posted it? If not, I really am losing it!

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score 0 · Answer 10

I don't know what meds. she is on. The doctor did x-rays when she did see my mom.
My sisiter didn't know if there were any broken bones or if she was bleeding internally. An MRI would show vascular dementia which is still treatable.The other MRI is four years old. Why are you sticking up for the LPN wanna be doctor?Who leaves an 85 y/o person sitting at home after a fall (hitting her head) and treating them with pain pills from where?

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score 3 · Answer 11

I agree with CWillie. You already know what's going on with your mom. Taking her to the ER unless she needs stitches or something else has happened (like a broken bone) won't result in a different outcome.

And I agree that the will and money are a separate issue. With what you've written, I agree with your sister's medical care of your mom in the example you cited. When my dad fell down a few times, we only took him to the ER when he wanted to go. Otherwise, he stayed home.

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score 2 · Answer 12

An MRI is just a diagnostic too, it's no magic bullet. You already know she had vascular problems and a history of TIAs, so what do you expect to learn from another MRI? I assume she is already taking medications to control her blood pressure and probably some type of blood thinner/anti platelet drugs, medically what more do you expect from her doctor? I assume that your sister should have the expertise to evaluate your Mom and would have sent her to the ER if she saw anything significant. I know when my mom fell while she was with her caregiver she was evaluated by the EMTs who helped her off the floor and not taken to the hospital.

The problem with your sister being POA and the re arranging of the inheritance are a separate issue. I think I'll leave that for others to comment on.

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Does an 85 y/o have the right to refuse going to ER after a fall (again)?

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