Need some advice from a dr. or nurse concerning visitation in the hospital.

[bighart]

Is a hospital obligated to respect a persons wishes concerning who can visit them? My niece's fiance who was in a bad car accident is having problems with his mother. Her fiance has a broken jaw that is wired shut and has trouble communicating right now does not want his mother to be able to force my niece to leave but she continues to be able to do just that. What should I advise my niece to do?

[nadinbrzezinski]

1. It is time your niece finds a lawyer

and good to hear that he is now conscious and able to make HIS wishes known.

[bighart]

4. He is doing far better than expected.

There is some concern about anoxic brain injury but he seems to be very aware and is following all commands. He started writing today and according to my niece it was very legible, said he needed to take a dump of all things.

Get this. His niece was planning a fund raiser for him this next weekend and his mother said that NONE of the money would be given to help with his daughters expenses and she didn't even want a picture of him with his daughter at the fund raiser. When his niece, his moms own granddaughter, said she would not do that his mom went off on her. The niece ended up canceling the fund raiser and is VERY upset that her own grandmother would treat her the way she did. This whole situation is just FUBAR.

[nadinbrzezinski]

9. Then here is the tricky question

if he is alert and oriented times three he has a right to say who stays and who goes. Here is where a lawyer might be needed.

After all mom will try to pretend otherwise, but he has a right to make those decisions... and I am glad he is doing much better.

Perhaps just a talk with Social Services will be enough to have that written down and expect a shit storm with mom either way

[bighart]

17. He is alert and following all commands, smiling, laughing and getting

back to his old orneriness.

[nadinbrzezinski]

19. Look here

more expansive than mine

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=6549214&mesg_id=6549326

[Lost-in-FL]

2. Is he intubated? Can he write? Seriously.

He needs to make a written statement so the nurses can put it in the chart about who can or cannot visit him.

[Skittles]

3. sounds like he doesn't mind who is visiting

he simply objects to one of the visitors (mom) telling another visitor (girlfriend) when to leave

[bighart]

5. It is a bit more complicated than that.

He really doesn't even want his mother in the room. Bad situation. She is a real piece of work. My niece and he have lived together for about 2 years and have a 6 month old daughter his mother doesn't even acknowledge.

[Lost-in-FL]

11. He needs to make a written statement and give it to the nurse.

If the mom doesn't comply then the nurse can call security.

[Skittles]

13. surely he can have mom banned from visitation

can he write?

[bighart]

21. Just started writng today

And asked for my wife and I to come visit!!

[Lost-in-FL]

6. He needs to make a decision as to when mom or girlfriend can visit...

or else the hospital will be obligated to kick both out if there is a confrontation between the two.

[bighart]

10. He has a trach tube but is not intubated now.

He is beginning to verbalize some and just started writing today.

[Lost-in-FL]

14. How old is he? If he is under 18.

Ask hospital security and verify what can be done (if he is a minor there could be complications since the mother is still the guardian).

[Fire_Medic_Dave]

7. How can the mother make her leave? Does she have power of attorney?

[Avalux]

8. If he is able to write, he needs to make a list of those he wants to visit.

If he can do that, the mother has no say and cannot prohibit your niece from visiting. Is he an adult?

[bighart]

15. He is 33.

It is a complicated situation. He coded 4 times on the day of the accident and there is some concern he has some brain injury as a result. His family was talking about taking him off life support at one point. He is recovering much more quickly than the dr's predicted at this point.

[Avalux]

30. A good thing they didn't take him off life support then!

If he is recovering quickly then I hope he can communicate what he wants very soon. It's a shame his mother is so controlling; makes me think the relationships weren't very good in the first place.

Tell your niece to hang in there and consult an attorney. She may just have to sneak in when mom isn't around for the time being; the nurse may be able to help especially if your niece's fiance wants her to be there.

:hug:

[bighart]

31. His relationship with his mom is not very good.

He didn't even call her "mom" until my niece insisted he should.

[Heddi]

12. I'm a Registered Nurse, so here's what I would do, or advise patients to do

1) how old is he? If he is a minor, then what his mom (or legal guardian says) kind of goes
--if he is not a minor, and has the ability to make decisions on his own, then his rules are the rules as far as visitors go.

If he can't talk b/c of the jaw wired shut, then he needs to put in writing something to the effect of "I have control over who visits and how long they stay, not my mother" and give it to the nurse.

The mother can't force anyone to do anything if the boyfriend is above the age of majority and has his mental facilities about him.

The nurse can communicate to the mother (as every nurse has had to do several times during their career) that he'd really like his GF to stay, and that is his decision to make, and that the nurse has to uphold the patient's decision.

If the mother causes a fit, or acts out, the RN can have her removed.

But the Boyfriend needs to do this, needs to initiate it, and needs to have his feelings known to the RN, through writing if that's the only way he can communicate.

He can also stipulate that the mother not be allowed to visit at all, or only visit for 2 hours a day if that's his wishes. He can request that no one wearing red sweatpants be allowed into his room....really, I've had some strange and not so strange requests, and as long as the patient is legally able to make decisions on their own behalf, I follow them.

[Lost-in-FL]

16. +1, nt

[nadinbrzezinski]

18. And in a few cases

you need to also involve a lawyer or \ and social services.

But he needs to do it.

[bighart]

20. He is 33.

Problem being there is some concern he may have suffered anoxic brain injury. His mom has done everything to withold info from my niece and we aren't sure if she has filed for guardianship or power of attorney.

[nadinbrzezinski]

22. Tricky phrase, alert and oriented times three

if he is... anoxic brain injury or not... he is capable of making those decisions.

If mom has filed with courts, it is critical that this is established PRONTO... and that she contact a lawyer... once it enters courts...

Well there is the law, there is mom, there is your niece, there is his fiance, and then there is the hospital... and none of them may agree... oh and I forgot there is the judge.

[bighart]

23. What a sad mess this whole thing is.

[nadinbrzezinski]

24. It is, he also asked for you to visit

that note is binding...

hugs

[bighart]

25. Cool.

I couldn't care more about this young man if he was blood relation to me. He has been such a positive influence in my niece's life!!

[Lost-in-FL]

26. Sorry you are going through that.

Independently of the type of brain injury he has if he is talking (communicating) he can still make desicions about visitors. He just need to put it in writing. That's all you really need.

[bighart]

27. Thanks for your concern and comments.

It is getting better. One thing that was very telling to me happened a week ago Saturday. We went to visit and he was still pretty out of it. His mom and several other of her family and friends were in the waiting area when we arrived with my our niece. No one spoke to us or even acknowledged we were there. We waited while they all went in to see him and at one point decided to go get something to drink. When we got back his mom was back in his room and everyone else came over to talk to us.

[Heddi]

28. well then

tell the neice to ask the nurse for a social service consult. THere are social workers at the hospital all the time, but primarily during the daytime.

Just because mom has Power of Atty on Monday doesn't mean she will automatically have it on Tuesday if his condition changes to where he is able to make decisions for himself.

The suspected anoxia is a bit troubling, because in my experience, people with anoxia have a wide range of symptoms...forgetting how to tie their shoe to needing to be taught how to talk again to having no residual effects.

If he does have all of his mental facilties about him, and doesn't have a POA, then the son can designate anyone he wants as power of attorney. He can designate the girlfriend, if that's his wish. If she fears any involvement on the part of the mom, she could always encourage him to fill the POA paperwork out with her desinated as POA right then. THe social worker will be able to get those forms, all hospitals have a notary, and there are about 10 trillion people that can act as witnesses. So it could all be done and finalized, at no cost, tomorrow morning in the hospital IF HE DOES NOT HAVE A POA ALREADY.

Now also, just because someone has a POA doesn't mean that the POA can override the patient's wishes IF THE PATIENT IS ABLE TO MAKE DECISIONS FOR HIMSELF>

Example: I'm a healthy 33 year old. My husband is my POA, and I am his.

If i were admitted to the hospital tomorrow for a broken leg, I'd still be able to make all my own medical decisions. My husband, or whoever is my POA only has decision making capabilities when I do not. So as long as the MD decides that i have the ability to make my own decisions, then I do. But once I go into a coma, or suffer a stroke, or anything like that, the decision-making turns over to my husband.

Once I recover from my coma and again have the ability to make reasoned decisions on my own, then I go back to making my own decisions, not my POA.

THe best bet would be to have the girlfriend speak with Social Services at the hospital. She doesn't need to be next of kin, or POA or anything to request a social service consult. She can speak with the social worker and explain her side and her concnerns. THe social worker will then speak in confidence with the boyfriend, and make reccomendations based on their conversation, including designating the girlfriend as POA if possible, or setting up visitation rules.

Even if the mom is POA, visitors really don't fall under the POA's decision unless the pt is in ICU and really critical. The POA decides about life support and medication and treatment and nursing homes, visitation really isn't something that we as RN's use the POA for, especially if it goes against the wishes of the patient.

[bighart]

29. You are a wealth of information!!

I am so glad you are here tonight.

[Heddi]

41. Oh Thanks

I'm actually at work, but it's been an enjoyable evening so I can post responses in between patients coming and going :D

[Fire_Medic_Dave]

33. How would the mother have any authority to have her thrown out?

[Lex]

34. next of kin

perhaps (esp. if he's not communicating)

[Fire_Medic_Dave]

35. He is communicating.

[Lex]

36. Just started writing today

but beforehand, not. According to the thread.

Sounds like he's not standing up to his mother in communication with the nurse.

[Fire_Medic_Dave]

40. I agree it sounds like he won't stand up to his Mom.

I'm sure he could have nodded or blinked yes if asked if he wanted the girl to stay.

[bighart]

45. He is just now beginning to see what is going on.

He was out of it until just under a week ago and is just starting to get a good idea of what the situation is really like.
If someone in authority in the hospital will listen to him he WILL let them know how he feels. Last night he was attempting to tell the nurse he didn't want his mom in his room but she ignored him.

[bighart]

47. he jsut started communicating in the last several days.

[BlooInBloo]

44. "The mother can't force anyone to do anything if the boyfriend is above the age of majority"...

Or emancipated, I assume?

[MiniMe]

32. Not a dr or nurse, but he should write out some cards with his wishes

Like "I want to be alone with my fiance now" or "I'm tired right now, please leave Mom" that he can hold up at appropriate times.

He can write whatever he wants on the cards. A few others popped into my head, but they are things that a son shouldn't say to his mother. Perhaps your niece could get him a pack of 3x5 cards and a sharpie so he can make his wishes known easily. He could keep them in a pack and just pick out the one he wants, or write a new one as needed.

[Lex]

37. sounds like he doesn't want to confront dear old mom

even with writing

[EmilyAnne]

38. Is there another "elder" on his side of the family who she can speak to about possibly reasoning

with this woman?

Also, can the young man write his wishes down?
Maybe even before the eyes of a nurse or doctor?
Though such a written request may not be immediately LEGALLY binding, it may cause his mother to accept and respect his wishes.

I am so sorry that she is dealing with future in-law issues.
These can be some of the most irrational of familial disputes.
I've been dealing with a particularly nasty one myself today.
I hope your niece's fiance gets well soon.

[bighart]

46. Going to try to do just that today.

Told my niece to get a social worker in the room and have him write a statement about who can visit and when. Something like "I will choose who visits and when".

[EmilyAnne]

39. Oopsy, dupsy duplicate! Nt

[ddeclue]

42. Sounds like you need a lawyer not a doctor.

[icymist]

43. Call the states' ombudsman.

You'll find the number posted by the nurses' station.