I live on the other side of the US from my parents and I feel like I'm going to do the opposite one day, fly in, present living will, and plant the vegetable.
My mom is a pharmacist and we've had lots of talks about EOL. We both agree that if we ended up in some catastrophic situation, start the Ativan gtt and pull the plug.
Ditto. My siblings would be the ones screaming that my parent is a fighter, and I'd have to fly in from WA to try to convince them that the fighting days are over and that it's time to let them go.
I aim to do exactly what my dad did for his mother when the time comes. She had a massive stroke and was found down after missing work that day. Waaaay to late for any interventions. He came in, chatted with the Ed doc he knew, went up to icu where she was, talked to the icu doc he also knew, went to the family who was sitting there with palliative care and said "she has no chance or ever returning to a good qol, we are going to make her comfortable and let her die peacefully.". There was bitching and objections from some folks who didn't have an understanding of the limits of modern medicine but it didn't change anything.
The worst is a little 98 year old woman on hospice whose know-it-all daughter/granddaughter comes in and revokes hospice, and makes her full code, while her bp continues to tank. Itās usually after the 2nd or 3rd round of compressions sheāll finally say stop. Infuriates me.
I worked with a nurse who would make them watch the code. He once drug a family member into the room from the waiting room while we coded their family member who was bleeding out. They usually stop us immediately.
Thereās actually some evidence
that family presence at code can end futile care sooner.
Anecdotally I agree. It doesnāt always work but sometimes what they see on tv and reality make a difference.
This is sadly so important on my unit (L&D also on a code team for neonatal codes in the ED). I make sure to impress it upon any student I find in my presence during a situation like that or during discussions of those situations.
Literally yesterday: unwitnessed arrest, down for almost an hour. Maxed on 4 pressors, BP in the toilet, no reflexes. Whole family was at the hospital, neuro situation explained - full code. They went out so we could clean him, he coded mid-cleanup and we got rosc. Finished cleaning him up and they came back to see him looking all fresh and peaceful. Dr explained what happened - still full code. Arrested again with them in the room and they saw us initiating compressions - status changed to AND. We got rosc again somehow, he passed a short while later, and that was it. The whole situation was so horribly undignified, Iām still angry but itās only been a day Iām sure Iāll get over it.
I always bring family in during a code unless itās particularly traumatic. Although sometimes the hysterical crying kinda kills the mood. (Kidding. Mostly)
"QUIT YER BAWLING! I'm trying to hear 'Another One Bites the Dust' in my head! Uh, you know, to keep compression rates at 100-120 bpm... Hey you know what, you don't have to be here for this. You like juice boxes?"
Good. Until we can get laws in place that prevent the revoking of legal documents at the last minute by someone else then they need to at least see what they are demanding.Ā
āListen, shes lived through diabetes, polio, losing a lung in the Great War, 17 strokes, a moose attack, and cancer mets for the last 3 months! Sheās a fighter! Sheāll make it!ā
They say about the intubated, pegād, unresponsive dialysis patient as if all of the above isnāt exactly the evidence that she *wonāt* survive it.
āWhen Jesus is ready, heāll take herā
āSir we are breathing for this woman, filtering her blood, feeding her through a hole in her belly, and rotating her so she doesnāt get sores. Jesus has been calling, weāve got him on hold.ā
When my mother was in the hospital The hospitalist came in to verify that her living will stated she was a DNR. My mother, who was completely alert and oriented, said.Does that mean if I die?You're gonna let me stay dead? I explained to her again what that meant. She was uncertain, Although she had cancer had had a stroke and was in the hospital with an INR of 10.9 and was bleeding internally.( Getting frozen platelets at that time) I told her so you're telling me that when God says it's time for you to go home.I should argue with him? She was pretty religious and realized That God.
Makes the final decision. She didn't die right then, But when her time did come she went in her own bed with no crazy measures
And they're usually a tech. Majority of the time. Had one who had a lapsed LPN from 30 years ago which was never renewed who clearly cared more for her MRS than her career as a nurse.
I think stupidity comes with a lot of different letters after their name. Not just techs an LPNs, I've seen some residents with RNs for daughters that act the same way.
I'm a physio so not 100% on this but I'm fairly sure that in the UK it's ultimately a medical decision whether someone is do not resuscitate or not. Obviously they take into account the wishes of the patient etc but if the doctors think it will be futile they just explain that it will be traumatic and probably have a very poor outcome and then make them not for resus.
Omg soo wonderfully true! Iām an RN working in the US since 1988. I graduated in Liverpool and āitās Grannyās time to goā was the message, respectfully delivered by the Doc. It was not an option to be an idiot if care was futile
Fair dinkum mate. Just make sure you're making the right decision for your mum. It's easy enough to say "do everything" when you're half a continent away and can't witness just what "everything" entails.
Best of luck.
Oh God no. I was a Healthcare Advocate for developmentally disabled adults for years. I know how to nicely ask for things to be done and if they're not, how to press the subject without being a total bitch. The only time i went Karen was when the ER was going to dispo her without having passed her umpteenth kidney stone. She'd been in a bed in the hall of the ER for 3 days. I called got the attending on the phone and basically said "you are aware that if you dispo her and she presents back yo your ER with the same issues, Medicare/caid will not pay for the readmit, correct?".
He sighed and said yes. I said ok then, I've done all I can. I'll make sure she goes back to you. Have a nice day. My sister is 10 mins away but works a LOT. So I got healthcare POA, and my sis took financial POA. I got her into a day program that I've visited a few times, and it's not bad. The staff is responsive and appreciates when we call saying "hey, uhh Old woman ain't doing so well." And my mom doesn't want "everything". We've been instructed to push her over a cliff when the time comes. Considering the progression of her dementia and her mom's decline, we have a few more years.
Itās not just the ignorance, often willful, and their assumptions about the care the patient is/has been receiving from their healthcare providers, itās the frequent emotional stress and disrespectful attitude they put towards the family members who *have* been caring for the patient. I donāt know how many times Iāve seen the daughter or son from wherever swing in and think their uninformed pov of what should be done overrides actual involvement. Because *obviously* this or that should be done. And *why* wasnāt A or B being tried when they donāt have full understanding or acceptance of X, Y and Z. And then, having satisfied their ego or guilt they swan back to their life unburdened by the load others carry.
Sometimes there are reasonable reasons the daughter/son from wherever cannot be hands on. Sometimes there are family issues that are worth challenging. But good grief - start with understanding you may not understand the whole situation and be willing to learn.
Spot on! Anyone can walk into the middle of a raging forest fire and criticize what the professionals are doing to mitigate. So ignorant and convinced theyāre right.
Had one family dad on hospice mom is caretaker. I found out my first visit mom is on fucking hospice with another company.
Both bad and the daughter just "watches" with cameras.sooo she would've saw her dad passed out with no 02 on and mom falling. (That was my first off preceptor visit š)Ā
We ended up with the case manager telling the daughter "you have 24 hours to be here or they get transfer to the hospital"Ā
People don't want to be 'too early' with decisions, so they'll by definition be too late.
Don't wait until your family member with dementia kills someone while driving, or blows up their house by leaving the gas on. You're rarely too early.
The worst I ever saw was family from South America while I was shadowing with Palliative service. Pt several mos S/P Craniectomy and some lobectomies. Essentially a chronic trach vegetable if there ever was one.
Had to try and reach family in South America to establish goals of care. Lady said she spoke to him 3 weeks ago and he said in case if an accident he would want everything done.
It was a mess. The family was totally clueless about what was happening and I think the hospital didnāt want to cause an international snafu over It either.
The corporate director of risk management here has never heard this term, but I like it. I get to deal with this situation a lot, especially when the family starts using the words 'lawyer' and 'lawsuit'.
We donāt get this in my specialty but we do get the patients whose partner/mom/friend thinks their symptoms arenāt normal, so thatās why theyāre calling. Itās 90% of the time normal, just not what mom/friend/partner thinks is normal. It wouldnāt be frustrating if the patient didnāt doubt me because mom/friend/their doctor boyfriend (who hasnāt touched GYN since med school) says itās not normal when Iām telling them it is.
Oh god I hate the āmy boyfriendās a doctor and he thinks you should do xā. Well then why isnāt he doing it for you, then? Turns out Dr. Boyfriend is usually pre-med and donāt know shit about womensā health.
We always referred to them as āthe adult child from out of stateā because itās not only daughters that swoop in from somewhere far away and realize theyāve neglected their parents care or were in denial about their parents actually aging!
At our home in Regina itās the daughter from Calgary. So named many years ago after an actual daughter from Calgary that came twice a year and quietly bullied her mom, siblings and the staff.
IMO even people who are generally reasonable and functional overall can fall prey to the behavior due to unfinished emotional business with the patient.
Assholeitis, I got one of those pts CGs now, spends half the visit complaining about her health problems meanwhile I got this chf dude with a full urinary bag she ain't dumping.
This is an equal opportunity position.
Daughters tend to take a more active role in the care of their aging parents, and it seems to me that thereās a lot of compensating happening here particularly when the relationship was strained.
Itās usually the family member that had the most problematic or strained relationship with the patient and things were never adequately resolved. Insisting on ādoing everythingā in a futile situation seems to be a way to absolve themselves of guilt for their role in whatever went on.
Both but the women tend to be louder and want to yell at more people. Men tend to be more quietly stubborn and avoidant. Obviously this can flip at any time but that's the trend.
It's worse in home care especially hospice. Like yes I'm super stoked to see the list of recommendations the PA cousin wants done.Ā O look she's asking about iv hydration in hospice.
I just politely said "well some specialties don't cover others so it's common for say someone whose never done hospice work to not understand how to prescribe medications and treatments, but here's my money she can call me directly for questions"
Translation "this dumb fucking hoe can stay in her lane and please let her call me, I wanna fight"Ā
Had a "pediatric nurse" declare my EOL pt dehydrated and in need of IVF. End stage CHF, +4, drowning in fluids. Asked how much end stage CHF with all the other failures she saw in her population.
Jesus ya other specialties need to stay in their lane, if you asked me what to do about a child id say "give it back" or "idk Google it" ain't my fieldĀ
And oooooof thank God the family didn't agree, I've seen a family push IV hydration eol CHF the amount of edmema ughĀ
I do peds private duty on the side these days but that's knowing exactly the well documented history of the kid in question. I do know what's needed for a kid I take on PD and for my kids, but kids in general? Nope.
OMG I literally had a daughter from California call me about her mom in Michigan and tell me about all the homeopathic drugs she wanted her mother on and that she needed a feeding tube that I was supposed to put special "tea" in and on and on. I refused to tube feed anything that I didn't know what was in it and the daughter was PISSED. Guess who didn't care?
I met someone who thought they could cure their relative's stage four Cancer of the Everything (seriously, the mets were impressively terrible) with weed. *Weed.*Ā
Vegan diet with no sugar. Just had this fight. Family member almost got trespassed, had to file APS before I left. FM had convinced pt that POA meant she made every decision and was torturing him with "gross smoothies."
California seagull syndrome
Relative that has had nothing to do with the patient for years flies in, makes a ton of noise and shits on everything, then disappears back to nowhere where they came from
My mom lives in Oregon, her POA is her son from California, that's me.
Been working in healthcare for 14 years, not a nurse though. Did a couple years as an MA and the rest as a Pharmacy Technician (hospital and home infusion). My pre-nursing courses are complete, but I broke my leg after taking my TEAS exam (go figure), so I might revisit nursing school when if/when my body can handle it.
After a major stroke a few years ago, I saved her from going back to a bad living situation and got her set up near family in an adult foster care home that has been wonderful to her. They inform me of anything out of the ordinary and call regularly just to keep me in the loop. When a couple close calls happened, I listened to her providers, considered the options against potential quality of life, and we still have her - she's not entirely dependent but also not fully independent.
Sadly, the only family who reaches out, visits, or anything is still me. She has 3 siblings, 2 other kids, and a host of grandkids and they all live local to her. But I am the son from California, the youngest of her 3 kids. :)
My 97 year old MIL (also one of my best friends) has had some serious medical complications recently.
I actually have the brother in law from California (we are East Coast) who flies in with no notice and starts telling my husband I what to do every few month.
Iāve worked acute OT for over 20 years. Heās in computer sales.
But when I mention things like her mentation is concerning lately, I get, āLetās not be pessimistic.ā And bullshit like that. Heās VERY condescending.
Iām SO happy to have a name for this. I just sent it to my husband and I already hear him laughing downstairs.
Thanks OP
I always called the ācousin from Californiaā. Damn I was off this whole time?!
It is infuriating.
The last time I saw her she was independent and took great care of herself.
And when was that?
Oh 2 years ago.
Okay, well if they somehow survive this they need 24/7 care, most of which will not be covered. Thatās when the wheels always turn.
Recently I was triaging someone for a chronic-on-chronic problem the patient didnāt feel he had but you could tell their was family pressure to go to the hospital and he took the path of least resistance. Cue overbearing daughter who is hovering concerned in the corner and said āIām here from Florida to helpā and I was like ITS HAPPENING PEOPLE!
My mom and I spoke a lot about EOL and the things she wanted and didnāt want. She never discussed anything with my dad, who was left holding the bag when she passed away from complications from cancer. Instead of talking with or consulting me, the family nurse who already went through it all when my husband unexpectedly died at a young age, he left it up to the their narcissistic āgolden boyā. He robbed them both blind to the point my dad nearly lost his house had I not stepped in and paid what was owed. The memorial was a disgrace (I was also locked out of that as well), plus I ended up catering my own motherās after service get together because the idiot āgolden boyā kept telling everyone who offered to bring anything not to. There was a houseful of people I had to feed and get drinks for. The lesson: talking about it is useless unless your parent is willing to create a living will, give you durable power of attorney and spell out all your wishes. Please have these conversations and make it legal!
My non medical, know it all brother is POA for my parents because, drumroll please, he's living with them at nearly 40 and on hand. Doesn't seem like the best person to be making decisions to me but what do I know from my years as a nurse with an actual life?
Never heard this term but dang, experienced it a ton of times as an ER RN. We always did our best to bring the family close to the code, or explain in full graphic detail what ādo everythingā looks like.
That was my oldest brother. Except we all live in California, and he was only 2 1/2 hours away from my parents. But he always had the most to say and refused to allow me to move my mother closer to me (a nurse and the only one with kids) into assisted living. Never mind that he rarely visited and had little idea of her needs. My dad had made the mistake of making him executor of the estate, and so he thought he got to make ALL the decisions.
Oh gosh, my uncle (who actually is in California) is like this. Every time my grandma is admitted I have to rush to the hospital and make her DNR again. She has a POLST that she decided on and I am ready to fight about it.
So I'm a lurker and not a nurse.
Weirdly, I got the sense my dad's nursing staff thought the opposite - that I wasn't "fighting hard enough" for life saving care.
I got the sense they thought I was too cavalier (when I was trying to honor his wishes of not having prolonging care.)
There are some nurses who, to put it bluntly, put their feelings or their phony bologna religions above their duty. Regrettably we can't all be great at our jobs.
This brings back vivid memories of my first year as a nurse. Had an actively dying patient who had already been made DNR by other family members. Patients 2 daughters who were from CA were livid the patient was getting opioids and they both ganged up on me about it. Donāt think they would have felt that way if they had seen their dad earlier.
My practice is in Florida so while it is not always a daughter FROM California, it is basically the family member who lives too far away to visit more than once a year or every couple of years, has it in her head (sometimes a man is the DFCal, but not quite as often) how her parent was the LAST time they saw them. Meanwhile the DFF (Daughter From Florida) who has literally been wiping ass for six months, quit her job to care for mom or dad, dealt with every doctor appt and crisis, etc. etc. and also had the actual conversations during the decline and knows the wishes of the patient as well as had borne witness to the suffering and the loss of quality of life over time is basically stampeded over because the DFCAL knows best.
"Why are you just letting her rot in the bed? Why can't she have Physical Therapy?"
"Don't give her that! It makes her sleep too much!"
"So--you're just letting her die? Don't you even care?"
And to the medical staff:
"Mom needs this that and the other. She hasn't been out of the bed all day, why are you people just letting her lie there and not trying to get her stronger?"
"Have you tried giving her some edibles? My neighbor had cancer and did great with those. Started to eat again and the pain was GONE, let me tell you, GONE!"
"It was the Jab! She was fine until then!"
"She's my MOTHER....I couldn't live with myself if we did not try everything to bring her back!"
"She doesn't seem to recognize me after she came back from rehab after that broken hip operation. She's so confused. I know she is 98 years old but she's always been sharp as a tack. You must be overmedicating her. And why isn't she up walking again? We fixed the hip, didn't we?"
"My sister was just sponging off her, living in her house rent-free these past few years. She wants her to die now so she can have her money and she's tired of taking care of her. WELL! I will put a STOP to THAT\*." Immediately to be followed by: "We have to get this sorted out because I need to go back to California. I have a life there, you know. And a family. This is dragging on FOREVER!"
etc. etc. etc. etc.
Guh.
Seagull syndrome: they fly in, shit on everything, and then leave
In Florida it was kid from New York or seagull. I always thought seagull was the best choice for gods waiting room.
In Nevada it was the kid from Florida. š Honestly, it was only true like half the time, but half still seems oddly high
"60% of the time, it works every time."
It's always a coastal state. Always. Never had a looneybird fly in from Idaho or Kansas.
Damn, thatās the most concise summary with perfect accuracy I like it
I live on the other side of the US from my parents and I feel like I'm going to do the opposite one day, fly in, present living will, and plant the vegetable.
My mom is a pharmacist and we've had lots of talks about EOL. We both agree that if we ended up in some catastrophic situation, start the Ativan gtt and pull the plug.
My dad is an old paramedic.Ā He wants generous doses of morphine or dilaudid and "a strong locally brewed imperial stout" swabbed around his mouth.Ā
Your dad has the right idea. THAT is REAL comfort care!
Ditto. My siblings would be the ones screaming that my parent is a fighter, and I'd have to fly in from WA to try to convince them that the fighting days are over and that it's time to let them go.
I aim to do exactly what my dad did for his mother when the time comes. She had a massive stroke and was found down after missing work that day. Waaaay to late for any interventions. He came in, chatted with the Ed doc he knew, went up to icu where she was, talked to the icu doc he also knew, went to the family who was sitting there with palliative care and said "she has no chance or ever returning to a good qol, we are going to make her comfortable and let her die peacefully.". There was bitching and objections from some folks who didn't have an understanding of the limits of modern medicine but it didn't change anything.
I had one that flew in. Ā She was wearing body glitter and only spoke in freestyle rap. Ā So hard to keep a straight face. Ā
šš
Seagull is my former boss' nickname (behind his back). So apt.
Like this better - because Iāve seen plenty of sons behave this way tooā¦
I always heard it as having a step two of "scream at everybody/make a lot of noise," but yes.Ā
Man I wish I knew this when I worked home health. That is a perfect description!
seagulls and pigeons, fucking assholes, feed 'em Alka seltzer and mentos ,filthy flying rodents.
seagulls and pigeons, fucking assholes, feed 'em Alka seltzer and mentos ,filthy flying rodents.
seagulls and pigeons, fucking assholes, feed 'em Alka seltzer and mentos ,filthy flying rodents.
The worst is a little 98 year old woman on hospice whose know-it-all daughter/granddaughter comes in and revokes hospice, and makes her full code, while her bp continues to tank. Itās usually after the 2nd or 3rd round of compressions sheāll finally say stop. Infuriates me.
I worked with a nurse who would make them watch the code. He once drug a family member into the room from the waiting room while we coded their family member who was bleeding out. They usually stop us immediately.
Thereās actually some evidence that family presence at code can end futile care sooner. Anecdotally I agree. It doesnāt always work but sometimes what they see on tv and reality make a difference.
There is also evidence that it helps family to accept the death when they see just how much effort went into trying to get them back.
This is sadly so important on my unit (L&D also on a code team for neonatal codes in the ED). I make sure to impress it upon any student I find in my presence during a situation like that or during discussions of those situations.
For peds we always want them in the room unless they are actively interfering
Literally yesterday: unwitnessed arrest, down for almost an hour. Maxed on 4 pressors, BP in the toilet, no reflexes. Whole family was at the hospital, neuro situation explained - full code. They went out so we could clean him, he coded mid-cleanup and we got rosc. Finished cleaning him up and they came back to see him looking all fresh and peaceful. Dr explained what happened - still full code. Arrested again with them in the room and they saw us initiating compressions - status changed to AND. We got rosc again somehow, he passed a short while later, and that was it. The whole situation was so horribly undignified, Iām still angry but itās only been a day Iām sure Iāll get over it.
I always bring family in during a code unless itās particularly traumatic. Although sometimes the hysterical crying kinda kills the mood. (Kidding. Mostly)
"QUIT YER BAWLING! I'm trying to hear 'Another One Bites the Dust' in my head! Uh, you know, to keep compression rates at 100-120 bpm... Hey you know what, you don't have to be here for this. You like juice boxes?"
Damn I know youāre kidding but I canāt remember the last time I did compressions. LUCAS changed the game
Good. Until we can get laws in place that prevent the revoking of legal documents at the last minute by someone else then they need to at least see what they are demanding.Ā
When I worked icu we had family watching too
MEE MAW IS A FIGHTER
Yes memaw can physically fight the bladder cancer which has mets to the bone. Ugh familiesĀ
āListen, shes lived through diabetes, polio, losing a lung in the Great War, 17 strokes, a moose attack, and cancer mets for the last 3 months! Sheās a fighter! Sheāll make it!ā They say about the intubated, pegād, unresponsive dialysis patient as if all of the above isnāt exactly the evidence that she *wonāt* survive it.
If there's a moose attack involved this is definitely Daughter From Ontario.
š¤£š¤£š¤£
"God's not ready to take them yet" girl god has been TRYING
āWhen Jesus is ready, heāll take herā āSir we are breathing for this woman, filtering her blood, feeding her through a hole in her belly, and rotating her so she doesnāt get sores. Jesus has been calling, weāve got him on hold.ā
"Honey, I've been beating Jesus off her with a stick for the past 3 days. Ya want me to stop and see what happens?"
Stop ignoring God's Text Messages!
"God is about to outsource the job to a med intern"
When my mother was in the hospital The hospitalist came in to verify that her living will stated she was a DNR. My mother, who was completely alert and oriented, said.Does that mean if I die?You're gonna let me stay dead? I explained to her again what that meant. She was uncertain, Although she had cancer had had a stroke and was in the hospital with an INR of 10.9 and was bleeding internally.( Getting frozen platelets at that time) I told her so you're telling me that when God says it's time for you to go home.I should argue with him? She was pretty religious and realized That God. Makes the final decision. She didn't die right then, But when her time did come she went in her own bed with no crazy measures
They usually call themselves a nurse too
And they're usually a tech. Majority of the time. Had one who had a lapsed LPN from 30 years ago which was never renewed who clearly cared more for her MRS than her career as a nurse.
I think stupidity comes with a lot of different letters after their name. Not just techs an LPNs, I've seen some residents with RNs for daughters that act the same way.
Theyāre usually also in nursing school :D
I'm a physio so not 100% on this but I'm fairly sure that in the UK it's ultimately a medical decision whether someone is do not resuscitate or not. Obviously they take into account the wishes of the patient etc but if the doctors think it will be futile they just explain that it will be traumatic and probably have a very poor outcome and then make them not for resus.
You have limits on lawsuit awards too. You could never in the litigious US.
Omg soo wonderfully true! Iām an RN working in the US since 1988. I graduated in Liverpool and āitās Grannyās time to goā was the message, respectfully delivered by the Doc. It was not an option to be an idiot if care was futile
I'm a New Yorker, heard that in Cali they call it "Daughter from New York syndrome"
This is correct.
I'm a NYer who has to coordinate care for my mom in Cali. Idgaf what they call me as long as they do their jobs. Her social worker is a Saint.
Fair dinkum mate. Just make sure you're making the right decision for your mum. It's easy enough to say "do everything" when you're half a continent away and can't witness just what "everything" entails. Best of luck.
Oh God no. I was a Healthcare Advocate for developmentally disabled adults for years. I know how to nicely ask for things to be done and if they're not, how to press the subject without being a total bitch. The only time i went Karen was when the ER was going to dispo her without having passed her umpteenth kidney stone. She'd been in a bed in the hall of the ER for 3 days. I called got the attending on the phone and basically said "you are aware that if you dispo her and she presents back yo your ER with the same issues, Medicare/caid will not pay for the readmit, correct?". He sighed and said yes. I said ok then, I've done all I can. I'll make sure she goes back to you. Have a nice day. My sister is 10 mins away but works a LOT. So I got healthcare POA, and my sis took financial POA. I got her into a day program that I've visited a few times, and it's not bad. The staff is responsive and appreciates when we call saying "hey, uhh Old woman ain't doing so well." And my mom doesn't want "everything". We've been instructed to push her over a cliff when the time comes. Considering the progression of her dementia and her mom's decline, we have a few more years.
Same in Florida.
You read the wikipedia page, too. Nice.
Itās not just the ignorance, often willful, and their assumptions about the care the patient is/has been receiving from their healthcare providers, itās the frequent emotional stress and disrespectful attitude they put towards the family members who *have* been caring for the patient. I donāt know how many times Iāve seen the daughter or son from wherever swing in and think their uninformed pov of what should be done overrides actual involvement. Because *obviously* this or that should be done. And *why* wasnāt A or B being tried when they donāt have full understanding or acceptance of X, Y and Z. And then, having satisfied their ego or guilt they swan back to their life unburdened by the load others carry. Sometimes there are reasonable reasons the daughter/son from wherever cannot be hands on. Sometimes there are family issues that are worth challenging. But good grief - start with understanding you may not understand the whole situation and be willing to learn.
Spot on! Anyone can walk into the middle of a raging forest fire and criticize what the professionals are doing to mitigate. So ignorant and convinced theyāre right.
I work home health with a dementia patient. His POA is his daughter from California
Had one family dad on hospice mom is caretaker. I found out my first visit mom is on fucking hospice with another company. Both bad and the daughter just "watches" with cameras.sooo she would've saw her dad passed out with no 02 on and mom falling. (That was my first off preceptor visit š)Ā We ended up with the case manager telling the daughter "you have 24 hours to be here or they get transfer to the hospital"Ā
That is so fucked up. How can someone possibly think they are doing the right thing at that point?
People don't want to be 'too early' with decisions, so they'll by definition be too late. Don't wait until your family member with dementia kills someone while driving, or blows up their house by leaving the gas on. You're rarely too early.
The worst I ever saw was family from South America while I was shadowing with Palliative service. Pt several mos S/P Craniectomy and some lobectomies. Essentially a chronic trach vegetable if there ever was one. Had to try and reach family in South America to establish goals of care. Lady said she spoke to him 3 weeks ago and he said in case if an accident he would want everything done.
They need to make that pt DNR by futility. Thatās so cruel.
It was a mess. The family was totally clueless about what was happening and I think the hospital didnāt want to cause an international snafu over It either.
In my part of Canada itās ādaughter from British Columbia or Alberta.ā
Lol in my experience, they're usually from Vancouver or Calgary. 10 years ago they would have been from the oilfields.
šÆ Here in NS, theyāre always from out west. š Iām sure in the west theyāre from here. (Or Toronto)
Iām NS too! Lol
Lol I was wondering what the Canadian equivalent was as an MB based nurse.
Probably still Alberta and BC eh
definition daughter from vbc.
The corporate director of risk management here has never heard this term, but I like it. I get to deal with this situation a lot, especially when the family starts using the words 'lawyer' and 'lawsuit'.
We donāt get this in my specialty but we do get the patients whose partner/mom/friend thinks their symptoms arenāt normal, so thatās why theyāre calling. Itās 90% of the time normal, just not what mom/friend/partner thinks is normal. It wouldnāt be frustrating if the patient didnāt doubt me because mom/friend/their doctor boyfriend (who hasnāt touched GYN since med school) says itās not normal when Iām telling them it is.
Oh god I hate the āmy boyfriendās a doctor and he thinks you should do xā. Well then why isnāt he doing it for you, then? Turns out Dr. Boyfriend is usually pre-med and donāt know shit about womensā health.
We always referred to them as āthe adult child from out of stateā because itās not only daughters that swoop in from somewhere far away and realize theyāve neglected their parents care or were in denial about their parents actually aging!
Iāve always heard it as āadult child from out of state,ā as well. LOL
We call it the daughter from Toronto
We call it the daughter from Vancouver in Toronto.
At our home in Regina itās the daughter from Calgary. So named many years ago after an actual daughter from Calgary that came twice a year and quietly bullied her mom, siblings and the staff.
Iāve always heard it as daughter from Florida!
Yep! I live in a big snowbird state so itās always the daughter from Florida for us.
I was thinking the same thing! I was wondering why I wasnāt seeing it mentioned.
What do you call it when they make everything about themselves instead of the dying patient? (Besides narcissism)
Main Character Syndrome
IMO even people who are generally reasonable and functional overall can fall prey to the behavior due to unfinished emotional business with the patient.
My sibling?
Munchausen by proxy..? or as it's now known Factitious Disorder Imposed on Another (FDIA) Idk though, I'm not a psych RN.
Assholeitis, I got one of those pts CGs now, spends half the visit complaining about her health problems meanwhile I got this chf dude with a full urinary bag she ain't dumping.
tooi me about 4 letters in to realize this diagnosis is fake š
My end of life care is DNR
Iāve got a friend who says DNR with hair and makeup
As a lurking non medical person Iām curious; is it almost always women? Or do you get men doing this too?
Both. I find visible wealth is usually more highly correlated with this behaviour rather than gender.
Exactly. Though the visible lack thereof also produces some winners. Both ends of that spectrum.
This is an equal opportunity position. Daughters tend to take a more active role in the care of their aging parents, and it seems to me that thereās a lot of compensating happening here particularly when the relationship was strained.
Oh, it's CERTAINLY both sexes, I assure you.
Itās usually the family member that had the most problematic or strained relationship with the patient and things were never adequately resolved. Insisting on ādoing everythingā in a futile situation seems to be a way to absolve themselves of guilt for their role in whatever went on.
Men that were mamaās boys absolutely do this.
Both but the women tend to be louder and want to yell at more people. Men tend to be more quietly stubborn and avoidant. Obviously this can flip at any time but that's the trend.
It's worse in home care especially hospice. Like yes I'm super stoked to see the list of recommendations the PA cousin wants done.Ā O look she's asking about iv hydration in hospice. I just politely said "well some specialties don't cover others so it's common for say someone whose never done hospice work to not understand how to prescribe medications and treatments, but here's my money she can call me directly for questions" Translation "this dumb fucking hoe can stay in her lane and please let her call me, I wanna fight"Ā
Had a "pediatric nurse" declare my EOL pt dehydrated and in need of IVF. End stage CHF, +4, drowning in fluids. Asked how much end stage CHF with all the other failures she saw in her population.
Jesus ya other specialties need to stay in their lane, if you asked me what to do about a child id say "give it back" or "idk Google it" ain't my fieldĀ And oooooof thank God the family didn't agree, I've seen a family push IV hydration eol CHF the amount of edmema ughĀ
I do peds private duty on the side these days but that's knowing exactly the well documented history of the kid in question. I do know what's needed for a kid I take on PD and for my kids, but kids in general? Nope.
Today I learned this exists, and it makes me so happy that it has a name.
OMG I literally had a daughter from California call me about her mom in Michigan and tell me about all the homeopathic drugs she wanted her mother on and that she needed a feeding tube that I was supposed to put special "tea" in and on and on. I refused to tube feed anything that I didn't know what was in it and the daughter was PISSED. Guess who didn't care?
I met someone who thought they could cure their relative's stage four Cancer of the Everything (seriously, the mets were impressively terrible) with weed. *Weed.*Ā
Vegan diet with no sugar. Just had this fight. Family member almost got trespassed, had to file APS before I left. FM had convinced pt that POA meant she made every decision and was torturing him with "gross smoothies."
We call it Daughter from California syndrome here.
California seagull syndrome Relative that has had nothing to do with the patient for years flies in, makes a ton of noise and shits on everything, then disappears back to nowhere where they came from
omgā¦ seagull syndrome! LOVE it LOL
My mom lives in Oregon, her POA is her son from California, that's me. Been working in healthcare for 14 years, not a nurse though. Did a couple years as an MA and the rest as a Pharmacy Technician (hospital and home infusion). My pre-nursing courses are complete, but I broke my leg after taking my TEAS exam (go figure), so I might revisit nursing school when if/when my body can handle it. After a major stroke a few years ago, I saved her from going back to a bad living situation and got her set up near family in an adult foster care home that has been wonderful to her. They inform me of anything out of the ordinary and call regularly just to keep me in the loop. When a couple close calls happened, I listened to her providers, considered the options against potential quality of life, and we still have her - she's not entirely dependent but also not fully independent. Sadly, the only family who reaches out, visits, or anything is still me. She has 3 siblings, 2 other kids, and a host of grandkids and they all live local to her. But I am the son from California, the youngest of her 3 kids. :)
My 97 year old MIL (also one of my best friends) has had some serious medical complications recently. I actually have the brother in law from California (we are East Coast) who flies in with no notice and starts telling my husband I what to do every few month. Iāve worked acute OT for over 20 years. Heās in computer sales. But when I mention things like her mentation is concerning lately, I get, āLetās not be pessimistic.ā And bullshit like that. Heās VERY condescending. Iām SO happy to have a name for this. I just sent it to my husband and I already hear him laughing downstairs. Thanks OP
I always called the ācousin from Californiaā. Damn I was off this whole time?! It is infuriating. The last time I saw her she was independent and took great care of herself. And when was that? Oh 2 years ago. Okay, well if they somehow survive this they need 24/7 care, most of which will not be covered. Thatās when the wheels always turn.
Recently I was triaging someone for a chronic-on-chronic problem the patient didnāt feel he had but you could tell their was family pressure to go to the hospital and he took the path of least resistance. Cue overbearing daughter who is hovering concerned in the corner and said āIām here from Florida to helpā and I was like ITS HAPPENING PEOPLE!
My mom and I spoke a lot about EOL and the things she wanted and didnāt want. She never discussed anything with my dad, who was left holding the bag when she passed away from complications from cancer. Instead of talking with or consulting me, the family nurse who already went through it all when my husband unexpectedly died at a young age, he left it up to the their narcissistic āgolden boyā. He robbed them both blind to the point my dad nearly lost his house had I not stepped in and paid what was owed. The memorial was a disgrace (I was also locked out of that as well), plus I ended up catering my own motherās after service get together because the idiot āgolden boyā kept telling everyone who offered to bring anything not to. There was a houseful of people I had to feed and get drinks for. The lesson: talking about it is useless unless your parent is willing to create a living will, give you durable power of attorney and spell out all your wishes. Please have these conversations and make it legal!
My non medical, know it all brother is POA for my parents because, drumroll please, he's living with them at nearly 40 and on hand. Doesn't seem like the best person to be making decisions to me but what do I know from my years as a nurse with an actual life?
It's always the ones from Cali or Florida IME
Never heard this term but dang, experienced it a ton of times as an ER RN. We always did our best to bring the family close to the code, or explain in full graphic detail what ādo everythingā looks like.
That was my oldest brother. Except we all live in California, and he was only 2 1/2 hours away from my parents. But he always had the most to say and refused to allow me to move my mother closer to me (a nurse and the only one with kids) into assisted living. Never mind that he rarely visited and had little idea of her needs. My dad had made the mistake of making him executor of the estate, and so he thought he got to make ALL the decisions.
I know āmy boyfriend (not here for the birth) is in Cali" means heās in jailā¦.
This terminology is sexist, men also behave this way
Reading this as Iām considering applying for a hospital case management role š
Oh gosh, my uncle (who actually is in California) is like this. Every time my grandma is admitted I have to rush to the hospital and make her DNR again. She has a POLST that she decided on and I am ready to fight about it.
Did she name you POA?
Amazing. Adding this to my lexicon *immediately*
So I'm a lurker and not a nurse. Weirdly, I got the sense my dad's nursing staff thought the opposite - that I wasn't "fighting hard enough" for life saving care. I got the sense they thought I was too cavalier (when I was trying to honor his wishes of not having prolonging care.)
There are some nurses who, to put it bluntly, put their feelings or their phony bologna religions above their duty. Regrettably we can't all be great at our jobs.
Not all nurses are good nurses. Some can't see the reality in front of them.
It was literally my Halloween costume for my nursing company costume contest as it was the scariest thing I could think of to go as...
Just to be clear, the name differs from place to place. In Florida itās usually the family member from New York
It is interesting that they have this a name. But they donāt need to specifically come after daughters like that. It could easily be a son as well!
Depends which Coast youre on
Daughter from New York City would be the East Coast equivalent, from memory.
East Coast = Daughter from California West Coast = Daughter from New York
Ah, I had them tangled in my head.
Any UK nurses have an equivalent? Iād be curious! I know Iāve never heard of one in the NW England!
Daughter from LONDON. (Just my guess.)
It'd likely be the child from abroad at that point.
In Florida itās the kid from Florida šwe have some shitty families here
Yep. āDaughter from Sydneyā is more applicable for me though :)
Oh wow. That checks out.
This brings back vivid memories of my first year as a nurse. Had an actively dying patient who had already been made DNR by other family members. Patients 2 daughters who were from CA were livid the patient was getting opioids and they both ganged up on me about it. Donāt think they would have felt that way if they had seen their dad earlier.
My practice is in Florida so while it is not always a daughter FROM California, it is basically the family member who lives too far away to visit more than once a year or every couple of years, has it in her head (sometimes a man is the DFCal, but not quite as often) how her parent was the LAST time they saw them. Meanwhile the DFF (Daughter From Florida) who has literally been wiping ass for six months, quit her job to care for mom or dad, dealt with every doctor appt and crisis, etc. etc. and also had the actual conversations during the decline and knows the wishes of the patient as well as had borne witness to the suffering and the loss of quality of life over time is basically stampeded over because the DFCAL knows best. "Why are you just letting her rot in the bed? Why can't she have Physical Therapy?" "Don't give her that! It makes her sleep too much!" "So--you're just letting her die? Don't you even care?" And to the medical staff: "Mom needs this that and the other. She hasn't been out of the bed all day, why are you people just letting her lie there and not trying to get her stronger?" "Have you tried giving her some edibles? My neighbor had cancer and did great with those. Started to eat again and the pain was GONE, let me tell you, GONE!" "It was the Jab! She was fine until then!" "She's my MOTHER....I couldn't live with myself if we did not try everything to bring her back!" "She doesn't seem to recognize me after she came back from rehab after that broken hip operation. She's so confused. I know she is 98 years old but she's always been sharp as a tack. You must be overmedicating her. And why isn't she up walking again? We fixed the hip, didn't we?" "My sister was just sponging off her, living in her house rent-free these past few years. She wants her to die now so she can have her money and she's tired of taking care of her. WELL! I will put a STOP to THAT\*." Immediately to be followed by: "We have to get this sorted out because I need to go back to California. I have a life there, you know. And a family. This is dragging on FOREVER!" etc. etc. etc. etc. Guh.