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That's HUGE!!!! wonderful news. Safe travels, my friend.
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She actually has a diabetic appointment (only thing we can drag her to) while we are there. We will attempt to see what else can be taken care of while we are there. She will let my husband go in and talk to the doctor with her.
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Are you going to push the "thought" of a doctor with your MIL? We all know where that is going, don't we?

I think the time has come for someone in the family to contact APS or the Department of Health; don't you think it's unhealthy for your adult children living in the adjacent building to be exposed to her unsanitary and unhygienic conditions?
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Thanks! Not sure how much good it will do, but we will try to push the thought of a doctor again when we are home.
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Royenburg, the fact that you've reached out, shows your concern, when you return home do your best to get her to the ER, for at least an x-ray, cultures and treatment and that may be all that you can do, from the sounds of it. The clean up of your brand new apartment is the other thing that you must find a way to take care of due to the unsanitary living conditions. Your MIL will need to face the facts, that she may die, if she continues to ignore her symptoms. You need to document everything you do, and the call to APS may well take her off your hands if they find her a Vulnerable Adult, who refuses treatment. Thay may recommend an involuntary mental health evaluation and hospitalization, and this too, maybe the best approach, and you may want to ask for it, called BAKER ACT. I hope you are able to find a solution for her. You are doing the right thing!
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You said “No posting to me on she hates docs, please. I can read.” I just posted that because while I know you can read, you said the following:

1) Worse case scenario is that she has colon cancer. Get her to a doc STAT!
2) Get a colonoscopy.
3) Knowing that she needs a mental assessment
4) Why can't the son/dil/grandkids get her to a mental assessment? they don't want to take very ill granny to ER? In no circumstances is it normal to just go to the toilet in your pants! THIS WOMAN NEEDS HELP DESPERATELY!

You kept saying we needed to take her, so I was just trying to show that it’s not possible when even the ambulance driver says that he can’t force her to go as long as she has the ability to say no.
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There is no way this woman gets to dictate ANYTHING! I agree with the hospice....worth a shot. No, to the Immodium...too much is going to be a bad thing! I'll say it again...ignorance is not always bliss. So if she has cancer, she could treated for it unless she wants to be stubborn enough before it's too late and doc says "well, if you'd have come 6 months sooner, I could have helped you, now...sorry." No posting to me on she hates docs, please. I can read.
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Oh, and she may have developed vascular dementia from the stroke. Something to consider in any evaluation of her competence to reason from facts.

At least with my mom, her vascular dementia has not affected her memory much, or her ability to know what day of the week it is, etc. But she can't REASON anymore. If she sees a spot on her skin, she thinks she has leprosy, etc.
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If a call to APS produces a reaction of " we can't do anything", then I would call Hospice. You can honestly tell her it's not costing anything as it is covered by Medicare. They will at least give you an honest assessment of what is going on.

Oh, and I'd give her back the Immodium. If she's not going to follow doctor's orders, she should at least get some relief from this ordeal.
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I think we were tyoing at the same time. Glad you are going home soon
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Perhaps the diabetic doctor that said she is showing signs of dementia could be called from Norway, and LEAVE A MESSAGE, explaining this entire situation. Even if he/she can't talk to you, you can leave a message for the doctor. Ask if the doctor would be willing to make a referral to either palliative care, who can come and talk to the family and assess the situation / and her.........and/or to psych for an evaluation for a hold as being gravely disabled...ie, unable to care for self. This will, if she is found unable to care for self...ie found lying in her own poop, lead the way to future guardianship or being placed(maybe son can photo or video, because theses assessments are done at the moment the person is in the house, if they don't see it happening , it didn't happen, so evidence and history and a paper trail can help) . A short term fix...there are online stores that sell incontinence underwear that look like regular underwear ....she would not have to even know what they were.......
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Whoa! I didn’t realize people were still answering! Thank you. We’ve been traveling a bit and I just received an email that I had more replies. Let me see if I can answer all the questions that you’ve had.

Who has POA should the original POA be unable to fulfill his duties? I have no idea. I’ll try to find out. The POA was done over 10 years ago so we may have known at one point but just forgotten.

You don't mention how old MIL is but a geriatric psychiatric evaluation would not be out of the question. She is 76.

As others stated, should she slip and fall again and can't get up, have the EMTs take her to the hospital "to get checked over". We tried to do this once but she refused to get in the ambulance. Ambulance driver said there was nothing he could do if she refused.

A huge concern I would have is c-diff if there is bad diarrhea. The home health care aid said she doesn’t believe she has c-diff. She said that there is a smell that is undeniable with that.

How does your spouse feel about all this? My husband is the oldest. Ever since he was small enough to talk, his mother has told him that he is responsible for taking care of her in her old age. She even had that talk with me before we were married to make sure I was onboard with that if I was marrying her son. He also promised his dad before he died (he died from multiple myeloma) that he would take care of his mother after he passed. He feels like it is his responsibility to keep her out of the nursing home.

What we do know is that she must be scared out of her mind: that is why she refused the colonoscopy, that is why she is pretending that there is nothing wrong, nothing to see here, and biting anyone who doesn't agree with her. She HATES doctors. She had only been to doctors for the birth of her children (no prenatal care) before she had her stroke in 2010. And she refused to even go to the hospital after her stroke for 48 hours. We received a call from her neighbor that something was wrong. We called her and couldn’t understand her as she was slurring her words. Called neighbor back and told them to take her to the hospital. She refused. The neighbor didn’t want to do anything else about it. We called the “sibs” and they said “if she doesn’t want to go, she doesn’t have to go”. The next day we called again and told her she could either 1) go with the neighbor or 2) go in an ambulance. She went with the neighbor. They said her blood sugar was almost 400 and that she had indeed had a stroke. She was in the hospital for 2 weeks. Now it’s a major ordeal just to get her to go to her diabetes appointments every 3 months. She said the doctor is the one that gave her diabetes because they want to take her money. And she hasn’t been to a dentist since she was a teenager. Dentists just want to take her money as well. (she hasn't bit anyone)

I think she needs an aide at least twice a day, to clean up the poop, for starters. She has an aide 2 times a week. That is the most she would agree too. We live in a very small town and the aide has to drive over 30 minutes to get to her. It took almost 2 months to get anyone that would even agree to come 2 times a week.

Why can't the son/dil/grandkids get her to a mental assessment? She is refusing to even allow them in her house. Keeps the doors locked. Son and DIL are in a real hard spot. Even if they could get into her house, she refuses to go to the doctor and the ambulance crew said they can never force her to go with them as long as she is capable of saying no.

Part of the problem is that we have brought these symptoms forward to her regular care doctor, her GI doctor (that she refuses to go back to), the doctor that did the surgery for the impaction, the social worker that came for 2 months after she returned home from that surgery, the home health care aide that is there 2 times a week and the company that the aide works for. When she was in the nursing home immediately following the surgery awaiting for the apartment to be finished the nursing home said that she had to pay for it herself as she did NOT belong there. She was there for our convenience. We bring it up to everyone and they all said that as she is competent there is nothing we/they can do as long as she is refusing. My husband said the only good thing about that is he thinks we have some sort of protection from any claims that she’s not being taken care of as we have documented in all of her medical records our concerns. We also built her an apartment onto our house to take care of her that is 100% handicapped accessible and the plans were drawn up with her social worker’s guidance on what she needed.

We go home a week from today so I’ll look into the what else we can do while we are home. Thanks for all the answers and help!
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I fear two things-
#1 She is very dehydrated
#2 She is very anemic
With these 2 things against her, she may not have long!!!!!!!!!!!
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Biting-who said she's biting ?
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Churchmouse: The OP states mom lives close to son/dil/grandkids so yes, just like that unless they don't want to take very ill granny to ER? In no circumstances is it normal to just go to the toilet in your pants! THIS WOMAN NEEDS HELP DESPERATELY! Quite sad. Just that she has lost 75# should be alarming to her, but she is too ill.
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Rainmom: Why can't the son/dil/grandkids get her to a mental assessment? It's too bad that while this ill woman is present in the room that someone else couldn't have known what her life is like, make a comment to her about it and then possibly or let's say hopefully she would agree to legal incompetency! Sure-a real long shot, but ....??
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Rainmom: Go Baker Act.
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I think that the best and first thing to do would be to get MIL to the ER for an x-ray, as she does have a history of bowel obstruction and emergent surgery. Beyond that, it is to be worked out by the family. This is such a tough position to be in, regarding additional tests.
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There is no for sure, JessieBelle, simply because it would depend on a number of factors which could all be different in every case.

For precedents, there are all kinds of interesting cases which concern people with learning disabilities: can they consent to carry on a pregnancy to term, can they consent to a termination, can they refuse treatment, can they consent to sterilisation, can they refuse sterilisation. These people being physically healthy adults with all their lives ahead of them, and therefore their quality of life at stake for a considerable time, the courts become quite animated when it comes to these discussions in a way that they don't seem to when the patients are in their eighties or nineties. But the ethical principles are the same.

I do know from a close, informed source that even when patients are deemed to be mentally incompetent their preferences, fears, phobias, anxieties and beliefs are certainly considered, and taken into account if possible. Considerable lengths are gone to, and it can be extremely time-consuming. Do you remember Tom Cruise as Rainman in the film trying to get his brother onto a flight? That wasn't a bad example. In the case of my source, while she will take great trouble to persuade rather than force compliance, if she believed something to be clinically desirable she would get it carried out. In some of her colleagues' cases, they draw the line at essential, rather than desirable; and let more go by.
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Well I know in the UK Jessie and unless medication is a risk to the health of others i.e. failure to take an antipsychotic med which would result in violence then you cannot covertly medicate. I am pretty sure that you would NOT be able to give them any treatment that they refuse UNLESS and even then UNTIL a POA for health and welfare has been invoked at which point that falls into the realm of someone else making decisions for you. If you are a ward of court however I have no idea how this applies. I do know someone who is a ward of court and they have said he must have a catheter fitted. they don't have to deal with the fitting of it though and he wont allow anyone near him without a full on fight.

My question would be who would go to the human rights with this issue because I suspect that if incompetent they wouldn't be able to instruct anyone. It would only be when relatives got involved that that could become an issue
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Something that I wonder about is if you could force a routine, e.g. a colonoscopy, on someone even if they have been declared legally incompetent. I know you can force things on someone who has been committed, but being incompetent and being committed are two different things. People who are incompetent still retain certain civil rights. Can you make an incompetent person have a colonoscopy or even take medication if they choose not to? I don't know, but wouldn't be surprised if the answer was no. It might declare something even more stringent that the declaration of incompetence. Does anyone know for sure?
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Some people just have 5H1T for brains Stacey
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Royneberg when you phone the POA you might remind him that to know there is self neglect and to do nothing is classed as elderly abuse and can result in a jail sentence...Just so as he is aware that you will drop that bombshell fully and squarely in his lap if he doesn't DO something and its too late to resign the position and say there ya go not my problem - it is already his problem
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I read today that developing a warped sense of humour is an early sign of dementia....I will just leave that one out there folks....
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Pamstegma, Yes, I agree, and I have a ripping sense of humor, but this isn't the first or second time that this poster has given such terrible and inappropriate responses here on the AC, and I find them to be so offensive, that it get riled up I suppose! That is probably why tgey do it! It's not very sensitive, when this same person expects sensitivity to their own problems and posts! Thanks Pam, always the voice of reason!
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staceyb, poop jokes have been around a long time. In rehab, when my roommate and I waited forever for help getting to the bathroom, I encouraged her to deploy "shxx revenge" and just go in her bed. The visiting nun found that very amusing.
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Nasmir, your comments are out of line and inappropriate! You say things just to riled people up! I suspect, you are someone who has nothing better to do with your time, then to write on blogs for some sort of Jollies! TRY to be sensitive to others misgivings! I have tried many times to be supportive of you, but you come back with such nonsense that I'm getting annoyed with you! Keep it up, and I will report you to the AC Administration!
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I think she needs an aide at least twice a day, to clean up the poop, for starters. Then start looking into memory care, because it is time for that.
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Nasmir, the OP is in Norway, but the srama is happening in the US. Thus, the OP's difficulty in managing this situation.
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Llama, you said "Worse case scenario is that she has colon cancer. Get her to a doc STAT!"

What, just like that? The OP is in Norway. The MIL is in the States. How, precisely, is the OP to get her MIL to a doctor "stat."?

If the MIL has a partially obstructed bowel, what is coming out is probably more leakage than diarrhoea as such. The MIL may not be feeling normal sensations of urgency. This is not typical incontinence. Therefore, the MIL is not necessarily as nuts as she sounds, as nuts as she would be if she were just merrily pooping in the ordinary way, apart from its being all over the place. She is behaving in a crazily dangerous way in her determination to deny the issue, but she isn't necessarily demented.

She is quite possibly also anaemic; and she may have the other problems associated with being extremely sick. What we do know is that she must be scared out of her mind: that is why she refused the colonoscopy, that is why she is pretending that there is nothing wrong, nothing to see here, and biting anyone who doesn't agree with her.

Until she has been assessed and declared lacking capacity, to conduct the colonoscopy without her consent would be criminal assault and no doctor would do it. Even if she had been so declared, a doctor would still hesitate. A colonoscopy is an ordeal for a consenting, informed adult. What would it be like for a frightened, resisting, sick old woman? It isn't the operational difficulty - that's what sedatives are for - it is the ethics of it that would trouble a responsible practitioner.

Then you would need to think it through, to what are you expecting to find, what will you do if you find it, and what is the potential benefit to your patient? Unless you have a reasonable expectation of a measurably improved outcome, you do not conduct painful and intrusive investigations.

So this isn't a scenario with a one sentence solution to it. I hope the OP hasn't been put off coming back to update us.
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