If we suspect foulplay from a distance, how can we help?

1 answer | Last updated: Apr 06, 2012
A fellow caregiver asked...

My wife and I have a situation with her father, my father-in-law. He is currently in the hospital recovery from surgery, at age 80, and during his stay we have had a couple incidents with poor decisions of his wife (of 86 years) and her adult children (my wife's step-siblings). My wife, her brother, and sister are all in their early 40's and their 3 step-siblings range in ages from 50-65 years. The wife (or step-mother) and the oldest step-sibling appear to be more concerned with when this man is going to "pass away", rather than trying to ensure that he returns to good health as quickly as possible. The day after his surgery, which was major for a man of his age and consisted of repairing of four (4) abdominal aneurysms, the wife and her daughter went against the doctor's orders and continued to give him water (vice the sponging of the lips only) and now he has fluid's in his lungs. Which is why the doctor specifically explained was the purpose for not giving him any liquids orally.

Now 6 days later he is still in ICU with fluid in his lungs and closely monitored, it has definitely slowed his recovery. We have reason to believe that in some ways they are trying to hasten the recovery process, mainly because of the eldest step-sibling wanting him to sign over his house and making arrangements for the wife to live with her in the future. This was partially substantiated by one of the other step-siblings who did not care to witness these acts and decided to return to his home in another state before the surgery.

My wife and I live two states away from her father and because of her job had to return home, but her brother lives less than an hour away and sister lives in the same town of Chesapeake, VA.

My questions are: Are their any rights that my wife and siblings have over the decisions made by the step mother? Are there any organizations or administrations that can check in or monitor the care that he is receiving, both in the hospital and once he returns home? Is there anything that we can do to in this situation...period?

Expert Answers

Barbara Repa, a Caring.com senior editor, is an attorney, a journalist specializing in aging issues, and the author of Your Rights in the Workplace (Nolo), now in its 10th edition.

It may either help or hurt to know that the situation you describe is a common one: When one family member has a serious brush with a health problem, it often triggers a chain reaction of actions and emotions among those who are related"”some of them helpful, some of them confusing, some of them downright irksome. And it can all be more difficult to sort out when you're living two states away.

What can be helpful to keep in mind, although sometimes almost impossible to see, is that in most cases, people are acting in a way they believe is best. Their actions might be motivated by guilt, stress, vulnerability, fear of losing the ill person, fear of their own mortality, a desire to help, a need to control"”or some combination of the whole messy lot.

As to who has rights to control your father-in-law's care: If he is able to express his own preferences and wishes, then they should be honored"”and the medical staff is duty-bound to follow them. If not and he has completed a power of attorney appointing an agent to act for him, then that person controls. If there is a POA and you disagree with the agent's actions, you can go through the time-tested but sometimes nettlesome process of challenging it in the issuing court.

And if your father-in-law is unable to speak for himself and has no documents specifying his healthcare wishes, then realistically, the doctors and other care providers are must swayed by the voices of the warm bodies in the room: in your case, your father-in-law's wife and his daughter.

If you feel that your father-in-law is receiving inappropriate or substandard care while in a hospital or other health facility, your best bet may be to apppeal to the patient representative or ombudsman for help.

Once he is being cared for at home, you realistically have fewer options. You can go through informal channels of asking a neighbor or trusted relative who lives close by to monitor the situation. Or if you feel the care is tantamount to neglect, you can contact the local Area on Aging or Adult Protective Services agency for help. Both of these steps, however, are rather drastic"”and may escalate the feelings of distrust and angst in the family.

The most effective step, which may also be the most difficult, would be to hold a meeting of all involved in the care"”with everyone agreeing to listen to all points of view. In the best cases, all may be able to chip in something of value: time, money, expertise.

If this seems like something only the Waltons could accomplish, or at least tough to accomplish in your current situation, consider calling in a family mediator to help you find a few good solutions. Most communities offer such services for a low cost or even free through neighborhood mediation groups"”or you can look in the phone book for individuals who focus on family conflicts.

I mention these drastic steps because you have described a fairly fraught situation that will in all likehihood get worse over time. If you don't act to solve it, you risk a lifetime of hurt and angry feelings"”and a possible lifetime of estranged family members.